WorldWideScience

Sample records for significantly higher risk

  1. The risk of being depressed is significantly higher in cancer patients than in the general population

    DEFF Research Database (Denmark)

    Hartung, T J; Brähler, E; Faller, H

    2017-01-01

    BACKGROUND: Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence...... of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS: We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer......% participated (51% women, mean age = 58 years). We estimated that one in four cancer patients (24%) is depressed (PHQ-9 ≥ 10). The odds of being depressed among cancer patients were more than five times higher than in the general population (OR, 5.4; 95% CI, 4.6-6.2). Patients with pancreatic (M = 8.0, SD = 5...

  2. Sterol 27-Hydroxylase Polymorphism Significantly Associates With Shorter Telomere, Higher Cardiovascular and Type-2 Diabetes Risk in Obese Subjects

    Directory of Open Access Journals (Sweden)

    Sofia Pavanello

    2018-06-01

    Full Text Available Background/objectivesThe pathologic relationship linking obesity and lipid dismetabolism with earlier onset of aging-related disorders, including cardiovascular disease (CVD and type-2 diabetes (T2D, is not fully elucidate. Chronic inflammatory state, in obese individuals, may accelerate cellular aging. However, leukocyte telomere length (LTL, the cellular biological aging indicator, is elusively linked with obesity. Recent studies indicate that sterol 27-hydroxylase (CYP27A1 is an emerging antiatherogenic enzyme, that, by converting extrahepatic cholesterol to 27-hydroxycholesterol, facilitates cholesterol removal via high-density lipoprotein-cholesterol (HDL-C. We tested the hypothesis that obese subjects who carry at least three copies of CYP27A1 low-hydroxylation (LH activity genome-wide-validated alleles (rs4674345A, rs1554622A, and rs4674338G present premature aging, as reflected in shorter LTL and higher levels of CVD/T2D risk factors, including reduced HDL-C.Subjects/methodsObese subjects from SPHERE project {n = 1,457; overweight [body mass index (BMI 25–30 kg/m2] 65.8% and severe-obese (BMI > 30 kg/m2 34.2%} were characterized for the presence from 0 to 6 LH-CYP27A1 allele copy number. Univariate and multivariable sex–age–smoking-adjusted linear-regression models were performed to compare CVD/T2D risk factors and biological aging (LTL in relation to the combined BMI-LH groups: overweight-LH: 0–2, overweight-LH: 3–6, severe-obese-LH: 0–2, and severe-obese-LH: 3–6.ResultsHigher LTL attrition was found in severe-obese than overweight individuals (p < 0.001. Multivariable model reveals that among severe-obese patients those with LH: 3–6 present higher LTL attrition than LH: 0–2 (p < 0.05. Univariate and multivariable models remarkably show that insulin resistance is higher both in overweight-LH: 3–6 vs overweight-LH: 0–2 (p < 0.001 and in severe-obese-LH: 3–6 vs severe-obese-LH: 0–2 (p

  3. Competitive Intelligence: Significance in Higher Education

    Science.gov (United States)

    Barrett, Susan E.

    2010-01-01

    Historically noncompetitive, the higher education sector is now having to adjust dramatically to new and increasing demands on numerous levels. To remain successfully operational within the higher educational market universities today must consider all relevant forces which can impact present and future planning. Those institutions that were…

  4. Risk control and the minimum significant risk

    International Nuclear Information System (INIS)

    Seiler, F.A.; Alvarez, J.L.

    1996-01-01

    Risk management implies that the risk manager can, by his actions, exercise at least a modicum of control over the risk in question. In the terminology of control theory, a management action is a control signal imposed as feedback on the system to bring about a desired change in the state of the system. In the terminology of risk management, an action is taken to bring a predicted risk to lower values. Even if it is assumed that the management action taken is 100% effective and that the projected risk reduction is infinitely well known, there is a lower limit to the desired effects that can be achieved. It is based on the fact that all risks, such as the incidence of cancer, exhibit a degree of variability due to a number of extraneous factors such as age at exposure, sex, location, and some lifestyle parameters such as smoking or the consumption of alcohol. If the control signal is much smaller than the variability of the risk, the signal is lost in the noise and control is lost. This defines a minimum controllable risk based on the variability of the risk over the population considered. This quantity is the counterpart of the minimum significant risk which is defined by the uncertainties of the risk model. Both the minimum controllable risk and the minimum significant risk are evaluated for radiation carcinogenesis and are shown to be of the same order of magnitude. For a realistic management action, the assumptions of perfectly effective action and perfect model prediction made above have to be dropped, resulting in an effective minimum controllable risk which is determined by both risk limits. Any action below that effective limit is futile, but it is also unethical due to the ethical requirement of doing more good than harm. Finally, some implications of the effective minimum controllable risk on the use of the ALARA principle and on the evaluation of remedial action goals are presented

  5. Indian women with higher serum concentrations of folate and vitamin B12 are significantly less likely to be infected with carcinogenic or high-risk (HR types of human papillomaviruses (HPVs

    Directory of Open Access Journals (Sweden)

    Chandrika J Piyathilake

    2010-01-01

    Full Text Available Chandrika J Piyathilake1, Suguna Badiga1, Proma Paul2, Vijayaraghavan K3, Haripriya Vedantham3, Mrudula Sudula3, Pavani Sowjanya3, Gayatri Ramakrishna4, Keerti V Shah5, Edward E Partridge6, Patti E Gravitt21Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB, Birmingham, AL, USA; 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3SHARE INDIA, Mediciti Institute of Medical Sciences, Ghanpur, India; 4Center for DNA Fingerprinting and Diagnostics, Hyderabad, India; 5Department of Molecular biology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA; 6UAB Comprehensive Cancer Center, The University of Alabama Birmingham (UAB, Birmingham, AL, USABackground: Studies conducted in the USA have demonstrated that micronutrients such as folate and vitamin B12 play a significant role in modifying the natural history of high-risk human papillomaviruses (HR-HPVs, the causative agent for developing invasive cervical cancer (CC and its precursor lesions.Objective: The purpose of the current study was to investigate whether these micronutrients have similar effects on HR-HPV infections in Indian women.Methods: The associations between serum concentrations of folate and vitamin B12 and HR-HPV infections were evaluated in 724 women who participated in a CC screening study in the southern state of Andhra Pradesh, India. Serum folate and vitamin B12 concentrations were measured by using a competitive radio-binding assay. Digene hybrid capture 2 (HC2 assay results were used to categorize women into two groups, positive or negative for HR-HPVs. Unconditional logistic regression models specified a binary indicator of HC2 (positive/negative as the dependent variable and serum folate concentrations combined with serum vitamin B12 concentrations as the independent predictor of primary interest. Models were fitted, adjusting for age, education, marital status, parity

  6. Significance and basic patterns of risk communication

    International Nuclear Information System (INIS)

    Obermeier, O.P.

    1996-01-01

    The philosophically coloured paper on the aspects of risk communication patterns in society shows that debates about risks are governed by a number of stereotype characters representing the individualist and manager type, bureaucracy and law-and-order type, ego-centered embarrassment activist, and fundamentalist. Every risk-relevant group in the study tries to push forward its own interests. Risk communication is understood as a process of social dealing. (HP) [de

  7. Is higher risk sex common among male or female youths?

    Science.gov (United States)

    Berhan, Yifru; Berhan, Asres

    2015-01-01

    There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries' Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel-Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15-19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.

  8. Psychosocial risks evaluation factors: study with higher education teachers

    Directory of Open Access Journals (Sweden)

    Sara Lopes Borges

    2018-02-01

    Method: The study consisted of the administration of two instruments, one for the characterization of the sample and the other for assessing psychosocial risk factors — the Copenhagen Psychosocial Questionnaire — consisting of 76 items (5-point Likert scale, distributed in five dimensions, which measure indicators of exposure to psychosocial risks and their effects. Results: The study included 59 teachers, mostly men (50.8%, aged between 41 - 50 years (45.8%, with master's degree (59%, assistant professors (47.5%; with a stable employment relationship (68%, years of service between 14-17 years (18.7% and teaching between 11 - 17 hours a week (64.4%. The analysis of the various subscales revealed a psychosocial risk, showing that teachers are in a situation of vulnerability. There were significant differences between the risks experienced in public higher education and those experienced in private higher education. Gender, age, academic background, and professional category influenced the type of psychosocial risk. Conclusions: The study confirms the importance of the evaluation of psychosocial risk factors in the exercise of the teaching profession in higher education. It is recognized that it is necessary to assess and manage psychosocial risks in order to promote healthy working conditions, ensure respect and fair treatment, and encourage the promotion of work / family life balance, in order to minimize psychosocial risks and situations of vulnerability in higher education teachers.

  9. MODERN RISK MEASURES FOR INDIVIDUAL HIGHER EDUCATION INVESTMENT RISK EVALUATION

    Directory of Open Access Journals (Sweden)

    Vona Mate

    2014-07-01

    Full Text Available One of the reasons why people get degree and participate in organized education is that they want to raise their human capital or signal their inner abilities to future employers by sorting themselves out. In both cases they can expect return to their investment, because they can expect higher life-time earnings than those who do not have degree. In this paper we will refer this activity as higher education investment or education investment. In this paper the investment of the state into educating their citizens will not be considered. The question of this paper will develop the findings of Vona (2014. I suggested to introduce modern risk measures because individual risk-taking became a serious question. It was considered that modern risk measures can help to solve some issues with the relation of investment and risk. However before applying some measures from a different field of science, namely investment finance and financial mathematics, to another, economics of education, there must be a very careful consideration, because there are debate over these measures applicability even on their field of science. Value at Risk is not coherent and Expected Shortfall is only one of a great deal of possible tail loss measures. For this reason it will be discussed in detail how should we should adopt the measures, what kind of data is necessary for calculating this risk measures and what kind of new insight they can bring. With the aid of a numerical example it will be shown that with expected shortfall measure we can reflect some large losses, and potential high value of diversification. We show the value at risk based measure is not coherent and this means it points out something different in this environment. It is can be an indicator of loss in opportunities for high end returns.

  10. Higher-order risk preferences in social settings.

    Science.gov (United States)

    Heinrich, Timo; Mayrhofer, Thomas

    2018-01-01

    We study prudence and temperance (next to risk aversion) in social settings. Previous experimental studies have shown that these higher-order risk preferences affect the choices of individuals deciding privately on lotteries that only affect their own payoff. Yet, many risky and financially relevant decisions are made in the social settings of households or organizations. We elicit higher-order risk preferences of individuals and systematically vary how an individual's decision is made (alone or while communicating with a partner) and who is affected by the decision (only the individual or the partner as well). In doing so, we can isolate the effects of other-regarding concerns and communication on choices. Our results reveal that the majority of choices are risk averse, prudent, and temperate across social settings. We also observe that individuals are influenced significantly by the preferences of a partner when they are able to communicate and choices are payoff-relevant for both of them.

  11. Mainstreaming disaster risk management in higher education

    Directory of Open Access Journals (Sweden)

    MARCIA VILLASANA

    Full Text Available Universities should actively participate in disseminating and fostering a culture for disaster risk management (DRM among students and the community. Particularly in countries with high levels of risk, education plays a key role in raising awareness on the importance of preventing and implementing conscious risk management. Though the incorporation of DRM into the curricula, education programs become a mechanism to prepare students from a perspective of strengthening of values, citizenship, and social sensibility towards how disaster represents a disruption of the functioning of a community and impairs business activity. This paper presents the proposal for the integration of DRM of a private university in Mexico, one of the countries particularly susceptible to extreme hydrometereological and geological events. The proposal includes a concentration area for undergraduate business students, a mandatory introductory course for all business majors, and for the business community an executive education program for SMEs

  12. Association between low education and higher global cardiovascular risk.

    Science.gov (United States)

    Di Chiara, Tiziana; Scaglione, Alessandra; Corrao, Salvatore; Argano, Christiano; Pinto, Antonio; Scaglione, Rosario

    2015-05-01

    This study was designed to evaluate the impact of educational status on global cardiovascular risk in a southern Italian urban population. The study population consisted of 488 consecutive outpatients aged 18 years and older. Educational status was categorized according to the number of years of formal education as follows: (1) low education group (education group (10-15 years). In both groups, cardiometabolic comorbidities (obesity, visceral obesity, diabetes, dyslipidemia, metabolic syndrome, microalbuminuria, left ventricular hypertrophy) and global cardiovascular risk, according to international guidelines, were analyzed. Left ventricular mass index and ejection fraction by echocardiography and E/A ratio, by pulsed-wave Doppler, were calculated. The low education group was characterized by a significantly higher prevalence of patients with visceral obesity (P=.021), hypertension (P=.010), metabolic syndrome (P=.000), and microalbuminuria (P=.000) and greater global cardiovascular risk (P=.000). Significantly increased levels of microalbuminuria (P=.000) and significantly decreased values of E/A ratio (P=.000) were also detected in the low education group. Global cardiovascular risk correlated directly with waist-to-hip ratio (P=.010), microalbuminuria (P=.015), and the metabolic syndrome (P>.012) and inversely with educational status (P=.000). Education was independently (P=.000) associated with global cardiovascular risk. These data indicate a strong association between low education and cardiometabolic comorbidities suitable to influence the evolution of chronic degenerative diseases. Preventive strategies need to be more efficient and more effective in this patient population. ©2015 Wiley Periodicals, Inc.

  13. Risk management in higher education and research in the Netherlands

    NARCIS (Netherlands)

    Helsloot, I.; Jong, W

    2006-01-01

    This study examines risk in higher education and research on the basis of a classification into three domains. The practical utility of this division into three domains is that it makes it easier to see what risks are unique to higher education (custodianship of knowledge), what risks are dependent

  14. Amaurosis fugax: risk factors and prevalence of significant carotid stenosis

    Directory of Open Access Journals (Sweden)

    Kvickström P

    2016-10-01

    Full Text Available Pia Kvickström,1 Bertil Lindblom,2,3 Göran Bergström,4,5 Madeleine Zetterberg2,3 1Department of Ophthalmology, Skaraborg Hospital, Skövde, 2Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, 3Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 4Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, 5Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden Purpose: The purpose of this study was to describe clinical characteristics and prevalence of carotid stenosis in patients with amaurosis fugax (AF.Method: Patients diagnosed with AF and subjected to carotid ultrasound in 2004–2010 in Sahlgrenska University Hospital, Gothenburg (n=302, were included, and data were retrospectively collected from medical records.Results: The prevalence of significant carotid stenosis was 18.9%, and 14.2% of the subjects were subjected to carotid endarterectomy. Significant associations with risk of having ≥70% stenosis were male sex (adjusted odds ratio [aOR]: 2.62; 95% confidence interval [CI]: 1.26–5.46, current smoking (aOR: 6.26; 95% CI: 2.62–14.93, diabetes (aOR: 3.68; 95% CI: 1.37–9.90 and previous vasculitis (aOR: 10.78; 95% CI: 1.36–85.5. A majority of the patients (81.4% was seen by an ophthalmologist prior to the first ultrasound. Only 1.7% of the patients exhibited retinal artery emboli at examination.Conclusion: The prevalence of carotid stenosis among patients with AF is higher than has previously been demonstrated in stroke patients. An association with previously reported vascular risk factors and with vasculitis is seen in this patient group. Ocular findings are scarce. Keywords: amaurosis fugax, carotid stenosis, carotid ultrasound, giant cell arteritis, transient ischemic attack, transient monocular visual loss

  15. SUPERVISION OF CREDIT INSTITUTIONS SIGNIFICANT RISKS TO FINANCIAL STABILITY

    Directory of Open Access Journals (Sweden)

    LUCIAN-ION MEDAR

    2014-12-01

    Full Text Available Financial stability of Romanian banking system is determined by the constant supervision of credit institutions significant risks. Accession of Romania to Union Banking requires the signing of a linked protocol between the central bank and European Central Bank regarding prudential supervision to ensure financial stability. This means that from the next year, the central bank will impose a new supervision of credit institutions in our country. And especially to those credit institutions that do not fall under European supervisors, according to the procedures of the ECB. Through this study we propose to specify the main elements of management of significant risks to ensure financial stability.

  16. [Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department].

    Science.gov (United States)

    Peng, Lu-Ting; Li, Rong; Zhao, Wei-Hua; Chen, Yin-Hua; Li, Xiao-Mei; Chen, Meng-Ying; Cao, Jia; Li, Xiao-Nan

    2013-10-01

    To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management. Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded. Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (Pnutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (Pnutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (Pnutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.

  17. Ecological Risk Assessment of Genetically Modified Higher Plants (GMHP)

    DEFF Research Database (Denmark)

    Kjær, C.; Damgaard, C.; Kjellsson, G.

    Preface This publication is a first version of a manual identifying the data needs for ecological risk assessment of genetically modified higher plants (GMHP). It is the intention of the authors to stimulate further discussion of what data are needed in order to conduct a proper ecological risk...... of the project Biotechnology: elements in environmental risk assessment of genetically modified plants. December 1999 Christian Kjær Introduction In ecological risk assessment of transgenic plants, information on a wide range of subjects is needed for an effective and reliable assessment procedure...... in the amendment to the directive. This report suggests a structured way to identify the type of data needed to perform a sound ecological risk assessment for genetically modified higher plants (GMHP). The identified data types are intended to support the evaluation of the following risks: risk of invasion...

  18. Are female healthcare workers at higher risk of occupational injury?

    Science.gov (United States)

    Alamgir, Hasanat; Yu, Shicheng; Drebit, Sharla; Fast, Catherine; Kidd, Catherine

    2009-05-01

    Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector. To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector. Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling. A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues. Occupational health and safety initiatives should be gender sensitive and developed accordingly.

  19. Higher Heart Failure Risk Seen in Some Cancers

    Science.gov (United States)

    Some people treated for breast cancer or lymphoma have a higher risk of developing congestive heart failure than people who haven’t had cancer, a new study shows. As this Cancer Currents blog post reports, the risk persisted for at least 20 years.

  20. Higher Education IT Compliance through the Prism of Risk Controls

    Science.gov (United States)

    Feehan, Patrick J.

    2013-01-01

    In 2013, compliance issues march, unceasingly, through every aspect of higher education. Yet the intricacies of privacy, information security, data governance, and IT policy as compliance and risk areas within the IT organization can reverberate and impact every other department within the higher education institution. The primary focus is always…

  1. Significantly higher Carabid beetle (Coleoptera: Carabidae) catch in conventionally than in organically managed Christmas tree plantations

    DEFF Research Database (Denmark)

    Bagge, Søren; Lund, Malthe; Rønn, Regin

    2012-01-01

    Carabid beetles play an important role as consumers of pest organisms in forestry and agriculture. Application of pesticides may negatively affect abundance and activity of carabid beetles, thus reducing their potential beneficial effect. We investigated how abundance and diversity of pitfall...... trapped carabid beetles (Coleoptera, Carabidae) varied between conventionally and organically managed Caucasian Fir (Abies nordmanniana (Stev.)) plantations, in northern Zealand, Denmark. We recorded significantly higher numbers of carabid beetle specimens and species at conventionally than at organically...

  2. Assessment of postmenopausal women and significant risk factors for osteoporosis.

    Science.gov (United States)

    Schnatz, Peter F; Marakovits, Kimberly A; O'Sullivan, David M

    2010-09-01

    The assessment of osteoporosis risk factors can help guide early intervention. The objective of this study was to analyze numerous potential risk factors to see which were associated with postmenopausal osteoporosis. Women aged 49 or greater presenting for dual-energy x-ray absorptiometry bone scans were recruited from radiology sites in the Hartford, Connecticut, area between January 2007 and March 2009, inclusive. Information was collected regarding primary and secondary risk factors for osteoporosis development, as well as family history and history of pregnancy and breast-feeding. Survey results were subsequently correlated with each woman's dual-energy x-ray absorptiometry scan results. In a sample of 619 women, history of fracture (odds ratio [OR], 12.49), weight less than 127 pounds (OR, 3.50), and use of anticoagulants (OR, 5.40) increased the chance of developing osteoporosis. In contrast, multiparity (OR, 0.45) and history of breast-feeding (OR, 0.38) decreased the development of osteoporosis in postmenopausal women. In women aged 49 to 54, breast-feeding was significantly protective, while low body mass index was most indicative of osteoporosis in women ages 55 to 64. Both previous fracture and low body mass index were associated with osteoporosis in women over age 64. The current results are consistent with other studies suggesting that previous fracture, low body weight, and use of anticoagulants increase the risk of osteoporosis. Our results also suggest that a history of pregnancy and breast-feeding protects against the development of postmenopausal osteoporosis, especially in women aged 49 to 54.

  3. Higher prevalence of risk factors for type 2 diabetes mellitus and subsequent higher incidence in men

    DEFF Research Database (Denmark)

    Almdal, Thomas; Scharling, Henrik; Jensen, Jan Skov

    2008-01-01

    , non-fasting blood glucose and triglycerides. Significantly more men (242, 5.4%) than women (152, 2.5%) developed type 2 DM. The odds ratio (OR) for developing diabetes with a BMI above 30 kg/m(2) compared to a BMI of 20-25 kg/m(2) was 8.1 in women and 6.3 in men; for a non-fasting plasma glucose of 8.......4-11.0 mmol/l compared to a plasma glucose of 5.5-6.4, the ORs were 7.8 in women and 4.7 in men. The OR for developing diabetes in persons with a non-fasting triglyceride level above 2.0 mmol/l compared to 1.0-2.0 mmol/l was 1.8 in both sexes; women with non -fasting triglycerides below 1.0 mmol/l had...... or non-fasting plasma glucose >11.1 mmol/l) were excluded. Some 6154 women and 4733 men were studied and followed up in 1981-1983 or in 1991-1994. The significance of risk factors was examined by multiple logistic regression analysis. RESULTS: Initially, a higher proportion of men than women had high...

  4. How significant is perceived environmental risk to business location decisions?

    International Nuclear Information System (INIS)

    Allison, T.; Calzonetti, F.

    1996-01-01

    It has been argued that adverse perceptions of risk associated with high-level nuclear waste (HLNW) facilities will have significant impacts on the attraction of new, and the maintenance of existing business activities in areas in which adverse perceptions develop. We examine this proposition by the considering the importance of environmental amenities and a range of other factors to business location decisions using evidence from surveys of more than 400 manufacturing and business service establishments in Colorado and Utah. We show that the importance of environmental amenities varies according to a number of factors, in particular the type of product (manufactured product or business service), type of establishment (single-establishment firm or establishment of a multilocational firm) and establishment employment size. Policies designed to offset the loss of business activity that might result from adverse risk perceptions associated with HLNW facilities must therefore take into account how sensitive various forms of business activity present or likely to locate in any particular area might be to environmental factors

  5. Suffering from Loneliness Indicates Significant Mortality Risk of Older People

    Directory of Open Access Journals (Sweden)

    Reijo S. Tilvis

    2011-01-01

    Full Text Available Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31% than subjects not feeling lonely (23%, <.001. Excess mortality (HR=1.38, 95% CI=1.21-1.57 of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI=1.17-1.51 and after further controlling for subjective health 1.17 (CI=1.02-1.33. The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.

  6. How significant is perceived environmental risk to business location decisions?

    Energy Technology Data Exchange (ETDEWEB)

    Allison, T. [Argonne National Lab., IL (United States); Calzonetti, F. [West Virginia Univ., Morgantown, WV (United States)

    1996-12-31

    It has been argued that adverse perceptions of risk associated with high-level nuclear waste (HLNW) facilities will have significant impacts on the attraction of new, and the maintenance of existing business activities in areas in which adverse perceptions develop. We examine this proposition by the considering the importance of environmental amenities and a range of other factors to business location decisions using evidence from surveys of more than 400 manufacturing and business service establishments in Colorado and Utah. We show that the importance of environmental amenities varies according to a number of factors, in particular the type of product (manufactured product or business service), type of establishment (single-establishment firm or establishment of a multilocational firm) and establishment employment size. Policies designed to offset the loss of business activity that might result from adverse risk perceptions associated with HLNW facilities must therefore take into account how sensitive various forms of business activity present or likely to locate in any particular area might be to environmental factors.

  7. Disaster risk assessment pattern in higher education centers

    OpenAIRE

    M. Omidvari; J. Nouri; M. Mapar

    2015-01-01

    Disasters are one of the most important challenges which must be considered by every management system. Higher education centers have high disaster risk because of their risk factors (existence of historical and scientific documents and resources and expensive laboratory equipment in these centers emphasizes the importance of disaster management). Moreover, the existence of young volunteers of human resources in universities urges the necessity of making these people familiar with disaster ma...

  8. List of Higher Risk Countries and Territories (IDRC, April 2012 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    List of Higher Risk Countries and Territories (IDRC, April 2012). Afghanistan. Belarus. Burundi. Central African Republic. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Eritrea. Former Soviet Union, countries of. Iran. Iraq. Korea, Democratic People's Republic of. Liberia. Libya. Mali. Myanmar ...

  9. List of Higher Risk Countries and Territories (IDRC, July 2013 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    List of Higher Risk Countries and Territories (IDRC, July 2013). Afghanistan. Central African Republic. Congo, Brazzaville. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Equatorial Guinea. Eritrea. Former Soviet Union, countries of. Gabon. Guinea-Bissau. Iran. Iraq. Korea, Democratic People's ...

  10. List of Higher Risk Countries and Territories (IDRC, September 2012 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    List of Higher Risk Countries and Territories (IDRC, September 2012). Afghanistan. Belarus. Burundi. Central African Republic. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Eritrea. Former Soviet Union, countries of. Iran. Iraq. Korea, Democratic People's Republic of. Liberia. Libya. Mali.

  11. The prevalence of coeliac disease is significantly higher in children compared with adults.

    Science.gov (United States)

    Mariné, M; Farre, C; Alsina, M; Vilar, P; Cortijo, M; Salas, A; Fernández-Bañares, F; Rosinach, M; Santaolalla, R; Loras, C; Marquès, T; Cusí, V; Hernández, M I; Carrasco, A; Ribes, J; Viver, J M; Esteve, M

    2011-02-01

    Some limited studies of coeliac disease have shown higher frequency of coeliac disease in infancy and adolescence than in adulthood. This finding has remained unnoticed and not adequately demonstrated. To assess whether there are age and gender differences in coeliac disease prevalence. A total of 4230 subjects were included consecutively (1 to ≥80 years old) reproducing the reference population by age and gender. Sample size was calculated assuming a population-based coeliac disease prevalence of 1:250. After an interim analysis, the paediatric sample was expanded (2010 children) due to high prevalence in this group. Anti-transglutaminase and antiendomysial antibodies were determined and duodenal biopsy was performed if positive. Log-linear models were fitted to coeliac disease prevalence by age allowing calculation of percentage change of prevalence. Differences between groups were compared using Chi-squared test. Twenty-one subjects had coeliac disease (male/female 1:2.5). Coeliac disease prevalence in the total population was 1:204. Coeliac disease prevalence was higher in children (1:71) than in adults (1:357) (P = 0.00005). A significant decrease of prevalence in older generations was observed [change of prevalence by age of -5% (95% CI: -7.58 to -2.42%)]. In the paediatric expanded group (1-14 years), a decrease of coeliac disease prevalence was also observed [prevalence change: -17% (95% CI: -25.02 to -6.10)]. The prevalence of coeliac disease in childhood was five times higher than in adults. Whether this difference is due to environmental factors influencing infancy, or latency of coeliac disease in adulthood, remains to be demonstrated in prospective longitudinal studies. © 2010 Blackwell Publishing Ltd.

  12. Water Exchange Produces Significantly Higher Adenoma Detection Rate Than Water Immersion: Pooled Data From 2 Multisite Randomized Controlled Trials.

    Science.gov (United States)

    Leung, Felix W; Koo, Malcolm; Cadoni, Sergio; Falt, Premysl; Hsieh, Yu-Hsi; Amato, Arnaldo; Erriu, Matteo; Fojtik, Petr; Gallittu, Paolo; Hu, Chi-Tan; Leung, Joseph W; Liggi, Mauro; Paggi, Silvia; Radaelli, Franco; Rondonotti, Emanuele; Smajstrla, Vit; Tseng, Chih-Wei; Urban, Ondrej

    2018-03-02

    To test the hypothesis that water exchange (WE) significantly increases adenoma detection rates (ADR) compared with water immersion (WI). Low ADR was linked to increased risk for interval colorectal cancers and related deaths. Two recent randomized controlled trials of head-to-head comparison of WE, WI, and traditional air insufflation (AI) each showed that WE achieved significantly higher ADR than AI, but not WI. The data were pooled from these 2 studies to test the above hypothesis. Two trials (5 sites, 14 colonoscopists) that randomized 1875 patients 1:1:1 to AI, WI, or WE were pooled and analyzed with ADR as the primary outcome. The ADR of AI (39.5%) and WI (42.4%) were comparable, significantly lower than that of WE (49.6%) (vs. AI P=0.001; vs. WI P=0.033). WE insertion time was 3 minutes longer than that of AI (Prate (vs. AI) of the >10 mm advanced adenomas. Right colon combined advanced and sessile serrated ADR of AI (3.4%) and WI (5%) were comparable and were significantly lower than that of WE (8.5%) (vs. AI P<0.001; vs. WI P=0.039). Compared with AI and WI, the superior ADR of WE offsets the drawback of a significantly longer insertion time. For quality improvement focused on increasing adenoma detection, WE is preferred over WI. The hypothesis that WE could lower the risk of interval colorectal cancers and related deaths should be tested.

  13. Significance of data acquisition for a risk concept

    International Nuclear Information System (INIS)

    Hoemke, P.

    1975-01-01

    A risk assessment for the safety of nuclear power plants is now being developed in the FRG. This paper deals with the influence of input data on the estimation of risks and presents the data compilation of reliability data in the prototype compilation IRS-RWE. It will be stated that data compilation in power plants gives reasonable results and is an essential requirement for the introduction of risk estimation in nuclear safety. (orig.) [de

  14. Disaster risk assessment pattern in higher education centers

    Directory of Open Access Journals (Sweden)

    M. Omidvari

    2015-04-01

    Full Text Available Disasters are one of the most important challenges which must be considered by every management system. Higher education centers have high disaster risk because of their risk factors (existence of historical and scientific documents and resources and expensive laboratory equipment in these centers emphasizes the importance of disaster management. Moreover, the existence of young volunteers of human resources in universities urges the necessity of making these people familiar with disaster management rules and responses in emergency conditions. Creating appropriate tools for disaster management assessment makes it correct and precise in higher education systems using the presented conceptual model. The present model was planned so as to cover three phases which exist before, during, and after disaster. Studies were performed in one of the largest higher education centers in Tehran: Science and Research Branch of Islamic Azad University Campus. Results showed high-risk disasters in these centers which must be taken into consideration continuously. The objective of this study was to create appropriate patterns of disaster risk management in these centers.

  15. External Stakeholders of Higher Education Institutions in Poland: Their Identification and Significance

    Science.gov (United States)

    Piotrowska-Piatek, Agnieszka

    2017-01-01

    In the context of the ongoing changes in the management systems of higher education, the issue of higher education institutions' (HEIs) relationships with external stakeholders are of key importance. This article discusses this problem from the perspective of Polish higher education system. The aim of it is to answer the following questions: (1)…

  16. Significant enhancement in thermoelectric performance of nanostructured higher manganese silicides synthesized employing a melt spinning technique.

    Science.gov (United States)

    Muthiah, Saravanan; Singh, R C; Pathak, B D; Avasthi, Piyush Kumar; Kumar, Rishikesh; Kumar, Anil; Srivastava, A K; Dhar, Ajay

    2018-01-25

    The limited thermoelectric performance of p-type Higher Manganese Silicides (HMS) in terms of their low figure-of-merit (ZT), which is far below unity, is the main bottle-neck for realising an efficient HMS based thermoelectric generator, which has been recognized as the most promising material for harnessing waste-heat in the mid-temperature range, owing to its thermal stability, earth-abundant and environmentally friendly nature of its constituent elements. We report a significant enhancement in the thermoelectric performance of nanostructured HMS synthesized using rapid solidification by optimizing the cooling rates during melt-spinning followed by spark plasma sintering of the resulting melt-spun ribbons. By employing this experimental strategy, an unprecedented ZT ∼ 0.82 at 800 K was realized in spark plasma sintered 5 at% Al-doped MnSi 1.73 HMS, melt spun at an optimized high cooling rate of ∼2 × 10 7 K s -1 . This enhancement in ZT represents a ∼25% increase over the best reported values thus far for HMS and primarily originates from a nano-crystalline microstructure consisting of a HMS matrix (20-40 nm) with excess Si (3-9 nm) uniformly distributed in it. This nanostructure, resulting from the high cooling rates employed during the melt-spinning of HMS, introduces a high density of nano-crystallite boundaries in a wide spectrum of nano-scale dimensions, which scatter the low-to-mid-wavelength heat-carrying phonons. This abundant phonon scattering results in a significantly reduced thermal conductivity of ∼1.5 W m -1 K -1 at 800 K, which primarily contributes to the enhancement in ZT.

  17. ASSESSING SELF-STUDY WORK’S SIGNIFICANT SKILLS FOR SUCCESSFUL LEARNING IN THE HIGHER SCHOOL

    Directory of Open Access Journals (Sweden)

    Galina V. Milovanova

    2017-06-01

    Full Text Available Introduction: the problem of organizing students’ independent work/self-study is not new, but the changes in the higher school for the last two decades show that the experience accumulated in the traditional educational model can be applied only when it is processed in the present-day conditions. The article analyses the innovative component of the educational process in terms of a significant increase in the volume of compulsory independent work in the university. Particular attention is paid to determining the levels of the formation of skills for independent work in terms of students’ readiness for its implementa¬tion. The aim of the research is to identify the most significant skills of independent work for successful study at the university. Materials and Methods: the research is based on general scholarly methods: analysis, comparison, generalisation. A questionnaire survey was carried out and a correlation analysis of the results was presented. The mathematical statistics methods in Excel application were u sed for processing the survey data. Results: the article focused on the relevance of formation the students’ ability to work independently in the learning process. Requirements for professionals recognize the need for knowledge and skills, but more importantly, the ability and readiness to complete this knowledge and be in a state of continuous education and self-education. In turn, readiness to self-education cannot exist without independent work. The ratio of students to work independently and their skills’ levels in this area of the gnostic, design, structural, organisational and communicative blocks were identified because o f the research. Discussion and Conclusions: the levels of the formation of the skills for independent work influence on the success of the learning. There is a correlation between indicators of achievement and the ability to work independently. Organisation and communication skills have significant

  18. 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.

  19. 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

  20. Retinal vascular calibres are significantly associated with cardiovascular risk factors

    DEFF Research Database (Denmark)

    von Hanno, T.; Bertelsen, G.; Sjølie, Anne K.

    2014-01-01

    . Association between retinal vessel calibre and the cardiovascular risk factors was assessed by multivariable linear and logistic regression analyses. Results: Retinal arteriolar calibre was independently associated with age, blood pressure, HbA1c and smoking in women and men, and with HDL cholesterol in men......Purpose: To describe the association between retinal vascular calibres and cardiovascular risk factors. Methods: Population-based cross-sectional study including 6353 participants of the TromsO Eye Study in Norway aged 38-87years. Retinal arteriolar calibre (central retinal artery equivalent...... cardiovascular risk factors were independently associated with retinal vascular calibre, with stronger effect of HDL cholesterol and BMI in men than in women. Blood pressure and smoking contributed most to the explained variance....

  1. Significance of earthquake risk in nuclear power plant probabilistic risk assessments

    International Nuclear Information System (INIS)

    Sues, R.H.; Amico, P.J.; Campbell, R.D.

    1990-01-01

    During the last eight years, approximately 25 utility-sponsored probabilistic risk assessments (PRAs) have been conducted for US nuclear reactors. Of these, ten have been published, seven of which have included complete seismic risk assessment. The results of the seven published PRAs are reviewed here in order to ascertain the significance of the risk due to earthquake initiating events. While PRA methodology has been in a state of development over the past seven years, and the results are subject to interpretation (as discussed in the paper), from the review conducted it is clear that earthquake-induced initiating events are important risk contributors. It is concluded that earthquake initiating events should not be dismissed, a priori, in any nuclear plant risk assessment. (orig.)

  2. Significance, definition, classification and risk factors of chronic ...

    African Journals Online (AJOL)

    stimulating agents are considered. 15. Physicians should reduce the dose or extend the administration interval, depending on kidney function, when administering drugs that are renally excreted. 16. NSAIDs, contrast media and diuretics are high-grade risk factors for a decline (often permanent) in kidney function in patients.

  3. A current perspective on the risk significance of steam explosions

    International Nuclear Information System (INIS)

    Snyder, A.W.

    1982-01-01

    The view currently held in the Sandia National Laboratory is that, in the case of a meltdown in the reactor core, the probability of a steam explosion is greater than was estimated in WASH-1400, but that the extent and effect of an explosion will be very much smaller than assumed in WASH-1400. This results in a far smaller total risk with regard to containment. In WASH-1400, a nominal conditional probability of 1% was assumed for a containment rupture in a PWR-type reactor, should a large part of the reactor fuel be subject to meltdown during the course of the accident. The German risk analysis study 'Deutsche Risikostudie Kernkraftwerke' dated 1979 considers an explosion of a size sufficient to represent a threat to containment to be considerably more improbable than was assumed in WASH-1400. (orig./DG) [de

  4. Genome-wide significant risk associations for mucinous ovarian carcinoma

    DEFF Research Database (Denmark)

    Kelemen, Linda E; Lawrenson, Kate; Tyrer, Jonathan

    2015-01-01

    at 2q13 in colorectal tumors (P = 0.03, FDR = 0.09). Chromosome conformation capture analysis identified interactions between the HOXD9 promoter and risk-associated SNPs at 2q31.1. Overexpressing HOXD9 in MOC cells augmented the neoplastic phenotype. These findings provide the first evidence for MOC...... susceptibility variants and insights into the underlying biology of the disease....

  5. Teenage Smoking: Higher Excise Tax Should Significantly Reduce the Number of Smokers

    Science.gov (United States)

    1989-06-30

    12 to 17, in the United States, about 3.5 million use tobacco products, almost 3 million smoke marijuana , 6 million drink alcohol, and 1 million use...particularly in indoor environments. As a result nonsmokers tend to face a greater risk of cancer and of becoming less healthy in general. (The details on

  6. Assurance of Fault Management: Risk-Significant Adverse Condition Awareness

    Science.gov (United States)

    Fitz, Rhonda

    2016-01-01

    Fault Management (FM) systems are ranked high in risk-based assessment of criticality within flight software, emphasizing the importance of establishing highly competent domain expertise to provide assurance for NASA projects, especially as spaceflight systems continue to increase in complexity. Insight into specific characteristics of FM architectures seen embedded within safety- and mission-critical software systems analyzed by the NASA Independent Verification Validation (IVV) Program has been enhanced with an FM Technical Reference (TR) suite. Benefits are aimed beyond the IVV community to those that seek ways to efficiently and effectively provide software assurance to reduce the FM risk posture of NASA and other space missions. The identification of particular FM architectures, visibility, and associated IVV techniques provides a TR suite that enables greater assurance that critical software systems will adequately protect against faults and respond to adverse conditions. The role FM has with regard to overall asset protection of flight software systems is being addressed with the development of an adverse condition (AC) database encompassing flight software vulnerabilities.Identification of potential off-nominal conditions and analysis to determine how a system responds to these conditions are important aspects of hazard analysis and fault management. Understanding what ACs the mission may face, and ensuring they are prevented or addressed is the responsibility of the assurance team, which necessarily should have insight into ACs beyond those defined by the project itself. Research efforts sponsored by NASAs Office of Safety and Mission Assurance defined terminology, categorized data fields, and designed a baseline repository that centralizes and compiles a comprehensive listing of ACs and correlated data relevant across many NASA missions. This prototype tool helps projects improve analysis by tracking ACs, and allowing queries based on project, mission

  7. The Significance of Blackstone's Understanding of Sovereign Immunity for America's Public Institutions of Higher Education.

    Science.gov (United States)

    Snow, Brian A.; Thro, William E.

    2001-01-01

    Asserts that from the perspective of America's public institutions of higher education, Blackstone's greatest legacy is his understanding of sovereign immunity. Explores the similarities between Blackstone's understanding of sovereign immunity and the current jurisprudence of the U.S. Supreme Court. (EV)

  8. Health risk and significance of mercury in the environment.

    Science.gov (United States)

    Li, W C; Tse, H F

    2015-01-01

    Mercury (Hg) has long been recognised as a global pollutant, because it can remain in the atmosphere for more than 1 year. The mercury that enters the environment is generally acknowledged to have two sources: natural and anthropogenic. Hg takes three major forms in the environment, namely methyl-Hg (MeHg), Hg(0) and Hg(2+). All three forms of Hg adversely affect the natural environment and pose a risk to human health. In particular, they may damage the human central nervous system, leading to cardiovascular, respiratory and other diseases. MeHg is bioavailable and can be bioaccumulated within food webs. Therefore, several methods of eliminating Hg from the soil and the aquatic system have been proposed. The focus of this article is on phytoremediation, as this technique provides a low-cost and environmentally friendly alternative to traditional methods.

  9. Solar cells from 120 PPMA carbon-contaminated feedstock without significantly higher reverse current or shunt

    Energy Technology Data Exchange (ETDEWEB)

    Manshanden, P.; Coletti, G. [ECN Solar Energy, Petten (Netherlands)

    2012-09-15

    In a bid to drive down the cost of silicon wafers, several options for solar grade silicon feedstock have been investigated over the years. All methods have in common that the resulting silicon contains higher levels of impurities like dopants, oxygen, carbon or transition metals, the type and level of impurities depending on the raw materials and refining processes. In this work wafers from a p-type mc-Si ingot made with feedstock contaminated with 120 ppma of carbon have been processed into solar cells together with reference uncontaminated feedstock from semiconductor grade polysilicon with <0.4 ppma carbon. The results show that comparable reverse current, shunts, and efficiencies can be reached for both types of wafers. Gettering and defect hydrogenation effectiveness also did not deviate from the reference. Electroluminescence pictures do not show increased hotspot formation, even at -16V.

  10. Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

    Science.gov (United States)

    Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

    2017-04-01

    The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Spatially resolved flux measurements of NOx from London suggest significantly higher emissions than predicted by inventories.

    Science.gov (United States)

    Vaughan, Adam R; Lee, James D; Misztal, Pawel K; Metzger, Stefan; Shaw, Marvin D; Lewis, Alastair C; Purvis, Ruth M; Carslaw, David C; Goldstein, Allen H; Hewitt, C Nicholas; Davison, Brian; Beevers, Sean D; Karl, Thomas G

    2016-07-18

    To date, direct validation of city-wide emissions inventories for air pollutants has been difficult or impossible. However, recent technological innovations now allow direct measurement of pollutant fluxes from cities, for comparison with emissions inventories, which are themselves commonly used for prediction of current and future air quality and to help guide abatement strategies. Fluxes of NOx were measured using the eddy-covariance technique from an aircraft flying at low altitude over London. The highest fluxes were observed over central London, with lower fluxes measured in suburban areas. A footprint model was used to estimate the spatial area from which the measured emissions occurred. This allowed comparison of the flux measurements to the UK's National Atmospheric Emissions Inventory (NAEI) for NOx, with scaling factors used to account for the actual time of day, day of week and month of year of the measurement. The comparison suggests significant underestimation of NOx emissions in London by the NAEI, mainly due to its under-representation of real world road traffic emissions. A comparison was also carried out with an enhanced version of the inventory using real world driving emission factors and road measurement data taken from the London Atmospheric Emissions Inventory (LAEI). The measurement to inventory agreement was substantially improved using the enhanced version, showing the importance of fully accounting for road traffic, which is the dominant NOx emission source in London. In central London there was still an underestimation by the inventory of 30-40% compared with flux measurements, suggesting significant improvements are still required in the NOx emissions inventory.

  12. European Randomized Study of Screening for Prostate Cancer Risk Calculator: External Validation, Variability, and Clinical Significance.

    Science.gov (United States)

    Gómez-Gómez, Enrique; Carrasco-Valiente, Julia; Blanca-Pedregosa, Ana; Barco-Sánchez, Beatriz; Fernandez-Rueda, Jose Luis; Molina-Abril, Helena; Valero-Rosa, Jose; Font-Ugalde, Pilar; Requena-Tapia, Maria José

    2017-04-01

    To externally validate the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculator (RC) and to evaluate its variability between 2 consecutive prostate-specific antigen (PSA) values. We prospectively catalogued 1021 consecutive patients before prostate biopsy for suspicion of prostate cancer (PCa). The risk of PCa and significant PCa (Gleason score ≥7) from 749 patients was calculated according to ERSPC-RC (digital rectal examination-based version 3 of 4) for 2 consecutive PSA tests per patient. The calculators' predictions were analyzed using calibration plots and the area under the receiver operating characteristic curve (area under the curve). Cohen kappa coefficient was used to compare the ability and variability. Of 749 patients, PCa was detected in 251 (33.5%) and significant PCa was detected in 133 (17.8%). Calibration plots showed an acceptable parallelism and similar discrimination ability for both PSA levels with an area under the curve of 0.69 for PCa and 0.74 for significant PCa. The ERSPC showed 226 (30.2%) unnecessary biopsies with the loss of 10 significant PCa. The variability of the RC was 16% for PCa and 20% for significant PCa, and a higher variability was associated with a reduced risk of significant PCa. We can conclude that the performance of the ERSPC-RC in the present cohort shows a high similitude between the 2 PSA levels; however, the RC variability value is associated with a decreased risk of significant PCa. The use of the ERSPC in our cohort detects a high number of unnecessary biopsies. Thus, the incorporation of ERSPC-RC could help the clinical decision to carry out a prostate biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Higher prevalence of risk factors for type 2 diabetes mellitus and subsequent higher incidence in men

    DEFF Research Database (Denmark)

    Almdal, T.; Scharling, H.; Jensen, J.S.

    2008-01-01

    Background: This study investigates risk factors and the incidence of type 2 diabetes mellitus (type 2 DM) in both sexes of a northern European population. Methods: A total of 14,223 randomly selected men and women were studied from 1976 to 1978. Patients with diabetes (self-reported type 2 DM......, non-fasting blood glucose and triglycerides. Significantly more men (242, 5.4%) than women (152, 2.5%) developed type 2 DM. The odds ratio (OR) for developing diabetes with a BMI above 30 kg/m(2) compared to a BMI of 20-25 kg/m(2) was 8.1 in women and 6.3 in men; for a non-fasting plasma glucose of 8.......4-11.0 mmol/l compared to a plasma glucose of 5.5-6.4, the ORs were 7.8 in women and 4.7 in men. The OR for developing diabetes in persons with a non-fasting triglyceride level above 2.0 mmol/l compared to 1.0-2.0 mmol/l was 1.8 in both sexes; women with non -fasting triglycerides below 1.0 mmol/l had...

  14. Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?

    Science.gov (United States)

    Rehm, Jürgen; Lachenmeier, Dirk W; Room, Robin

    2014-10-21

    Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking. The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol's exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation. A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.

  15. Coronary artery disease in a rural population of Bangladesh: is dyslipidemia or adiposity a significant risk?

    Directory of Open Access Journals (Sweden)

    Sajal Krishna Banerjee

    2017-07-01

    Full Text Available Background and Aims: The prevalence of cardiovascular diseases (CVD are on the increase worldwide and more in the developing countries. Coronary artery disease (CAD constitutes the major brunt of CVD. Despite the increasing morbidity and mortality, Bangladesh has a few published data on CAD in rural population. This study addressed the prevalence of CAD and its risk factors in rural population of Bangladesh. Study methods: Sixteen villages were purposively selected in a rural area. A population census was conducted in the selected area. The census yielded eligible participants, who reached at least eighteen years of age. Those who willingly consented to participate were enlisted. Each participant was interviewed regarding CAD risk (age, sex, social class, occupation, illness, family history. Anthropometry (height, weight, waist- and hip-girth was recorded. Resting blood pressure (BP was measured. Blood sample was collected for fasting blood glucose (FBG, total cholesterol (Chol, triglycerides (Tg, low density lipoproteins (LDL, very low density lipoproteins (VLDL and high density (HDL. All participants having FBG>5.5mmol/l or systolic (SBP ³135 or diastolic BP (DBP ³85mmHg underwent electrocardiography (ECG. A team of cardiologists selected and accomplished exercise tolerance test (ETT and echocardiography (Echo. Results: The prevalence of CAD was 4.5% (95% CI: 3.85 – 5.15. Compared with the female (3.5%, CI, 2.76 – 4.24 the male participants had significantly higher prevalence of CAD (6.0%, CI, 4.83 – 7.13. Comparison of characteristics between participants with and without CAD showed that age, SBP, DBP and FBG were significantly higher in CAD group. Bivariate analysis showed that age, sex, social class, glycemic status, metabolic syndrome (MetS and smoking were significantly related to CAD. Stepwise logistic regression proved only male sex, rich social class, hypertension and diabetes had independent risk of CAD; whereas, age, obesity

  16. A genome-wide association study demonstrates significant genetic variation for fracture risk in Thoroughbred racehorses

    Science.gov (United States)

    2014-01-01

    Background Thoroughbred racehorses are subject to non-traumatic distal limb bone fractures that occur during racing and exercise. Susceptibility to fracture may be due to underlying disturbances in bone metabolism which have a genetic cause. Fracture risk has been shown to be heritable in several species but this study is the first genetic analysis of fracture risk in the horse. Results Fracture cases (n = 269) were horses that sustained catastrophic distal limb fractures while racing on UK racecourses, necessitating euthanasia. Control horses (n = 253) were over 4 years of age, were racing during the same time period as the cases, and had no history of fracture at the time the study was carried out. The horses sampled were bred for both flat and National Hunt (NH) jump racing. 43,417 SNPs were employed to perform a genome-wide association analysis and to estimate the proportion of genetic variance attributable to the SNPs on each chromosome using restricted maximum likelihood (REML). Significant genetic variation associated with fracture risk was found on chromosomes 9, 18, 22 and 31. Three SNPs on chromosome 18 (62.05 Mb – 62.15 Mb) and one SNP on chromosome 1 (14.17 Mb) reached genome-wide significance (p fracture than cases, p = 1 × 10-4), while a second haplotype increases fracture risk (cases at 3.39 times higher risk of fracture than controls, p = 0.042). Conclusions Fracture risk in the Thoroughbred horse is a complex condition with an underlying genetic basis. Multiple genomic regions contribute to susceptibility to fracture risk. This suggests there is the potential to develop SNP-based estimators for genetic risk of fracture in the Thoroughbred racehorse, using methods pioneered in livestock genetics such as genomic selection. This information would be useful to racehorse breeders and owners, enabling them to reduce the risk of injury in their horses. PMID:24559379

  17. Coronary risk assessment by point-based vs. equation-based Framingham models: significant implications for clinical care.

    Science.gov (United States)

    Gordon, William J; Polansky, Jesse M; Boscardin, W John; Fung, Kathy Z; Steinman, Michael A

    2010-11-01

    US cholesterol guidelines use original and simplified versions of the Framingham model to estimate future coronary risk and thereby classify patients into risk groups with different treatment strategies. We sought to compare risk estimates and risk group classification generated by the original, complex Framingham model and the simplified, point-based version. We assessed 2,543 subjects age 20-79 from the 2001-2006 National Health and Nutrition Examination Surveys (NHANES) for whom Adult Treatment Panel III (ATP-III) guidelines recommend formal risk stratification. For each subject, we calculated the 10-year risk of major coronary events using the original and point-based Framingham models, and then compared differences in these risk estimates and whether these differences would place subjects into different ATP-III risk groups (20% risk). Using standard procedures, all analyses were adjusted for survey weights, clustering, and stratification to make our results nationally representative. Among 39 million eligible adults, the original Framingham model categorized 71% of subjects as having "moderate" risk (20%) risk. Estimates of coronary risk by the original and point-based models often differed substantially. The point-based system classified 15% of adults (5.7 million) into different risk groups than the original model, with 10% (3.9 million) misclassified into higher risk groups and 5% (1.8 million) into lower risk groups, for a net impact of classifying 2.1 million adults into higher risk groups. These risk group misclassifications would impact guideline-recommended drug treatment strategies for 25-46% of affected subjects. Patterns of misclassifications varied significantly by gender, age, and underlying CHD risk. Compared to the original Framingham model, the point-based version misclassifies millions of Americans into risk groups for which guidelines recommend different treatment strategies.

  18. Significance of metabolites in the environmental risk assessment of pharmaceuticals consumed by human.

    Science.gov (United States)

    Han, Eun Jeong; Lee, Dong Soo

    2017-08-15

    The purpose of this study is to demonstrate the significance of metabolites to the ERA of human pharmaceuticals. The predicted exposure concentrations (PECs) in surface water were estimated for a total of 24 selected active pharmaceutical ingredients (APIs) and their metabolites using a life cycle based emission estimation model combined with a multimedia fate model with Monte-Carlo calculations. With the eco-toxicity data, the hazard quotients (HQs) of the metabolites were compared with those of individual parents alone. The results showed that PEC or toxicity or both of the metabolites was predicted to be higher than that of their parent APIs, which resulted in a total of 18 metabolites (from 12 parents) that have greater HQs than their parents. This result clearly demonstrated that some metabolites may potentially pose greater risk than their parent APIs in the water environment. Therefore, significance of metabolites should be carefully evaluated for monitoring strategy, priority setting, and scoping of the environmental risk assessment of APIs. The method used in the present work may serve as a pragmatic approach for the purpose of preliminary screening or priority setting of environmental risk posed by both APIs and their metabolites. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Day napping and short night sleeping are associated with higher risk of diabetes in older adults.

    Science.gov (United States)

    Xu, Qun; Song, Yiqing; Hollenbeck, Albert; Blair, Aaron; Schatzkin, Arthur; Chen, Honglei

    2010-01-01

    To examine whether day napping or short night sleeping is associated with higher risk of diabetes. This was a prospective study of hours of day napping and night sleeping assessed in 1996-1997 in relation to diabetes diagnosed between 2000 and 2006 (n = 10,143) among 174,542 participants in the National Institutes of Health (NIH)-AARP Diet and Health Study. Odds ratios (ORs) and 95% CI were derived from multivariate logistic regression models. Longer day napping was associated with a higher risk of diabetes. After adjustment for potential confounders, ORs were 1.23 (95% CI 1.18-1.29) for those reporting or =1 h of napping compared with individuals who did not nap (P(trend) or =9 h. In both analyses, additional adjustment for BMI only modestly attenuated the associations. Further analysis showed a statistically significant interaction between hours of napping and sleeping on diabetes (P(interaction) napping, only short night sleeping was associated with higher occurrence of diabetes, whereas among those with > or =1 h of napping, both long and short sleeping was associated with higher risk. Day napping and short night sleeping are associated with higher risk of diabetes. The association between sleep duration and diabetes may be modified by napping habit.

  20. 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.

  1. Head multidetector computed tomography: emergency medicine physicians overestimate the pretest probability and legal risk of significant findings.

    Science.gov (United States)

    Baskerville, Jerry Ray; Herrick, John

    2012-02-01

    This study focuses on clinically assigned prospective estimated pretest probability and pretest perception of legal risk as independent variables in the ordering of multidetector computed tomographic (MDCT) head scans. Our primary aim is to measure the association between pretest probability of a significant finding and pretest perception of legal risk. Secondarily, we measure the percentage of MDCT scans that physicians would not order if there was no legal risk. This study is a prospective, cross-sectional, descriptive analysis of patients 18 years and older for whom emergency medicine physicians ordered a head MDCT. We collected a sample of 138 patients subjected to head MDCT scans. The prevalence of a significant finding in our population was 6%, yet the pretest probability expectation of a significant finding was 33%. The legal risk presumed was even more dramatic at 54%. These data support the hypothesis that physicians presume the legal risk to be significantly higher than the risk of a significant finding. A total of 21% or 15% patients (95% confidence interval, ±5.9%) would not have been subjected to MDCT if there was no legal risk. Physicians overestimated the probability that the computed tomographic scan would yield a significant result and indicated an even greater perceived medicolegal risk if the scan was not obtained. Physician test-ordering behavior is complex, and our study queries pertinent aspects of MDCT testing. The magnification of legal risk vs the pretest probability of a significant finding is demonstrated. Physicians significantly overestimated pretest probability of a significant finding on head MDCT scans and presumed legal risk. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Walls of straw – the cyber risks to higher education

    Directory of Open Access Journals (Sweden)

    Phillip Wood

    2014-07-01

    Full Text Available Globally, in every facet of life, advances in communications technology and our reliance on computers and the internet allow us to live and work more efficiently than ever before. Higher education relies on the development of knowledge and the need to conduct and communicate research activity. Universities are often bound in research activity to business, government and other organizations whose interests need to be protected and managed. But is there a disparity in approach? Is research activity, security and the protection of privileged, proprietary and classified information appropriately implemented and managed in higher education? In this article the author questions: are there gaps open to cyberattack?

  3. Quantification, Risk, and the Rhetoric of Higher Education Management

    Science.gov (United States)

    Dale, Leigh

    2012-01-01

    This essay is a contribution to the literature of critique of higher education policy and management. It offers a general discussion of problems arising from the proliferation of mechanisms of audit and quality assurance within the context of concerns about dependence on quantitative measures of values. It argues that uncritical dependence on…

  4. Serum concentration of alpha-1 antitrypsin is significantly higher in colorectal cancer patients than in healthy controls

    International Nuclear Information System (INIS)

    Pérez-Holanda, Sergio; Blanco, Ignacio; Menéndez, Manuel; Rodrigo, Luis

    2014-01-01

    The association between alpha-1 antitrypsin (AAT) deficiency and colorectal cancer (CRC) is currently controversial. The present study compares AAT serum concentrations and gene frequencies between a group of CRC patients and a control group of healthy unrelated people (HUP). 267 CRC subjects (63% males, 72 ± 10 years old) were enlisted from a Hospital Clinic setting in Asturias, Spain. The HUP group comprised 327 subjects (67% males, mean age 70 ± 7.5 years old) from the same geographical region. Outcome measures were AAT serum concentrations measured by nephelometry, and AAT phenotyping characterization by isoelectric focusing. Significantly higher serum concentrations were found among CRC (208 ± 60) than in HUP individuals (144 ± 20.5) (p = 0.0001). No differences were found in the phenotypic distribution of the Pi*S and Pi*Z allelic frequencies (p = 0.639), although the frequency of Pi*Z was higher in CRC (21%) than in HUP subjects (15%). The only statistically significant finding in this study was the markedly higher AAT serum concentrations found in CRC subjects compared with HUP controls, irrespective of whether their Pi* phenotype was normal (Pi*MM) or deficient (Pi*MS, Pi*MZ and Pi*SZ). Although there was a trend towards the more deficient Pi* phenotype the more advanced the tumor, the results were inconclusive due to the small sample size. Consequently, more powerful studies are needed to reach firmer conclusions on this matter

  5. An integrated PRA module for fast determination of risk significance and improvement effectiveness

    International Nuclear Information System (INIS)

    Chao, Chun-Chang; Lin, Jyh-Der

    2004-01-01

    With the widely use of PRA technology in risk-informed applications, to predict the changes of CDF and LERF becomes a standard process for risk-informed applications. This paper describes an integrated PRA module prepared for risk-informed applications. The module contains a super risk engine, a super fault tree engine, an advanced PRA model and a tool for data base maintenance. The individual element of the module also works well for purpose other than risk-informed applications. The module has been verified and validated through a series of scrupulous benchmark tests with similar software. The results of the benchmark tests showed that the module has remarkable accuracy and speed even for an extremely large-size top-logic fault tree as well as for the case in which large amount of MCSs may be generated. The risk monitor for nuclear power plants in Taiwan is the first application to adopt the module. The results predicted by the risk monitor are now accepted by the regulatory agency. A tool to determine the risk significance according to the inspection findings will be the next application to adopt the module in the near future. This tool classified the risk significance into four different color codes according to the level of increase on CDF. Experience of application showed that the flexibility, the accuracy and speed of the module make it useful in any risk-informed applications when risk indexes must be determined by resolving a PRA model. (author)

  6. TCF7L2 variant genotypes and type 2 diabetes risk in Brazil: significant association, but not a significant tool for risk stratification in the general population

    Directory of Open Access Journals (Sweden)

    Mill JG

    2008-12-01

    Full Text Available Abstract Background Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population. Methods We genotyped the single nucleotide polymorphisms (SNP rs7903146 of the TCF7L2 gene in 560 patients with known coronary disease enrolled in the MASS II (Medicine, Angioplasty, or Surgery Study Trial and in 1,449 residents of Vitoria, in Southeast Brazil. The associations of this gene variant to diabetes risk and metabolic characteristics in these two different populations were analyzed. To access the potential benefit of using this marker for diabetes risk prediction in the general population we analyzed the impact of this genetic variant on a validated diabetes risk prediction tool based on clinical characteristics developed for the Brazilian general population. Results SNP rs7903146 of the TCF7L2 gene was significantly associated with type 2 diabetes in the MASS-II population (OR = 1.57 per T allele, p = 0.0032, confirming, in the Brazilian population, previous reports of the literature. Addition of this polymorphism to an established clinical risk prediction score did not increased model accuracy (both area under ROC curve equal to 0.776. Conclusion TCF7L2 rs7903146 T allele is associated with a 1.57 increased risk for type 2 diabetes in a Brazilian cohort of patients with known coronary heart disease. However, the inclusion of this polymorphism in a risk prediction tool developed for the general population resulted in no improvement of performance. This is the first study, to our knowledge, that has confirmed this recent association in a South American population and adds to the great consistency of this finding in studies around the world

  7. Analysis of human error and organizational deficiency in events considering risk significance

    International Nuclear Information System (INIS)

    Lee, Yong Suk; Kim, Yoonik; Kim, Say Hyung; Kim, Chansoo; Chung, Chang Hyun; Jung, Won Dea

    2004-01-01

    In this study, we analyzed human and organizational deficiencies in the trip events of Korean nuclear power plants. K-HPES items were used in human error analysis, and the organizational factors by Jacobs and Haber were used for organizational deficiency analysis. We proposed the use of CCDP as a risk measure to consider risk information in prioritizing K-HPES items and organizational factors. Until now, the risk significance of events has not been considered in human error and organizational deficiency analysis. Considering the risk significance of events in the process of analysis is necessary for effective enhancement of nuclear power plant safety by focusing on causes of human error and organizational deficiencies that are associated with significant risk

  8. Plucking the Golden Goose: Higher Royalty Rates on the Oil Sands Generate Significant Increases in Government Revenue

    Directory of Open Access Journals (Sweden)

    Kenneth J. McKenzie

    2011-09-01

    Full Text Available The Alberta government’s 2009 New Royalty Framework elicited resistance on the part of the energy industry, leading to subsequent reductions in the royalties imposed on natural gas and conventional oil. However, the oil sands sector, subject to different terms, quickly accepted the new arrangement with little complaint, recognizing it as win-win situation for industry and the government. Under the framework, Alberta recoups much more money in royalties — about $1 billion over the two year period of 2009 and 2010 — without impinging significantly on investment in the oil sands. This brief paper demonstrates that by spreading the financial risks and benefits to everyone involved, the new framework proves it’s possible to generate increased revenue without frightening off future investment. The same model could conceivably be applied to the conventional oil and natural gas sectors.

  9. Pregnant Women in Sport Climbing - Is there a Higher Risk for Preterm Birth?

    Science.gov (United States)

    Drastig, Jan; Hillebrandt, David; Rath, Werner; Küpper, Thomas

    2017-02-01

    Sport climbing is a popular recreational sport with an increasing proportion of female athletes. International recommendations emphasize the physical and mental benefits of regular sport activity during any uncomplicated pregnancy. In this context, sport climbing is associated with a high risk potential.The aim of this study was to examine if there is a higher risk for preterm birth in active climbing athletes.Original manuscript.A retrospective self-report online survey in the German language collected data between September 2012 and November 2013. In addition to anthropometric and demographic data, data on climbing experience, preferred climbing discipline, skill level and changes of climbing habits during pregnancy, known risk factors for preterm birth and information on delivery and the newborn were requested. The rate of preterm birth of the survey was tested with Fisher's exact test with information from the German Federal Statistical Office.Sample size was 32. 72% had a university degree, 81% were primiparous, all were singleton pregnancies. A 33 rd questionnaire was excluded because of described preeclampsia. Age ranged between 21 and 39 years, climbing experience before pregnancy between 2 and 24 years, and skill level before pregnancy between 4 and 7 on the UIAA scale (International Climbing and Mountaineering Federation). Half of the women climbed until the 36 th week and 90% adjusted their climbing habits mostly by reducing climbing difficulty and doing more top roping. 2 preterm births in the 36 th week of gestation were found (2 from 15, p=0.36). According to the data from the German Federal Statistical Office, 8.9% births in the year 2013 in Germany were preterm.This is the first study investigating the risk of preterm birth in recreational sport climbing athletes. No significantly higher proportion of preterm birth could be found. Limitations are small sample size and high social status of participants. What is known about the subject: Sport

  10. Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation.

    Science.gov (United States)

    Butler, Javed; Stankewicz, Mark A; Wu, Jack; Chomsky, Don B; Howser, Renee L; Khadim, Ghazanfar; Davis, Stacy F; Pierson, Richard N; Wilson, John R

    2005-02-01

    Pre-transplant fixed pulmonary hypertension is associated with higher post-transplant mortality. In this study, we assessed the significance of pre-transplant reversible pulmonary hypertension in patients undergoing cardiac transplantation. Overall, we studied 182 patients with baseline normal pulmonary pressures or reversible pulmonary hypertension, defined as a decrease in pulmonary vascular resistance (PVR) to 50 mm Hg had a higher risk of death (odds ratio [OR] 5.96, 95% confidence interval [CI] 1.46 to 19.84 as compared with PAS 4.0 WU, but patients with TPG > or =16 had a higher risk of mortality (OR 4.93, 95% CI 1.84 to 13.17). PAS pressure was an independent predictor of mortality (OR 1.04, 95% CI 1.02 to 1.06). Recipient body mass index, history of sternotomy; and donor ischemic time were the other independent predictors of mortality. Pre-transplant pulmonary hypertension, even when reversible to a PVR of < or =2.5 WU, is associated with a higher mortality post-transplant.

  11. Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study.

    Science.gov (United States)

    Salimzadeh, Hamideh; Bishehsari, Faraz; Delavari, Alireza; Barzin, Gilda; Amani, Mohammad; Majidi, Azam; Sadjadi, Alireza; Malekzadeh, Reza

    2016-12-20

    We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer. This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm. Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. From risk management to uncertainty management: a significant change in project management

    Institute of Scientific and Technical Information of China (English)

    LI Gui-jun; ZHANG Yue-song

    2006-01-01

    Starting with the meanings of the terms "risk" and "uncertainty,"" he paper compares uncertainty management with risk management in project management. We bring some doubt to the use of "risk" and "uncertainty" interchangeably in project management and deem their scope, methods, responses, monitoring and controlling should be different too. Illustrations are given covering terminology, description, and treatment from different perspectives of uncertainty management and risk management. Furthermore, the paper retains that project risk management (PRM) processes might be modified to facilitate an uncertainty management perspective,and we support that project uncertainty management (PUM) can enlarge its contribution to improving project management performance, which will result in a significant change in emphasis compared with most risk management.

  13. Relationship between obesity and the risk of clinically significant depression: Mendelian randomisation study.

    LENUS (Irish Health Repository)

    Hung, Chi-Fa

    2014-07-01

    Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue.

  14. Cardiovascular risk and stress in employees of a higher education institution

    Directory of Open Access Journals (Sweden)

    Eugênio Barbosa de Melo Júnior

    2016-01-01

    Full Text Available Objective: to analyze the association between high levels of stress and the frequency of cardiovascular risk factors in employees of a higher education institution. Methods: this is a cross-sectional study with 201 employees of a university. A form containing socioeconomic data, the International Physical Activity Questionnaire (short version, the Alcohol Use Disorders Identification Test and the Work Stress Scale were used for data collection. Data analysis was performed using the probability ratio and One-way analysis of variance tests. Results: worrisome frequencies of cardiovascular risk factors were identified, in which sedentary lifestyle, excess weight, and increased abdominal circumference presented the most expressive indexes. Regarding the stressors evaluated, some of the employees had increased stress indexes, distributed between the medium and high levels. Conclusion: sedentary lifestyle, excess weight, and increased abdominal circumference presented expressive high indexes, without statistically significant associations with the level of stress.

  15. Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma.

    Science.gov (United States)

    Avet-Loiseau, Hervé; Fonseca, Rafael; Siegel, David; Dimopoulos, Meletios A; Špička, Ivan; Masszi, Tamás; Hájek, Roman; Rosiñol, Laura; Goranova-Marinova, Vesselina; Mihaylov, Georgi; Maisnar, Vladimír; Mateos, Maria-Victoria; Wang, Michael; Niesvizky, Ruben; Oriol, Albert; Jakubowiak, Andrzej; Minarik, Jiri; Palumbo, Antonio; Bensinger, William; Kukreti, Vishal; Ben-Yehuda, Dina; Stewart, A Keith; Obreja, Mihaela; Moreau, Philippe

    2016-09-01

    The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24%) were categorized with high-risk cytogenetics (KRd, n = 48; Rd, n = 52) and 317 (76%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2% vs 59.6% (high-risk cytogenetics) and 91.2% vs 73.5% (standard-risk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2% vs 5.8% and 38.1% vs 6.5%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01080391. © 2016 by The American Society of Hematology.

  16. Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Jung-Im Shin

    2017-11-01

    Discussion: Higher pretransplantation HbA1c above 5.4% is independently associated with greater risk of PTDM among kidney transplant recipients. A continuous relationship between pretransplantation HbA1c and risk of PTDM suggests that increased risk starts at HbA1c levels well below current thresholds for prediabetes.

  17. New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

    DEFF Research Database (Denmark)

    Olsen, M H; Hansen, T W; Christensen, M K

    2008-01-01

    subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P...CRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population....

  18. Tribes and Territories in the 21st Century: Rethinking the Significance of Disciplines in Higher Education. International Studies in Higher Education

    Science.gov (United States)

    Trowler, Paul, Ed.; Saunders, Murray, Ed.; Bamber, Veronica, Ed.

    2012-01-01

    The "tribes and territories" metaphor for the cultures of academic disciplines and their roots in different knowledge characteristics has been used by those interested in university life and work since the early 1990s. This book draws together research, data and theory to show how higher education has gone through major change since then…

  19. Macroecology of parental care in arthropods: higher mortality risk leads to higher benefits of offspring protection in tropical climates.

    Science.gov (United States)

    Santos, Eduardo S A; Bueno, Pedro P; Gilbert, James D J; Machado, Glauco

    2017-08-01

    The intensity of biotic interactions varies around the world, in such a way that mortality risk imposed by natural enemies is usually higher in the tropics. A major role of offspring attendance is protection against natural enemies, so the benefits of this behaviour should be higher in tropical regions. We tested this macroecological prediction with a meta-regression of field experiments in which the mortality of guarded and unguarded broods was compared in arthropods. Mortality of unguarded broods was higher, and parental care was more beneficial, in warmer, less seasonal environments. Moreover, in these same environments, additional lines of defence further reduced offspring mortality, implying that offspring attendance alone is not enough to deter natural enemies in tropical regions. These results help to explain the high frequency of parental care among tropical species and how biotic interactions influence the occurrence of parental care over large geographic scales. Finally, our findings reveal that additional lines of defences - an oftentimes neglected component of parental care - have an important effect on the covariation between the benefits of parental care and the climate-mediated mortality risk imposed by natural enemies. © 2016 Cambridge Philosophical Society.

  20. Exploring Perceived Risk and Risk Reduction Strategies in the Pursuit of Higher Education Abroad

    Science.gov (United States)

    Lam, Jason M. S.; Tong, David Yoon Kin; Ariffin, Ahmad Azmi M.

    2017-01-01

    While past studies have merely focused on perceived risks that influence how students select the destination of international education best suited to their needs, research on perceived risk regarding post-purchase behavior remains limited. This study attempts to extend and redefine the perceived risk paradigm by uncovering the underlying elements…

  1. Low Carbon Rice Farming Practices in the Mekong Delta Yield Significantly Higher Profits and Lower Greenhouse Gas Emissions

    Science.gov (United States)

    Rudek, J.; Van Sanh, N.; Tinh, T. K.; Tin, H. Q.; Thu Ha, T.; Pha, D. N.; Cui, T. Q.; Tin, N. H.; Son, N. N.; Thanh, H. H.; Kien, H. T.; Kritee, K.; Ahuja, R.

    2014-12-01

    The Vietnam Low-Carbon Rice Project (VLCRP) seeks to significantly reduce GHG emissions from rice cultivation, an activity responsible for more than 30% of Vietnam's overall GHG emissions, while improving livelihoods for the rice farmer community by decreasing costs and enhancing yield as well as providing supplemental farmer income through the sale of carbon credits. The Mekong Delta makes up 12% of Vietnam's land area, but produces more than 50% of the country's rice, including more than 90% of the rice for export. Rice cultivation is the main source of income for 80% of farmers in the Mekong Delta. VLCRP was launched in late 2012 in the Mekong Delta in two major rice production provinces, Kien Giang and An Giang. To date, VLCRP has completed 11 crop seasons (in Kien Giang and An Giang combined), training over 400 farmer households in applying VLCRP's package of practices (known as 1 Must - 6 Reductions) and building technical capacity to its key stakeholders and rice farmer community leaders. By adopting the 1 Must- 6 Reductions practices (including reduced seeding density, reduced fertilizer and pesticide application, and alternative wetting and drying water management), rice farmers reduce their input costs while maintaining or improving yields, and decreasing greenhouse gas emissions. The VLCRP package of practices also deliver other environmental and social co-benefits, such as reduced water pollution, improved habitat for fishery resources and reduced health risks for farmers through the reduction of agri-chemicals. VLCRP farmers use significantly less inputs (50% reduction in seed, 30% reduction in fertilizer, 40-50% reduction in water) while improving yields 5-10%, leading to an increase in profit from 10% to as high as 60% per hectare. Preliminary results indicate that the 1 Must- 6 Reductions practices have led to approximately 40-65% reductions in greenhouse gas emissions, equivalent to 4 tons of CO2e/ha/yr in An Giang and 35 tons of CO2e/ha/yr in Kien

  2. An emergency department intervention to protect an overlooked group of children at risk of significant harm.

    LENUS (Irish Health Repository)

    Kaye, P

    2012-02-01

    BACKGROUND: Parental psychiatric disorder, especially depression, personality disorder and deliberate self-harm, is known to put children at greater risk of mental illness, neglect or physical, emotional and sexual abuse. Without a reliable procedure to identify children of parents presenting with these mental health problems, children at high risk of significant harm can be easily overlooked. Although deliberate self-harm constitutes a significant proportion of emergency presentations, there are no guidelines which address the emergency physician\\'s role in identifying and assessing risk to children of these patients. METHODS: A robust system was jointly developed with the local social services child protection team to identify and risk-stratify children of parents with mental illness. This allows us to intervene when we identify children at immediate risk of harm and to ensure that social services are aware of potential risk to all children in this group. The referral process was audited repeatedly to refine the agreed protocol. RESULTS: The proportion of patients asked by the emergency department personnel about dependent children increased and the quality of information received by the social services child protection team improved. CONCLUSIONS: All emergency departments should acknowledge the inadequacy of information available to them regarding patients\\' children and consider a policy of referral to social services for all children of parents with mental health presentations. This process can only be developed through close liaison within the multidisciplinary child protection team.

  3. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    Science.gov (United States)

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

  4. Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple-Sparing Mastectomy?

    Science.gov (United States)

    Frey, Jordan D; Alperovich, Michael; Levine, Jamie P; Choi, Mihye; Karp, Nolan S

    2017-07-01

    History of smoking has been implicated as a risk factor for reconstructive complications in nipple-sparing mastectomy (NSM), however there have been no direct analyses of outcomes in smokers and nonsmokers. All patients undergoing NSM at New York University Langone Medical Center from 2006 to 2014 were identified. Outcomes were compared for those with and without a smoking history and stratified by pack-year smoking history and years-to-quitting (YTQ). A total of 543 nipple-sparing mastectomies were performed from 2006 to 2014 with a total of 49 in patients with a history of smoking. Reconstructive outcomes in NSM between those with and without a smoking history were equivalent. Those with a smoking history were not significantly more likely to have mastectomy flap necrosis (p = 0.6251), partial (p = 0.8564), or complete (p = 0.3365) nipple-areola complex (NAC) necrosis. Likewise, active smokers alone did not have a higher risk of complications compared to nonsmokers or those with smoking history. Comparing nonsmokers and those with a less or greater than 10 pack-year smoking history, those with a > 10 pack-year history had significantly more complete NAC necrosis (p = 0.0114, smoking history or >5 YTQ prior to NSM were equivalent to those without a smoking history. We demonstrate that NSM may be safely offered to those with a smoking history although a > 10 pack-year smoking history or <5 YTQ prior to NSM may impart a higher risk of reconstructive complications, including complete NAC necrosis. © 2017 Wiley Periodicals, Inc.

  5. Human isolates of Salmonella enterica serovar Typhimurium from Taiwan displayed significantly higher levels of antimicrobial resistance than those from Denmark.

    Science.gov (United States)

    Torpdahl, Mia; Lauderdale, Tsai-Ling; Liang, Shiu-Yun; Li, Ishien; Wei, Sung-Hsi; Chiou, Chien-Shun

    2013-02-01

    Salmonella enterica serovar Typhimurium is a major zoonotic pathogen with a high prevalence of antimicrobial resistance. This pathogen can disseminate across borders and spread far distances via the food trade and international travel. In this study, we compared the genotypes and antimicrobial resistance of 378 S. Typhimurium isolates collected in Taiwan and Denmark between 2009 and 2010. Genotyping revealed that many S. Typhimurium strains were concurrently circulating in Taiwan, Denmark and other countries in 2009 and 2010. When compared to the isolates collected from Denmark, the isolates from Taiwan displayed a significantly higher level of resistance to 11 of the 12 tested antimicrobials. Seven genetic clusters (A-G) were designated for the isolates. A high percentage of the isolates in genetic clusters C, F and G were multidrug-resistant. Of the isolates in cluster C, 79.2% were ASSuT-resistant, characterized by resistance to ampicillin, streptomycin, sulfamethoxazole, and tetracycline. In cluster F, 84.1% of the isolates were ACSSuT-resistant (resistant to ASSuT and chloramphenicol). Cluster G was unique to Taiwan and characterized in most isolates by the absence of three VNTRs (ST20, ST30 and STTR6) as well as a variety of multidrug resistance profiles. This cluster exhibited very high to extremely high levels of resistance to several first-line drugs, and among the seven clusters, it displayed the highest levels of resistance to cefotaxime and ceftazidime, ciprofloxacin and gentamicin. The high prevalence of antimicrobial resistance in S. Typhimurium from Taiwan highlights the necessity to strictly regulate the use of antimicrobials in the agriculture and human health care sectors. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Prognostic significance of neurological signs in high-risk infants : a systematic review

    NARCIS (Netherlands)

    Hamer, Elisa G.; Hadders-Algra, Mijna

    The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of

  7. Prognostic significance of neurological signs in high-risk infants - a systematic review

    NARCIS (Netherlands)

    Hamer, E.G.; Hadders-Algra, M.

    2016-01-01

    The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of

  8. Geoinformation monitoring of the educational risk in educational institutions of higher education

    Directory of Open Access Journals (Sweden)

    Aleksandr N. Kolesenkov

    2017-01-01

    geoinformation technologies will ensure the integration of attributive and space-time data, taking into account geographical reference to the cartographic basis from the divisions of educational institutions, will allow quickly modeling the processes and evaluating the implementation of the educational programs.A mathematical model, a method and an algorithm for assessing the effectiveness of the implementation of educational programs in educational institutions have been developed. Evaluation of the characteristics of training directions is carried out through the application of the classification method, the decision tree is used, which allows to order many specialties and training directions in a hierarchical, consistent structure according to the established rules. The proposed model for assessing the educational risk in educational institutions will make a comprehensive evaluation of the processes, taking place in the divisions, since it takes into account pedagogical, economic and social aspects.The analysis of the components and functions of the educational risk was carried out. The program implementation of the proposed approaches in the database management system has been implemented. To implement the application, the following development tools are used: PostgreSQL database management system; integrated development environment Microsoft Visual Studio Community 2015; technology for creating ASP.NET 5 web applications; programming languages SQL, C #, JavaScript. The results of approbation of the proposed technology on the basis of the data of the admission committee of the educational institution are presented.In conclusion, we can note that the scientific approach to the assessment of educational risk leads to significant generalizations in the field of the outcome of the implementation of educational programs in higher education institutions.

  9. Risk and Threat via Online Social Network among Academia at Higher Education

    Science.gov (United States)

    Shaker Hussain, Hanizan; Din, Roshidi; Zulkarnaen Khidzir, Nik; Azhar Mat Daud, Khairul; Ahmad, Suzastri

    2018-05-01

    The evolution of information and communication technologies (ICT) nowadays has changed the life style of human living. The current modern societies have adopted ICT as an important thing that they are really needed in their life, especially as a tool to be used for communications activity. However, unfortunately ICT also exposed its user in circumstances of risk, threats and vulnerability. This paper will discuss the risk and threats to the users who are using social media as a medium to communicate. In this paper, the fraction of user will be divided by two types which are gender and working experience. The data that obtained from the distributed of questionnaires among respondent will be analysed by using SPSS. Data will be analysed by using two-way ANOVA statistic in order to examine the significant level in between gender and working experience as an independent variable in this study with the level of threats in cybersecurity risk towards lecturers who are working in higher education institutions in Malaysia. This article also will provide an empirical data and will be referred to another researcher in the future for their further research perhaps.

  10. Significantly increased risk of carotid atherosclerosis with arsenic exposure and polymorphisms in arsenic metabolism genes

    International Nuclear Information System (INIS)

    Hsieh, Yi-Chen; Lien, Li-Ming; Chung, Wen-Ting; Hsieh, Fang-I; Hsieh, Pei-Fan; Wu, Meei-Maan; Tseng, Hung-Pin; Chiou, Hung-Yi; Chen, Chien-Jen

    2011-01-01

    Individual susceptibility to arsenic-induced carotid atherosclerosis might be associated with genetic variations in arsenic metabolism. The purpose of this study is to explore the interaction effect on risk of carotid atherosclerosis between arsenic exposure and risk genotypes of purine nucleoside phosphorylase (PNP), arsenic (+3) methyltransferase (As3MT), and glutathione S-transferase omega 1 (GSTO1) and omega 2 (GSTO2). A community-based case-control study was conducted in northeastern Taiwan to investigate the arsenic metabolic-related genetic susceptibility to carotid atherosclerosis. In total, 863 subjects, who had been genotyped and for whom the severity of carotid atherosclerosis had been determined, were included in the present study. Individual well water was collected and arsenic concentration determined using hydride generation combined with flame atomic absorption spectrometry. The result showed that a significant dose-response trend (P=0.04) of carotid atherosclerosis risk associated with increasing arsenic concentration. Non-significant association between genetic polymorphisms of PNP Gly51Ser, Pro57Pro, As3MT Met287Thr, GSTO1 Ala140Asp, and GSTO2 A-183G and the risk for development of carotid atherosclerosis were observed. However, the significant interaction effect on carotid atherosclerosis risk was found for arsenic exposure (>50 μg/l) and the haplotypes of PNP (p=0.0115). A marked elevated risk of carotid atherosclerosis was observed in subjects with arsenic exposure of >50 μg/l in drinking water and those who carried the PNP A-T haplotype and at least either of the As3MT risk polymorphism or GSTO risk haplotypes (OR, 6.43; 95% CI, 1.79-23.19). In conclusion, arsenic metabolic genes, PNP, As3MT, and GSTO, may exacerbate the formation of atherosclerosis in individuals with high levels of arsenic concentration in well water (>50 μg/l). - Highlights: →Arsenic metabolic genes might be associated with carotid atherosclerosis. → A case

  11. Significantly increased risk of carotid atherosclerosis with arsenic exposure and polymorphisms in arsenic metabolism genes

    Energy Technology Data Exchange (ETDEWEB)

    Hsieh, Yi-Chen [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wusing St., Taipei 11031, Taiwan (China); Lien, Li-Ming [Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); School of Medicine, Taipei Medical University, Taipei, Taiwan (China); Department of Neurology, Shin Kong WHS Memorial Hospital, Taipei, Taiwan (China); Chung, Wen-Ting [Department of Neurology, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan (China); Hsieh, Fang-I; Hsieh, Pei-Fan [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wusing St., Taipei 11031, Taiwan (China); Wu, Meei-Maan [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wusing St., Taipei 11031, Taiwan (China); Graduate Institute of Basic Medicine, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan (China); Tseng, Hung-Pin [Department of Neurology, Lotung Poh-Ai Hospital, I-Lan, Taiwan (China); Chiou, Hung-Yi, E-mail: hychiou@tmu.edu.tw [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wusing St., Taipei 11031, Taiwan (China); Chen, Chien-Jen [Genomics Research Center, Academia Sinica, Taipei, Taiwan (China)

    2011-08-15

    Individual susceptibility to arsenic-induced carotid atherosclerosis might be associated with genetic variations in arsenic metabolism. The purpose of this study is to explore the interaction effect on risk of carotid atherosclerosis between arsenic exposure and risk genotypes of purine nucleoside phosphorylase (PNP), arsenic (+3) methyltransferase (As3MT), and glutathione S-transferase omega 1 (GSTO1) and omega 2 (GSTO2). A community-based case-control study was conducted in northeastern Taiwan to investigate the arsenic metabolic-related genetic susceptibility to carotid atherosclerosis. In total, 863 subjects, who had been genotyped and for whom the severity of carotid atherosclerosis had been determined, were included in the present study. Individual well water was collected and arsenic concentration determined using hydride generation combined with flame atomic absorption spectrometry. The result showed that a significant dose-response trend (P=0.04) of carotid atherosclerosis risk associated with increasing arsenic concentration. Non-significant association between genetic polymorphisms of PNP Gly51Ser, Pro57Pro, As3MT Met287Thr, GSTO1 Ala140Asp, and GSTO2 A-183G and the risk for development of carotid atherosclerosis were observed. However, the significant interaction effect on carotid atherosclerosis risk was found for arsenic exposure (>50 {mu}g/l) and the haplotypes of PNP (p=0.0115). A marked elevated risk of carotid atherosclerosis was observed in subjects with arsenic exposure of >50 {mu}g/l in drinking water and those who carried the PNP A-T haplotype and at least either of the As3MT risk polymorphism or GSTO risk haplotypes (OR, 6.43; 95% CI, 1.79-23.19). In conclusion, arsenic metabolic genes, PNP, As3MT, and GSTO, may exacerbate the formation of atherosclerosis in individuals with high levels of arsenic concentration in well water (>50 {mu}g/l). - Highlights: {yields}Arsenic metabolic genes might be associated with carotid atherosclerosis. {yields

  12. Ranking of risk significant components for the Davis-Besse Component Cooling Water System

    International Nuclear Information System (INIS)

    Seniuk, P.J.

    1994-01-01

    Utilities that run nuclear power plants are responsible for testing pumps and valves, as specified by the American Society of Mechanical Engineers (ASME) that are required for safe shutdown, mitigating the consequences of an accident, and maintaining the plant in a safe condition. These inservice components are tested according to ASME Codes, either the earlier requirements of the ASME Boiler and Pressure Vessel Code, Section XI, or the more recent requirements of the ASME Operation and Maintenance Code, Section IST. These codes dictate test techniques and frequencies regardless of the component failure rate or significance of failure consequences. A probabilistic risk assessment or probabilistic safety assessment may be used to evaluate the component importance for inservice test (IST) risk ranking, which is a combination of failure rate and failure consequences. Resources for component testing during the normal quarterly verification test or postmaintenance test are expensive. Normal quarterly testing may cause component unavailability. Outage testing may increase outage cost with no real benefit. This paper identifies the importance ranking of risk significant components in the Davis-Besse component cooling water system. Identifying the ranking of these risk significant IST components adds technical insight for developing the appropriate test technique and test frequency

  13. Applying Service Performance Guarantees to Reduce Risk Perception in the Purchase and Consumption of Higher Education

    Directory of Open Access Journals (Sweden)

    Nooraini Mohamad Sheriff

    2006-12-01

    Full Text Available The intangible nature of education is one contributor to consumers’ perception of risk prior to their purchase and consumption. This risk includes: functional risk, financial risk, temporal risk, physical risk, psychological risk and social risk. The presence of these risks often makes consumer evaluation prior to purchase and consumption difficult. Invoking a service guarantee is a platform available to enable higher educational institutions to minimize such risk perception so as to induce purchase. Specifically, service guarantee for higher education entails the application of teaching performance guarantee. This form of guarantee focuses on two important customer groups of higher educational institutions namely, students and faculty members, and focuses only on a specific performance aspect such as instructor’s performance. Thus, if students are dissatisfied with an instructor’s performance they are entitled to receive their money back. The imposition of such a teaching performance guarantee would implicate instructor’s accountability for certain aspects of their performance. It also establishes a mechanism to solicit feedback to better understand why and how instructors fail. Consequently, service performance guarantee creates a high level of customer focus and signals instructors’ care towards students

  14. A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification

    Energy Technology Data Exchange (ETDEWEB)

    Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel); Packianathan, Satyaseelan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Shourbaji, Rania A. [Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States); Zhang Zhen; Graves, Mathew [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Khan, Majid A. [Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States); Baird, Michael C. [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Russell, George [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)

    2012-03-01

    Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT (p < 0.0001). Chi-square test and multiple logistic regression analysis showed no significant association between all other factors and the risk of HO (race, gender, cause and type of fracture, surgical approach, or the use of indomethacin). Conclusions: Our data suggest that there is higher incidence and risk of HO if prophylactic RT is significantly delayed after a displaced acetabular fracture. Thus, RT should be administered as early as clinically possible after the trauma. Patients undergoing RT >3 weeks from their displaced acetabular fracture should be informed of the higher risk (>90%) of developing HO despite prophylaxis.

  15. Lower zinc bioavailability may be related to higher risk of subclinical atherosclerosis in Korean adults.

    Directory of Open Access Journals (Sweden)

    Su Kyoung Jung

    Full Text Available BACKGROUND: There is a proposed link between dietary zinc intake and atherosclerosis, but this relationship remains unclear. Phytate may contribute to this relationship by influencing zinc bioavailability. OBJECTIVE: The aim of this study is to examine the relationship between zinc bioavailability and subclinical atherosclerosis in healthy Korean adults. MATERIALS AND METHODS: The present cross-sectional analysis used baseline data from the Korean multi-Rural Communities Cohort Study (MRCohort, which is a part of The Korean Genome Epidemiology Study (KoGES. A total of 5,532 subjects (2,116 men and 3,416 women aged 40 years and older were recruited from rural communities in South Korea between 2005 and 2010. Phytate:zinc molar ratio, estimated from a food-based food frequency questionnaire (FFQ of 106 food items, was used to determine zinc bioavailability, and carotid intima media thickness (cIMT and pulse wave velocity (PWV were measured to calculate the subclinical atherosclerotic index. RESULTS: We found that phytate:zinc molar ratio is positively related to cIMT in men. A higher phytate:zinc molar ratio was significantly related to an increased risk of atherosclerosis in men, defined as the 80(th percentile value of cIMT (5(th vs. 1(st quintile, OR = 2.11, 95% CI 1.42-3.15, P for trend = 0.0009, and especially in elderly men (5(th vs. 1(st quintile, OR = 2.58, 95% CI 1.52-4.37, P for trend = 0.0021. We found a positive relationship between phytate:zinc molar ratio and atherosclerosis risk among women aged 65 years or younger. Phytate:zinc molar ratio was not found to be related to PWV. CONCLUSIONS: Lower zinc bioavailability may be related to higher atherosclerosis risk.

  16. Why do perfectionists have a higher burnout risk than others? The mediational effect of workaholism

    OpenAIRE

    van Beek, Ilona; Schaufeli, Wilmar B.; Taris, Toon W.

    2010-01-01

    Previous research has revealed that perfectionists have a higher burnout risk than others, but the mechanisms accounting for this association have rarely been examined. The present study proposes that workaholism mediates this relation, as previous research revealed that (a) perfectionists are more likely to be workaholics than others, and (b) workaholics have a higher burnout risk than others. Using cross-sectional data from 199 Dutch managers, regression analyses revealed that holding high ...

  17. Network Diffusion-Based Prioritization of Autism Risk Genes Identifies Significantly Connected Gene Modules

    Directory of Open Access Journals (Sweden)

    Ettore Mosca

    2017-09-01

    Full Text Available Autism spectrum disorder (ASD is marked by a strong genetic heterogeneity, which is underlined by the low overlap between ASD risk gene lists proposed in different studies. In this context, molecular networks can be used to analyze the results of several genome-wide studies in order to underline those network regions harboring genetic variations associated with ASD, the so-called “disease modules.” In this work, we used a recent network diffusion-based approach to jointly analyze multiple ASD risk gene lists. We defined genome-scale prioritizations of human genes in relation to ASD genes from multiple studies, found significantly connected gene modules associated with ASD and predicted genes functionally related to ASD risk genes. Most of them play a role in synapsis and neuronal development and function; many are related to syndromes that can be in comorbidity with ASD and the remaining are involved in epigenetics, cell cycle, cell adhesion and cancer.

  18. Higher Education in the United Arab Emirates: An Analysis of the Outcomes of Significant Increases in Supply and Competition

    Science.gov (United States)

    Wilkins, Stephen

    2010-01-01

    During the last decade, several countries across the Middle and Far East have established higher education hubs, some of which have grown rapidly by attracting foreign universities to set up international branch campuses. The United Arab Emirates (UAE) is by far the largest host of international branch campuses globally, having over 40 providers…

  19. Accreditation and Its Significance for Programs of Higher Education in Criminology and Criminal Justice: A Review of the Literature.

    Science.gov (United States)

    Simpson, Antony E.

    The development of minimum standards in higher education through the evolution of accreditation in specialized disciplines, and standard setting in criminology and criminal justice education are examined. The very different experiences with the concept of accreditation encountered in the fields of public administration and law are considered. Law…

  20. Interpretation of risk significance of passive component aging using probabilistic structural analysis

    International Nuclear Information System (INIS)

    Phillips, J.H.; Atwood, C.L.

    1993-01-01

    The probabilistic risk assessments (PRAs) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. Except as initiating events, the possible failure of passive components is given little consideration. The NRC is sponsoring a project at INEL to investigate the risk significance of passive components as they age. For this project, we developed a technique to calculate the failure probability of passive components over time, and demonstrated the technique by applying it to a weld in the auxiliary feedwater (AFW) system. A decreasing yearly rupture rate for this weld was calculated instead of the increasing rupture rate trend one might expect. We attribute this result to infant mortality; that is, most of those initial flaws that will eventually lead to rupture will do so early in life. This means that although each weld in a population may be wearing out, the population as a whole can exhibit a decreasing rupture rate. This observation has implications for passive components in commercial nuclear plants and other facilities where aging is a concern. For the population of passive components that exhibit a decreasing failure rate, risk increase is not a concern. The next step of the work is to identify the attributes that contribute to this decreasing rate, and to determine any attributes that would contribute to an increasing failure rate and thus to an increased risk

  1. A Risk and Standards Based Approach to Quality Assurance in Australia's Diverse Higher Education Sector

    Science.gov (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2015

    2015-01-01

    The Australian Government Tertiary Education Quality and Standards Agency's (TEQSA's) role is to assure that quality standards are being met by all registered higher education providers. This paper explains how TEQSA's risk-based approach to assuring higher education standards is applied in broad terms to a diverse sector. This explanation is…

  2. Higher Education Is Associated with a Lower Risk of Dementia after a Stroke or TIA. The Rotterdam Study.

    Science.gov (United States)

    Mirza, Saira Saeed; Portegies, Marileen L P; Wolters, Frank J; Hofman, Albert; Koudstaal, Peter J; Tiemeier, Henning; Ikram, M Arfan

    2016-01-01

    Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains unknown. Within the population-based Rotterdam Study, 12,561 participants free of stroke, TIA and dementia were followed for occurrence of stroke, TIA and dementia. Across the levels of education, associations of incident stroke or TIA with subsequent development of dementia and differences in cognitive decline following stroke or TIA were investigated. During 124,862 person-years, 1,463 persons suffered a stroke or TIA, 1,158 persons developed dementia, of whom 186 developed dementia after stroke or TIA. Risk of dementia after a stroke or TIA, compared to no stroke or TIA, was highest in the low education category (hazards ratio [HR] 1.46, 95% CI 1.18-1.81) followed by intermediate education category (HR 1.36, 95% CI 1.03-1.81). No significant association was observed in the high education category (HR 0.62, 95% CI 0.25-1.54). In gender stratified analyses, decrease in risk of dementia with increasing education was significant only in men. Higher education is associated with a lower risk of dementia after stroke or TIA, particularly in men, which might be explained by a higher cognitive reserve. © 2016 S. Karger AG, Basel.

  3. Significant association between RGS14 rs12654812 and nephrolithiasis risk among Guangxi population in China.

    Science.gov (United States)

    Long, Jun; Chen, Yang; Lin, Haisong; Liao, Ming; Li, Tianyu; Tong, Lei; Wei, Suchun; Xian, Xiaoying; Zhu, Jia; Chen, Jianxin; Tian, Jiarong; Wang, Qiuyan; Mo, Zengnan

    2018-03-26

    Nephrolithiasis is a worldwide health problem that affects almost all populations. This study aimed to evaluate the association between rs12654812 of regulator of G protein signaling 14 (RGS14) gene and nephrolithiasis in the Chinese population. A total of 1541 participators including 830 cases and 711 controls were included from Guangxi area in China. Age, sex, BMI, smoking status, drinking status, creatinine, uric acid, and urea nitrogen were analyzed between the case group and control group. We found that the G/A+A/A genotypes of rs12654812 had a significantly increased nephrolithiasis risk after adjusting age, sex, BMI, smoking, drinking, and hypertension, compared with G/G genotype (OR = 1.361, 95% CI = 1.033-1.794, P = .029). This hazardous effect was more pronounced in subgroup of age < 50, ever smoking, ever drinking, creatinine normal, and high uric acid. The G/A genotype of rs12654812 also had a significantly increased nephrolithiasis risk compared with G/G genotype. The A allele of rs12654812 significantly increased the risk of nephrolithiasis compared with the G allele after adjusting for age, sex, BMI, smoking, drinking and hypertension (OR = 1.277, 95% CI = 1.013-1.609, P = .038). Our results suggest that the RGS14 polymorphism is involved in the etiology of nephrolithiasis and thus may be a genetic marker for nephrolithiasis. © 2018 Wiley Periodicals, Inc.

  4. Risk factors of significant pain syndrome 90 days after minor thoracic injury: trajectory analysis.

    Science.gov (United States)

    Daoust, Raoul; Emond, Marcel; Bergeron, Eric; LeSage, Natalie; Camden, Stéphanie; Guimont, Chantal; Vanier, Laurent; Chauny, Jean-Marc

    2013-11-01

    The objective was to identify the risk factors of clinically significant pain at 90 days in patients with minor thoracic injury (MTI) discharged from the emergency department (ED). A prospective, multicenter, cohort study was conducted in four Canadian EDs from November 2006 to November 2010. All consecutive patients aged 16 years or older with MTI were eligible at discharge from EDs. They underwent standardized clinical and radiologic evaluations at 1 and 2 weeks, followed by standardized telephone interviews at 30 and 90 days. A pain trajectory model characterized groups of patients with different pain evolutions and ascertained specific risk factors in each group through multivariate analysis. In this cohort of 1,132 patients, 734 were eligible for study inclusion. The authors identified a pain trajectory that characterized 18.2% of the study population experiencing clinically significant pain (>3 of 10) at 90 days after a MTI. Multivariate modeling found two or more rib fractures, smoking, and initial oxygen saturation below 95% to be predictors of this group of patients. To the authors' knowledge, this is the first prospective study of trajectory modeling to detect risk factors associated with significant pain at 90 days after MTI. These factors may help in planning specific treatment strategies and should be validated in another prospective cohort. © 2013 by the Society for Academic Emergency Medicine.

  5. Low bone density risk is higher in exercising women with multiple triad risk factors.

    Science.gov (United States)

    Gibbs, Jenna C; Nattiv, Aurelia; Barrack, Michelle T; Williams, Nancy I; Rauh, Mitchell J; Nichols, Jeanne F; De Souza, Mary Jane

    2014-01-01

    The cumulative effect of the female athlete triad (Triad) risk factors on the likelihood of low bone mineral density (BMD) in exercising women is unclear. This study aimed to determine the risk of low BMD in exercising women with multiple Triad risk factors. We retrospectively examined cross-sectional data from 437 exercising women (mean ± SD age of 18.0 ± 3.5 yr, weighed 57.5 ± 7.1 kg with 24.5% ± 6.1% body fat) obtained at baseline from 4 prospective cohort studies examining Triad risk factors. Questionnaires were completed to obtain information on demographic characteristics, self-reported eating attitudes/behaviors, menstrual function, sport/activity participation, and medication use. Height and body weight were measured. BMD was measured using dual energy x-ray absorptiometry. Low BMD was defined as z-scores of exercising women. Further research should be conducted to develop a user-friendly algorithm integrating these indicators of risk for low BMD in exercising women (particularly factors associated with low BMI/body weight, menstrual dysfunction, lean sport/activity participation, and elevated dietary restraint).

  6. Depression with melancholic features is associated with higher long-term risk for dementia.

    Science.gov (United States)

    Simões do Couto, Frederico; Lunet, Nuno; Ginó, Sandra; Chester, Catarina; Freitas, Vanda; Maruta, Carolina; Figueira, Maria Luísa; de Mendonça, Alexandre

    2016-09-15

    Depression has been reported to increase the risk of subsequently developing dementia, but the nature of this relation remains to be elucidated. Depression can be a prodrome/manifestation of dementia or an early risk factor, and the effect may differ according to depression subtypes. Our aim was to study the association between early-onset depression and different depression subtypes, and the later occurrence of dementia. We conducted a cohort study including 322 subjects with depression, recruited between 1977 and 1984. A comparison cohort (non-exposed) was recruited retrospectively, to include 322 subjects admitted at the same hospital for routine surgery (appendicectomy or cholecystectomy), at the same period as the depressed cohort. Subjects were contacted again between 2009 and 2014, to assess their dementia status. We computed the risk for dementia in subjects with early onset depression and quantified the association between different depression subtypes (namely melancholic, anxious, and psychotic) and dementia. The odds of dementia were increased by 2.90 times (95% C.I. 1.61-5.21; pdepressed cohort when compared to the surgical cohort. When the analysis was restricted to patients younger than 45 years old at baseline, the odds for dementia in the depressed cohort were also significantly higher when compared to the surgical cohort (8.53; 95% C.I. 2.40-30.16). In the multivariate Cox analysis, subjects having depression with melancholic features had an increased risk for developing dementia compared to those without melancholic features (HR=3.64; 95% C.I. 1.78-11.26; p=0.025). About 59% of the participants with depression and 53% of those non-exposed were lost during follow up. The inclusion of biological biomarkers would strengthen the results. The sample included a low number of bipolar patients. These results support depression as an early risk factor for dementia. Depression with melancholic features was found as an important risk factor for dementia

  7. Current State of the Art: Management of Higher Risk Myelodysplastic Syndromes.

    Science.gov (United States)

    Komrokji, Rami S

    2016-08-01

    The higher risk myelodysplastic syndrome (MDS) patients, defined by the International Prognostic Scoring System (IPSS) as intermediate-2 or high-risk groups, compromise a third of MDS patients who have an expected survival of less than 1.5 years. Our ability to better define higher risk MDS improved with the proposal of new clinical risk models such as the revised IPSS and by integration of molecular data, including somatic gene mutations. Allogeneic hematopoietic stem-cell transplantation (AHSCT) remains the only curative option. In higher risk MDS patients, proceeding early with AHSCT is associated with maximum survival gain. The decision to pursue AHSCT is individualized according to disease risk, comorbidities, and functional status. The role of therapy before AHSCT remains controversial, and the role of post-AHSCT maintenance is evolving. Hypomethylating agents are the only medications that alter the natural history of the disease. Azacitidine is the only drug reported to improve overall survival in higher risk MDS patients. Appropriate use and assessment of response is key for assuring patients benefit of such limited options. Treatment after failure of hypomethylating agents is an unmet need. The role of detectable somatic gene mutations in prognosis and tailoring therapy continue to emerge. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Risk-Significant Adverse Condition Awareness Strengthens Assurance of Fault Management Systems

    Science.gov (United States)

    Fitz, Rhonda

    2017-01-01

    As spaceflight systems increase in complexity, Fault Management (FM) systems are ranked high in risk-based assessment of software criticality, emphasizing the importance of establishing highly competent domain expertise to provide assurance. Adverse conditions (ACs) and specific vulnerabilities encountered by safety- and mission-critical software systems have been identified through efforts to reduce the risk posture of software-intensive NASA missions. Acknowledgement of potential off-nominal conditions and analysis to determine software system resiliency are important aspects of hazard analysis and FM. A key component of assuring FM is an assessment of how well software addresses susceptibility to failure through consideration of ACs. Focus on significant risk predicted through experienced analysis conducted at the NASA Independent Verification Validation (IVV) Program enables the scoping of effective assurance strategies with regard to overall asset protection of complex spaceflight as well as ground systems. Research efforts sponsored by NASA's Office of Safety and Mission Assurance defined terminology, categorized data fields, and designed a baseline repository that centralizes and compiles a comprehensive listing of ACs and correlated data relevant across many NASA missions. This prototype tool helps projects improve analysis by tracking ACs and allowing queries based on project, mission type, domaincomponent, causal fault, and other key characteristics. Vulnerability in off-nominal situations, architectural design weaknesses, and unexpected or undesirable system behaviors in reaction to faults are curtailed with the awareness of ACs and risk-significant scenarios modeled for analysts through this database. Integration within the Enterprise Architecture at NASA IVV enables interfacing with other tools and datasets, technical support, and accessibility across the Agency. This paper discusses the development of an improved workflow process utilizing this

  9. The problem of "significant risk": exploring the public health impact of criminalizing HIV non-disclosure.

    Science.gov (United States)

    Mykhalovskiy, Eric

    2011-09-01

    Using criminal law powers to respond to people living with HIV (PHAs) who expose sexual partners to HIV or transmit the virus to them is a prominent global HIV public policy issue. While there are widespread concerns about the public health impact of HIV-related criminalization, the social science literature on the topic is limited. This article responds to that gap in knowledge by reporting on the results of qualitative research conducted with service providers and PHAs in Canada. The article draws on a studies in the social organization of knowledge perspective and insights from critical criminology and work on the "medico-legal borderland." It investigates the role played by the legal concept of "significant risk" in coordinating criminal law governance and its interface with public health and HIV prevention. In doing so, the article emphasizes that exploring the public health impact of criminalization must move past the criminal law--PHA dyad to address broader social and institutional processes relevant to HIV prevention. Drawing on individual and focus group interviews, this article explores how criminal law governance shapes the activities of providers engaged in HIV prevention counseling, conceptualized as a complex of activities linking clinicians, public health officials, front-line counselors, PHAs, and others. It emphasizes three key findings: (1) the concept of significant risk poses serious problems to risk communication in HIV counseling and contributes to contradictory advice about disclosure obligations; (2) criminalization discourages PHAs' openness about HIV non-disclosure in counseling relationships; and (3) the recontextualization of public health interpretations of significant risk in criminal proceedings can intensify criminalization. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Determining significant endpoints for ecological risk analyses. 1997 annual progress report

    Energy Technology Data Exchange (ETDEWEB)

    Hinton, T.G.; Congdon, J.; Rowe, C.; Scott, D. [Univ. of Georgia, Aiken, SC (US). Savannah River Ecology Lab.; Bedford, J.; Whicker, F.W. [Colorado State Univ., Fort Collins, CO (US)

    1997-11-01

    'This report summarizes the first year''s progress of research funded under the Department of Energy''s Environmental Management Science Program. The research was initiated to better determine ecological risks from toxic and radioactive contaminants. More precisely, the research is designed to determine the relevancy of sublethal cellular damage to the performance of individuals and to identify characteristics of non-human populations exposed to chronic, low-level radiation, as is typically found on many DOE sites. The authors propose to establish a protocol to assess risks to non-human species at higher levels of biological organization by relating molecular damage to more relevant responses that reflect population health. They think that they can achieve this by coupling changes in metabolic rates and energy allocation patterns to meaningful population response variables, and by using novel biological dosimeters in controlled, manipulative dose/effects experiments. They believe that a scientifically defensible endpoint for measuring ecological risks can only be determined once its understood the extent to which molecular damage from contaminant exposure is detrimental at the individual and population levels of biological organization.'

  11. Preoperative immobility significantly impacts the risk of postoperative complications in bariatric surgery patients.

    Science.gov (United States)

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

    2018-03-05

    Preoperative immobility in general surgery patients has been associated with an increased risk of postoperative complications. It is unknown if immobility affects bariatric surgery outcomes. The aim of this study was to determine the impact of immobility on 30-day postoperative bariatric surgery outcomes. This study took place at a university hospital in the United States. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures. Preoperative immobility was defined as limited ambulation most or all the time. Logistic regression analysis was performed to determine if immobile patients are at increased risk (odds ratio [OR]) for 30-day complications. There were 148,710 primary minimally invasive bariatric procedures in 2015. Immobile patients had an increased risk of mortality (OR 4.59, Pbariatric surgery outcomes. Immobile patients have a significantly increased risk of morbidity and mortality. This study provides an opportunity for the development of multiple quality initiatives to improve the safety and perioperative complication profile for immobile patients undergoing bariatric surgery. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  12. PERSONAL AND ENVIRONMENTAL RISK FACTORS SIGNIFICANTLY ASSOCIATED WITH ELEVATED BLOOD LEAD LEVELS IN RURAL THAI CHILDREN.

    Science.gov (United States)

    Swaddiwudhipong, Witaya; Kavinum, Suporn; Papwijitsil, Ratchadaporn; Tontiwattanasap, Worawit; Khunyotying, Wanlee; Umpan, Jiraporn; BoonthuM, Ratchaneekorn; Kaewnate, Yingyot; Boonmee, Sasis; Thongchub, Winai; Rodsung, Thassanee

    2014-11-01

    A community-based study was conducted to determine personal risk factors and environmental sources of lead exposure for elevated blood lead levels (≥ 10 µg/dl, EBLLs) among rural children living at the Thailand-Myanmar border in Tak Province, northwestern Thailand. Six hundred ninety-five children aged 1-14 years old were screened for BLLs. Environmental specimens for lead measurements included samples of water from the streams, taps, and household containers, house floor dust, and foods. Possible lead release from the cooking ware was determined using the leaching method with acetic acid. The overall prevalence of EBLLs was 47.1% and the geometric mean level of blood lead was 9.16 µg/dl. Personal risk factors significantly associated with EBLLs included being male, younger age, anemia, and low weight-for-age. Significant environmental risk factors were exposure to a lead-acid battery of solar energy system and use of a non-certified metal cooking pot. Some families whose children had high BLLs reported production of lead bullets from the used batteries at home. About one-third of the house dust samples taken near batteries contained lead content above the recommended value, compared with none of those taken from other areas and from the houses with no batteries. The metal pots were safe for cooking rice but might be unsafe for acidic food preparation. Both nutritional intervention and lead exposure prevention programs are essential to reduce EBLLs in this population.

  13. The H3 antagonist ABT-288 is tolerated at significantly higher exposures in subjects with schizophrenia than in healthy volunteers.

    Science.gov (United States)

    Othman, Ahmed A; Haig, George; Florian, Hana; Locke, Charles; Gertsik, Lev; Dutta, Sandeep

    2014-06-01

    ABT-288 is a potent and selective H3 receptor antagonist with procognitive effects in several preclinical models. In previous studies, 3 mg once daily was the maximal tolerated dose in healthy volunteers. This study characterized the safety, tolerability and pharmacokinetics of ABT-288 in stable subjects with schizophrenia. This was a randomized, double-blind, placebo-controlled, dose-escalating study of ABT-288 (10 dose levels, from 1 to 60 mg once daily for 14 days) in stable subjects with schizophrenia treated with an atypical antipsychotic. In each dose group, five to seven and two to three participants were assigned to ABT-288 and placebo, respectively. Of the 67 participants enrolled, nine participants (on ABT-288) were prematurely discontinued, in seven of these due to adverse events. ABT-288 was generally safe and tolerated at doses up to 45 mg once daily. The most common adverse events, in decreasing frequency (from 31 to 5%), were abnormal dreams, headache, insomnia, dizziness, somnolence, dysgeusia, dry mouth, psychotic disorder, parosmia and tachycardia. Adverse events causing early termination were psychotic events (four) and increased creatine phosphokinase, pyrexia and insomnia (one each). The half-life of ABT-288 ranged from 28 to 51 h, and steady state was achieved by day 12 of dosing. At comparable multiple doses, ABT-288 exposure in subjects with schizophrenia was 45% lower than that previously observed in healthy subjects. At trough, ABT-288 cerebrospinal fluid concentrations were 40% of the total plasma concentrations. ABT-288 was tolerated at a 15-fold higher dose and 12-fold higher exposures in subjects with schizophrenia than previously observed in healthy volunteers. The greater ABT-288 tolerability was not due to limited brain uptake. © 2013 The British Pharmacological Society.

  14. Sources of Inspiration: The role of significant persons in young people's choice of science in higher education

    Science.gov (United States)

    Sjaastad, Jørgen

    2012-07-01

    The objectives of this article were to investigate to which extent and in what ways persons influence students' choice of science, technology, engineering, and mathematics (STEM) in tertiary education, and to assess the suitability of an analytical framework for describing this influence. In total, 5,007 Norwegian STEM students completed a questionnaire including multiple-choice as well as open-ended questions about sources of inspiration for their educational choice. Using the conceptualisation of significant persons suggested by Woelfel and Haller, the respondents' descriptions of parents and teachers are presented in order to elaborate on the different ways these significant persons influence a STEM-related educational choice. Parents engaged in STEM themselves are models, making the choice of STEM familiar, and they help youngsters define themselves through conversation and support, thus being definers. Teachers are models by displaying how STEM might bring fulfilment in someone's life and by giving pupils a positive experience with the subjects. They help young people discover their STEM abilities, thus being definers. Celebrities are reported to have minor influence on STEM-related educational choices. Both qualitative and quantitative analyses indicate that interpersonal relationships are key factors in order to inspire and motivate a choice of STEM education. Implications for recruitment issues and for research on interpersonal influence are discussed. It is suggested that initiatives to increase recruitment to STEM might be aimed at parents and other persons in interpersonal relationships with youth as a target group.

  15. Adult Arabs have higher risk for diabetes mellitus than Jews in Israel.

    Science.gov (United States)

    Jaffe, Anat; Giveon, Shmuel; Wulffhart, Liat; Oberman, Bernice; Baidousi, Maslama; Ziv, Arnona; Kalter-Leibovici, Ofra

    2017-01-01

    Diabetes mellitus is an emerging epidemic in the Arab world. Although high diabetes prevalence is documented in Israeli Arabs, information from cohort studies is scant. This is a population study, based on information derived between 2007-2011, from the electronic database of the largest health fund in Israel, among Arabs and Jews. Prevalence, 4-year-incidence and diabetes hazard ratios [HRs], adjusted for sex and the metabolic-syndrome [MetS]-components, were determined in 3 age groups (Arabs (males: 49%, age: 39.4±17.3) and 16,012 Jews (males: 50%, age: 40.5 ±17.6). The overall age and sex-adjusted diabetes prevalence rates were much higher among Arabs 18.4% (95%CI: 17.6-19.1); and 10.3% (95%CI: 9.7-10.9) among Jews. Arab females had higher prevalence rates 20.0% (95%CI: 19-21) than Arab males 16.7% (95%CI: 15.7-17.8). Annual incidence rates were also significantly higher among Arabs 2.9% (95%CI: 2.7-3.1) than among Jews 1.7% (95%CI: 1.6-1.8). This held true across all age and sex subgroups. Adjustment for body mass index [BMI] attenuated HR estimates associated with Arab ethnicity across all age subgroups, mainly in the Arabs than Jews. Males, however, did not differ by ethnicity. Arabs, mainly female, have high incidence and prevalence of diabetes. This excess risk is only partially explained by the high prevalence of obesity. Effective culturally-congruent diabetes prevention and treatment and an effective engagement partnership with the Arab community are of paramount need.

  16. A generic standard for assessing and managing activities with significant risk to health and safety

    International Nuclear Information System (INIS)

    Wilde, T.S.; Sandquist, G.M.

    2005-01-01

    Some operations and activities in industry, business, and government can present an unacceptable risk to health and safety if not performed according to established safety practices and documented procedures. The nuclear industry has extensive experience and commitment to assessing and controlling such risks. This paper provides a generic standard based upon DOE Standard DOE-STD-3007- 93, Nov 1993, Change Notice No. 1, Sep 1998. This generic standard can be used to assess practices and procedures employed by any industrial and government entity to ensure that an acceptable level of safety and control prevail for such operations. When any activity and operation is determined to involve significant risk to health and safety to workers or the public, the organization should adopt and establish an appropriate standard and methodology to ensure that adequate health and safety prevail. This paper uses DOE experience and standards to address activities with recognized potential for impact upon health and safety. Existing and future assessments of health and safety issues can be compared and evaluated against this generic standard for insuring that proper planning, analysis, review, and approval have been made. (authors)

  17. Splenectomy is associated with a higher risk for venous thromboembolism: A prospective cohort study.

    Science.gov (United States)

    Lee, Debora H; Barmparas, Galinos; Fierro, Nicole; Sun, Beatrice J; Ashrafian, Sogol; Li, Tong; Ley, Eric J

    2015-12-01

    Thrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE. This was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure. In total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE. Splenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  18. Clinical significance of radioimmunological HPL findings in long-term management of premature delivery risk

    International Nuclear Information System (INIS)

    Ruckhaeberle, K.-E.; Bilek, K.; Viehweg, B.; Kuehndel, K.; Colditz, U.; Baer, G.

    1981-01-01

    Premature birth is not only characterized by premature delivery action but it is ever more frequently interpreted as the disturbed fetoplacental unit syndrome. In an attempt to therapeutically prevent premature delivery the placental function should be monitored. Possible intrauterine survival should be assessed as accurately as possible against extrauterine survival in order that the necessary tocolysis time could be determined. In our observations, clinical significance was studied of radioimmunologically determined HPL values in the serum under tocolysis conditions at premature birth risk on the basis of postnatal classification of the postnatal condition and of the particularity of the adaptation phase of the neonates. The significance of HPL determination in checking the fetoplacental unit during tocolysis should be arrived at while also using other diagnostic techniques, such as oxytocinase or estriol, ultrasound biometry, cardiotocography. (author)

  19. Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Murray, Anna; Bennett, Claire E; Perry, John R B; Weedon, Michael N; Jacobs, Patricia A; Morris, Danielle H; Orr, Nicholas; Schoemaker, Minouk J; Jones, Michael; Ashworth, Alan; Swerdlow, Anthony J

    2011-01-01

    Women become infertile approximately 10 years before menopause, and as more women delay childbirth into their 30s, the number of women who experience infertility is likely to increase. Tests that predict the timing of menopause would allow women to make informed reproductive decisions. Current predictors are only effective just prior to menopause, and there are no long-range indicators. Age at menopause and early menopause (EM) are highly heritable, suggesting a genetic aetiology. Recent genome-wide scans have identified four loci associated with variation in the age of normal menopause (40-60 years). We aimed to determine whether theses loci are also risk factors for EM. We tested the four menopause-associated genetic variants in a cohort of approximately 2000 women with menopause≤45 years from the Breakthrough Generations Study (BGS). All four variants significantly increased the odds of having EM. Comparing the 4.5% of individuals with the lowest number of risk alleles (two or three) with the 3.0% with the highest number (eight risk alleles), the odds ratio was 4.1 (95% CI 2.4-7.1, P=4.0×10(-7)). In combination, the four variants discriminated EM cases with a receiver operator characteristic area under the curve of 0.6. Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM in an independent cohort from the BGS. The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.

  20. Significance, definition, classification and risk factors of chronic kidney disease in South Africa.

    Science.gov (United States)

    Meyers, A M

    2015-03-01

    Renal dysfunction or chronic kidney disease (CKD) is found in 10% of the global population and is classified into five stages according to the estimated glomerular filtration rate (eGFR). No matter where a patient lives, estimation of the GFR is mandatory for decision-making and obtained by the simple measurement of a serum creatinine level. The objective of diagnosing CKD lies in its future prevention, early detection and proper treatment, which will prevent or delay functional deterioration. Primary hypertension (PH) occurs in 25% of South Africa (SA)s black population and is the putative cause of stage 5 CKD in 40 - 60% of these patients. Moreover, in this group, stage 5 CKD occurs at a relatively young age (35 - 45 years) compared with other population groups in whom stage 5 CKD resulting from PH usually occurs between 60 and 70 years of age. In the cohort study, PH has been found in 12 - 16% of black school learners (mean age 17 years) compared with 1.8 - 2% of other ethnic groups (mixed race, Asian, white). End-stage renal failure (ESRF) is the fifth most common cause of death in SA, excluding post-traumatic cases. In addition, undiagnosed or poorly controlled PH is a potent risk factor for other cardiovascular disease (CVD), e.g. congestive cardiac failure, myocardial infarction, stroke. Significant protein is also associated with CVD and protein >1 g/d is a significant risk factor for ESRF.

  1. Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events

    DEFF Research Database (Denmark)

    Khashan, Ali; Abel, Kathryn; McNamee, R.

    2008-01-01

    CONTEXT: Most societies believe that a mother's psychological state can influence her unborn baby. Severe adverse life events during pregnancy have been consistently associated with an elevated risk of low birth weight and prematurity. Such events during the first trimester have also been...... associated with risk of congenital malformations. OBJECTIVE: To assess the effect in offspring of antenatal maternal exposure to an objective measure of stress on risk of adverse neurodevelopment, specifically schizophrenia. We hypothesized that the strongest relationship would be to maternal exposures...... not linked with a higher risk of schizophrenia. CONCLUSIONS: Our population-based study suggests that severe stress to a mother during the first trimester may alter the risk of schizophrenia in offspring. This finding is consistent with ecological evidence from whole populations exposed to severe stressors...

  2. Identifying Adult Dengue Patients at Low Risk for Clinically Significant Bleeding.

    Directory of Open Access Journals (Sweden)

    Joshua G X Wong

    Full Text Available Clinically significant bleeding is important for subsequent optimal case management in dengue patients, but most studies have focused on dengue severity as an outcome. Our study objective was to identify differences in admission parameters between patients who developed clinically significant bleeding and those that did not. We sought to develop a model for discriminating between these patients.We conducted a retrospective study of 4,383 adults aged >18 years who were hospitalized with dengue infection at Tan Tock Seng Hospital, Singapore from 2005 to 2008. Patients were divided into those with clinically significant bleeding (n = 188, and those without (n = 4,195. Demographic, clinical, and laboratory variables on admission were compared between groups to determine factors associated with clinically significant bleeding during hospitalization.On admission, female gender (p38°C (p38°C (aOR 1.81; 95% CI: 1.27-2.61, nausea/vomiting (aOR 1.39; 95% CI: 0.94-2.12, ANC (aOR 1.3; 95% CI: 1.15-1.46, ALC (aOR 0.4; 95% CI: 0.25-0.64, hematocrit percentage (aOR 0.96; 95% CI: 0.92-1.002 and platelet count (aOR 0.993; 95% CI: 0.988-0.998. At the cutoff of -3.919, the model achieved an AUC of 0.758 (sensitivity:0.87, specificity: 0.38, PPV: 0.06, NPV: 0.98.Clinical risk factors associated with clinically significant bleeding were identified. This model may be useful to complement clinical judgement in triaging adult dengue patients given the dynamic nature of acute dengue, particularly in pre-identifying those less likely to develop clinically significant bleeding.

  3. Conflicts at work are associated with a higher risk of cardiovascular disease

    Science.gov (United States)

    Jacob, Louis; Kostev, Karel

    2017-01-01

    Background: Only few authors have analyzed the impact of workplace conflicts and the resulting stress on the risk of developing cardiovascular disorders. The goal of this study was to analyze the association between workplace conflicts and cardiovascular disorders in patients treated by German general practitioners. Methods: Patients with an initial documentation of a workplace conflict experience between 2005 and 2014 were identified in 699 general practitioner practices (index date). We included only those who were between the ages of 18 and 65 years, had a follow-up time of at least 180 days after the index date, and had not been diagnosed with angina pectoris, myocardial infarction, coronary heart diseases, or stroke prior to the documentation of the workplace mobbing. In total, the study population consisted of 7,374 patients who experienced conflicts and 7,374 controls for analysis. The main outcome measure was the incidence of angina pectoris, myocardial infarction, and stroke correlated with workplace conflict experiences. Results: After a maximum of five years of follow-up, 2.9% of individuals who experienced workplace conflict were affected by cardiovascular diseases, while only 1.4% were affected in the control group (p-value <0.001). Workplace conflict was associated with a 1.63-fold increase in the risk of developing cardiovascular diseases. Finally, the impact of workplace conflict was higher for myocardial infarction (OR=2.03) than for angina pectoris (OR=1.79) and stroke (OR=1.56). Conclusions: Overall, we found a significant association between workplace conflicts and cardiovascular disorders. PMID:28496397

  4. Conflicts at work are associated with a higher risk of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Jacob, Louis

    2017-04-01

    Full Text Available Background: Only few authors have analyzed the impact of workplace conflicts and the resulting stress on the risk of developing cardiovascular disorders. The goal of this study was to analyze the association between workplace conflicts and cardiovascular disorders in patients treated by German general practitioners. Methods: Patients with an initial documentation of a workplace conflict experience between 2005 and 2014 were identified in 699 general practitioner practices (index date. We included only those who were between the ages of 18 and 65 years, had a follow-up time of at least 180 days after the index date, and had not been diagnosed with angina pectoris, myocardial infarction, coronary heart diseases, or stroke prior to the documentation of the workplace mobbing. In total, the study population consisted of 7,374 patients who experienced conflicts and 7,374 controls for analysis. The main outcome measure was the incidence of angina pectoris, myocardial infarction, and stroke correlated with workplace conflict experiences. Results: After a maximum of five years of follow-up, 2.9% of individuals who experienced workplace conflict were affected by cardiovascular diseases, while only 1.4% were affected in the control group Workplace conflict was associated with a 1.63-fold increase in the risk of developing cardiovascular diseases. Finally, the impact of workplace conflict was higher for myocardial infarction (OR=2.03 than for angina pectoris (OR=1.79 and stroke (OR=1.56. Conclusions: Overall, we found a significant association between workplace conflicts and cardiovascular disorders.

  5. Heavy Smoking Is Associated With Lower Age at First Episode of Acute Pancreatitis and a Higher Risk of Recurrence.

    Science.gov (United States)

    Munigala, Satish; Conwell, Darwin L; Gelrud, Andres; Agarwal, Banke

    2015-08-01

    There is limited data on cigarette smoking and the risk of acute pancreatitis (AP). We evaluated the influence of cigarette smoking on AP risk and clinical presentation in a large cohort of Veteran's Administration (VA) patients. Retrospective study of VA patients from 1998 to 2007. Exclusion criteria included (1) history of chronic pancreatitis (n = 3222) or gallstones (n = 14,574) and (2) age younger than 15 years (n = 270). A 2-year washout period was used to exclude patients with pre-existing recurrent AP. The study included 484,624 patients. From 2001 to 2007, a total of 6799 (1.4%) patients had AP. Alcohol (risk ratio, 4.20) and smoking (risk ratio, 1.78) were independent significant risk factors of AP on multiple regression analysis. Smoking increased the risk of AP in both nonalcoholics (0.57% vs 1.1%) and alcoholics (2.6% vs 4.1%). Smoking was associated with younger mean age at first episode of AP and higher likelihood of recurrent AP (≥4 episodes) in both nonalcoholics and alcoholics. The interval between recurrent episodes was not altered by alcohol or smoking. In a large cohort of VA patients, smoking is an independent risk factor for AP and augmented the effect of alcohol on the risk, age of onset, and recurrence of AP.

  6. Getting Your Ducks in a Row: IT Governance, Risk, and Compliance Programs in Higher Education

    Science.gov (United States)

    Bichsel, Jacqueline; Feehan, Patrick

    2014-01-01

    Higher education IT governance, risk, and compliance (GRC) programs are in the development stage. Few institutions have all three programs in place, and many institutions are unclear where they should start when instituting or maturing their IT GRC programs. In addition, they are often uncertain as to whether GRC programs should be developed in…

  7. Risky Business: An Integrated Institutional Theory for Understanding High-Risk Decision Making in Higher Education

    Science.gov (United States)

    Turner, Lauren A.; Angulo, A. J.

    2018-01-01

    Lauren A. Turner and A. J. Angulo explore how institutional theory can be applied to explain variance in higher education organizational strategies. Given strong regulatory, normative, and cultural-cognitive pressures to conform, they ask, why do some colleges engage in high-risk decision making? To answer this, they bring together classic and…

  8. Study finds stronger nicotine dependency associated with higher risk of lung cancer

    Science.gov (United States)

    NCI headed study finds people who are highly addicted to nicotine -- those who smoke their first cigarette within five minutes after awakening -- are at higher risk of developing lung cancer than those who wait for an hour or more to smoke.

  9. Adult Arabs have higher risk for diabetes mellitus than Jews in Israel.

    Directory of Open Access Journals (Sweden)

    Anat Jaffe

    Full Text Available Diabetes mellitus is an emerging epidemic in the Arab world. Although high diabetes prevalence is documented in Israeli Arabs, information from cohort studies is scant.This is a population study, based on information derived between 2007-2011, from the electronic database of the largest health fund in Israel, among Arabs and Jews. Prevalence, 4-year-incidence and diabetes hazard ratios [HRs], adjusted for sex and the metabolic-syndrome [MetS]-components, were determined in 3 age groups (<50 years, 50-59 years, and ≥60 years.The study cohort included 17,044 Arabs (males: 49%, age: 39.4±17.3 and 16,012 Jews (males: 50%, age: 40.5 ±17.6. The overall age and sex-adjusted diabetes prevalence rates were much higher among Arabs 18.4% (95%CI: 17.6-19.1; and 10.3% (95%CI: 9.7-10.9 among Jews. Arab females had higher prevalence rates 20.0% (95%CI: 19-21 than Arab males 16.7% (95%CI: 15.7-17.8. Annual incidence rates were also significantly higher among Arabs 2.9% (95%CI: 2.7-3.1 than among Jews 1.7% (95%CI: 1.6-1.8. This held true across all age and sex subgroups. Adjustment for body mass index [BMI] attenuated HR estimates associated with Arab ethnicity across all age subgroups, mainly in the <50yrs age group from HR 2.04 (95%CI: 1.74-2.40 to 1.64 (95%CI: 1.40-1.92. BMI at incident diabetes among females was higher in Arabs than Jews. Males, however, did not differ by ethnicity.Arabs, mainly female, have high incidence and prevalence of diabetes. This excess risk is only partially explained by the high prevalence of obesity. Effective culturally-congruent diabetes prevention and treatment and an effective engagement partnership with the Arab community are of paramount need.

  10. RISK FACTORS AND CLINICAL SIGNIFICANCE OF PRECHOROIDAL CLEFT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Kim, Jong Min; Kang, Se Woong; Son, Dae Yong; Bae, Kunho

    2017-11-01

    To investigate the risk factors associated with prechoroidal cleft occurrence after treatment for neovascular age-related macular degeneration (nAMD) and to elucidate its clinical significance. Two hundred thirty-four subjects who were treated for neovascular age-related macular degeneration were assessed to identify prechoroidal cleft on optical coherence tomography. Clinical variables were compared between patients manifesting a cleft (cleft group) and patients who did not (control group). Prechoroidal cleft was detected in 29 of 234 patients (8.1%). Although the baseline visual acuity was not different between the 2 groups, logMAR visual acuity at final visit was 0.89 ± 0.74 (with approximate Snellen equivalent of 20/160) in the cleft group and 0.65 ± 0.69 (with approximate Snellen equivalent of 20/100) in controls (P age-related macular degeneration (P age-related macular degeneration, and a submacular hemorrhage treated by pneumatic displacement were the independent risk factors for development of prechoroidal cleft. Eyes with a cleft, especially clefts that develop early, generally had worse prognoses than eyes without clefts.

  11. Genetic variation in VEGF does not contribute significantly to the risk of congenital cardiovascular malformation.

    Directory of Open Access Journals (Sweden)

    Helen R Griffin

    Full Text Available Several previous studies have investigated the role of common promoter variants in the vascular endothelial growth factor (VEGF gene in causing congenital cardiovascular malformation (CVM. However, results have been discrepant between studies and no study to date has comprehensively characterised variation throughout the gene. We genotyped 771 CVM cases, of whom 595 had the outflow tract malformation Tetralogy of Fallot (TOF, and carried out TDT and case-control analyses using haplotype-tagging SNPs in VEGF. We carried out a meta-analysis of previous case-control or family-based studies that had typed VEGF promoter SNPs, which included an additional 570 CVM cases. To identify rare variants potentially causative of CVM, we carried out mutation screening in all VEGF exons and splice sites in 93 TOF cases. There was no significant effect of any VEGF haplotype-tagging SNP on the risk of CVM in our analyses of 771 probands. When the results of this and all previous studies were combined, there was no significant effect of the VEGF promoter SNPs rs699947 (OR 1.05 [95% CI 0.95-1.17]; rs1570360 (OR 1.17 [95% CI 0.99-1.26]; and rs2010963 (OR 1.04 [95% CI 0.93-1.16] on the risk of CVM in 1341 cases. Mutation screening of 93 TOF cases revealed no VEGF coding sequence variants and no changes at splice consensus sequences. Genetic variation in VEGF appears to play a small role, if any, in outflow tract CVM susceptibility.

  12. Higher education is associated with a lower risk of dementia after a stroke or TIA : The Rotterdam study

    NARCIS (Netherlands)

    S.S. Mirza (Saira); M.L.P. Portegies (Marileen); F.J. Wolters (Frank J.); A. Hofman (Albert); P.J. Koudstaal (Peter Jan); H.W. Tiemeier (Henning); M.A. Ikram (Arfan)

    2016-01-01

    markdownabstract__Background:__ Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains

  13. Is Sex with Older Male Partners Associated with Higher Sexual Risk Behavior Among Young Black MSM?

    Science.gov (United States)

    Chamberlain, Nicholas; Mena, Leandro A; Geter, Angelica; Crosby, Richard A

    2017-08-01

    Participants at a sexual health clinic completed a survey with questions regarding sexual risk behavior and partner characteristics. Of 585 participants eligible for analysis, 124 reported generally having older male partners. These participants were significantly more likely to be HIV-infected (p < 0.001), have four or more sex partners as a "bottom" (p = 0.04), have concurrent partners (p = 0.01), and have partners suspected of having an sexually transmitted infection (p = 0.05) than participants without older partners. With analysis restricted to HIV- individuals, risk behaviors did not differ significantly between the groups. HIV- individuals with older partners may be at increased risk of HIV infection due to increased HIV prevalence among older sexual partners and not due to increased risk behaviors with these partners.

  14. Duplications of the neuropeptide receptor gene VIPR2 confer significant risk for schizophrenia.

    LENUS (Irish Health Repository)

    Vacic, Vladimir

    2011-03-24

    Rare copy number variants (CNVs) have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large (>500-kilobase) CNVs at several loci, including microdeletions at 1q21.1 (ref. 2), 3q29 (ref. 3), 15q13.3 (ref. 2) and 22q11.2 (ref. 4) and microduplication at 16p11.2 (ref. 5). However, these CNVs collectively account for a small fraction (2-4%) of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 (0.35%) patients versus 2 of 7,431 (0.03%) controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs.

  15. Significance of specificity of Tinetti B-POMA test and fall risk factor in third age of life.

    Science.gov (United States)

    Avdić, Dijana; Pecar, Dzemal

    2006-02-01

    As for the third age, psychophysical abilities of humans gradually decrease, while the ability of adaptation to endogenous and exogenous burdens is going down. In 1987, "Harada" et al. (1) have found out that 9.5 million persons in USA have difficulties running daily activities, while 59% of them (which is 5.6 million) are older than 65 years in age. The study has encompassed 77 questioned persons of both sexes with their average age 71.73 +/- 5.63 (scope of 65-90 years in age), chosen by random sampling. Each patient has been questioned in his/her own home and familiar to great extent with the methodology and aims of the questionnaire. Percentage of questioned women was 64.94% (50 patients) while the percentage for men was 35.06% (27 patients). As for the value of risk factor score achieved conducting the questionnaire and B-POMA test, there are statistically significant differences between men and women, as well as between patients who fell and those who never did. As for the way of life (alone or in the community), there are no significant statistical differences. Average results gained through B-POMA test in this study are statistically significantly higher in men and patients who did not provide data about falling, while there was no statistically significant difference in the way of life. In relation to the percentage of maximum number of positive answers to particular questions, regarding gender, way of life and the data about falling, there were no statistically significant differences between the value of B-POMA test and the risk factor score (the questionnaire).

  16. Helicobacter pylori Infection is a Significant Factor Risk for Hyperhomocysteinemia in the Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Soudabeh Fallah

    2016-01-01

    Full Text Available ABSTRACT This work aimed to determine whether seropositivity to Helicobacter pylori infection was an independent risk factor for hyperhomocysteinemia patients with cardiovascular disease. The H. pylori IgG, IgA and homocystein levels in 96 patients with cardiovascular disease and 64 participants free of cardiovascular disease as control subjects were determined by ELISA assay. The results showed that seropositivity to H. pylori IgG and IgA levels of coronary artery disease (CADpatients was significantly higher than the controls and CAD patients with H. pylori IgG and IgA negative antibodies. A significant correlation was found between the seropositivity to H. pylori IgG and homocysteine levels of CAD patients in comparison with the controls and CAD patients with seronegativity to H. pylori IgG and IgA (r=0.233, P= 0.019 . The involvement of H. pylori infection in atherosclerosis process was based on the chronic inflammation, which might facilitate the CAD-related pathologies. The effect of the presence of H. pylori infection on homocysteine levels elevation in the CAD patients (as a risk factor independent of other traditional factors was remarkable.

  17. Higher Birthweight and Maternal Pre-pregnancy BMI Persist with Obesity Association at Age 9 in High Risk Latino Children.

    Science.gov (United States)

    Kjaer, Thora Wesenberg; Faurholt-Jepsen, Daniel; Medrano, Rosalinda; Elwan, Deena; Mehta, Kala; Christensen, Vibeke Brix; Wojcicki, Janet M

    2018-02-03

    Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.

  18. Environmental program with operational cases to reduce risk to the marine environment significantly

    International Nuclear Information System (INIS)

    Cline, J.T.; Forde, R.

    1991-01-01

    In this paper Amoco Norway Oil Company's environmental program is detailed, followed by example operational programs and achievements aimed to minimize environmental risks to the marine environment at Valhall platform. With a corporate goal to be a leader in protecting the environment, the appropriate strategies and policies that form the basis of the environmental management system are incorporated in the quality assurance programs. Also, included in the program are necessary organizational structures, responsibilities of environmental affairs and line organization personnel, compliance procedures and a waste task force obliged to implement operations improvements. An internal environmental audit system has been initiated, in addition to corporate level audits, which, when communicated to the line organization closes the environmental management loop through experience feed back. Environmental projects underway are significantly decreasing the extent and/or risk of pollution from offshore activities. The cradle to grave responsibility is assumed with waste separated offshore and onshore followed by disposal in audited sites. A $5 MM program is underway to control produced oily solids and reduce oil in produced water aiming to less than 20 ppm. When oil-based mud is used in deeper hole sections, drill solids disposed at sea average less than 60 g oil/kg dry cuttings using appropriate shaker screens, and a washing/centrifuge system to remove fines. Certain oily liquid wastes are being injected down hole whereas previously they were burned using a mud burner. Finally, a program is underway with a goal to eliminate sea discharge of oil on cuttings through injection disposal of oily wastes, drilling with alternative muds such as a cationic water base mud, and/or proper onshore disposal of oily wastes

  19. Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

    NARCIS (Netherlands)

    Schaapveld, M.; van den Belt-Dusebout, A. W.; Gietema, J. A.; de Wit, R.; Horenblas, S.; Witjes, J. A.; Hoekstra, H. J.; Kiemeney, L. A. L. M.; Louwman, W. J.; Ouwens, G. M.; Aleman, B. M. P.; van Leeuwen, F. E.

    2012-01-01

    BACKGROUND: Testicular germ cell tumour (TGCT) patients are at increased risk of developing a contralateral testicular germ cell tumour (CTGCT). It is unclear whether TGCT treatment affects CTGCT risk. METHODS: The risk of developing a metachronous CTGCT (a CTGCT diagnosed >= 6 months after a

  20. Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk

    DEFF Research Database (Denmark)

    Hesselvig, J Halskou; Ahlehoff, O; Dreyer, L

    2017-01-01

    Systemic lupus erythematosus (SLE) is a well-known cardiovascular risk factor. Less is known about cutaneous lupus erythematosus (CLE) and the risk of developing cardiovascular disease (CVD). Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients diagnosed...

  1. Large Critical Shoulder Angle Has Higher Risk of Tendon Retear After Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Li, Hong; Chen, Yuzhou; Chen, Jiwu; Hua, Yinghui; Chen, Shiyi

    2018-05-01

    Los Angeles, Constant, and visual analog scale scores. Postoperative magnetic resonance imaging revealed that the large CSA group had 9 cases of retear, with a significantly higher retear rate than the control group (15% vs 0%, P = .03). Furthermore, the tendon SNQ of the large CSA group was significantly greater than that of the control group. CSA did not appear to influence postoperative functional outcomes, while those in the large CSA group had poor tendon integrity after rotator cuff repair. These findings indicate that a large CSA is associated with an increased risk of rotator cuff tendon retear after repair.

  2. Simultaneous Health Risk Behaviors in Adolescents Associated with Higher Economic Class in the Northeast of Brazil

    Directory of Open Access Journals (Sweden)

    Arley Santos Leão

    2017-01-01

    Full Text Available Design. The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective. The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods. The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results. Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions. It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors.

  3. Why do perfectionists have a higher burnout risk than others? The mediational effect of workaholism

    Directory of Open Access Journals (Sweden)

    van Beek, Ilona

    2010-04-01

    Full Text Available Previous research has revealed that perfectionists have a higher burnout risk than others, but the mechanisms accounting for this association have rarely been examined. The present study proposes that workaholism mediates this relation, as previous research revealed that (a perfectionists are more likely to be workaholics than others, and (b workaholics have a higher burnout risk than others. Using cross-sectional data from 199 Dutch managers, regression analyses revealed that holding high standards towards oneself (a self-directed indicator of perfectionism was unrelated to any of the three dimensions of the Maslach Burnout Inventory. However, high concern over making mistakes in the face of others (representing socially prescribed perfectionism was systematically associated with high levels of burnout and workaholism. Moreover, workaholism was positively associated with high levels of exhaustion. Subsequent mediation analysis revealed that the association between (the socially prescribed aspect of perfectionism and burnout (emotional exhaustion was mediated by workaholism.

  4. Indexed effective orifice area is a significant predictor of higher mid- and long-term mortality rates following aortic valve replacement in patients with prosthesis-patient mismatch.

    Science.gov (United States)

    Chen, Jian; Lin, Yiyun; Kang, Bo; Wang, Zhinong

    2014-02-01

    Prosthesis-patient mismatch (PPM) is defined as a too-small effective orifice area (EOA) of an inserted prosthetic relative to body size, resulting in an abnormally high postoperative gradient. It is unclear, however, whether residual stenosis after aortic valve replacement (AVR) has a negative impact on mid- and long-term survivals. We searched electronic databases, including PubMed, Embase, Medline and the Cochrane controlled trials register, through October 2012, to identify published full-text English studies on the association between PPM and mortality rates. A significant PPM was defined as an indexed EOA (iEOA)<0.85 cm2/m2, and severe PPM as an iEOA<0.65 cm2/m2. Two reviewers independently assessed the studies for inclusion and extracted data. Fourteen observational studies, involving 14 874 patients, met our final inclusion criteria. Meta-analysis demonstrated that PPM significantly increased mid-term (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.19-1.69) and long-term (OR 1.52, 95% CI 1.26-1.84) all-cause mortalities. Subgroup analysis showed that PPM was associated with higher mid- and long-term mortality rates only in younger and predominantly female populations. Risk-adjusted sensitivity analysis showed that severe PPM was associated with reduced survival (adjusted hazard ratio [HR] 1.50, 95% CI 1.24-1.80), whereas moderate PPM was not (adjusted HR 0.96, 95% CI 0.86-1.07). Regardless of severity, however, PPM had a negative effect on survival in patients with impaired ejection fraction (adjusted HR 1.26, 95% CI 1.09-1.47). PPM (iEOA<0.85 cm2/m2) after AVR tended to be associated with increased long-term all-cause mortality in younger patients, females and patients with preoperative left ventricular dysfunction. Severe PPM (iEOA<0.65 cm2/m2) was a significant predictor of reduced long-term survival in all populations undergoing AVR.

  5. Obese with higher FNDC5/Irisin levels have a better metabolic profile, lower lipopolysaccharide levels and type 2 diabetes risk.

    Science.gov (United States)

    Bonfante, Ivan Luiz Padilha; Chacon-Mikahil, Mara Patricia Traina; Brunelli, Diego Trevisan; Gáspari, Arthur Fernandes; Duft, Renata Garbellini; Oliveira, Alexandre Gabarra; Araujo, Tiago Gomes; Saad, Mario Jose Abdalla; Cavaglieri, Cláudia Regina

    2017-12-01

    Thus, the aim of this study was to compare if higher or smaller fibronectin type 3 domain-containing protein 5 (FNDC5)/irisin levels are associated with inflammatory and metabolic markers, caloric/macronutrient intake, physical fitness and type 2 diabetes mellitus (T2DM) risk in obese middle-aged men, and also to correlate all variables analyzed with FNDC5/irisin. On the basis of a cluster study, middle-aged obese men (IMC: 31.01 ± 1.64 kg/m2) were divided into groups of higher and smaller levels of FNDC5/irisin. The levels of leptin, resistin, adiponectin, tumor necrosis factor alpha (TNFα), interleukin 6 and 10 (IL6, IL10), lipopolysaccharide (LPS), glucose, insulin, glycated hemoglobin, insulin resistance and sensibility, lipid profile, risk of T2DM development, body composition, rest energy expenditure, caloric/macronutrient intake and physical fitness were measured. The higher FNDC5/ irisin group presented improved insulin sensibility (homeostasis model assessment - sensibility (HOMA-S) (p = 0.01) and QUICKI index (p risk of T2DM development (p = 0.02), tendency to decrease serum resistin (p = 0.08) and significant lower LPS levels (p = 0.02). Inverse correlations between FNDC5/irisin and body weight (r -0.46, p = 0.04), neck circumference (r -0.51, p = 0.02), free fat mass (r -0.49, p = 0.02), triglycerides (r -0.43, p = 0.05) and risk of developing T2DM (r -0.61, p = 0.04) were observed. These results suggest that higher FNDC5/irisin levels in obese middle-aged men are related to a better metabolic profile and lower risk of T2DM development and serum LPS, a potential inducer of insulin resistance.

  6. Duplications of the Neuropeptide Receptor VIPR2 Confer Significant Risk for Schizophrenia

    Science.gov (United States)

    Vacic, Vladimir; McCarthy, Shane; Malhotra, Dheeraj; Murray, Fiona; Chou, Hsun-Hua; Peoples, Aine; Makarov, Vladimir; Yoon, Seungtai; Bhandari, Abhishek; Corominas, Roser; Iakoucheva, Lilia M.; Krastoshevsky, Olga; Krause, Verena; Larach-Walters, Verónica; Welsh, David K.; Craig, David; Kelsoe, John R.; Gershon, Elliot S.; Leal, Suzanne M.; Aquila, Marie Dell; Morris, Derek W.; Gill, Michael; Corvin, Aiden; Insel, Paul A.; McClellan, Jon; King, Mary-Claire; Karayiorgou, Maria; Levy, Deborah L.; DeLisi, Lynn E.; Sebat, Jonathan

    2012-01-01

    Rare copy number variants (CNVs) play a prominent role in the etiology of schizophrenia and other neuropsychiatric disorders1. Substantial risk for schizophrenia is conferred by large (>500 kb) CNVs at several loci, including microdeletions at 1q21.1 2, 3q29 3, 15q13.3 2 and 22q11.2 4 and microduplication at 16p11.2 5. However, these CNVs collectively account for a small fraction (2-4%) of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy number gains at chromosome 7q36.3 with schizophrenia (P= 4.0×10-5, OR = 16.14 [3.06, ∞]). Microduplications with variable breakpoints occurred within a 362 kb region and were detected in 29 of 8,290 (0.35%) patients versus two of 7,431 (0.03%) controls in the combined sample (p-value= 5.7×10-7, odds ratio (OR) = 14.1 [3.5, 123.9]). All duplications overlapped or were located within 89 kb upstream of the vasoactive intestinal peptide receptor VIPR2. VIPR2 transcription and cyclic-AMP signaling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered VIP signaling in the pathogenesis of schizophrenia and suggest VIPR2 as a potential target for the development of novel antipsychotic drugs. PMID:21346763

  7. Derivation of a No-Significant-Risk-Level (NSRL) for diethanolamine (DEA).

    Science.gov (United States)

    Wang, Bingxuan; Amacher, David E; Whittaker, Margaret H

    2014-02-01

    Diethanolamine (DEA) has been listed on the State of California's Proposition 65 List. This listing is based in part on tumors reported in a National Toxicology Program (NTP) 2-year dermal carcinogenicity study in mice which found clear evidence of carcinogenic activity in B6C3F₁ mice based on increased incidences of liver neoplasms in both sexes, and increased incidences of renal tubule neoplasms in males. Although considerable controversy exists on the relevance of the NTP study to humans, industries are obligated to comply with the Proposition 65 labeling requirement and drinking water discharge prohibition, unless they are able to demonstrate that DEA levels in their products are below a specific No Significant Risk Level (NSRL). The State of California has not published an NSRL for DEA. In this article, a NSRL of 5.6 μg/day and a life-stage-adjusted NSRL(adj) of 1.4 μg/day are derived from the NTP carcinogenicity study using a benchmark dose modeling method based on the incidence of hepatocellular carcinomas in female mice, in accordance with the guidelines of California EPA. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

    International Nuclear Information System (INIS)

    Piot, J M; Royer, M; Schmidt-Tanguy, A; Hoppé, E; Gardembas, M; Bourrée, T; Hunault, M; François, S; Boyer, F; Ifrah, N; Renier, G; Chevailler, A; Audran, M; Chappard, D; Libouban, H; Mabilleau, G; Legrand, E; Bouvard, B

    2015-01-01

    Monoclonal gammopathies of undetermined significance (MGUS) have been shown to be associated with an increased risk of fractures. This study describes prospectively the bone status of MGUS patients and determines the factors associated with vertebral fracture. We included prospectively 201 patients with MGUS, incidentally discovered, and with no known history of osteoporosis: mean age 66.6±12.5 years, 48.3% women, 51.7% immunoglobulin G (IgG), 33.3% IgM and 10.4% IgA. Light chain was kappa in 64.2% patients. All patients had spinal radiographs and bone mineral density measurement in addition to gammopathy assessment. At least one prevalent non-traumatic vertebral fracture was discovered in 18.4% patients and equally distributed between men and women. Fractured patients were older, had a lower bone density and had also more frequently a lambda light chain isotype. Compared with patients with κ light chain, the odds ratio of being fractured for patients with λ light chain was 4.32 (95% confidence interval 1.80–11.16; P=0.002). These results suggest a high prevalence of non-traumatic vertebral fractures in MGUS associated with lambda light chain isotype and not only explained by low bone density

  9. Anabolic steroids detected in bodybuilding dietary supplements - a significant risk to public health.

    Science.gov (United States)

    Abbate, V; Kicman, A T; Evans-Brown, M; McVeigh, J; Cowan, D A; Wilson, C; Coles, S J; Walker, C J

    2015-07-01

    Twenty-four products suspected of containing anabolic steroids and sold in fitness equipment shops in the United Kingdom (UK) were analyzed for their qualitative and semi-quantitative content using full scan gas chromatography-mass spectrometry (GC-MS), accurate mass liquid chromatography-mass spectrometry (LC-MS), high pressure liquid chromatography with diode array detection (HPLC-DAD), UV-Vis, and nuclear magnetic resonance (NMR) spectroscopy. In addition, X-ray crystallography enabled the identification of one of the compounds, where reference standard was not available. Of the 24 products tested, 23 contained steroids including known anabolic agents; 16 of these contained steroids that were different to those indicated on the packaging and one product contained no steroid at all. Overall, 13 different steroids were identified; 12 of these are controlled in the UK under the Misuse of Drugs Act 1971. Several of the products contained steroids that may be considered to have considerable pharmacological activity, based on their chemical structures and the amounts present. This could unwittingly expose users to a significant risk to their health, which is of particular concern for naïve users. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Kidneys at Higher Risk of Discard: Expanding the Role of Dual Kidney Transplantation

    Science.gov (United States)

    Tanriover, B.; Mohan, S.; Cohen, D. J.; Radhakrishnan, J.; Nickolas, T. L.; Stone, P. W.; Tsapepas, D. S.; Crew, R. J.; Dube, G. K.; Sandoval, P. R.; Samstein, B.; Dogan, E.; Gaston, R. S.; Tanriover, J. N.; Ratner, L. E.; Hardy, M. A.

    2014-01-01

    Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI) >85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (90%). Kidneys with KDPI >90% were associated with increased odds of discard (OR = 1.99, 95% CI 1.74–2.29) compared to ones with KDPI 90% were associated with lower overall allograft failure (HR = 0.74, 95% CI 0.62–0.89) and better patient survival (HR = 0.79, 95% CI 0.64–0.98) compared to single ECD kidneys with KDPI >90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile. PMID:24472195

  11. No higher risk for colorectal cancer in atrophic gastritis-related hypergastrinemia.

    Science.gov (United States)

    Lahner, Edith; Sbrozzi-Vanni, Andrea; Vannella, Lucy; Corleto, Vito Domenico; Di Giulio, Emilio; Delle Fave, Gianfranco; Annibale, Bruno

    2012-09-01

    Atrophic gastritis of the corporal mucosa is a frequent cause of hypergastrinemia. Hypergastrinemia is implicated in colorectal cancer development. To assess whether hypergastrinemic atrophic gastritis is associated with a higher risk of neoplastic colorectal lesions. Among 441 hypergastrinemic atrophic gastritis patients, 160 who were aged >40 and underwent colonoscopy for anaemia, diarrhoea or colorectal cancer-screening were retrospectively selected. Each patient was age- and gender-matched with a normogastrinemic control with healthy stomach. Controls had colonoscopy, gastroscopy with biopsies and gastrin assessment. 160 hypergastrinemic atrophic gastritis patients and 160 controls were included. 28 atrophic gastritis patients and 36 controls had neoplastic colorectal lesions (p=0.33). Patients and controls did not differ for frequency of colorectal adenomas (10.6% vs. 13.1%, p=0.60) or cancer (6.9% vs. 9.4%, p=0.54). Hypergastrinemic atrophic gastritis was not associated with a higher probability of developing colorectal cancer (OR 1.03, 95% CI 0.34-3.16). Age >50 years (OR 3.86) but not hypergastrinemia (OR 0.61) was associated with colorectal cancer. Hypergastrinemic atrophic gastritis is not associated with higher risk for colorectal cancer. Atrophic gastritis-related hypergastrinemia is not associated with an increased risk of neoplastic colorectal lesions. Closer surveillance of colonic neoplasia in atrophic gastritis patients seems not appropriate. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Methodology to identify risk-significant components for inservice inspection and testing

    International Nuclear Information System (INIS)

    Anderson, M.T.; Hartley, R.S.; Jones, J.L. Jr.; Kido, C.; Phillips, J.H.

    1992-08-01

    Periodic inspection and testing of vital system components should be performed to ensure the safe and reliable operation of Department of Energy (DOE) nuclear processing facilities. Probabilistic techniques may be used to help identify and rank components by their relative risk. A risk-based ranking would allow varied DOE sites to implement inspection and testing programs in an effective and cost-efficient manner. This report describes a methodology that can be used to rank components, while addressing multiple risk issues

  13. Higher perceived risk of antimicrobials is related to lower antimicrobial usage among pig farmers in four European countries.

    Science.gov (United States)

    Visschers, V H M; Postma, M; Sjölund, M; Backhans, A; Collineau, L; Loesken, S; Belloc, C; Dewulf, J; Emanuelson, U; Grosse Beilage, E; Siegrist, M; Stärk, K D C

    2016-11-12

    The prudent use of antimicrobials (AMs) should be widened in pig farming to reduce the risk of AM resistance (AMR) in human and veterinary medicine. It is therefore important to understand pig farmers' motivators and the barriers to AM usage (AMU) on their farms. The authors investigated pig farmers' self-estimated levels of AMU, their perceived benefits and risks and the need for AMs in a cross-sectional survey in Belgium, France, Germany and Sweden. The authors also compared these perceptions between the four countries and related them to pig farmers' actual AMU. The results showed that farmers who used more AMs also estimated their own usage as higher. Farmers perceived many benefits but relatively few risks of AMU in pig farming. Some significant cross-country differences in farmers' perceptions were found, but they were relatively small. After controlling for country differences and farm differences, only perceived risks had a significant association with AMU. The authors therefore conclude that in order to promote prudent AMU, it seems most promising to focus on the structural differences in pig farming and veterinary medicine (e.g. legislation, role of the veterinarian) among countries. In addition, interventions which aim at reducing AMU should increase farmers' awareness of the risks of extensive AMU. British Veterinary Association.

  14. Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison's disease.

    Science.gov (United States)

    Meyer, Gesine; Koch, Maike; Herrmann, Eva; Bojunga, Jörg; Badenhoop, Klaus

    2018-05-01

    Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.

  15. Managing Reputation Risk and Situational Crisis in Higher Institutions of Learning

    Directory of Open Access Journals (Sweden)

    Andem Ita Effiong

    2014-05-01

    Full Text Available Extant literature on crisis and corporate reputation management has presented the Situational Crisis Communication Theory (SCCT model as a valid and reliable framework for managing crisis and predicting stakeholders’perceptions of organizations’ reputation in times of crisis. In order to verifythe applicability of the model in higher institutions of learning in adeveloping country context, a study was conducted in September, 2011 in twopublic universities in Nigeria. The findings of the study revealed thatalthough the institutions did not fully implement the core tenets of SCCT, thestrategies adopted in each of the two crisis situations were similar to some ofthe recommendations of the SCCT in different ways. While one institutionfocused on a strategy similar to what the SCCT model describes as “rebuildcrisis response strategy” with informing and adjusting tactics, the secondinstitution utilized a victimization or “Victimage” strategy with strongattribution of blames; and frequent reminder of the stakeholders of the extentof losses that the institution would incur from the crisis. The outcome wasthat the institution with high emphasis on rebuilding and informationadjustment strategy recorded very little damage to its reputation capital, duringand after the crises. Conversely, the second institution which believed invictimization and high attribution recorded significant losses in reputation assets,which included withdrawal of key stakeholders and loss of recognition ofprograms by some professional agencies. The implication for crisis managers in thetwo institutions includes the need to always approach situational crises in aholistic manner. Such holistic approach would involve a refocus, critical analysis,planning and implementation of crisis response strategies based on the relevantsituations, events, and the people concerned. The research was designed as acase study with focus group discussions as the data collection method

  16. Significance and basic patterns of risk communication; Bedeutung und Grundzuege der Risikokommunikation

    Energy Technology Data Exchange (ETDEWEB)

    Obermeier, O.P. [Gerling Akademie fuer Risikoforschung AG, Muenchen (Germany)]|[Gerling Akademie fuer Risikoforschung AG, Zurich (Switzerland)]|[Augsburg Univ. (Germany)

    1996-11-01

    The philosophically coloured paper on the aspects of risk communication patterns in society shows that debates about risks are governed by a number of stereotype characters representing the individualist and manager type, bureaucracy and law-and-order type, ego-centered embarrassment activist, and fundamentalist. Every risk-relevant group in the study tries to push forward its own interests. Risk communication is understood as a process of social dealing. (HP) [Deutsch] Die nahezu philosophischen Ueberlegungen zum Thema Risiko belegen, dass alle Risikodiskussionen von den Besitzindividualisten, Buerokraten, Betroffenheitsaktivisten und Fundamentalisten dominiert werden. Jede risikorelevante Gruppierung versucht ihre Gruppenegoismen durchzusetzen. Risikokommunikation wird als Prozess des sozialen Aushandelns aufgefasst. (HP)

  17. Toddlers with Early Behavioral Problems at Higher Family Demographic Risk Benefit the Most from Maternal Emotion Talk.

    Science.gov (United States)

    Brophy-Herb, Holly E; Bocknek, Erika London; Vallotton, Claire D; Stansbury, Kathy E; Senehi, Neda; Dalimonte-Merckling, Danielle; Lee, Young-Eun

    2015-09-01

    To test the hypothesis that toddlers at highest risk for behavioral problems from the most economically vulnerable families will benefit most from maternal talk about emotions. This study included 89 toddlers and mothers from low-income families. Behavioral problems were rated at 2 time points by masters-level trained Early Head Start home visiting specialists. Maternal emotion talk was coded from a wordless book-sharing task. Coding focused on mothers' emotion bridging, which included labeling emotions, explaining the context of emotions, noting the behavioral cues of emotions, and linking emotions to toddlers' own experiences. Maternal demographic risk reflected a composite score of 5 risk factors. A significant 3-way interaction between Time 1 toddler behavior problems, maternal emotion talk, and maternal demographic risk (p = .001) and examination of slope difference tests revealed that when maternal demographic risk was greater, more maternal emotion talk buffered associations between earlier and later behavior problems. Greater demographic risk and lower maternal emotion talk intensified Time 1 behavior problems as a predictor of Time 2 behavior problems. The model explained 54% of the variance in toddlers' Time 2 behavior problems. Analyses controlled for maternal warmth to better examine the unique contributions of emotion bridging to toddlers' behaviors. Toddlers at highest risk, those with more early behavioral problems from higher demographic-risk families, benefit the most from mothers' emotion talk. Informing parents about the use of emotion talk may be a cost-effective, simple strategy to support at-risk toddlers' social-emotional development and reduce behavioral problems.

  18. Unintended allergens in precautionary labelled and unlabelled products pose significant risks to UK allergic consumers

    NARCIS (Netherlands)

    Remington, B.C.; Baumert, J.L.; Blom, W.M.; Houben, G.F.; Taylor, S.L.; Kruizinga, A.G.

    2015-01-01

    Background Allergens in food may pose a risk to allergic consumers. While there is EU regulation for allergens present as an ingredient, this is not the case for unintended allergen presence (UAP). Food companies use precautionary allergen labels to inform allergic individuals of a potential risk

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  20. Retinopathy of prematurity: a review of risk factors and their clinical significance.

    Science.gov (United States)

    Kim, Sang Jin; Port, Alexander D; Swan, Ryan; Campbell, J Peter; Chan, R V Paul; Chiang, Michael F

    2018-04-19

    Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors. We review the existing literature addressing various possible ROP risk factors. Although there have been contradictory reports, and the risk may vary between different populations, understanding ROP risk factors is essential to develop predictive models, to gain insights into pathophysiology of retinal vascular diseases and diseases of prematurity, and to determine future directions in management of and research in ROP. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

    Directory of Open Access Journals (Sweden)

    Elsa S. Strotmeyer

    2011-01-01

    Full Text Available Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG ≥126 mg/dL. Peripheral artery disease (PAD was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9 and BMI ≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7, but similar for BMI ≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78. PAD (HR = 1.25 (95% CI: 0.92–1.57 and longer walk time (HR = 1.07 (95% CI: 1.04–1.10 modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57. Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.

  2. A quantitative approach for risk-informed safety significance categorization in option-2

    International Nuclear Information System (INIS)

    Ha, Jun Su; Seong, Poong Hyun

    2004-01-01

    OPTION-2 recommends that Structures, Systems, or Components (SSCs) of Nuclear Power Plants (NPPs) should be categorized into four groups according to their safety significance as well as whether they are safety-related or not. With changes to the scope of SSCs covered by 10 CFR 50, safety-related components which categorized into low safety significant SSC (RISC-3 SSC) can be exempted from the existing conservative burden (or requirements). As OPTION-2 paradigm is applied, a lot of SSCs may be categorized into RISC-3 SSCs. Changes in treatment of the RISC-3 SSCs will be recommended and then finally the recommended changes shall be evaluated. Consequently, before recommending the changes in treatment, probable candidate SSCs for the changes in treatment need to be identified for efficient risk-informed regulation and application (RIRA). Hence, in this work, a validation focused on the RISC-3 SSCs is proposed to identify probable candidate SSCs. Burden to Importance Ratio (BIR) is utilized as a quantitative measure for the validation. BIR is a measure representing the extent of resources or requirements imposed on a SSC with respect to the value of the importance measure of the SSC. Therefore SSCs having high BIR can be considered as probable candidate SSCs for the changes in treatment. In addition, the final decision whether RISC-3 SSCs can be considered as probable candidate SSCs or not should be made by an expert panel. For the effective decision making, a structured mathematical decision-making process is constructed based on Belief Networks (BBN) to overcome demerits of conventional group meeting based on unstructured discussion for decision-making. To demonstrate the usefulness of the proposed approach, the approach is applied to 22 components selected from 512 In-Service Test (IST) components of Ulchin unit 3. The results of the application show that the proposed approach can identify probable candidate SSCs for changes in treatment. The identification of the

  3. The significance of biological, environmental, and social risk factors for prostate cancer in a cohort study in Brazil

    Directory of Open Access Journals (Sweden)

    Frederico R. Romero

    2012-12-01

    Full Text Available Purpose To evaluate the significance of several risk factors for prostate cancer in a cohort of Brazilian men. Subjects and methods: Men ≥ 40 years-old participating in a prostate cancer screening program between December 2006 and April 2011 in the city of Curitiba, Brazil, were evaluated to determine the prevalence, relative risk (RR and 95% CI of prostate cancer according to age, race, ethnicity, family history of prostate cancer, educational level, and history of vasectomy, increased blood pressure, diabetes mellitus, and urethritis. Results In 2121 men included in this study, prostate cancer prevalence was 0.6% for men between 40-49 years versus 2.0% (adjusted RR = 2.58, 7.7% (adjusted RR = 5.76, and 8.4% (adjusted RR = 4.88 for men 50-59 years, 60-69 years, and ≥ 70 years, respectively (p 0.05; 6.1% in African descendants, in comparison to 3.0% in non-African descendants (adjusted RR = 3.17, p 0.05; and 4.8% in participants with incomplete elementary school level or lower, compared to 2.2% in men with complete elementary school level or higher education (adjusted RR = 1.85, p > 0.05. Men with/without history of vasectomy, increased blood pressure, diabetes, and urethritis had a prostate cancer prevalence of 0.8%/3.0% (adjusted RR = 0.23, p > 0.05, 3.8%/2.2% (adjusted RR = 1.16, p > 0.05, 3.7%/2.6% (adjusted RR = 1.39, p > 0.05, and 2.6%/2.6% (adjusted RR = 0.99, p > 0.05, respectively. Conclusions Risk factors associated with an increased prevalence of prostate cancer in this cohort included increasing age and African ethnicity.

  4. The Cancer of the Prostate Risk Assessment (CAPRA) in patients treated with external beam radiation therapy: Evaluation and optimization in patients at higher risk of relapse

    International Nuclear Information System (INIS)

    Halverson, Schuyler; Schipper, Matthew; Blas, Kevin; Lee, Vivien; Sabolch, Aaron; Olson, Karin; Sandler, Howard M.; Feng, Felix Y.; Hamstra, Daniel A.

    2011-01-01

    Background: The Cancer of the Prostate Risk Assessment (CAPRA) was developed to predict freedom from biochemical failure (FFBF) following radical prostatectomy (RP). Its utility following external beam radiation therapy (EBRT) has not been externally evaluated. Methods: A retrospective study of 612 patients treated with dose-escalated EBRT at University of Michigan Medical Center. Results: Compared to the derivation cohort, EBRT treated patients had higher-risk disease (28% with CAPRA of 6–10 vs. 5%, respectively). A total of 114 patients (19%) had BF with 5-year BF ranging from 7% with CAPRA 0–3 to 35% with CAPRA 7–10. For RT patients the risk of BF at 5-year was similar to 4 surgical cohorts for CAPRA scores 0–2 but lower for all CAPRA scores ⩾ 3. The difference favoring RT increased with increasing CAPRA score reaching a 27–50% absolute improved at 5-years for CAPRA scores of 6–10. On multivariate analysis each CAPRA point increased the risk of BF (p < 0.0001) while Gleason pattern 5 in the biopsy also increased BF (p = 0.01) and long-term androgen deprivation therapy (ADT) significantly reduced the risk of BF (p = 0.015). Conclusions: Compared to surgical series the risk of BF was lower with dose-escalated EBRT with the greatest difference at the highest CAPRA scores.

  5. Significant determinants of academic performance by new students enrolled in the higher distance education system of Ecuador. The case of the Universidad Técnica Particular de Loja

    Directory of Open Access Journals (Sweden)

    Luis F. Moncada Mora

    2011-12-01

    Full Text Available In this article we present the significant determiners of academic performance of new students enrolled in the higher distance education system of Ecuador. A description and correlation of the variables were undertaken to formalize the probabilistic model that confirms the positive, negative, individual and global effects.

  6. Stepping reaction time and gait adaptability are significantly impaired in people with Parkinson's disease: Implications for fall risk.

    Science.gov (United States)

    Caetano, Maria Joana D; Lord, Stephen R; Allen, Natalie E; Brodie, Matthew A; Song, Jooeun; Paul, Serene S; Canning, Colleen G; Menant, Jasmine C

    2018-02-01

    Decline in the ability to take effective steps and to adapt gait, particularly under challenging conditions, may be important reasons why people with Parkinson's disease (PD) have an increased risk of falling. This study aimed to determine the extent of stepping and gait adaptability impairments in PD individuals as well as their associations with PD symptoms, cognitive function and previous falls. Thirty-three older people with PD and 33 controls were assessed in choice stepping reaction time, Stroop stepping and gait adaptability tests; measurements identified as fall risk factors in older adults. People with PD had similar mean choice stepping reaction times to healthy controls, but had significantly greater intra-individual variability. In the Stroop stepping test, the PD participants were more likely to make an error (48 vs 18%), took 715 ms longer to react (2312 vs 1517 ms) and had significantly greater response variability (536 vs 329 ms) than the healthy controls. People with PD also had more difficulties adapting their gait in response to targets (poorer stepping accuracy) and obstacles (increased number of steps) appearing at short notice on a walkway. Within the PD group, higher disease severity, reduced cognition and previous falls were associated with poorer stepping and gait adaptability performances. People with PD have reduced ability to adapt gait to unexpected targets and obstacles and exhibit poorer stepping responses, particularly in a test condition involving conflict resolution. Such impaired stepping responses in Parkinson's disease are associated with disease severity, cognitive impairment and falls. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Fire increases the risk of higher soil N2O emissions from Mediterranean Macchia ecosystems

    DEFF Research Database (Denmark)

    Karhu, Kristiina; Dannenmann, M.; Kitzler, B.

    2015-01-01

    on climate change. However, the potential importance of indirect GHG emissions due to changes in soil biological and chemical properties after fire is less well known. Increased soil mineral nitrogen (N) concentrations after fire pose a risk for increased emissions of gaseous N, but studies on the post......-fire N2O production and soil N turnover rates (mineralization, nitrification, microbial immobilization, denitrification) are still rare. We determined N2O production, rates of N turnover and pathways for N2O production from the soil of burned and unburned plots of a Macchia shrubland in central Spain...... using a 15N labelling approach. Measurements were initiated before the controlled burning and continued for up to half a year after fire. Fire markedly increased the risk of N2O emissions from soil through denitrification (N2O production rate was 3 to ≈30 times higher in burned soils compared to control...

  8. Examination of risk significant configuration during low power and shutdown with ORION and PSA

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chul Kyu; Oh, Seung Jong [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2015-10-15

    This paper suggests an approach to calculate the increased CDF corresponding to Orange and Red states in ORION program and analyzed the result of calculation. This approach is expected to be useful for checking the adequacy of the LPSD PSA. And also, the result of this calculation can provide the information about which SSCs for certain SF are more sensitive to risk in particular POS. Defense-in-depth is a safety philosophy in which multiple lines of defense and conservative design and evaluation methods are applied to ensure the safety of the public. Based on this philosophy EPRI developed Outage Risk Assessment and Management (ORAM) program as a qualitative assessment to better manage the risk during low power and shutdown event after the Vogtle loss of vital AC power and RHR event in 1990. Each risk level of RED, ORANGE color status caused by the degradation of each key safety function might be different depend on the importance of each key safety function. However we can't know how much different. If we know the quantitative information about the risk level represented by color, we can take and prepare concrete actions to reduce the risk level of the plant with rescheduling maintenance, strengthen surveillance for important safety function, and developing outage management strategy. The probabilistic safety analysis for low power and shutdown period can provide risk information with quantitative value related on the degradation of redundancy and diversity level for the safety functions during outage. In this study, we calculated the increased Core Damage frequency (CDF) of each RED and ORANGE states in ORION program caused by the degradation of each key safety function by modifying LPSD PSA model. The result of calculation and analysis could be effective to check adequacy and find improvement for these two methods.

  9. Pregnant women carrying female fetuses are at higher risk of placental malaria infection.

    Directory of Open Access Journals (Sweden)

    Ishag Adam

    Full Text Available The pathophysiology of the placental malaria is not fully understood. If there is a fetal sex-specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections.This study was conducted to assess whether the sex of the fetus was associated with placental malaria infections.A cross-sectional study was performed including a secondary analysis of a cohort of women who were investigated for prevalence and risk factors (including fetal sex for placental malaria in eastern Sudan. Placental histology was used to diagnose placental malaria infections.Among 339 women enrolled, the mean (SD age was 25.8 (6.7 years and parity was 2.7 (2.2. Among the new born babies, 157 (46.3% were male and 182 (53.7% were female. Five (1.5%, 9 (2.7% and 103 (30.4% of the 339 placentas had active, active-chronic, past-chronic malaria infection on histopathology examination respectively, while 222 (65.5% of them showed no malaria infection. Logistic regression analyses showed no associations between maternal age or parity and placental malaria infections. Women who have blood group O (OR = 1.95, 95% CI = 1.19-3.10; P = 0.007 and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57-4.13; P< 0.001.Fetal gender may be a novel risk factor for placental malaria. In this work the female placentas were at higher risk for malaria infections than the male placentas.

  10. Low External Workloads Are Related to Higher Injury Risk in Professional Male Basketball Games

    Directory of Open Access Journals (Sweden)

    Toni Caparrós, Martí Casals, Álvaro Solana, Javier Peña

    2018-06-01

    Full Text Available The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs. Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6 and those running less or equal than 1.3 miles per game (lower workload (IRR, 6.42 ; 95% CI, 2.52-16.3 had a higher risk of injury during games (p < 0.01 in both cases. Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles.

  11. Communicating risk: news media reportage of a significant nuclear contamination incident in the UK

    International Nuclear Information System (INIS)

    Walker, G.P.; Macgill, S.M.

    1988-02-01

    The way the mass media reported a controversial discharge incident at British Nuclear Fuel's reprocessing plant at Sellafield in Cumbria in November 1983 is discussed. Apart from the Windscale fire in 1957 this was the most serious radiation incident at any nuclear installation in the United Kingdom. The aim of the study was to use that incident to develop a more complete understanding of the way information about risk is communicated through the news media. Two issues, in particular, are assessed. First, the accuracy of the reports of events and how factual, technical or scientific aspects of risk are portrayed through the news media. Secondly, risk evaluation is studied: what value judgements are made, what sentiments of alarm, danger and hazard are presented. (author)

  12. Higher morale is associated with lower risk of depressive disorders five years later among very old people.

    Science.gov (United States)

    Niklasson, Johan; Näsman, Marina; Nyqvist, Fredrica; Conradsson, Mia; Olofsson, Birgitta; Lövheim, Hugo; Gustafson, Yngve

    The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, pfive years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Interactions among Candidate Genes Selected by Meta-Analyses Resulting in Higher Risk of Ischemic Stroke in a Chinese Population.

    Directory of Open Access Journals (Sweden)

    Man Luo

    Full Text Available Ischemic stroke (IS is a multifactorial disorder caused by both genetic and environmental factors. The combined effects of multiple susceptibility genes might result in a higher risk for IS than a single gene. Therefore, we investigated whether interactions among multiple susceptibility genes were associated with an increased risk of IS by evaluating gene polymorphisms identified in previous meta-analyses, including methylenetetrahydrofolate reductase (MTHFR C677T, beta fibrinogen (FGB, β-FG A455G and T148C, apolipoprotein E (APOE ε2-4, angiotensin-converting enzyme (ACE insertion/deletion (I/D, and endothelial nitric oxide synthase (eNOS G894T. In order to examine these interactions, 712 patients with IS and 774 controls in a Chinese Han population were genotyped using the SNaPshot method, and multifactor dimensionality reduction analysis was used to detect potential interactions among the candidate genes. The results of this study found that ACE I/D and β-FG T148C were significant synergistic contributors to IS. In particular, the ACE DD + β-FG 148CC, ACE DD + β-FG 148CT, and ACE ID + β-FG 148CC genotype combinations resulted in higher risk of IS. After adjusting for potential confounding IS risk factors (age, gender, family history of IS, hypertension history and history of diabetes mellitus using a logistic analysis, a significant correlation between the genotype combinations and IS patients persisted (overall stroke: adjusted odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.22-2.02, P < 0.001, large artery atherosclerosis subtype: adjusted OR = 1.50, 95% CI: 1.08-2.07, P = 0.016, small-artery occlusion subtype: adjusted OR = 2.04, 95% CI: 1.43-2.91, P < 0.001. The results of this study indicate that the ACE I/D and β-FG T148C combination may result in significantly higher risk of IS in this Chinese population.

  14. Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan

    Directory of Open Access Journals (Sweden)

    Elbashir Mustafa I

    2011-08-01

    Full Text Available Abstract Background Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes. Methods This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb 11 g/dl, n = 303. Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW and stillbirth. Results There were 9578 deliveries at Kassala hospital, 4012 (41.8% women had anaemia and 303 (3.2% had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, P = 0.007. Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7, and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0. The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia. The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, P Conclusions The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.

  15. Higher risk of developing a subsequent migraine in adults with nonapnea sleep disorders: A nationwide population-based cohort study.

    Science.gov (United States)

    Harnod, Tomor; Wang, Yu-Chiao; Kao, Chia-Hung

    2015-05-01

    This nationwide population-based cohort study evaluated the effect of nonapnea sleep disorders (NSDs) on the subsequent development of a migraine. We identified 46,777 patients aged 20 years and older who were diagnosed with an NSD (ICD-9-CM: 307.4 or 780.5) and without coding for apnea-sleep disorders (ICD-9-CM: 780.51, 780.53, or 780.57) between 2000 and 2002 as the sleep disorder (SD) cohort. A comparison cohort of 93,552 people was enrolled. We calculated the adjusted hazard ratio (aHR) for developing a migraine (ICD-9-CM: 346) after adjusting for age, sex, comorbidity, and drug use. A Kaplan-Meier analysis was used to measure the cumulative incidence of a migraine between 2 curves until the end of 2011. The cumulative incidence of a migraine was significantly higher in the SD cohort. The aHR for developing a migraine in the SD cohort was 3.52 (95% CI=3.28-3.79). The risk of developing a migraine with an NSD was higher in men (aHR=4.31) than in women (aHR=3.35). The age-stratified effect of an NSD on developing a migraine was highest among patients aged 55 years and younger. Higher risks of developing a migraine were observed among the participants without any comorbidity and without any drug treatment for their insomnia. The findings of this population-based cohort study indicate a higher risk of developing a subsequent migraine in patients with an NSD, which could be considered an independent, predisposing factor for developing subsequent a migraine in adulthood. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Constructing a holistic approach to disaster risk reduction: the significance of focusing on vulnerability reduction.

    Science.gov (United States)

    Palliyaguru, Roshani; Amaratunga, Dilanthi; Baldry, David

    2014-01-01

    As a result of the increase in natural disaster losses, policy-makers, practitioners, and members of the research community around the world are seeking effective and efficient means of overcoming or minimising them. Although various theoretical constructs are beneficial to understanding the disaster phenomenon and the means of minimising losses, the disaster risk management process becomes less effective if theory and practice are set apart from one another. Consequently, this paper seeks to establish a relationship between two theoretical constructs, 'disaster risk reduction (DRR)' and 'vulnerability reduction', and to develop a holistic approach to DRR with particular reference to improving its applicability in practical settings. It is based on a literature review and on an overall understanding gained through two case studies of post-disaster infrastructure reconstruction projects in Sri Lanka and three expert interviews in Sri Lanka and the United Kingdom. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  17. An assessment of the risk significance of human errors in selected PSAs and operating events

    International Nuclear Information System (INIS)

    Palla, R.L. Jr.; El-Bassioni, A.

    1991-01-01

    Sensitivity studies based on Probabilistic Safety Assessments (PSAs) for a pressurized water reactor and a boiling water reactor are described. In each case human errors modeled in the PSAs were categorized according to such factors as error type, location, timing, and plant personnel involved. Sensitivity studies were then conducted by varying the error rates in each category and evaluating the corresponding change in total core damage frequency and accident sequence frequency. Insights obtained are discussed and reasons for differences in risk sensitivity between plants are explored. A separate investigation into the role of human error in risk-important operating events is also described. This investigation involved the analysis of data from the USNRC Accident Sequence Precursor program to determine the effect of operator-initiated events on accident precursor trends, and to determine whether improved training can be correlated to current trends. The findings of this study are also presented. 5 refs., 15 figs., 1 tab

  18. Secondhand smoke risk in infants discharged from an NICU: potential for significant health disparities?

    Science.gov (United States)

    Stotts, Angela L; Evans, Patricia W; Green, Charles E; Northrup, Thomas F; Dodrill, Carrie L; Fox, Jeffery M; Tyson, Jon E; Hovell, Melbourne F

    2011-11-01

    Secondhand smoke exposure (SHSe) threatens fragile infants discharged from a neonatal intensive care unit (NICU). Smoking practices were examined in families with a high respiratory risk infant (born at very low birth weight; ventilated > 12 hr) in a Houston, Texas, NICU. Socioeconomic status, race, and mental health status were hypothesized to be related to SHSe and household smoking bans. Data were collected as part of The Baby's Breath Project, a hospital-based SHSe intervention trial targeting parents with a high-risk infant in the NICU who reported a smoker in the household (N = 99). Measures of sociodemographics, smoking, home and car smoking bans, and depression were collected. Overall, 26% of all families with a high-risk infant in the NICU reported a household smoker. Almost half of the families with a smoker reported an annual income of less than $25,000. 46.2% of families reported having a total smoking ban in place in both their homes and cars. Only 27.8% families earning less than $25,000 reported having a total smoking ban in place relative to almost 60% of families earning more (p < .01). African American and Caucasian families were less likely to have a smoking ban compared with Hispanics (p < .05). Mothers who reported no smoking ban were more depressed than those who had a household smoking ban (p < .02). The most disadvantaged families were least likely to have protective health behaviors in place to reduce SHSe and, consequently, are most at-risk for tobacco exposure and subsequent tobacco-related health disparities. Innovative SHSe interventions for this vulnerable population are sorely needed.

  19. Angiotensin-converting enzyme genotype is not a significant genetic risk factor for idiopathic nephrotic syndrome in Croatian children.

    Science.gov (United States)

    Batinić, Danko; Sertić, Jadranka; Ćorić, Marijana; Konjevoda, Paško; Batinić, Danica; Milošević, Danko

    2015-01-01

    The association of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with idiopathic nephrotic syndrome (INS) is controversial. Only scarce information on European populations is available. The aim of the study was to investigate the distribution of the ACE gene I/D polymorphism and its impact on INS in children from Croatia. Ninety-five children with INS were investigated: 30 with minimal change disease (MCD), 35 with mesangial proliferative glomerulonephritis (MesPGN) and 30 with focal segmental glomerulosclerosis (FSGS). The control group consisted of 73 healthy adults. ACE gene was analyzed using the PCR method. The results were correlated with clinical features, renal morphology and response to immunosuppresive therapy. There was no correlation of ACE genotype with gender, age of the disease onset, level of proteinuria, presence of hematuria or hypertension, and GFR at onset of the disease. No statistically significant differences in ACE genotype or allele frequencies between the controls and whole group of patients, MCD group, MesPGN group, FSGS group, steroid sensitive (SS) patients, steroid resistant (SR) patients, as well as each other, were found, although DD genotype tended to be more frequent in FSGS patients, SR patients, and frequent relapsers. Among 11 children treated with cyclophosphamide the D allele was significantly higher among non-responders (p = 0.003). DD genotype is not a genetic risk factor for acquiring INS nor significant phenotype modifier regarding to clinical and pathohistological picture and response to steroids in Croatian children. The potential application of ACE genotyping in predicting cyclophosphamide response deserves further investigation. © 2015 S. Karger AG, Basel.

  20. Gender inequality in the risk of violence: material deprivation is linked to higher risk for adolescent girls.

    Science.gov (United States)

    Nasr, Inas; Sivarajasingam, Vaseekaran; Jones, Sarah; Shepherd, Jonathan

    2010-11-01

    To investigate the association between material deprivation and injury sustained in violence by adolescents aged 11-17 years. Computerised data relating to gender, attendance date and resident postcode of all patients aged 11-17 years who received treatment for violence-related injuries at seven emergency departments (ED) in South Wales over 12 months, 1 October 2005 to 30 September 2006, were studied. The resident populations, by electoral division of three unitary authorities in Wales, Cardiff, Swansea and Newport, were obtained from the NHS administrative register. The relationships between demographic variables and material deprivation as measured by the Townsend deprivation index were analysed. Altogether 699 (475 boys; 224 girls) adolescents aged 11-17 years resident in Cardiff, Swansea and Newport attended ED in South Wales following violence. Boys and girls living in the most deprived areas had higher assault injury rates compared with those living in the most affluent areas. In the context of sustaining violence-related injury, material deprivation affected girls aged 11-17 years to a much greater extent (Cardiff most deprived vs most affluent rate ratio 6.31, Swansea 10.11, Newport 2.90) than boys of the same age group (Cardiff most deprived vs most affluent rate ratio 2.02, Swansea 7.74, Newport 1.74). Material deprivation was associated with a higher risk of violence-related injury for adolescent girls compared with adolescent boys. Risk-taking behaviour for adolescent boys and girls may be different under different socioeconomic conditions. Violence prevention efforts should focus more on tackling neighbourhood inequalities, particularly those related to material deprivation in adolescent girls.

  1. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  2. Does vacuum delivery carry a higher risk of shoulder dystocia? Review and meta-analysis of the literature.

    Science.gov (United States)

    Dall'Asta, Andrea; Ghi, Tullio; Pedrazzi, Giuseppe; Frusca, Tiziana

    2016-09-01

    Vacuum extractor has been increasingly used over the last decades and is acknowledged as a risk factor for shoulder dystocia (SD). In this meta-analysis we assess the actual risk of SD following a vacuum delivery compared to spontaneous vaginal delivery (SVD) and forceps. Systematic literature search (English literature only) on MEDLINE, EMBASE, ScienceDirect, the Cochrane library and ClinicalTrials.gov conducted up to May 2015. Key search terms included: Operative/Vacuum/Forceps delivery [Mesh] and shoulder dystocia and subheadings. 2 stage-process study selection. We included only studies where data concerning the occurrence of SD following operative vaginal delivery were reported as adjusted odds ratio (AOR) and no significant difference in confounding factors for SD was recorded. Included trials clustered according to the delivery mode (1) vacuum vs. SVD, (2) forceps vs. vacuum. Methodological quality of each study evaluated with the Newcastle-Ottawa System (NOS). 87 potentially relevant papers. After applying inclusion and exclusion criteria only 7 were selected for the meta-analysis. Vacuum delivery appeared associated with a higher risk of SD than SVD in both fixed and random model (OR 2.87 and 2.98 respectively). No difference in the rate of SD was found between vacuum and forceps (p>0.05). Vacuum extractor carries an increased risk of SD compared with spontaneous vaginal delivery whereas the occurrence of SD does not seem to vary following vacuum or forceps. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Higher Caffeinated Coffee Intake Is Associated with Reduced Malignant Melanoma Risk: A Meta-Analysis Study.

    Directory of Open Access Journals (Sweden)

    Jibin Liu

    Full Text Available Several epidemiological studies have determined the associations between coffee intake level and skin cancer risk; however, the results were not yet conclusive. Herein, we conducted a systematic review and meta-analysis of the cohort and case-control studies for the association between coffee intake level and malignant melanoma (MM risk.Studies were identified through searching the PubMed and MEDLINE databases (to November, 2015. Study-specific risk estimates were pooled under the random-effects model.Two case-control studies (846 MM patients and 843 controls and five cohort studies (including 844,246 participants and 5,737 MM cases were identified. For caffeinated coffee, the pooled relative risk (RR of MM was 0.81 [95% confidential interval (95% CI = 0.68-0.97; P-value for Q-test = 0.003; I2 = 63.5%] for those with highest versus lowest quantity of intake. In the dose-response analysis, the RR of MM was 0.955 (95% CI = 0.912-0.999 for per 1 cup/day increment of caffeinated coffee consumption and linearity dose-response association was found (P-value for nonlinearity = 0.326. Strikingly, no significant association was found between the decaffeinated coffee intake level and MM risk (pooled RR = 0.92, 95% CI = 0.81-1.05; P-value for Q-test = 0.967; I2 = 0%; highest versus lowest quantity of intake.This meta-analysis suggested that caffeinated coffee might have chemo-preventive effects against MM but not decaffeinated coffee. However, larger prospective studies and the intervention studies are warranted to confirm these findings.

  4. Determining significant endpoints for ecological risk analyses. 1998 annual progress report

    Energy Technology Data Exchange (ETDEWEB)

    Hinton, T.G.; Congdon, J.; Scott, D. [Univ. of Georgia, Aiken, SC (US). Savannah River Ecology Lab.; Rowe, C. [Univ. of Puerto Rico, San Juan (PR); Bedford, J.; Whicker, W. [Colorado State Univ., Fort Collins, CO (US)

    1998-06-01

    'The goal of this report is to establish a protocol for assessing risks to non-human populations exposed to environmental stresses typically found on many DOE sites. The authors think that they can achieve this by using novel biological dosimeters in controlled, manipulative dose/effects experiments, and by coupling changes in metabolic rates and energy allocation patterns to meaningful population response variables (such as age-specific survivorship, reproductive output, age at maturity and longevity). This research is needed to determine the relevancy of sublethal cellular damage to the performance of individuals and populations exposed to chronic, low-level radiation, and radiation with concomitant exposure to chemicals. They believe that a scientifically defensible endpoint for measuring ecological risks can only be determined once its understood the extent to which molecular damage from contaminant exposure is detrimental at the individual and population levels of biological organization. The experimental facility will allow them to develop a credible assessment tool for appraising ecological risks, and to evaluate the effects of radionuclide/chemical synergisms on non-human species. This report summarizes work completed midway of a 3-year project that began in November 1996. Emphasis to date has centered on three areas: (1) developing a molecular probe to measure stable chromosomal aberrations known as reciprocal translocations, (2) constructing an irradiation facility where the statistical power inherent in replicated mesocosms can be used to address the response of non-human organisms to exposures from low levels of radiation and metal contaminants, and (3) quantifying responses of organisms living in contaminated mesocosms and field sites.'

  5. Duplications of the Neuropeptide Receptor VIPR2 Confer Significant Risk for Schizophrenia

    OpenAIRE

    Vacic, Vladimir; McCarthy, Shane; Malhotra, Dheeraj; Murray, Fiona; Chou, Hsun-Hua; Peoples, Aine; Makarov, Vladimir; Yoon, Seungtai; Bhandari, Abhishek; Corominas, Roser; Iakoucheva, Lilia M.; Krastoshevsky, Olga; Krause, Verena; Larach-Walters, Verónica; Welsh, David K.

    2011-01-01

    PUBLISHED PMID:21346763 Rare copy number variants (CNVs) play a prominent role in the etiology of schizophrenia and other neuropsychiatric disorders 1 . Substantial risk for schizophrenia is conferred by large (>500 kb) CNVs at several loci, including microdeletions at 1q21.1 2 , 3q29 3 , 15q13.3 2 and 22q11.2 4 and microduplication at 16p11.2 5 . However, these CNVs collectively account for a small fraction (2-4%) of cases, and the relevant ...

  6. Prognostic significance of smoking in addition to established risk factors in patients with Dukes B and C colorectal cancer: a retrospective analysis.

    Science.gov (United States)

    Diamantis, N; Xynos, I D; Amptulah, S; Karadima, M; Skopelitis, H; Tsavaris, N

    2013-01-01

    To investigate the prognostic significance of smoking in addition to established risk factors in patients with Dukes stage B and C colorectal cancer (CRC). 291 consecutive non-selected CRC patients were studied retrospectively. Twenty-three variables were examined using a regression statistical model to identify relevant prognostic factors related to disease free survival (DFS) and overall survival (OS). On multivariate analysis DFS was found to be negatively affected in patients with a smoking history of ≤10 pack-years vs. non-smokers (p<0.016). Additionally, performance status (PS)<90 (p<0.001), Dukes stage C (p<0.001) and elevated tumor markers (p<0.001) at the time of diagnosis were found to adversely affect DFS. Smoking also had a significant association with relapse. Patients with a smoking history of ≤10 pack-years had 2.45 (p<0.018) higher risk of recurrence compared to patients with no smoking history. OS was influenced by Karnofsky performance status (PS), Dukes stage, and elevated tumor markers. In particular patients with PS< 90 had a 4.69-fold higher risk of death (p<0.001) than patients with better PS. Stage C disease was associated with 2.27-fold higher risk of death (p<0.001) than stage B disease, and patients with elevated tumor markers at the time of diagnosis had 2.74-fold higher risk of death (p<0.014) when compared to those whose tumor markers were normal at presentation. Our study associates smoking and relapse incidence in non-clinical- trial CRC patients and reiterates the prognostic significance of PS, stage and tumor markers at the time of diagnosis.

  7. Normal LVEF measurements are significantly higher in females asassessed by post-stress resting Tc-99m sestamibi gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Kim, Jong Ho; Shin, Eak Kyun

    1999-01-01

    Volume-LVEF relationship is one of the most important factors of automatic EF quantification algorithm from gated myocardial perfusion SPECT(gMPS) (Germano et al. JNM, 1995). Gender difference whereby normal LVEF measurements are higher in females assessed by gMPS (Yao et al. JNM 1997). To validate true physiologic value of LVEF vs sampling or measured error, various parameters were evaluated statistically in both gender and age matched 200 subjects (mean age= 58.41±15.01) with normal LVEF more than 50%, and a low likelihood of coronary artery disease. Correlation between LVEDVi(ml/m2) and LVEF was highly significant (r=-0.62, p<0.0001) with similar correlations noted in both male (r=-0.45, p<0.0001) and female (r=-0.67, p<0.0001) subgroups. By multivariate analysis, LV volume and stroke volume was the most significant factor influencing LVEF in male and female, respectively. In conclusion, there is a significant negative correlation between LV volume and LVEF as measured by Tc-99m gated SPECT. Higher normal LVEF value should be applied to females as assessed by post-stress resting Tc-99m Sestamibi gated myocardial perfusion SPECT

  8. Higher visceral fat area increases the risk of vitamin D insufficiency and deficiency in Chinese adults.

    Science.gov (United States)

    Zhang, Meilin; Li, Ping; Zhu, Yufeng; Chang, Hong; Wang, Xuan; Liu, Weiqiao; Zhang, Yuwen; Huang, Guowei

    2015-01-01

    Visceral fat area (VFA), a novel sex-specific index for visceral fat obesity (VFO) might play a major role in the development of vitamin D deficiency. However, the association between VFA and vitamin D insufficiency and deficiency in Chinese population is less clear. The aim of this study was to explore the population-level association between VFA and vitamin D insufficiency and deficiency among Chinese men and women. This cross-sectional study involved 1105 adults aged 20-70 years living in Tianjin who were randomly selected and medically examined. All subjects underwent the bioelectrical impedance analysis (BIA) method to estimate the VFA. Serum 25-hydroxyvitamin D3 (25(OH) D3) level was assayed by the high-performance liquid chromatography (HPLC) method and defined insufficiency and deficiency following recommended cutoffs. The association between VFA and vitamin D insufficiency and deficiency was estimated using binary regression analysis. The total prevalence of vitamin D insufficiency (25(OH) D3: 20-29 μg/L) and deficiency (25(OH) D3  0.05). Moreover, increased VFA was observed to be associated with higher vitamin D insufficiency or deficiency risk with a positive dose-response trend (P for trend convenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of vitamin D insufficiency and deficiency in routine health examination.

  9. Two significant experiences related to radon in a high risk area in Spain

    International Nuclear Information System (INIS)

    Sainz, C.; Gutierrez-Villanueva, J.-L.; Fuente, I.; Quindos, L.; Soto, J.; Quindos-Poncela, L.S.; Arteche, J.-L.

    2010-01-01

    Radon is a natural radioactive gas and it is currently accepted as being responsible for lung cancer in some cases. One of the most important sources of indoor radon is from the soil. The RADON content of soil is also a very important factor to be taken into account. The natural radiation map of Spain (MARNA) classifies the country into three regions with different levels of natural gamma radiation. There are some areas in Spain with high levels of natural radiation one of those is the province of Salamanca. Western part of this province presents a population of 20 000 inhabitants and 7% of the houses have an indoor radon concentration above 400 Bq·m -3 . In this high risk area, the village of Villar de la Yegua is of special interest: 11% of the houses in this village have an indoor radon level below 400 Bq·m -3 , 89% have above 400 Bq·m -3 and 71% of the houses have a radon concentration above 1000 Bq·m -3 . An old uranium mine site close to this village has been selected for the construction of an experimental pilot house. It is a two story house located in the place with a very high 226 Ra concentration in soil. Radon in soil at 1 m depth has an average level of 250 kBq·m -3 . We present in this work the characteristics of the experimental unit located in this high risk area and we describe the zone where one of the Spanish villages with the highest radon concentration is located. This is a very interesting place for further research on indoor radon concentration and it is a unique opportunity of testing radon monitors, radon passive detectors and remedial actions for the mitigation of radon in real conditions. It is common to carry out intercomparison exercises under laboratory conditions. Nonetheless, it is not so common to develop these exercises in real conditions as we have in the experimental unit we present here. We offer in this work the possibility for other research groups of testing their equipment in this unit and we also show the evolution of

  10. Women undergoing aortic surgery are at higher risk for unplanned readmissions compared with men especially when discharged home.

    Science.gov (United States)

    Flink, Benjamin J; Long, Chandler A; Duwayri, Yazan; Brewster, Luke P; Veeraswamy, Ravi; Gallagher, Katherine; Arya, Shipra

    2016-06-01

    Women undergoing vascular surgery have higher morbidity and mortality. Our study explores gender-based differences in patient-centered outcomes such as readmission, length of stay (LOS), and discharge destination (home vs nonhome facility) in aortic aneurysm surgery. Patients were identified from the American College of Surgeons National Surgical Quality Improvement Project database (2011-2013) undergoing abdominal, thoracic, and thoracoabdominal aortic aneurysms (N = 17,763), who were discharged and survived their index hospitalization. The primary outcome was unplanned readmission, and secondary outcomes were discharge to a nonhome facility, LOS, and reasons for unplanned readmission. Univariate, multivariate, and stratified analyses based on gender and discharge destination were used. Overall, 1541 patients (8.7%) experienced an unplanned readmission, with a significantly higher risk in women vs men (10.8% vs 8%; P women compared with men persisted in multivariate analysis after controlling for covariates (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.05-1.4). Similarly, the rate of discharge to a nonhome facility was nearly double in women compared with men (20.6% vs 10.7%; P women compared with men occurred in patients who were discharged home (OR, 1.2; 95% CI, 1.02-1.4) but not in those who were discharged to a nonhome facility (OR, 1.06; 95% CI, 0.8-1.4). Significant differences in LOS were seen in patients who were discharged home. No gender differences were found in reasons for readmission with the three most common reasons being thromboembolic events, wound infections, and pneumonia. Gender disparity exists in the risk of unplanned readmission among aortic aneurysm surgery patients. Women who were discharged home have a higher likelihood of unplanned readmission despite longer LOS than men. These data suggest that further study into the discharge planning processes, social factors, and use of rehabilitation services is needed for women

  11. Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit.

    Science.gov (United States)

    Sakr, Yasser; Rubatto Birri, Paolo Nahuel; Kotfis, Katarzyna; Nanchal, Rahul; Shah, Bhagyesh; Kluge, Stefan; Schroeder, Mary E; Marshall, John C; Vincent, Jean-Louis

    2017-03-01

    Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. Observational cohort study. Seven hundred and thirty ICUs in 84 countries. All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.

  12. Poor glycemic control of diabetes mellitus is associated with higher risk of prostate cancer detection in a biopsy population.

    Directory of Open Access Journals (Sweden)

    Juhyun Park

    Full Text Available To evaluate the impact of glycemic control of diabetes mellitus (DM on prostate cancer detection in a biopsy population.We retrospectively reviewed the records of 1,368 men who underwent prostate biopsy at our institution. We divided our biopsy population into three groups according to their history of DM, and their Hemoglobin A1c (HbA1c level: a no-DM (DM- group; a good glycemic control (DM+GC group (HbA1c <6.5%; and a poor glycemic control (DM+PC group (HbA1c ≥6.5%. For sub-analyses, the DM+PC group was divided into a moderately poor glycemic control (DM+mPC group (6.5≤ HbA1c <7.5% and a severely poor glycemic control (DM+sPC group (HbA1c ≥7.5%.Among 1,368 men, 338 (24.7% had a history of DM, and 393 (28.7% had a positive biopsy. There was a significant difference in prostatic specific antigen density (PSAD (P = 0.037 and the frequency of abnormal DRE findings (P = 0.031 among three groups. The occurrence rate of overall prostate cancer (P<0.001 and high-grade prostate cancer (P = 0.016 also presented with a significantly difference. In the multivariate analysis, the DM+PC group was significantly associated with a higher rate of overall prostate cancer detection in biopsy subjects compared to the DM- group (OR = 2.313, P = 0.001 but the DM+PC group was not associated with a higher rate of high-grade (Gleason score ≥7 diseases detected during the biopsy (OR = 1.297, P = 0.376. However, in subgroup analysis, DM+sPC group was significantly related to a higher risk of high-grade diseases compared to the DM- group (OR = 2.446, P = 0.048.Poor glycemic control of DM was associated with a higher risk of prostate cancer detection, including high-grade disease, in the biopsy population.

  13. [Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

    Science.gov (United States)

    Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

    2014-01-01

    Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

  14. Dietary patterns and significance of nutrition for women with low-risk pregnancy

    Directory of Open Access Journals (Sweden)

    Natália Sales de CARVALHO

    Full Text Available ABSTRACT Objective: To evaluate dietary patterns and significance of diet for pregnant women. Methods: Cross-sectional study carried out in eight health units in Fortaleza, Ceará, Brazil, with 201 pregnant women. The following instruments were used: a socio-economic and health questionnaire, the Free-Word Association Test, and a Food Frequency Questionnaire. Dietary patterns were identified using principal components and factor analysis. Poisson regression with 5% significance level was used. Results: Three dietary patterns were identified: current Brazilian pattern (beans, rice, processed meats, fats, refined grains, pasta and pastries, soft drink, sugar and sweets, cookies and crackers; healthy pattern (fruits and fruit juices, vegetables, whole grains, seafood, dairy products; and energy-rich pattern (salty deep-fried snacks, popcorn, packaged snacks, instant noodles, tubers, and chicken. Women who did not receive nutrition guidance during prenatal care showed less chance of adherence to the current Brazilian dietary pattern (PR=0.87, and therefore their level of consumption of foods commonly present in Brazilian diets was low. For most women, the significance of diet was reported as important and healthy, but it was not associated with any of the diet patterns identified. However, the women who did not consider that during pregnancy diet should be healthy showed greater chance of adherence to the energy-rich pattern (PR=1.18. This finding deserves special attention since excessive weight gain can have a negative effect on pregnancy. Conclusion: Nutrition guidance during prenatal care and the way pregnant women perceive their eating habits can influence their food choices during pregnancy.

  15. A significant association between BDNF promoter methylation and the risk of drug addiction.

    Science.gov (United States)

    Xu, Xuting; Ji, Huihui; Liu, Guili; Wang, Qinwen; Liu, Huifen; Shen, Wenwen; Li, Longhui; Xie, Xiaohu; Zhou, Wenhua; Duan, Shiwei

    2016-06-10

    As a member of the neurotrophic factor family, brain derived neurotrophic factor (BDNF) plays an important role in the survival and differentiation of neurons. The aim of our work was to evaluate the role of BDNF promoter methylation in drug addiction. A total of 60 drug abusers (30 heroin and 30 methylamphetamine addicts) and 52 healthy age- and gender-matched controls were recruited for the current case control study. Bisulfite pyrosequencing technology was used to determine the methylation levels of five CpGs (CpG1-5) on the BDNF promoter. Among the five CpGs, CpG5 methylation was significantly lower in drug abusers than controls. Moreover, significant associations were found between CpG5 methylation and addictive phenotypes including tension-anxiety, anger-hostility, fatigue-inertia, and depression-dejection. In addition, luciferase assay showed that the DNA fragment of BDNF promoter played a key role in the regulation of gene expression. Our results suggest that BDNF promoter methylation is associated with drug addiction, although further studies are needed to understand the mechanisms by which BDNF promoter methylation contributes to the pathophysiology of drug addiction. Copyright © 2016. Published by Elsevier B.V.

  16. Public safety risk management at socio-economic and / or historic-cultural significant dam sites

    Energy Technology Data Exchange (ETDEWEB)

    Earle, Gordon D.; Ryan, Katherine; Pyykonen, Nicole K.; Pitts, Lucas [Otonabee Region Conservation Authority, Peterborough, (Canada)

    2010-07-01

    The Lang Dam and adjoining gristmill, located near Peterborough are integral parts of the Lang Pioneer Village museum. Activities occurring within close proximity to the dam have led to safety issues. The owner (ORCA) has developed and implemented public safety management plans (PSMPs) for each of its water control structures, including the Lang Dam. ORCA gave special attention to the social, economic, aesthetic, historic and cultural dimensions associated the implementation of public safety management plans. These factors play a significant role in how well public safety measures (PSMs) are received by stakeholder groups and the general public. This paper reported the challenges of developing and implementing a PSMP for the Lang Dam, with the focus on property site-specific PSMS while preserving socio-economic and historic-cultural character and values. It was demonstrated that the dam owners, regulatory authorities, control agencies and preservationists need to come together to develop a holistic public safety management process.

  17. Interim data monitoring to enroll higher-risk participants in HIV prevention trials

    Directory of Open Access Journals (Sweden)

    Umo-Otong John

    2009-06-01

    Full Text Available Abstract Background Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. Methods We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. Results A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. Conclusion Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. Trial Registration The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770

  18. Carboxyhemoglobin levels as a predictor of risk for significant hyperbilirubinemia in African-American DAT(+) infants.

    Science.gov (United States)

    Schutzman, D L; Gatien, E; Ajayi, S; Wong, R J

    2016-05-01

    To compare the degree of hemolysis in a group of direct antiglobulin test (DAT) positive (pos) African-American (AA) infants as measured by carboxyhemoglobin corrected (COHbc) for carbon monoxide in ambient air to a similar group of DAT negative (neg) ABO incompatible infants and a group without blood group incompatibility. To determine if COHbc is a better predictor of significant hyperbilirubinemia than DAT status. A prospective study of 180 AA infants from the Well-Baby Nursery of an inner city community hospital, all of whose mothers were type O pos. Infants (60) were ABO incompatible DAT pos, 60 were ABO incompatible DAT neg and 60 were type O(+). Blood for COHbc was drawn at the time of the infants' initial bilirubin and the infants' precise percentile on the Bhutani nomogram was calculated. Mean COHbc of type O(+) infants was 0.76±0.21 and 0.78±0.24% for ABO incompatible DAT neg infants (P=0.63). Mean CoHbc for the ABO incompatible DAT pos infants was 1.03±0.41% (P0.90% (area under the curve(AUC) 0.8113). This was similar to the AUC of the receiver operating characteristic curve using any titer strength of DAT pos as a cutoff (0.7960). Although not greatly superior to the titer strength of DAT pos, COHbc is useful in determining if the etiology of severe hyperbilirubinemia is a hemolytic process.

  19. Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome: Prospective Analysis of the SUN Cohort

    Directory of Open Access Journals (Sweden)

    Amaya Lopez-Pascual

    2017-01-01

    Full Text Available Living in a geographically higher altitude affects oxygen availability. The possible connection between environmental factors and the development of metabolic syndrome (MetS feature is not fully understood, being the available epidemiological evidence still very limited. The aim of the present study was to evaluate the longitudinal association between altitude and incidence of MetS and each of its components in a prospective Spanish cohort, The Seguimiento Universidad de Navarra (SUN project. Our study included 6860 highly educated subjects (university graduates free from any MetS criteria at baseline. The altitude of residence was imputed with the postal code of each individual subject residence according to the data of the Spanish National Cartographic Institute and participants were categorized into tertiles. MetS was defined according to the harmonized definition. Cox proportional hazards models were used to assess the association between the altitude of residence and the risk of MetS during follow-up. After a median follow-up period of 10 years, 462 incident cases of MetS were identified. When adjusting for potential confounders, subjects in the highest category of altitude (>456 m exhibited a significantly lower risk of developing MetS compared to those in the lowest tertile (<122 m of altitude of residence [Model 2: Hazard ratio = 0.75 (95% Confidence interval: 0.58–0.97; p for trend = 0.029]. Living at geographically higher altitude was associated with a lower risk of developing MetS in the SUN project. Our findings suggest that geographical elevation may be an important factor linked to metabolic diseases.

  20. Higher tier field research in ecological risk assessment: a case study

    Energy Technology Data Exchange (ETDEWEB)

    Faber, J. [Alterra, Wageningen (Netherlands)

    2003-07-01

    A newly developed basic procedure for site-specific ecological risk assessment in The Netherlands was followed in practice for the first time. In line with conventional Triade approaches, the procedure includes multidisciplinary parameters from environmental chemistry, toxicology and ecology to provide multiple weight of evidence. However, land use at the contaminated site and its vicinity is given more importance, and research parameters are selected in accordance to specific objectives for land use in order to test for harmful effects to underlying ecosystem services. Moreover, the approach is characterized by repetitive interactions between stakeholders and researching consultants, in particular with respect to the choice of parameters and criteria to assess the results. The approach was followed in an ecological risk assessment to test the assumptions underlying a soil management plant for a rural area in The Netherlands, called 'Krimpenerwaard'. Throughout this region some 5000 polder ditches have been filled with waste materials originating from local households, waterway sludge, industrial wastes, car shredders, and more. Several sites are severely polluted by heavy metals, cyanide, PAH or chlorinated hydrocarbons and require remediation or clean up. However, the exact distribution of these wastes over the entire region is scarcely known, and the Krimpenerwaard as a whole is treated as one case of serious soil pollution. A soil management plan was constructed by 13 stakeholding parties, aiming for a 'functional clean up' in view of land use, by means of covering 'suspected' categories of wastes with a 30-cm layer of local type soil. The ecological risk assessment aims to verify the assumptions in the soil management plan regarding the prevention of possible undesirable effects induced by the various waste materials. A tiered approach is followed, including a screening for bioavailable contaminants, a testing for general effects

  1. ON THE EMPIRICAL FINDING OF A HIGHER RISK OF POVERTY IN RURAL AREAS: IS RURAL RESIDENCE ENDOGENOUS TO POVERTY?

    OpenAIRE

    Fisher, Monica G.

    2004-01-01

    Includes: On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?:COMMENT, by Thomas A. Hirschl; On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?: REPLY, by Monica Fisher. Research shows people are more likely to be poor in rural versus urban America. Does this phenomenon partly reflect that people who choose rural residence have unmeasured attributes related to human impoveris...

  2. Clinical significance of methicillin-resistant Staphylococcus aureus colonization on hospital admission: one-year infection risk.

    Directory of Open Access Journals (Sweden)

    Jessica P Ridgway

    Full Text Available BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA nasal colonization among inpatients is a well-established risk factor for MRSA infection during the same hospitalization, but the long-term risk of MRSA infection is uncertain. We performed a retrospective cohort study to determine the one-year risk of MRSA infection among inpatients with MRSA-positive nasal polymerase chain reaction (PCR tests confirmed by positive nasal culture (Group 1, patients with positive nasal PCR but negative nasal culture (Group 2, and patients with negative nasal PCR (Group 3. METHODOLOGY/PRINCIPAL FINDINGS: Subjects were adults admitted to a four-hospital system between November 1, 2006 and March 31, 2011, comprising 195,255 admissions. Patients underwent nasal swab for MRSA PCR upon admission; if positive, nasal culture for MRSA was performed; if recovered, MRSA was tested for Panton-Valentine Leukocidin (PVL. Outcomes included MRSA-positive clinical culture and skin and soft tissue infection (SSTI. Group 1 patients had a one-year risk of MRSA-positive clinical culture of 8.0% compared with 3.0% for Group 2 patients, and 0.6% for Group 3 patients (p<0.001. In a multivariable model, the hazard ratios for future MRSA-positive clinical culture were 6.52 (95% CI, 5.57 to 7.64 for Group 1 and 3.40 (95% CI, 2.70 to 4.27 for Group 2, compared with Group 3 (p<0.0001. History of MRSA and concurrent MRSA-positive clinical culture were significant risk factors for future MRSA-positive clinical culture. Group 1 patients colonized with PVL-positive MRSA had a one-year risk of MRSA-positive clinical culture of 10.1%, and a one-year risk of MRSA-positive clinical culture or SSTI diagnosis of 21.7%, compared with risks of 7.1% and 12.5%, respectively, for patients colonized with PVL-negative MRSA (p = 0.04, p = 0.005, respectively. CONCLUSIONS/SIGNIFICANCE: MRSA nasal colonization is a significant risk factor for future MRSA infection; more so if detected by

  3. Prevalence of conventional risk factors and lipid profiles in patients with acute coronary syndrome and significant coronary disease

    Directory of Open Access Journals (Sweden)

    González-Pacheco H

    2014-10-01

    Full Text Available Héctor González-Pacheco,1 Jesús Vargas-Barrón,2 Maite Vallejo,2 Yigal Piña-Reyna,3 Alfredo Altamirano-Castillo,1 Pedro Sánchez-Tapia,1 Carlos Martínez-Sánchez1 1Coronary Care Unit, National Institute of Cardiology in Mexico City, Mexico City, Mexico; 2Department of Clinical Research, National Institute of Cardiology in Mexico City, Mexico City, Mexico; 3Catheterization Laboratory, National Institute of Cardiology in Mexico City, Mexico City, Mexico Background: Among patients with coronary artery disease (CAD, 80%–90% present at least one conventional risk factor. On the other hand, lipid profile modification after a cardiovascular event related to acute coronary syndrome (ACS has been recognized. The prevalence of conventional risk factors and the lipid profile at the time of admission in patients with ACS and significant CAD (stenosis ≥50% determined through coronary angiography is not well described. Methods: We studied 3,447 patients with a diagnosis of ACS and significant CAD with stenosis ≥50%, as shown on angiography. We recorded the presence of conventional risk factors, including smoking, hypertension, dyslipidemia, and diabetes. In addition, we analyzed the lipid profiles within the first 24 hours of admission. We analyzed the studied population and compared findings according to sex.Results: Most patients (81.7% were male. ST-elevation myocardial infarction was present in 51.3% of patients, and non-ST-elevation acute coronary syndrome was present in 48.7%. The most frequent risk factor was smoking, which was present in 68% of patients, followed by hypertension (57.8%, dyslipidemia (47.5%, and diabetes (37.7%. In women, the most frequent risk factors were hypertension, diabetes, and dyslipidemia, whereas in men, smoking was the most frequent. We identified at least one risk factor in 95.7% of all patients, two or three risk factors in 62%, and four risk factors in 8.6% of patients. The lipid profile analysis revealed that

  4. Asian Adolescents with Excess Weight are at Higher Risk for Insulin Resistance than Non-Asian Peers.

    Science.gov (United States)

    Elsamadony, Ahmed; Yates, Kathy F; Sweat, Victoria; Yau, Po Lai; Mangone, Alex; Joseph, Adriana; Fierman, Arthur; Convit, Antonio

    2017-11-01

    The purpose of this study was to evaluate whether Asian American adolescents have higher metabolic risk from excess weight than non-Asians. Seven hundred thirty-three students, aged 14 to 19 years old, completed a school-based health screening. The 427 Asian and 306 non-Asian students were overall equivalent on age, sex, and family income. Height, weight, waist circumference, percent body fat, and blood pressure were measured. Fasting triglycerides, high- and low-density lipoproteins, glucose, and insulin levels were measured. Asian and non-Asians in lean or overweight/obesity groups were contrasted on the five factors that make up the metabolic syndrome. Asian adolescents carrying excess weight had significantly higher insulin resistance (IR), triglyceride levels, and waist-height ratios (W/H), despite a significantly lower overall BMI than corresponding non-Asians. Similarly, Asians had a stronger relationship between W/H and the degree of IR than non-Asian counterparts; 35% and 18% of the variances were explained (R 2  = 0.35, R 2  = 0.18) respectively, resulting in a significant W/H by racial group interaction (F change [1,236] = 11.56, P Asians have higher IR and triglyceride levels from excess weight than their non-Asian counterparts. One-size-fits-all public health policies targeting youth should be reconsidered and attention paid to Asian adolescents, including those with mild degrees of excess weight. © 2017 The Obesity Society.

  5. The ratio of nurse consultation and physician efficiency index of senior rheumatologists is significantly higher than junior physicians in rheumatology residency training

    DEFF Research Database (Denmark)

    Emamifar, Amir; van Bui Hansen, Morten Hai; Jensen Hansen, Inger Marie

    2017-01-01

    To elucidate the difference between ratios of nurse consultation sought by senior rheumatologists and junior physicians in rheumatology residency training, and also to evaluate physician efficiency index respecting patients with rheumatoid arthritis (RA). Data regarding outpatient visits for RA...... patients between November 2013 and 2015 were extracted. The mean interval (day) between consultations, the nurse/physician visits ratio, and physician efficiency index (nurse/physician visits ratio × mean interval) for each senior and junior physicians were calculated. Disease Activity Score in 28 joints....../physician visits ratio (P = .01) and mean efficiency index (P = .04) of senior rheumatologists were significantly higher than that of junior physicians. Regression analysis showed a positive correlation between physician postgraduate experience and physician efficiency index adjusted for DAS28 at baseline...

  6. High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital.

    Science.gov (United States)

    Popman, Amy; Richter, Marilize; Allen, Jacqueline; Wham, Carol

    2018-02-01

    To establish the prevalence of nutrition risk and associated risk factors among adults of advanced age newly admitted to hospital. A cross-sectional study was undertaken in adults aged over 85 years admitted to one of two hospital wards in Auckland within the previous 5 days. An interviewer-administered questionnaire was used to establish participant's socio-demographic and health characteristics. Markers of body composition and muscle strength were collected. Nutrition risk was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), dysphagia risk using the 10-Item Eating Assessment Tool (EAT-10) and level of cognition using the Montreal Cognitive Assessment. A total of 88 participants with a mean age of 90.0 ± 3.7 years completed the assessments. A third (28.4%) of the participants were categorised by the MNA-SF as malnourished and 43.2% were classified at risk of malnutrition. A third (29.5%) were at risk of dysphagia as assessed by EAT-10. Malnourished participants were more likely to be at risk of dysphagia (P = 0.015). The MNA-SF score was positively correlated with body mass index (r = 0.484, P strength (r = 0.250, P = 0.026) and negatively correlated with risk of dysphagia (r = -0.383, P strength and negatively correlated with dysphagia risk. Findings highlight the importance of screening for dysphagia risk, especially in those identified to be malnourished or at nutrition risk. © 2017 Dietitians Association of Australia.

  7. Higher relative, but lower absolute risks of myocardial infarction in women than in men

    DEFF Research Database (Denmark)

    Reuterwall, C; Hallqvist, J; Ahlbom, A

    1999-01-01

    Middle-aged men have often been the subjects of multifactorial studies of myocardial infarction (MI) risk factors. One major objective of the SHEEP study was to compare the effects of different MI risk factors in women and men.......Middle-aged men have often been the subjects of multifactorial studies of myocardial infarction (MI) risk factors. One major objective of the SHEEP study was to compare the effects of different MI risk factors in women and men....

  8. Patients with Duchenne muscular dystrophy are significantly shorter than those with Becker muscular dystrophy, with the higher incidence of short stature in Dp71 mutated subgroup.

    Science.gov (United States)

    Matsumoto, Masaaki; Awano, Hiroyuki; Lee, Tomoko; Takeshima, Yasuhiro; Matsuo, Masafumi; Iijima, Kazumoto

    2017-11-01

    Duchenne and Becker muscular dystrophy (DMD/BMD) are caused by mutations in the dystrophin gene and are characterized by severe and mild progressive muscle wasting, respectively. Short stature has been reported as a feature of DMD in the Western hemisphere, but not yet confirmed in Orientals. Height of young BMD has not been fully characterized. Here, height of ambulant and steroid naive Japanese 179 DMD and 42 BMD patients between 4 and 10 years of age was retrospectively examined using height standard deviation score (SDS). The mean height SDS of DMD was -1.08 SD that was significantly smaller than normal (p < 0.001), indicating short stature of Japanese DMD. Furthermore, the mean height SDS of BMD was -0.27 SD, suggesting shorter stature than normal. Remarkably, the mean height SDS of DMD was significantly smaller than that of BMD (p < 0.0001). In DMD higher incidence of short stature (height SDS < -2.5 SD) was observed in Dp71 subgroup having mutations in dystrophin exons 63-79 than others having mutations in exons 1-62 (27.8% vs. 7.5%, p = 0.017). These suggested that height is influenced by dystrophin in not only DMD but also BMD and that dystrophin Dp71 has a role in height regulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Higher energy efficient homes are associated with increased risk of doctor diagnosed asthma in a UK subpopulation.

    Science.gov (United States)

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

    2015-02-01

    The United Kingdom (UK) has one of the highest prevalence of asthma in the world, which represents a significant economic and societal burden. Reduced ventilation resulting from increased energy efficiency measures acts as a modifier for mould contamination and risk of allergic diseases. To our knowledge no previous study has combined detailed asset management property and health data together to assess the impact of household energy efficiency (using the UK Government's Standard Assessment Procedure) on asthma outcomes in an adult population residing in social housing. Postal questionnaires were sent to 3867 social housing properties to collect demographic, health and environmental information on all occupants. Detailed property data, residency periods, indices of multiple deprivation (IMD) and household energy efficiency ratings were also investigated. Logistic regression was used to calculate odds ratios and confidence intervals while allowing for clustering of individuals coming from the same location. Eighteen percent of our target social housing population were recruited into our study. Adults had a mean age of 59 (SD±17.3) years and there was a higher percentage of female (59%) and single occupancy (58%) respondents. Housing demographic characteristics were representative of the target homes. A unit increase in household Standard Assessment Procedure (SAP) rating was associated with a 2% increased risk of current asthma, with the greatest risk in homes with SAP >71. We assessed exposure to mould and found that the presence of a mouldy/musty odour was associated with a two-fold increased risk of asthma (OR 2.2 95%; CI 1.3-3.8). A unit increase in SAP led to a 4-5% reduction in the risk of visible mould growth and a mouldy/musty odour. In contrast to previous research, we report that residing in energy efficient homes may increase the risk of adult asthma. We report that mould contamination increased the risk of asthma, which is in agreement with existing

  10. Elderly women with metabolic syndrome present higher cardiovascular risk and lower relative muscle strength

    Energy Technology Data Exchange (ETDEWEB)

    Farias, Darlan Lopes; Tibana, Ramires Alsamir; Teixeira, Tatiane Gomes; Vieira, Denis César Leite; Tarja, Vitor; Nascimento, Dahan da Cunha; Silva, Alessandro de Oliveira [Universidade Católica de Brasília, Brasília, DF (Brazil); Funghetto, Silvana Schwerz [Universidade de Brasília, Brasília, DF (Brazil); Coura, Maritza Alves de Sousa; Valduga, Renato [Universidade Católica de Brasília, Brasília, DF (Brazil); Karnikowski, Margô Gomes de Oliveira [Universidade de Brasília, Brasília, DF (Brazil); Prestes, Jonato [Universidade Católica de Brasília, Brasília, DF (Brazil)

    2013-07-01

    To compare the metabolic, anthropometric, arterial blood pressure, and muscle strength parameters of elderly women with and without metabolic syndrome. A case-control study with 27 (67.3±4.8 years of age, 31.0±5.0kg/m{sup 2}) elderly women with metabolic syndrome and 33 (68.8±5.6 years of age, 27.2±5.3kg/m{sup 2}) sedentary control elderly women. They were submitted to an evaluation of body composition by means of dual-energy X-ray absorptiometry and muscle strength testing with 10 maximal repetitions of knee extension. When compared to the elderly women without metabolic syndrome, those with the metabolic syndrome had higher levels for body mass (72.2±13.5 versus 63.4±14.6kg, p=0.03), body mass index (31.0±5.0 versus 27.2±5.3kg/m{sup 2,} p=0.007), fat mass (30.9±9.9 versus 24.4±8.5kg, p=0.01), systolic arterial pressure (125.1±8.2 versus 119.3±8.7mmHg, p=0.01), diastolic arterial pressure (75.5±6.9 versus 71.4±6.7mmHg, p=0.03), mean arterial pressure (92.5±6.2 versus 87.1±6.7mmHg, p=0.004), blood glucose (103.8±19.1 versus 91.1±5.9mg/dL, p=0.001), triglycerides (187.1±70.2 versus 116.3±36.7mg/dL, p=0.001), and creatine kinase (122.6±58.6 versus 89.8±32.5U/L, p=0.01); lower levels were found for fat-free mass (55.9±5.8 versus 59.3±6.7%; p=0.05), HDL-C (40.7±5.0 versus 50.5±10.1mg/dL, p=0.001), and relative muscle strength (0.53±0.14 versus 0.62±0.12, p=0.01). Elderly women with metabolic syndrome have a higher cardiovascular risk and less relative muscle strength when compared to those without metabolic syndrome. Relative muscle strength may be related to the cardiovascularr risk factors of the metabolic syndrome.

  11. Elderly women with metabolic syndrome present higher cardiovascular risk and lower relative muscle strength

    International Nuclear Information System (INIS)

    Farias, Darlan Lopes; Tibana, Ramires Alsamir; Teixeira, Tatiane Gomes; Vieira, Denis César Leite; Tarja, Vitor; Nascimento, Dahan da Cunha; Silva, Alessandro de Oliveira; Funghetto, Silvana Schwerz; Coura, Maritza Alves de Sousa; Valduga, Renato; Karnikowski, Margô Gomes de Oliveira; Prestes, Jonato

    2013-01-01

    To compare the metabolic, anthropometric, arterial blood pressure, and muscle strength parameters of elderly women with and without metabolic syndrome. A case-control study with 27 (67.3±4.8 years of age, 31.0±5.0kg/m"2) elderly women with metabolic syndrome and 33 (68.8±5.6 years of age, 27.2±5.3kg/m"2) sedentary control elderly women. They were submitted to an evaluation of body composition by means of dual-energy X-ray absorptiometry and muscle strength testing with 10 maximal repetitions of knee extension. When compared to the elderly women without metabolic syndrome, those with the metabolic syndrome had higher levels for body mass (72.2±13.5 versus 63.4±14.6kg, p=0.03), body mass index (31.0±5.0 versus 27.2±5.3kg/m"2", p=0.007), fat mass (30.9±9.9 versus 24.4±8.5kg, p=0.01), systolic arterial pressure (125.1±8.2 versus 119.3±8.7mmHg, p=0.01), diastolic arterial pressure (75.5±6.9 versus 71.4±6.7mmHg, p=0.03), mean arterial pressure (92.5±6.2 versus 87.1±6.7mmHg, p=0.004), blood glucose (103.8±19.1 versus 91.1±5.9mg/dL, p=0.001), triglycerides (187.1±70.2 versus 116.3±36.7mg/dL, p=0.001), and creatine kinase (122.6±58.6 versus 89.8±32.5U/L, p=0.01); lower levels were found for fat-free mass (55.9±5.8 versus 59.3±6.7%; p=0.05), HDL-C (40.7±5.0 versus 50.5±10.1mg/dL, p=0.001), and relative muscle strength (0.53±0.14 versus 0.62±0.12, p=0.01). Elderly women with metabolic syndrome have a higher cardiovascular risk and less relative muscle strength when compared to those without metabolic syndrome. Relative muscle strength may be related to the cardiovascularr risk factors of the metabolic syndrome

  12. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Yue, Hu; Shan, Liu; Bin, Lv

    2018-02-19

    Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available. To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk. We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures. A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant. This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.

  13. A puzzle form of a non-verbal intelligence test gives significantly higher performance measures in children with severe intellectual disability.

    Science.gov (United States)

    Bello, Katrina D; Goharpey, Nahal; Crewther, Sheila G; Crewther, David P

    2008-08-01

    Assessment of 'potential intellectual ability' of children with severe intellectual disability (ID) is limited, as current tests designed for normal children do not maintain their interest. Thus a manual puzzle version of the Raven's Coloured Progressive Matrices (RCPM) was devised to appeal to the attentional and sensory preferences and language limitations of children with ID. It was hypothesized that performance on the book and manual puzzle forms would not differ for typically developing children but that children with ID would perform better on the puzzle form. The first study assessed the validity of this puzzle form of the RCPM for 76 typically developing children in a test-retest crossover design, with a 3 week interval between tests. A second study tested performance and completion rate for the puzzle form compared to the book form in a sample of 164 children with ID. In the first study, no significant difference was found between performance on the puzzle and book forms in typically developing children, irrespective of the order of completion. The second study demonstrated a significantly higher performance and completion rate for the puzzle form compared to the book form in the ID population. Similar performance on book and puzzle forms of the RCPM by typically developing children suggests that both forms measure the same construct. These findings suggest that the puzzle form does not require greater cognitive ability but demands sensory-motor attention and limits distraction in children with severe ID. Thus, we suggest the puzzle form of the RCPM is a more reliable measure of the non-verbal mentation of children with severe ID than the book form.

  14. Unit Risk Quotient (RQ) and Relative Significance of Radionuclide on Flora and Fauna to the EU-APR Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Keunsung [KHNP-CRI, Daejeon (Korea, Republic of); Kim, Sukhoon [FNC Technology Co., Ltd., Yongin (Korea, Republic of); Lee, Chonghui [KEPCO E and C, Yongin (Korea, Republic of)

    2015-05-15

    As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude.

  15. Unit Risk Quotient (RQ) and Relative Significance of Radionuclide on Flora and Fauna to the EU-APR Optimization

    International Nuclear Information System (INIS)

    Lee, Keunsung; Kim, Sukhoon; Lee, Chonghui

    2015-01-01

    As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude

  16. Overexpression of ETV4 protein in triple-negative breast cancer is associated with a higher risk of distant metastasis

    Directory of Open Access Journals (Sweden)

    Yuan ZY

    2014-09-01

    -overexpressed tumor had a significantly higher risk of developing distant metastasis (P<0.0001 and shorter overall survival and disease-free survival. Overexpression of ETV4 protein was an independent predictor of short disease-free survival of TNBC patients (P=0.021. Conclusion: Overexpression of ETV4 protein increases risk of developing distant metastasis and results in a poor prognosis for TNBC patients. Thus, ETV4 might be a novel target for developing an alternative therapeutic strategy for prevention of TNBC distant metastasis. Keywords: breast carcinoma, triple-negative, ETS translocation variant 4, ETV4, prognosis

  17. Quantitative weight of evidence assessment of higher tier studies on the toxicity and risks of neonicotinoids in honeybees. 3. Clothianidin.

    Science.gov (United States)

    Solomon, Keith R; Stephenson, Gladys L

    2017-01-01

    A quantitative weight of evidence (QWoE) methodology was used to assess higher tier studies on the effects of clothianidin (CTD) on honeybees. Assessment endpoints were population size and viability of commercially managed bees and quantity of hive products. A colony-level no-observed-adverse effect concentration (NOAEC) of 25 µg CTD/kg syrup, equivalent to an oral no-observed-adverse effect-dose (NOAED) of 7.3 ng/bee/d for all responses measured. Based on a NOAEC of 19.7 µg/kg pollen, the NOAED for honeybee larvae was 2.4 ng/bee larva/d. For exposures via dust, a no-observed-adverse effect rate of 4 g CTD/ha was used to assess relevance of exposures via deposition of dust. The overall weight of evidence suggested that there is minimal risk to honeybees from exposure to CTD from its use as a seed treatment. For exposures via dust, dust/seed and dust/foliar applications, there were no exposures greater than the NOAED for CTD in nectar and pollen, indicating a de minimis risk to honeybees when the route of exposure was via uptake in plants. Analysis of effect studies in the field indicated a consistent lack of relevant effects, regardless of the way CTD was applied. For exposures via dust, there were no adverse effects because of these applications and there were no exposures greater than the NOAED for CTD in nectar and pollen. The overall weight of evidence based on many studies indicated no adverse effects on colony viability or survival of the colony. Thus, the overall conclusion is that clothianidin, as currently used in good agricultural practices, does not present a significant risk to honeybees at the level of the colony.

  18. Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study.

    Science.gov (United States)

    Torres, M J; Féart, C; Samieri, C; Dorigny, B; Luiking, Y; Berr, C; Barberger-Gateau, P; Letenneur, L

    2015-08-01

    Falling and fractures are a public health problem in elderly people. The aim of our study was to investigate whether nutritional status is associated with the risk of falling or fracture in community-dwelling elderly. Poor nutritional status was significantly associated with a higher risk of both falling and fractures. Nutrition could play a role to prevent falls and fractures. The purpose of this study is to investigate whether a poor nutritional status is associated with the risk of falling and of fracture in community dwelling elderly. Baseline nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA). After a follow-up of 12 years, 6040 individuals with available data for falls and 6839 for fracture were included. People who presented the outcomes at baseline were excluded. Cox models were used to evaluate the associations between nutritional status and the risks of fall or fracture. The frequency of poor nutritional status (MNA ≤ 23.5), at baseline, was respectively 12.0% in the "fall study sample" and 12.8% in the "fracture study sample." Incident fall and fracture over 12 years were reported in 55.8 and 18.5% of the respective samples, respectively. In multivariate models controlled for sociodemographic data and several baseline health indicators, poor nutritional status was significantly associated with a higher risk of falling (hazard ratio (HR) = 1.66, 95% confidence interval (95% CI) 1.35-2.04 in men and HR = 1.20, 95% CI 1.07-1.34 in women) and with a higher risk of fracture (HR = 1.28, 95% CI 1.09-1.49). Poor nutritional status was associated with a higher risk of both falling and fractures in French elderly community-dwellers. Early screening and management of the nutritional status may be useful to reduce the frequency of these events in older people.

  19. Significant relationships between a simple marker of redox balance and lifestyle behaviours; Relevance to the Framingham risk score.

    Directory of Open Access Journals (Sweden)

    Neda Seyedsadjadi

    Full Text Available Oxidative stress has been closely linked to the progressive cell damage associated with emerging non-communicable disease (NCDs. Early detection of these biochemical abnormalities before irreversible cell damage occurs may therefore be useful in identifying disease risk at an individual level. In order to test this hypothesis, this study assessed the relationship between a simple measure of redox status and lifestyle risk factors for NCDs, and the population-based risk score of Framingham. In a cross-sectional study design, 100 apparently healthy middle-aged males (n = 48 and females (n = 52 were asked to complete a comprehensive lifestyle assessment questionnaire, followed by body fat percentage and blood pressure measurements, and blood collection. The ratio of plasma total antioxidant capacity to hydroperoxide (TAC/HPX was used as an index of redox balance. One-way ANOVA and multiple linear regression analysis were performed to analyse the association between TAC/HPX, lifestyle components and other plasma biomarkers. The TAC/HPX ratio was higher in males compared to females (t96 = 2.34, P = 0.021. TAC/HPX was also lower in participants with poor sleep quality (t93 = 2.39, P = 0.019, with high sleep apnoea risk (t62.2 = 3.32, P = 0.002, with high caffeine (F(2, 93 = 3.97, P = 0.022 and red meat intake (F(2, 93 = 5.55, P = 0.005. These associations were independent of gender. Furthermore, the TAC/HPX ratio decreased with increasing body fat percentage (F(2, 95 = 4.74, P = 0.011 and depression score (t94 = 2.38, P = 0.019, though these associations were dependent on gender. Importantly, a negative association was observed between TAC/HPX levels and the Framingham risk score in both males (r(45 = -0.39, P = 0.008 and females (r(50 = -0.33, P = 0.019 that was independent of other Framingham risk score components. Findings from this study suggests that a relatively simple measure of redox balance such as the TAC/HPX ratio may be a sensitive

  20. Transracial Mothering and Maltreatment: Are Black/White Biracial Children at Higher Risk?

    Science.gov (United States)

    Fusco, Rachel A.; Rautkis, Mary E.

    2012-01-01

    The number of people identifying as biracial is rapidly growing, though little is known about the experiences of interracial families. Previous work indicates that biracial children may be at elevated risk of entering the child welfare system. This could underscore additional risks faced by these families. This document includes data from the…

  1. Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy.

    Science.gov (United States)

    Lim, Woo Hyeon; Park, Chang Min; Yoon, Soon Ho; Lim, Hyun-Ju; Hwang, Eui Jin; Lee, Jong Hyuk; Goo, Jin Mo

    2018-03-01

    To evaluate the time-dependent incidence, risk factors and clinical significance of percutaneous lung biopsy (PLB)-related pneumothorax. From January 2012-November 2015, 3,251 patients underwent 3,354 cone-beam CT-guided PLBs for lung lesions. Cox, logistic and linear regression analyses were performed to identify time-dependent risk factors of PLB-related pneumothorax, risk factors of drainage catheter insertion and those of prolonged catheter placement, respectively. Pneumothorax occurred in 915/3,354 PLBs (27.3 %), with 230/915 (25.1 %) occurring during follow-ups. Risk factors for earlier occurrence of PLB-related pneumothorax include emphysema (HR=1.624), smaller target (HR=0.922), deeper location (HR=1.175) and longer puncture time (HR=1.036), while haemoptysis (HR=0.503) showed a protective effect against earlier development of pneumothorax. Seventy-five cases (8.2 %) underwent chest catheter placement. Mean duration of catheter placement was 3.2±2.0 days. Emphysema (odds ratio [OR]=2.400) and longer puncture time (OR=1.053) were assessed as significant risk factors for catheter insertion, and older age (parameter estimate=1.014) was a predictive factor for prolonged catheter placement. PLB-related pneumothorax occurred in 27.3 %, of which 25.1 % developed during follow-ups. Smaller target size, emphysema, deeply-located lesions were significant risk factors of PLB-related pneumothorax. Emphysema and older age were related to drainage catheter insertion and prolonged catheter placement, respectively. • One-fourth of percutaneous lung biopsy (PLB)-related pneumothorax occurs during follow-up. • Smaller, deeply-located target and emphysema lead to early occurrence of pneumothorax. • Emphysema is related to drainage catheter insertion for PLB-related pneumothorax. • Older age may lead to prolonged catheter placement for PLB-related pneumothorax. • Tailored management can be possible with time-dependent information of PLB-related pneumothorax.

  2. Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis.

    Science.gov (United States)

    Fusar-Poli, Paolo; De Micheli, Andrea; Cappucciati, Marco; Rutigliano, Grazia; Davies, Cathy; Ramella-Cravaro, Valentina; Oliver, Dominic; Bonoldi, Ilaria; Rocchetti, Matteo; Gavaghan, Lauren; Patel, Rashmi; McGuire, Philip

    2018-02-15

    The diagnostic and prognostic significance of the DSM-5-defined Attenuated Psychosis Syndrome (DSM-5-APS) in individuals undergoing an ultra high risk (UHR) clinical assessment for suspicion of psychosis risk is unknown. Prospective cohort study including all consecutive help-seeking individuals undergoing both a DSM-5-APS and a Comprehensive Assessment of At Risk Mental States (CAARMS 12/2006) assessment for psychosis risk at the Outreach and Support in South London (OASIS) UHR service (March 2013-April 2014). The diagnostic significance of DSM-5-APS was assessed with percent overall agreement, prevalence bias adjusted kappa, Bowker's test, Stuart-Maxwell test, residual analysis; the prognostic significance with Cox regression, Kaplan-Meier failure function, time-dependent area under the curve (AUC) and net benefits analysis. The impact of specific revisions of the DSM-5-APS was further tested. In 203 help-seeking individuals undergoing UHR assessment, the agreement between the DSM-5-APS and the CAARMS 12/2006 was only moderate (kappa 0.59). Among 142 nonpsychotic cases, those meeting DSM-5-APS criteria had a 5-fold probability (HR = 5.379) of developing psychosis compared to those not meeting DSM-5-APS criteria, with a 21-month cumulative risk of psychosis of 28.17% vs 6.49%, respectively. The DSM-5-APS prognostic accuracy was acceptable (AUC 0.76 at 24 months) and similar to the CAARMS 12/2006. The DSM-5-APS designation may be clinically useful to guide the provision of indicated interventions within a 7%-35% (2-year) range of psychosis risk. The removal of the criterion E or C of the DSM-5-APS may improve its prognostic performance and transdiagnostic value. The DSM-5-APS designation may be clinically useful in individuals accessing clinical services for psychosis prevention. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

  3. Risk-associated health disorders occuring in junior schoolchildren who attend schools with higher stress and intensity of educational process

    Directory of Open Access Journals (Sweden)

    N.V. Zaitseva

    2017-03-01

    Full Text Available We performed comparative sanitary-hygienic assessment of regime, stress and intensity of educational process in different educational establishments, a comprehensive secondary school and an innovative educational establishment - lyceum. We detected that studying regime tended to be tight, classes were longer and more intense than in an ordinary school, and educational process involved considerable intellectual, sensory and emotional loads for children; such loads reached "1st category intense" level. Schoolchildren attending lyceums are also busy with additional educational programs and it significantly increases length of total educational load on them. By the end of a school year 20% of lyceum pupils suffer from sympathoadrenal system overstress and it doesn't only determine emotional tonus level in children but also leads to disorders in concentration and decision-making speed, lower reading speed and articulation, slower motor reactions. 15% of lyceum pupils have higher activity of autonomous nervous system and lower adaptation of cardiovascular system to psycho emotional and physical loads. Lyceum pupils also run 2.5 times higher risk of chronic nervous system diseases evolvement than school children attending ordinary schools. Autonomous nervous system disorders, posture disorders and nutrition disorders are predominant nosologic pathology forms in lyceum pupils as they occur in them 1.6-2.9 times more frequent than in schoolchildren of the same age who attend an ordinary comprehensive school. We detected direct correlation between higher intellectual and emotional components of educational process, and total educational intensity as well, and frequency of autonomous system disorders and musculoskeletal system diseases in pupils.

  4. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

    joint space width (JSW) /=60 yr of age. Of factors entered into logistic regression analyses, only age (P LT 0.001 for right hips and P LT 0.001 for left hips) and hip dysplasia (P LT 0.001 for right hips and P = 0.004 for left hips) were significantly associated with hip OA prevalence in women. In men......, only hip dysplasia was associated with hip OA prevalence, P LT 0.001 in right hips and P = 0.001 in left hips. CONCLUSIONS: Of the individual risk factors investigated in this study, only age and hip dysplasia were associated with the development of hip osteoarthritis.......OBJECTIVES: The aim of this cross-sectional survey of 2232 women and 1336 men (age range 20-91 yr) was to investigate individual risk factors for hip joint osteoarthritis (OA). METHODS: Standardized, weight-bearing pelvic radiographs were evaluated. Radiological hip joint OA was defined as minimum...

  5. Rising atmospheric CO2 concentration may imply higher risk of Fusarium mycotoxin contamination of wheat grains.

    Science.gov (United States)

    Bencze, Szilvia; Puskás, Katalin; Vida, Gyula; Karsai, Ildikó; Balla, Krisztina; Komáromi, Judit; Veisz, Ottó

    2017-08-01

    Increasing atmospheric CO 2 concentration not only has a direct impact on plants but also affects plant-pathogen interactions. Due to economic and health-related problems, special concern was given thus in the present work to the effect of elevated CO 2 (750 μmol mol -1 ) level on the Fusarium culmorum infection and mycotoxin contamination of wheat. Despite the fact that disease severity was found to be not or little affected by elevated CO 2 in most varieties, as the spread of Fusarium increased only in one variety, spike grain number and/or grain weight decreased significantly at elevated CO 2 in all the varieties, indicating that Fusarium infection generally had a more dramatic impact on the grain yield at elevated CO 2 than at the ambient level. Likewise, grain deoxynivalenol (DON) content was usually considerably higher at elevated CO 2 than at the ambient level in the single-floret inoculation treatment, suggesting that the toxin content is not in direct relation to the level of Fusarium infection. In the whole-spike inoculation, DON production did not change, decreased or increased depending on the variety × experiment interaction. Cooler (18 °C) conditions delayed rachis penetration while 20 °C maximum temperature caused striking increases in the mycotoxin contents, resulting in extremely high DON values and also in a dramatic triggering of the grain zearalenone contamination at elevated CO 2 . The results indicate that future environmental conditions, such as rising CO 2 levels, may increase the threat of grain mycotoxin contamination.

  6. Higher Risk of Abdominal Obesity, Elevated LDL Cholesterol and Hypertriglyceridemia, but not of Hypertension, in People Living with HIV

    DEFF Research Database (Denmark)

    Gelpi, Marco; Afzal, Shoaib; Lundgren, Jens

    2018-01-01

    Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL...... and underwent blood pressure, waist-, hip-, weight-, and height-measurements. Non-fasting blood samples were obtained from all participants. We assessed whether HIV was independently associated with abdominal obesity, elevated LDL-C, hypertriglyceridemia and hypertension using logistic regression models...... adjusted for known risk factors. Results: HIV infection was associated with higher risk of abdominal obesity (adjusted odds ratio (aOR): 1.92[1.60-2.30]) for a given BMI, elevated LDL-C (aOR: 1.32[1.09-1.59]), hypertriglyceridemia (aOR 1.76[1.49-2.08]), and lower risk of hypertension (aOR: 0.63[0.54 - 0...

  7. Clinically Significant Contrast Induced Acute Kidney Injury after Non-Emergent Cardiac Catheterization - Risk Factors and Impact on Length of Hospital Stay

    International Nuclear Information System (INIS)

    Kashif, W.; Yaqub, S.; Khawaja, A.

    2013-01-01

    Objective: To evaluate the frequency and risk factors associated with clinically significant contrast-induced nephropathy (CIN) in patients undergoing non-emergent coronary angiography. Study Design: Descriptive study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007. Methodology: Case records of patients who underwent coronary angiography with a serum creatinine of >= 1.5 mg/dl at the time of procedure were evaluated. Clinically significant contrast induced nephropathy (CSCIN) was defined as either doubling of serum creatinine from baseline value within a week following the procedure or need for emergency hemodialysis after the procedure. Results: One hundred and sixteen patients met the inclusion criteria. Mean age was 64.0 +- 11.5 years, 72% were males. Overall prevalence of CIN was 17% (rise of serum creatinine by A= 0.5 mg/dl) while that of clinically significant CIN (CSCIN) was 9.5% (11 patients). Patients with CSCIN had significantly lower left ventricular ejection fraction (p = 0.03, OR: 0.24; 95% CI = 0.06 A= 0.91) and higher prevalence of cerebrovascular disease (p < 0.001, OR: 14.66; 95% CI = 3.30 - 65.08). Mean baseline serum creatinine was significantly higher, 3.0 +- 1.5 vs. 2.0 +- 1.1 mg/dl (p = 0.03, OR: 1.47; 95% CI = 1.03 - 2.11) whereas mean GFR estimated by Cockcroft-Gault formula was significantly lower at 25 +- 7.4 vs. 41.0 +- 14.6 ml/minute (p = 0.001, OR = 0.89, 95% CI = 0.84 A= 0.95) at the time of procedure in patients with CSCIN. Mean length of hospital stay was significantly higher in this group compared to those without CIN, 9.0 +- 5.1 vs. 3.0 +- 3.2 days (p = 0.001, OR = 1.31, 95% CI = 1.12 - 1.54). Multivariate analysis revealed low GFR (p = 0.001, OR = 0.88; 95% CI = 0.82 - 0.95) and low ejection fraction (p = 0.03, OR = 0.20; 95% CI = 0.04 - 0.91) to be independent factors associated with CSCIN. No significant differences were noted between the two groups in patients with

  8. Oral surgery in patients under antithrombotic therapy: perioperative bleeding as a significant risk factor for postoperative hemorrhage.

    Science.gov (United States)

    Rocha, Amanda L; Souza, Alessandra F; Martins, Maria A P; Fraga, Marina G; Travassos, Denise V; Oliveira, Ana C B; Ribeiro, Daniel D; Silva, Tarcília A

    2018-01-01

    : To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures. A total of eight cases of perioperative and 12 episodes of postoperative bleeding were documented. The complications were generally managed with local measures and did not require hospitalization. We found significant association of postoperative hemorrhage with increased perioperative bleeding (P = 0.043) and combination of anticoagulant and antiplatelet therapy (P bleeding is 8.8 times bigger than procedures without perioperative bleeding. Dental surgery in patients under antithrombotic therapy might be carried out without altering the regimen because of low risk of perioperative and postoperative bleeding. However, patients with increased perioperative bleeding should be closely followed up because of postoperative complications risk.

  9. Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury.

    Science.gov (United States)

    Backhaus, M; Citak, M; Tilkorn, D-J; Meindl, R; Schildhauer, T A; Fehmer, T

    2011-11-01

    Retrospective chart review. The aim of our study was to evaluate the mortality rate and further specific risk factors for Fournier's gangrene in patients with spinal cord injury (SCI). Division of Spinal Cord Injury, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Germany. All patients with a SCI and a Fournier's gangrene treated in our hospital were enrolled in this study. Following parameters were taken form patients medical records: age, type of SCI, cause of Fournier's gangrene, number of surgical debridements, length of hospital and intensive care unit stay, co morbidity factors and mortality rate. In addition, laboratory parameter including the laboratory risk indicator for necrotizing fasciitis (LRINEC) score and microbiological findings were analyzed. Clinical diagnosis was made via histological examination. A total of 16 male patients (15 paraplegic and one tetraplegic) were included in the study. In 81% of all cases, the origin of Fournier's gangrene was a pressure sore. The median LRINEC score on admission was 6.5. In the vast majority of cases, a polybacterial infection was found. No patient died during the hospital stay. The mean number of surgical debridements before soft tissue closure was 1.9 and after a mean time interval of 39.1 days wound closure was performed in all patients. Pressure sores significantly increase the risk of developing Fournier's gangrene in patients with SCI. We reported the results of our patients to increase awareness among physicians and training staff working with patients with a SCI in order to expedite the diagnosis.

  10. Significant Risk Factors for Postoperative Enlargement of Basal Ganglia Hematoma after Frameless Stereotactic Aspiration: Antiplatelet Medication and Concomitant IVH.

    Science.gov (United States)

    Son, Wonsoo; Park, Jaechan

    2017-09-01

    Frameless stereotactic aspiration of a hematoma can be the one of the treatment options for spontaneous intracerebral hemorrhage in the basal ganglia. Postoperative hematoma enlargement, however, can be a serious complication of intracranial surgery that frequently results in severe neurological deficit and even death. Therefore, it is important to identify the risk factors of postoperative hematoma growth. During a 13-year period, 101 patients underwent minimally invasive frameless stereotactic aspiration for basal ganglia hematoma. Patients were classified into two groups according to whether or not they had postoperative hematoma enlargement in a computed tomography scan. Baseline demographic data and several risk factors, such as hypertension, preoperative hematoma growth, antiplatelet medication, presence of concomitant intraventricular hemorrhage (IVH), were analysed via a univariate statistical study. Nine of 101 patients (8.9%) showed hematoma enlargement after frameless stereotactic aspiration. Among the various risk factors, concomitant IVH and antiplatelet medication were found to be significantly associated with postoperative enlargement of hematomas. In conclusion, our study revealed that aspirin use and concomitant IVH are factors associated with hematoma enlargement subsequent to frameless stereotactic aspiration for basal ganglia hematoma.

  11. Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.

    Science.gov (United States)

    Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

    2015-04-01

    To explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth. Prospective cohort study. OUs and planned home births in England. 8180 'higher risk' women in the Birthplace cohort. We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Composite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births. The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John

  12. Optimal dietary calcium intake in HIV treated patients: no femoral osteoporosis but higher cardiovascular risk.

    Science.gov (United States)

    Galli, Laura; Rubinacci, Alessandro; Cocorullo, Deborah; Salpietro, Stefania; Spagnuolo, Vincenzo; Gianotti, Nicola; Bigoloni, Alba; Vinci, Concetta; Mignogna, Giovanna; Sirtori, Marcella; Lazzarin, Adriano; Castagna, Antonella

    2014-04-01

    We performed a cross-sectional study on adult HIV-infected patients, on HAART, without calcium or vitamin D supplementation to evaluate if the cardiovascular risk or the presence of osteoporosis may be predictive factors of an optimal daily calcium intake (DCI>1000 mg/day). Patients underwent a dual-energy X-ray absorptiometry, measured biochemical parameters and compiled a validated questionnaire for the assessment of DCI. Osteoporosis (OP) was defined according to the WHO classification at either the vertebral spine or femoral neck. Cardiovascular risk was assessed by the 10-year Framingham cardiovascular risk score. 200 HIV-infected patients evaluated: 171 (86%) males with a median age of 48.1 (42.3-53.8) years and 10.6 (4.3-13.6) years of HAART exposure. DCI was 889 (589-1308) mg/day and 79 (40%) patients had an optimal DCI. Framingham risk>20% was found in 13 (6.7%) patients and femoral OP was diagnosed in 12 (6%) pts. By multivariate analysis, optimal DCI was more likely in patients with a Framingham risk>20% [OR = 5.547, 95% CI:1.337, p = 0.025] and less likely in patients with femoral osteoporosis [OR = 0.159, 95% CI: 0.018-0.790, p = 0.047]. We found that an optimal dietary calcium intake was more likely in patients with high cardiovascular risk and no femoral osteoporosis. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. A meta-analysis of indicated mental health prevention programs for at-risk higher education students.

    Science.gov (United States)

    Conley, Colleen S; Shapiro, Jenna B; Kirsch, Alexandra C; Durlak, Joseph A

    2017-03-01

    This meta-analysis found empirical support for the effectiveness of indicated prevention programs for higher education students at risk for subsequent mental health difficulties based on their current subclinical levels of various presenting problems, such as depression, anxiety, or interpersonal difficulties. A systematic literature search identified 79 controlled published and unpublished interventions involving 4,470 college, graduate, or professional students. Programs were effective at post-intervention overall (ES = 0.49, CI [0.43, 0.55]), and for both targeted outcomes (ES = 0.58, CI [0.51, 0.64]) as well as additional nontargeted outcomes assessed in the studies (ES = 0.32, CI [0.25, 0.39]). Interventions compared with a no-intervention or a wait-list control (ES = 0.64, CI [0.57, 0.71], k = 68) demonstrated significantly larger effects overall than did interventions compared with an attention-placebo control (ES = 0.27, CI [0.11, 0.43], k = 11), although both were significant. Among the former group, modality and presenting problem emerged as significant moderators of intervention effectiveness, and among the 43 of these that assessed effectiveness at an average follow-up period of 35 weeks, the positive effects from intervention remained strong (ES = 0.59, CI [0.50, 0.68]). Overall, programs were fairly brief, attracted and retained students, were positively rated by students, and effective when administered by paraprofessionals as well as professionals. Current findings are promising and stimulate recommendations for improving future research, such as expanding the range of outcomes assessed, and clarifying moderators and mediators of intervention impact. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. [Association of T174M polymorphism of the angiotensinogen gene with the higher risk of cerebral stroke in women].

    Science.gov (United States)

    Stetskaia, T A; Bushueva, O Iu; Bulgakova, I V; Vialykh, E K; Shuteeva, T V; Biriukov, A E; Ivanov, V P; Polonikov, A V

    2014-01-01

    To study the association of M235T (rs699) and T174M (rs4762) polymorphisms of the angiotensinogen (AGT) gene with the risk of cerebral stroke (CS) in the Russians of the Central Chernozem Region. A total of 638 DNA samples obtained from 353 patients with CS and 285 sex- and age-matched healthy individuals were examined. The polymorphisms were genotyped by polymerase chain reaction (T174M) and TaqMan allelic discrimination (M235T) assays. Heterozygous AGT 174TM genotype carriers were found to be at a higher risk for CS (odd ratio (OR) = 1.52; 95% confidence interval (CI), 1.08-2.15; p = 0.02). A gender-stratified analysis showed that the mutant 174M allele (OR = 1.86; 95% CI, 1.14-3.03, p = 0.01) and variant 174TM and 174MM genotypes (OR = 1.86; 95% CI, 1.09-3.20; p = 0.02) were associated with the higher risk of cerebral stroke in women. The association of AGT T174M polymorphism with the risk of CS was first found; but the higher risk of the disease in the carriers of variant alleles and genotypes was observed in the women only.

  15. Young Children in Immigrant Families Face Higher Risk of Food Insecurity. Research Brief. Publication #2009-07

    Science.gov (United States)

    Capps, Randy; Horowitz, Allison; Fortuny, Karina; Bronte-Tinkew, Jacinta; Zaslow, Martha

    2009-01-01

    Children in immigrant families are more likely than children in native-born families to face a number of risk factors for poor developmental outcomes, including higher poverty rates, lower household incomes, and linguistic isolation, (for example, when older children and adults in a household have difficulty speaking English). Previous research…

  16. Development of free statistical software enabling researchers to calculate confidence levels, clinical significance curves and risk-benefit contours

    International Nuclear Information System (INIS)

    Shakespeare, T.P.; Mukherjee, R.K.; Gebski, V.J.

    2003-01-01

    Confidence levels, clinical significance curves, and risk-benefit contours are tools improving analysis of clinical studies and minimizing misinterpretation of published results, however no software has been available for their calculation. The objective was to develop software to help clinicians utilize these tools. Excel 2000 spreadsheets were designed using only built-in functions, without macros. The workbook was protected and encrypted so that users can modify only input cells. The workbook has 4 spreadsheets for use in studies comparing two patient groups. Sheet 1 comprises instructions and graphic examples for use. Sheet 2 allows the user to input the main study results (e.g. survival rates) into a 2-by-2 table. Confidence intervals (95%), p-value and the confidence level for Treatment A being better than Treatment B are automatically generated. An additional input cell allows the user to determine the confidence associated with a specified level of benefit. For example if the user wishes to know the confidence that Treatment A is at least 10% better than B, 10% is entered. Sheet 2 automatically displays clinical significance curves, graphically illustrating confidence levels for all possible benefits of one treatment over the other. Sheet 3 allows input of toxicity data, and calculates the confidence that one treatment is more toxic than the other. It also determines the confidence that the relative toxicity of the most effective arm does not exceed user-defined tolerability. Sheet 4 automatically calculates risk-benefit contours, displaying the confidence associated with a specified scenario of minimum benefit and maximum risk of one treatment arm over the other. The spreadsheet is freely downloadable at www.ontumor.com/professional/statistics.htm A simple, self-explanatory, freely available spreadsheet calculator was developed using Excel 2000. The incorporated decision-making tools can be used for data analysis and improve the reporting of results of any

  17. Do adolescents who are night owls have a higher risk of dental caries? - a case-control study.

    Science.gov (United States)

    Lundgren, A-M; Öhrn, K; Jönsson, B

    2016-08-01

    The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits. A group of 196 adolescents (15 and 16 years old) were divided into two equal groups based on caries risk (case = high risk; and control = low risk). Before their dental examinations, they were asked to complete a questionnaire. The questionnaire included questions on circadian rhythm, dietary and oral self-care habits, and demographic variables. The participants were divided into three circadian types: evening types who are alert in the evening and tired in the morning; morning types who are the opposite; and neutral types who are neither particularly alert in the evening nor extremely tired in the morning. The most common sleep-cycle group type was neutral (50%). After this came evening types (37%) and finally morning types (13%). Morning and neutral types reported more frequently than evening types that they had breakfast every morning and brushed their teeth twice a day. More evening types were categorized as at high risk of caries. Circadian rhythm, breakfast habits and toothbrushing frequency were associated with a high risk of caries. The predicted probability of being at high risk of caries was almost four times higher for evening types than for morning types (OR 3.8; 95% CI 1.3-10.9). Adolescents who belonged to the evening circadian rhythm group brushed their teeth more seldom, ate breakfast less regularly and had a higher risk of caries than morning types. A patient's circadian rhythm should be considered when planning oral health education for adolescents with a high risk of caries. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Shorter leukocyte telomere length is associated with higher risk of infections

    DEFF Research Database (Denmark)

    Helby, Jens; Nordestgaard, Børge G; Benfield, Thomas

    2017-01-01

    In the general population, older age is associated with short leukocyte telomere length and with high risk of infections. In a recent study of allogeneic hematopoietic cell transplantation for severe aplastic anemia, long donor leukocyte telomere length was associated with improved survival...

  19. A method for risk-informed safety significance categorization using the analytic hierarchy process and bayesian belief networks

    International Nuclear Information System (INIS)

    Ha, Jun Su; Seong, Poong Hyun

    2004-01-01

    A risk-informed safety significance categorization (RISSC) is to categorize structures, systems, or components (SSCs) of a nuclear power plant (NPP) into two or more groups, according to their safety significance using both probabilistic and deterministic insights. In the conventional methods for the RISSC, the SSCs are quantitatively categorized according to their importance measures for the initial categorization. The final decisions (categorizations) of SSCs, however, are qualitatively made by an expert panel through discussions and adjustments of opinions by using the probabilistic insights compiled in the initial categorization process and combining the probabilistic insights with the deterministic insights. Therefore, owing to the qualitative and linear decision-making process, the conventional methods have the demerits as follows: (1) they are very costly in terms of time and labor, (2) it is not easy to reach the final decision, when the opinions of the experts are in conflict and (3) they have an overlapping process due to the linear paradigm (the categorization is performed twice - first, by the engineers who propose the method, and second, by the expert panel). In this work, a method for RISSC using the analytic hierarchy process (AHP) and bayesian belief networks (BBN) is proposed to overcome the demerits of the conventional methods and to effectively arrive at a final decision (or categorization). By using the AHP and BBN, the expert panel takes part in the early stage of the categorization (that is, the quantification process) and the safety significance based on both probabilistic and deterministic insights is quantified. According to that safety significance, SSCs are quantitatively categorized into three categories such as high safety significant category (Hi), potentially safety significant category (Po), or low safety significant category (Lo). The proposed method was applied to the components such as CC-V073, CV-V530, and SI-V644 in Ulchin Unit

  20. ICU Acquisition Rate, Risk Factors, and Clinical Significance of Digestive Tract Colonization With Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Detsis, Marios; Karanika, Styliani; Mylonakis, Eleftherios

    2017-04-01

    -lactamase-producing Enterobacteriaceae ranged from 5% to 10%. Previous use of beta-lactam/beta-lactamase or carbapenems and recent hospitalization were independent risk factors for extended-spectrum beta-lactamase-producing Enterobacteriaceae colonization, and colonization was associated with significantly higher frequency of extended-spectrum beta-lactamase-producing Enterobacteriaceae subsequent infection and increased mortality.

  1. The low risk of precancer after a screening result of human papillomavirus-negative/atypical squamous cells of undetermined significance papanicolaou and implications for clinical management.

    Science.gov (United States)

    Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Castle, Philip E; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Behrens, Catherine; Sharma, Abha; Zhao, Fang-Hui; Cuzick, Jack; Yang, Zi Hua; Kinney, Walter K

    2014-11-01

    Different US practice guidelines have conflicting recommendations for when women should return after a screening result of human papillomavirus (HPV)-negative with an equivocal Papanicolaou (Pap) result of atypical squamous cells of undetermined significance (ASC-US) (ie, return in either 3 or 5 years). One way to determine management is to compare the risk of precancer/cancer after an HPV-negative/ASC-US result with the risks after other negative screening results. For example, if the risk after an HPV-negative/ASC-US result was similar to the risk after a negative Pap test, a 3-year return would be preferred because guidelines agree that women with negative Pap test results should return in 3 years. Alternatively, if the risk after an HPV-negative/ASC-US result is similar to that after a cotest-negative result (HPV negative/Pap test negative), a 5-year return would be preferred because guidelines agree that women testing cotest negative should return in 5 years. The authors compared risks of cervical intraepithelial neoplasia of grade 3 or higher (CIN3+) and cervical cancer among women aged 30 years to 64 years at Kaiser Permanente Northern California with the following test results from 2003 through 2012: 17,191 women testing HPV negative/ASC-US; 980,268 women testing Pap test negative (regardless of HPV result); and 892,882 women testing cotest negative. The 5-year CIN3+ and cancer risks after an HPV-negative/ASC-US result were closer to the risks after a negative Pap test result (CIN3+: 0.48% vs 0.31% [P =.0019]; and cancer: 0.043% vs 0.031% [P =.4]) than after a negative cotest (CIN3+: 0.48% vs 0.11% [P<.0001]; and cancer: 0.043% vs 0.014% [P =.016]). Women testing HPV negative/ASC-US were found to have precancer/cancer risks that were more closely aligned with women with negative Pap test results, suggesting that women testing HPV negative/ASC-US should be managed similarly to women testing negative on Pap tests with a 3-year return for screening. © 2014

  2. Reducing Eating Disorder Onset in a Very High Risk Sample with Significant Comorbid Depression: A Randomized Controlled Trial

    Science.gov (United States)

    Taylor, C. Barr; Kass, Andrea E.; Trockel, Mickey; Cunning, Darby; Weisman, Hannah; Bailey, Jakki; Sinton, Meghan; Aspen, Vandana; Schecthman, Kenneth; Jacobi, Corinna; Wilfley, Denise E.

    2015-01-01

    Objective Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated on-line eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated. Method 206 women (M age = 20 ± 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or non-clinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or wait-list control. Assessments included the Eating Disorder Examination (EDE to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II. Results ED attitudes and behaviors improved more in the intervention than control group (p = 0.02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = 0.28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% versus 42%, p = 0.025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = 0.016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% versus 57%, NNT = 4). Conclusions An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research. PMID:26795936

  3. Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial.

    Science.gov (United States)

    Taylor, C Barr; Kass, Andrea E; Trockel, Mickey; Cunning, Darby; Weisman, Hannah; Bailey, Jakki; Sinton, Meghan; Aspen, Vandana; Schecthman, Kenneth; Jacobi, Corinna; Wilfley, Denise E

    2016-05-01

    Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated online eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated. 206 women (M age = 20 ± 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or nonclinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or waitlist control. Assessments included the Eating Disorder Examination (EDE, to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II. ED attitudes and behaviors improved more in the intervention than control group (p = .02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = .28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% vs. 42%, p = .025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = .016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% vs. 57%, NNT = 4). An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research. (c) 2016 APA, all rights reserved).

  4. Do hemophiliacs have a higher risk for dental caries than the general population?

    OpenAIRE

    Žaliūnienė, Rūta; Aleksejūnienė, Jolanta; Brukienė, Vilma; Pečiulienė, Vytautė

    2015-01-01

    Objective: The aim of this study was to examine if patients with hemophilia were at increased risk for dental decay as compared to the general population. Materials and methods: Census sampling was used in this case–control study to recruit cases (patients with hemophilia) and a control group individuals recruited randomly from the general population, which were matched with cases based on gender, age and place of residence. Clinical examinations included dental health and salivary assessm...

  5. Do hemophiliacs have a higher risk for dental caries than the general population?

    OpenAIRE

    Žaliūnienė, Rūta; Aleksejūnienė, Jolanta; Brukienė, Vilma; Pečiulienė, Vytautė

    2015-01-01

    Objective: The aim of this study was to examine if patients with hemophilia were at increased risk for dental decay as compared to the general population. Materials and methods: Census sampling was used in this case–control study to recruit cases (patients with hemophilia) and a control group individuals recruited randomly from the general population, which were matched with cases based on gender, age and place of residence. Clinical examinations included dental health and salivary assessment...

  6. Higher intake of fruits, vegetables or their fiber reduces the risk of type?2 diabetes: A meta?analysis

    OpenAIRE

    Wang, Ping?Yu; Fang, Jun?Chao; Gao, Zong?Hua; Zhang, Can; Xie, Shu?Yang

    2015-01-01

    Abstract Aims/Introduction Some previous studies reported no significant association of consuming fruit or vegetables, or fruit and vegetables combined, with type 2 diabetes. Others reported that only a greater intake of green leafy vegetables reduced the risk of type 2 diabetes. To further investigate the relationship between them, we carried out a meta‐analysis to estimate the independent effects of the intake of fruit, vegetables and fiber on the risk of type 2 diabetes. Materials and Meth...

  7. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength.

    Science.gov (United States)

    Sinaki, Mehrsheed; Brey, Robert H; Hughes, Christine A; Larson, Dirk R; Kaufman, Kenton R

    2005-08-01

    This controlled trial was designed to investigate the influence of osteoporosis-related kyphosis (O-K) on falls. Twelve community-dwelling women with O-K (Cobb angle, 50-65 degrees measured from spine radiographs) and 13 healthy women serving as controls were enrolled. Mean age of the O-K group was 76 years (+/-5.1), height 158 cm (+/-5), and weight 61 kg (+/-7.9), and mean age of the control group was 71 years (+/-4.6), height 161 cm (+/-3.8), and weight 66 kg (+/-11.7). Quantitative isometric strength data were collected. Gait was monitored during unobstructed level walking and during stepping over an obstacle of four different heights randomly assigned (2.5%, 5%, 10%, and 15% of the subject's height). Balance was objectively assessed with computerized dynamic posturography consisting of the sensory organization test. Back extensor strength, grip strength, and all lower extremity muscle groups were significantly weaker in the O-K group than the control group (P controls for all conditions of unobstructed and obstructed level walking. Obstacle height had a significant effect on all center-of-mass variables. The O-K subjects had significantly greater balance abnormalities on computerized dynamic posturography than the control group (P =0.002). Data show that thoracic hyperkyphosis on a background of reduced muscle strength plays an important role in increasing body sway, gait unsteadiness, and risk of falls in osteoporosis.

  8. Higher risk of complications in odynophagia-associated dysphagia in amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Karen Fontes Luchesi

    2014-03-01

    Full Text Available Objective This investigation aimed to identify associated factors with dysphagia severity in amyotrophic lateral sclerosis (ALS. Method We performed a cross-sectional study of 49 patients with ALS. All patients underwent fiberoptic endoscopy evaluation of swallowing and answered a verbal questionnaire about swallowing complaints. The patients were divided into groups according to dysphagia severity. Results Among the factors analyzed, only odynophagia was associated with moderate or severe dysphagia. Conclusion Odynophagia was associated with moderate and severe dysphagia in ALS and suggests a high risk of pulmonary and nutritional complications.

  9. Managing Reputation Risk and Situational Crisis in Higher Institutions of Learning

    OpenAIRE

    Effiong, Andem Ita

    2014-01-01

    Extant literature on crisis and corporate reputation management has presented the Situational Crisis Communication Theory (SCCT) model as a valid and reliable framework for managing crisis and predicting stakeholders’perceptions of organizations’ reputation in times of crisis. In order to verifythe applicability of the model in higher institutions of learning in adeveloping country context, a study was conducted in September, 2011 in twopublic universities in Nigeria. The findings of the stud...

  10. Post-migration living difficulties as a significant risk factor for PTSD in immigrants: a primary care study

    Directory of Open Access Journals (Sweden)

    Massimilano Aragona

    2012-09-01

    Full Text Available

    Background: recent research shows that severe/very severe post-migration living difficulties (PMLD have a negative impact on the mental health and social integration of refugees and asylum seekers. This study focuses on the role of PMLD in primary care “ordinary” immigrants.

    Methods: 443 primary care immigrants were asked to complete a self-administered questionnaire measuring the number and severity of pre-migratory potentially traumatic events (PTE, PMLD, and the current prevalence of a post-traumatic stress disorder (PTSD. The frequency of PMLD was assessed in the whole sample and compared in patients with and without PTSD. The effect of the number of PMLD on the risk of having a PTSD was studied by means of a regression analysis, adjusted by the number of PTE.

    Results: 391 patients completed the questionnaire and were enrolled into the study. The prevalence of PTSD was 10.2%. In the whole sample the most frequent PMLD were “no permission to work” (38.6% and “poverty” (34.5%. All PMLD (except “communication difficulties” were more frequent in patients with a PTSD. The number of PMLD significantly increased the likelihood to have a PTSD independently from PTE. Conclusions: severe/very severe post-migration living difficulties (PMLD increase significantly the risk of PTSD in primary care “ordinary” migrants. Our hypothesis is that they have a retraumatizing effect on individuals who are already vulnerable and with a low capacity to handle resettlement stress due to their previous traumatic history. The implications in clinical practice and for immigration policies are discussed.

  11. Should elderly patients with higher-risk myelodysplastic syndromes undergo allogeneic hematopoietic stem cell transplantation?

    Science.gov (United States)

    Zeidan, Amer M; Gore, Steven D

    2013-10-01

    Myelodysplastic syndromes (MDS) include a group of hematopoietic malignancies characterized by dysplastic changes, ineffective hematopoiesis and variable risk of leukemic progression. At diagnosis, 86% of MDS patients are ≥60 years. Azacitidine, the only drug that prolongs life in high-risk (HR)-MDS patients, adds a median of only 9.5 months to life. Allogeneic stem cell transplantation (alloSCT) remains the only potentially curative approach. Despite recent improvements including use of reduced intensity conditioning (RIC) that decrease transplant-related mortality, alloSCT continues to be used rarely in elderly MDS. There is paucity of data regarding outcomes of RIC alloSCT in elderly MDS patients, especially in direct comparison with azanucleosides. In this paper, the authors discuss the recent Markov decision analysis by Koreth et al. in which investigators demonstrated superior survival of patients with HR-MDS aged 60-70 years who underwent RIC alloSCT in comparison with those who were treated with azanucleosides.

  12. Investigating approaches to improving appropriate antibiotic use among higher risk ethnic groups.

    Science.gov (United States)

    Alden, Dana L; Tice, Alan D; Berthiaume, John T

    2010-11-01

    A field study with follow up investigations sought to: 1. determine whether cold packs (over-the-counter symptomtic treatments), coupled with in-office education, improve antibiotic-related knowledge, attitudes and behaviors more than in-office education alone in patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders; 2. identify possible reasons for intervention outcomes as described by physicians who participated in the field study; and 3. explore potential future directions based on a large sample survey of physicians in the field study's highly ethnic county. The intervention resulted in a pre- to post-consultation decrease in perceived need for and an increase in knowledge about antibiotic risks but had no impact on frequency of reported receipt of an antibiotic prescription. Unexpectedly, in-office education alone was more effective in increasing knowledge than in-office education plus the cold pack. In-depth interviews of field study physicians and a large scale physician survey suggest that cold pack interventions targeting patient populations with high percentages of Asian Americans and Hawaiian/Pacific Islanders may be more likely to succeed if accompanied by mass public education regarding risks and physician training regarding effective ways to talk to patients. Use of in-office education with cold packs alone may not achieve desired results. Hawaii Medical Journal Copyright 2010.

  13. Higher risk of probable mental emotional disorder in low or severe vision subjects

    Directory of Open Access Journals (Sweden)

    Lutfah Rif’ati

    2012-07-01

    health problem priority in Indonesia. This paper presents an assessment of severe visual impairments related to the risk of MED. Methods: This paper assessed a part of Basic Health Research (Riskesdas 2007 data. For this assessment, subjects 15 years old or more had their visual acuity measured using the Snellen chart and their mental health status determined using the Self Reporting Questionnaire (SRQ 20. A subject was considered to have probable MED if the subject had a total score of 6 or more on the SRQ. Based on the measure of visual acuity, visual acuity was divided into 3 categories: normal/mild (20/20 to 20/60; low vision (less than 20/60 to 3/60; and blind (less than 3/60 to 0/0. Results: Among 972,989 subjects, 554,886 were aged 15 years or older. 11.4% of the subjects had probable MED. The prevalence of low vision and blindness was 5.1% and 0.9%, respectively. Compared to subjects with normal or mild visual impairments, subjects with low vision had a 74% increased risk for probable MED [adjusted relative risk (RRa=1,75; 95% confidence interval (CI=1,71-1,79].  Blind subjects had a 2.7-fold risk to be probable MED (RRa=2.69; 95% CI=2.60-2.78] compared to subjects with normal or mild visual impairments. Conclusion: Visual impairment severity increased probable MED risk. Therefore, visual impairment subjects need more attention on probable MED. (Health Science Indones 2011;2:9-13

  14. Prostate-specific antigen cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

    International Nuclear Information System (INIS)

    Lankford, Scott P.; Pollack, Alan; Zagars, Gunar K.

    1997-01-01

    Purpose: Although the pretreatment serum prostate-specific antigen level (PSAL) is the single-most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV), an estimate of cancer volume based on PSA, has recently been described and has been purported to be more significant t than PSAL in predicting early biochemical failure after radiotherapy. We report a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4,Nx,M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV was calculated using a formula which takes into account PSAL, pretreatment prostate ultrasound volume, and Gleason score. The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, obtained for evidence of tumor progression. Results: The distributions of PSACV and PSAL were similar and, when normalized by log transformation, were highly correlated (p < 0.0001, linear regression). There was a statistically significant relationship between PSACV and several potential prognostic factors including PSAL, PSAD, stage, Gleason score, and

  15. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Nielsen, Jens Rokkedal; Abdulla, Jawdat

    2009-01-01

    AIMS: The aim of this study was to examine by a systematic literature review and meta-analysis whether the risk of atrial fibrillation (AF) is higher in athletes compared with not athletes. METHODS AND RESULTS: A comprehensive systematic search was conducted for case-control studies that examined....... There were 147 (23%) vs. 116 (12.5%) cases of AF among athletes compared with controls. The overall risk of AF was significantly higher in athletes than in controls with odds ratio (95% confidence interval)=5.29 (3.57-7.85), P=0.0001, and Z-score=8.08. For heterogeneity, the calculated chi2=2.92, P=0...

  16. Agrochemicals increase risk of human schistosomiasis by supporting higher densities of intermediate hosts.

    Science.gov (United States)

    Halstead, Neal T; Hoover, Christopher M; Arakala, Arathi; Civitello, David J; De Leo, Giulio A; Gambhir, Manoj; Johnson, Steve A; Jouanard, Nicolas; Loerns, Kristin A; McMahon, Taegan A; Ndione, Raphael A; Nguyen, Karena; Raffel, Thomas R; Remais, Justin V; Riveau, Gilles; Sokolow, Susanne H; Rohr, Jason R

    2018-02-26

    Schistosomiasis is a snail-borne parasitic disease that ranks among the most important water-based diseases of humans in developing countries. Increased prevalence and spread of human schistosomiasis to non-endemic areas has been consistently linked with water resource management related to agricultural expansion. However, the role of agrochemical pollution in human schistosome transmission remains unexplored, despite strong evidence of agrochemicals increasing snail-borne diseases of wildlife and a projected 2- to 5-fold increase in global agrochemical use by 2050. Using a field mesocosm experiment, we show that environmentally relevant concentrations of fertilizer, a herbicide, and an insecticide, individually and as mixtures, increase densities of schistosome-infected snails by increasing the algae snails eat and decreasing densities of snail predators. Epidemiological models indicate that these agrochemical effects can increase transmission of schistosomes. Identifying agricultural practices or agrochemicals that minimize disease risk will be critical to meeting growing food demands while improving human wellbeing.

  17. Significance of the sexual openings and supplementary structures on the phylogeny of brachyuran crabs (Crustacea, Decapoda, Brachyura), with new nomina for higher-ranked podotreme taxa.

    Science.gov (United States)

    Guinot, Danièle; Tavares, Marcos; Castro, Peter

    2013-01-01

    The patterns of complexity of the male and female sexual openings in Brachyura, which have been the source of uncertainties and conflicting opinions, are documented, together with a study of the morphologies of the coxal and sternal gonopores in both sexes, penises, spermathecae, and gonopods. The vulvae, male gonopores and penises are described among selected taxa of Eubrachyura, and their function and evolution examined in the context of a wide variety of mating behaviours. The location of female and male gonopores, the condition of the penis (coxal and sternal openings and modalities of protection), and related configurations of thoracic sternites 7 and 8, which are modified by the intercalation of a wide sternal part (thoracic sternites 7 and 8) during carcinisation, show evidence of deep homology. They represent taxonomic criteria at all ranks of the family-series and may be used to test lineages. Of particular significance are the consequences of the posterior expansion of the thoracic sternum, which influences the condition, shape, and sclerotisation of the penis, and its emergence from coxal (heterotreme) to coxo-sternal, which is actually still coxal (heterotreme), in contrast to a sternal emergence (thoracotreme). The heterotreme-thoracotreme distinction results from two different trajectories of the vas deferens and its ejaculatory duct via the P5 coxa (Heterotremata) or through the thoracic sternum (Thoracotremata). Dissections of males of several families have demonstrated that this major difference not only affects the external surface (perforation of the coxa or the sternum by the ejaculatory duct) but also the internal anatomy. There is no evidence for an ejaculatory duct passing through the articular membrane between the P5 coxa and the thoracic sternum in any Brachyura, even when the sternal male gonopore is very close to the P5 coxa. Trends towards the coxo-sternal condition are exemplified by multistate characters, varying from a shallow

  18. Short repeats in the heme oxygenase 1 gene promoter is associated with increased levels of inflammation, ferritin and higher risk of type-2 diabetes mellitus.

    Science.gov (United States)

    Andrews, Mónica; Leiva, Elba; Arredondo-Olguín, Miguel

    2016-09-01

    We evaluated the relationship between the HO1 genotype, ferritin levels and the risk of type-2 diabetes and inflammation. Eight hundred thirty-five individuals were evaluated and classified according to their nutritional status and the presence of type-2 diabetes: 153 overweight (OW); 62 obese (OB); 55 type-2 diabetes mellitus (DM); 202 OWDM; 239 OBDM and 124 controls (C). We studied biochemical (glycemia, insulin, lipid profile, liver enzyme, creatinine, hsCRP), hematological (hemoglobin, free erythrocyte protoporphyrin, transferrin receptor and serum Fe and ferritin) and oxidative stress (SOD, GHS and TBARS) parameters. We determined heme oxygenase activity and the (GT)n polymorphism in its gene promoter. Individuals with diabetes, independent of nutritional status, showed high levels of ferritin and HO activity compared to control subjects. Allelic frequency was not different between the groups (Chi(2), NS) however, genotypes were different (Chi(2), P1). The SS (short-short) genotype was higher in all DM individuals compared to controls and MM was higher in controls. SM (short-medium) genotype was an independent risk factor for DM in logistic regression analysis. We observed high risk for type-2 diabetes mellitus in the presence of SM genotype and high levels of ferritin (OR adjusted: 2.7; 1.9-3.6; p1; compared to control group). It was also significantly related to inflammation. The SM genotype in HO1 gene promoter and ferritin levels were associated with higher risk for type-2 diabetes and for having a higher marker of inflammation, which is the main risk factor for the development of chronic diseases. Copyright © 2016 Elsevier GmbH. All rights reserved.

  19. Increased Eating Frequency Is Associated with Lower Obesity Risk, But Higher Energy Intake in Adults: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yue-Qiao Wang

    2016-06-01

    Full Text Available Body weight is regulated by energy intake which occurs several times a day in humans. In this meta-analysis, we evaluated whether eating frequency (EF is associated with obesity risk and energy intake in adults without any dietary restriction. Experimental and observational studies published before July 2015 were selected through English-language literature searches in several databases. These studies reported the association between EF and obesity risk (odd ratios, ORs in adults who were not in dietary restriction. R software was used to perform statistical analyses. Ten cross-sectional studies, consisting of 65,742 participants, were included in this analysis. ORs were considered as effect size for the analysis about the effect of EF on obesity risk. Results showed that the increase of EF was associated with 0.83 time lower odds of obesity (i.e., OR = 0.83, 95% confidence intervals (CI 0.70–0.99, p = 0.040. Analysis about the effect of EF on differences in participants’ energy intake revealed that increased EF was associated with higher energy intake (β = 125.36, 95% CI 21.76–228.97, p = 0.017. We conclude that increased EF may lead to lower obesity risk but higher energy intake. Clinical trials are warranted to confirm these results and to assess the clinical practice applicability.

  20. Sharper angle, higher risk? The effect of cutting angle on knee mechanics in invasion sport athletes.

    Science.gov (United States)

    Schreurs, Mervin J; Benjaminse, Anne; Lemmink, Koen A P M

    2017-10-03

    Cutting is an important skill in team-sports, but unfortunately is also related to non-contact ACL injuries. The purpose was to examine knee kinetics and kinematics at different cutting angles. 13 males and 16 females performed cuts at different angles (45°, 90°, 135° and 180°) at maximum speed. 3D kinematics and kinetics were collected. To determine differences across cutting angles (45°, 90°, 135° and 180°) and sex (female, male), a 4×2 repeated measures ANOVA was conducted followed by post hoc comparisons (Bonferroni) with alpha level set at α≤0.05a priori. At all cutting angles, males showed greater knee flexion angles than females (pcutting angles with no differences in the amount of knee flexion -42.53°±8.95°, females decreased their knee flexion angle from -40.6°±7.2° when cutting at 45° to -36.81°±9.10° when cutting at 90°, 135° and 180° (pcutting towards sharper angles (pcutting angles and then stabilized compared to the 45° cutting angle (pcutting to sharper angles (pcutting angles demand different knee kinematics and kinetics. Sharper cutting angles place the knee more at risk. However, females and males handle this differently, which has implications for injury prevention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Knowledge sharing behaviour among non-academic staff in higher learning institutes: The role of trust and perceived risk

    Directory of Open Access Journals (Sweden)

    Muhammad Sabbir Rahman

    2018-03-01

    Full Text Available The purpose of the paper is to analyse knowledge sharing behaviour among non-academic staff of higher learning institutions. This research focuses on the mediation impact of perceived risk on trust and knowledge sharing behaviour. The research also proposes actions that can be taken by higher learning institutions to enhance trust among the staff in order to create a knowledge sharing environment at the workplace. This research applied confirmatory factor analysis and Structural Equation Modeling (SEM to evaluate the proposed measurement model and proved the research hypotheses. The findings from the research show that perceived risk plays a strong mediating role between trust and knowledge sharing behaviour among the non-academic staff of higher learning institutions. The SEM analysis also confirmed that the research model shows a good fit. This research highlights issues concerning knowledge sharing practices among non-academic staff and provides some recommendations to the managers to address these issues. The researchers agreed that more research needs to be done in this area as there are aspects that are yet to be explored. The findings of this research serve to add to the literature on knowledge sharing focussing on non-academic staff of higher learning institutions.

  2. Instant coffee consumption may be associated with higher risk of metabolic syndrome in Korean adults.

    Science.gov (United States)

    Kim, Hyo-Jin; Cho, Seongbeom; Jacobs, David R; Park, Kyong

    2014-10-01

    Cumulative evidence suggests that coffee consumption may have beneficial effects on metabolic diseases; however, few previous studies have considered the types of coffee consumed and the additives used. We investigated the relationship between coffee consumption and metabolic syndrome (MetSyn) and its components. We analyzed 17,953 Korean adults, aged 19-65 years, using cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2007-2011). Coffee consumption level, types of coffee consumed, and the additives used were assessed based on a food frequency questionnaire and 24-h recall. Demographic and lifestyle factors were assessed using self-administered questionnaires. Data on metabolic biomarkers were obtained from a health examination. Multivariable logistic regression was used to determine the odds ratios of prevalent metabolic syndrome and its components according to frequency and type of coffee consumption. We found that 76% of the subjects were habitual coffee drinkers, most of whom consumed instant coffee mix containing sugar and powder creamer. After multivariable adjustment, the odds ratios (95% CI) comparing those who consumed coffee ≥3 times/day with those who consumed coffee <1 time/week were 1.37 (1.15-1.63) for obesity, 1.33 (1.11-1.59) for abdominal obesity, 1.28 (1.09-1.51) for hypo-HDL cholesterolemia, and 1.37 (1.10-1.72) for metabolic syndrome. Instant-coffee drinkers were observed to have elevated risks of these metabolic conditions. Consumption of coffee, particularly instant coffee mix, may have harmful effects on MetSyn, perhaps partly deriving from excessive intake of sugar and powder creamer. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. The significance of recruiting underrepresented minorities in medicine: an examination of the need for effective approaches used in admissions by higher education institutions

    Directory of Open Access Journals (Sweden)

    Obed Figueroa

    2014-09-01

    Full Text Available The purpose of this paper is to examine the significance of recruiting underrepresented minorities in medicine (URM. This would include African Americans, Hispanics, and Native Americans. The research findings support the belief that URMs, upon graduating, are more likely to become practitioners in underserved communities, thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide. This paper analyzes the recruitment challenges for institutions, followed by a review of creative and effective approaches used by organizations and universities. The results have shown positive outcomes averaging a 50% increase in minority enrollments and retention. In other areas, such as cognitive development, modest gains were achieved in programs that were shorter in duration. The results nevertheless indicated steps in the right direction inspiring further program developments.

  4. PCR reveals significantly higher rates of Trypanosoma cruzi infection than microscopy in the Chagas vector, Triatoma infestans: High rates found in Chuquisaca, Bolivia

    Directory of Open Access Journals (Sweden)

    Lucero David E

    2007-06-01

    ' and TCZ2 (5' – CCT CCA AGC AGC GGA TAG TTC AGG – 3' primers. Amplicons were chromatographed on a 2% agarose gel with a 100 bp size standard, stained with ethidium bromide and viewed with UV fluorescence. For both the microscopy and PCR assays, we calculated sensitivity (number of positives by a method divided by the number of positives by either method and discrepancy (one method was negative and the other was positive at the locality, life stage and habitat level. The degree of agreement between PCR and microscopy was determined by calculating Kappa (k values with 95% confidence intervals. Results We observed a high prevalence of T. cruzi infection in T. infestans (81.16% by PCR and 56.52% by microscopy and discovered that PCR is significantly more sensitive than microscopic observation. The overall degree of agreement between the two methods was moderate (Kappa = 0.43 ± 0.07. The level of infection is significantly different among communities; however, prevalence was similar among habitats and life stages. Conclusion PCR was significantly more sensitive than microscopy in all habitats, developmental stages and localities in Chuquisaca, Bolivia. Overall we observed a high prevalence of T. cruzi infection in T. infestans in this area of Bolivia; however, microscopy underestimated infection at all levels examined.

  5. Outcomes of three universal eating disorder risk reduction programs by participants with higher and lower baseline shape and weight concern.

    Science.gov (United States)

    Wilksch, Simon M; Paxton, Susan J; Byrne, Susan M; Austin, S Bryn; O'Shea, Anne; Wade, Tracey D

    2017-01-01

    To investigate if baseline shape and weight concern (SWC) moderated outcomes in Prevention Across the Spectrum, a randomized-controlled trial (RCT) of 3 school-based programs aimed at reducing eating disorder and obesity risk factors. N = 1,316 Grade 7 and 8 girls and boys (M age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; Helping, Encouraging, Listening and Protecting Peers Initiative (HELPP) or control (usual school class). Moderation was explored by testing interaction effects for group (Media Smart; Life Smart; HELPP; Control) × moderator (SWC: higher-SWC; lower-SWC) × time (post-program; 6-month follow-up; 12-month follow-up), with baseline risk factor scores entered as covariates. Moderation effects were found for shape concern, weight concern, eating concern, regular eating (i.e., meal skipping), physical activity, body dissatisfaction, dieting, and perfectionism. Post-hoc testing found eating concern at post-program was the only variable where higher-SWC Media Smart participants experienced a reduction in risk relative to controls. Both higher-SWC Life Smart and HELPP participants reported an increase in eating concern relative to controls and both groups were skipping more meals than controls at 12-month follow-up. Amongst lower-SWC participants, Media Smart was the only group to experience a benefit relative to controls (physical activity). This study highlights the need for moderator analyses to become more routinely conducted in universal trials, to ensure that participants across baseline risk levels are benefiting and not harmed from program participation. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:66-75). © 2016 Wiley Periodicals, Inc.

  6. Disease risk in temperate amphibian populations is higher at closed-canopy sites.

    Directory of Open Access Journals (Sweden)

    C Guilherme Becker

    Full Text Available Habitat loss and chytridiomycosis (a disease caused by the chytrid fungus Batrachochytrium dendrobatidis - Bd are major drivers of amphibian declines worldwide. Habitat loss regulates host-pathogen interactions by altering biotic and abiotic factors directly linked to both host and pathogen fitness. Therefore, studies investigating the links between natural vegetation and chytridiomycosis require integrative approaches to control for the multitude of possible interactions of biological and environmental variables in spatial epidemiology. In this study, we quantified Bd infection dynamics across a gradient of natural vegetation and microclimates, looking for causal associations between vegetation cover, multiple microclimatic variables, and pathogen prevalence and infection intensity. To minimize the effects of host diversity in our analyses, we sampled amphibian populations in the Adirondack Mountains of New York State, a region with relatively high single-host dominance. We sampled permanent ponds for anurans, focusing on populations of the habitat generalist frog Lithobates clamitans, and recorded various biotic and abiotic factors that potentially affect host-pathogen interactions: natural vegetation, canopy density, water temperature, and host population and community attributes. We screened for important explanatory variables of Bd infections and used path analyses to statistically test for the strength of cascading effects linking vegetation cover, microclimate, and Bd parameters. We found that canopy density, natural vegetation, and daily average water temperature were the best predictors of Bd. High canopy density resulted in lower water temperature, which in turn predicted higher Bd prevalence and infection intensity. Our results confirm that microclimatic shifts arising from changes in natural vegetation play an important role in Bd spatial epidemiology, with areas of closed canopy favoring Bd. Given increasing rates of anthropogenic

  7. Lack of Significant Effects of Chlamydia trachomatis Infection on Cervical Adenocarcinoma Risk: Nested Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Vitaly Smelov

    Full Text Available A role of Chlamydia trachomatis in HPV-induced cervical carcinogenesis has been reported for cervical cancer but studies on cervical adenocarcinoma are limited.A total of 1,553 cervical smears taken up to 26 years before diagnosis in a large population-based nested case-control study of cervical adenocarcinoma (AC, 132 cases with matched controls, and adenocarcinoma in situ (AIS, 159 cases with matched controls were tested for C. trachomatis and HPV DNA by a type-specific PCR bead-based multiplex genotyping (TS-MPG assay.Only 1.7% of samples were positive for C. trachomatis, with no significant differences between AC/AIS cases and controls. HPV-positivity was detected in 49.3% of C. trachomatis-negative and 65.4% C. trachomatis-positive samples, respectively.A large prospective study did not find any risk for cervical adenocarcinoma and/or AIS conferred by C. trachomatis infection.C. trachomatis appears not to be involved in cervical adenocarcinomas.

  8. 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.

  9. Young males have a higher risk of developing schizophrenia: a Danish register study

    DEFF Research Database (Denmark)

    Thorup, Anne; Waltoft, Berit Lindum; Pedersen, Carsten Bøcker

    2007-01-01

    of schizophrenia in people aged up to 71 years.Method. Two cohorts were established by linking data from the Danish Civil Registration System (DCRS) with data from the Danish Psychiatric Central Register (DPCR), which covers all incident cases of schizophrenia from 15 to 71 years. We estimated the gender- and age......Background. Gender differences are commonly reported in schizophrenia research, especially with regard to age at onset. Few studies have reported the age- and gender-specific incidence of schizophrenia in people aged up to 71 years, and no studies have reported the cumulative incidence......-specific incidence rates of schizophrenia for people aged up to 71 years. We also estimated the cumulative incidences.Results. The incidence rates for males significantly exceeded those for females in the age range from 17 to 40 years. By their 72nd birthday, 1.59% of males and 1.17% of females had developed...

  10. Young males have a higher risk of developing schizophrenia: a Danish register study

    DEFF Research Database (Denmark)

    Thorup, Anne; Waltoft, Berit Lindum; Pedersen, Carsten Bøcker

    2007-01-01

    -specific incidence rates of schizophrenia for people aged up to 71 years. We also estimated the cumulative incidences.Results. The incidence rates for males significantly exceeded those for females in the age range from 17 to 40 years. By their 72nd birthday, 1.59% of males and 1.17% of females had developed......Background. Gender differences are commonly reported in schizophrenia research, especially with regard to age at onset. Few studies have reported the age- and gender-specific incidence of schizophrenia in people aged up to 71 years, and no studies have reported the cumulative incidence...... of schizophrenia in people aged up to 71 years.Method. Two cohorts were established by linking data from the Danish Civil Registration System (DCRS) with data from the Danish Psychiatric Central Register (DPCR), which covers all incident cases of schizophrenia from 15 to 71 years. We estimated the gender- and age...

  11. Global analysis of threat status reveals higher extinction risk in tropical than in temperate bird sister species

    Directory of Open Access Journals (Sweden)

    Reif Jiří

    2016-06-01

    Full Text Available Given increasing pressures upon biodiversity, identification of species’ traits related to elevated extinction risk is useful for more efficient allocation of limited resources for nature conservation. Despite its need, such a global analysis was lacking in the case of birds. Therefore, we performed this exercise for avian sister species using information about their global extinction risk from IUCN Red List. We focused on 113 pairs of sister species, each containing a threatened and an unthreatened species to factor out the effects of common evolutionary history on the revealed relationship. We collected data on five traits with expected relationships to species’ extinction risk based on previous studies performed at regional or national levels: breeding habitat (recognizing forest, grassland, wetland and oceanic species, latitudinal range position (temperate and tropics species, migration strategy (migratory and resident species, diet (carnivorous, insectivorous, herbivorous and omnivorous species and body mass. We related the extinction risk using IUCN threat level categories to species’ traits using generalised linear mixed effects models expecting lower risk for forest, temperate, omnivorous and smaller-bodied species. Our expectation was confirmed only in the case of latitudinal range position, as we revealed higher threat level for tropical than for temperate species. This relationship was robust to different methods of threat level expression and cannot be explained by a simple association of high bird species richness with the tropical zone. Instead, it seems that tropical species are more threatened because of their intrinsic characteristics such as slow life histories, adaptations to stable environments and small geographic ranges. These characteristics are obviously disadvantageous in conditions of current human-induced environmental perturbations. Moreover, given the absence of habitat effects, our study indicates that such

  12. Dysfunctional Default Mode Network in Methadone Treated Patients Who Have a Higher Heroin Relapse Risk.

    Science.gov (United States)

    Li, Wei; Li, Qiang; Wang, Defeng; Xiao, Wei; Liu, Kai; Shi, Lin; Zhu, Jia; Li, Yongbin; Yan, Xuejiao; Chen, Jiajie; Ye, Jianjun; Li, Zhe; Wang, Yarong; Wang, Wei

    2015-10-15

    The purpose of this study was to identify whether heroin relapse is associated with changes in the functional connectivity of the default mode network (DMN) during methadone maintenance treatment (MMT). Resting-state functional magnetic resonance imaging (fMRI) data of chronic heroin relapsers (HR) (12 males, 1 female, age: 36.1 ± 6.9 years) and abstainers (HA) (11males, 2 female; age: 42.1 ± 8.1 years) were investigated with an independent component analysis to address the functional connectivity of their DMN. Group comparison was then performed between the relapsers and abstainers. Our study found that the left inferior temporal gyrus and the right superior occipital gyrus associated with DMN showed decreased functional connectivity in HR when compared with HA, while the left precuneus and the right middle cingulum had increased functional connectivity. Mean intensity signal, extracted from left inferior temporal gyrus of HR patients, showed a significant negative correlation corresponding to the degree of heroin relapse. These findings suggest that altered functional connectivity of DMN may contribute to the potential neurobiological mechanism(s) of heroin relapse and have a predictive value concerning heroin relapse under MMT.

  13. Immediate treatment with bicalutamide 150mg as adjuvant therapy significantly reduces the risk of PSA progression in early prostate cancer

    DEFF Research Database (Denmark)

    See, W; Iversen, P; Wirth, M

    2003-01-01

    To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer.......To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer....

  14. Higher risk of developing major depression and bipolar disorder in later life among adolescents with asthma: a nationwide prospective study.

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2014-02-01

    Previous studies have suggested an immunological dysfunction in mood disorders, but rarely have investigated the temporal association between allergic diseases and mood disorders. Using the Taiwan National Health Insurance Research Database, we attempted to investigate the association between asthma in early adolescence and the risk of unipolar depression and bipolar disorder in later life. In all, 1453 adolescents with asthma aged between 10 and 15 years and 5812 age-/gender-matched controls were selected in 1998-2000. Subjects with unipolar depression and bipolar disorder that occurred up to the end of follow-up (December 31 2010) were identified. Adolescents with asthma had a higher incidence of major depression (2.8% vs. 1.1%, p bipolar disorder (1.0% vs. 0.3%, p adolescence was associated with an increased risk of developing major depression (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.14-2.89), any depressive disorder (HR: 1.74, 95% CI: 1.27-2.37), and bipolar disorder (HR: 2.27, 95% CI: 1.01-5.07), after adjusting for demographic data and comorbid allergic diseases. Adolescents with asthma had an elevated risk of developing mood disorders in later life. Further studies would be required to investigate the underlying mechanisms for this comorbid association and elucidate whether prompt intervention for asthma would decrease the risk of developing mood disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study.

    Science.gov (United States)

    Zhang, Zhu-Ming; Rautaharju, Pentti M; Prineas, Ronald J; Rodriguez, Carlos J; Loehr, Laura; Rosamond, Wayne D; Kitzman, Dalane; Couper, David; Soliman, Elsayed Z

    2016-05-31

    Race and sex differences in silent myocardial infarction (SMI) are not well established. The analysis included 9498 participants from the Atherosclerosis Risk in Communities (ARIC) study who were free of cardiovascular disease at baseline (visit 1, 1987-1989). Incident SMI was defined as ECG evidence of MI without clinically documented MI (CMI) after the baseline until ARIC visit 4 (1996-1998). Coronary heart disease and all-cause deaths were ascertained starting from ARIC visit 4 until 2010. During a median follow-up of 8.9 years, 317 participants (3.3%) developed SMI and 386 (4.1%) developed CMI. The incidence rates of both SMI and CMI were higher in men (5.08 and 7.96 per 1000-person years, respectively) than in women (2.93 and 2.25 per 1000-person years, respectively; Prace were detected. SMI represents >45% of incident MIs and is associated with poor prognosis. Race and sex differences in the incidence and prognostic significance of SMI exist that may warrant considering SMI in personalized assessments of coronary heart disease risk. © 2016 American Heart Association, Inc.

  16. Response to Instruction in Preschool: Results of Two Randomized Studies with Children At Significant Risk of Reading Difficulties

    Science.gov (United States)

    Lonigan, Christopher J.; Phillips, Beth M.

    2015-01-01

    Although response-to-instruction (RTI) approaches have received increased attention, few studies have evaluated the potential impacts of RTI approaches with preschool populations. This manuscript presents results of two studies examining impacts of Tier II instruction with preschool children. Participating children were identified as substantially delayed in the acquisition of early literacy skills despite exposure to high-quality, evidence-based classroom instruction. Study 1 included 93 children (M age = 58.2 months; SD = 3.62) attending 12 Title I preschools. Study 2 included 184 children (M age = 58.2 months; SD = 3.38) attending 19 Title I preschools. The majority of children were Black/African American, and about 60% were male. In both studies, eligible children were randomized to receive either 11 weeks of need-aligned, small-group instruction or just Tier I. Tier II instruction in Study 1 included variations of activities for code- and language-focused domains with prior evidence of efficacy in non-RTI contexts. Tier II instruction in Study 2 included instructional activities narrower in scope, more intensive, and delivered to smaller groups of children. Impacts of Tier II instruction in Study 1 were minimal; however, there were significant and moderate-to-large impacts in Study 2. These results identify effective Tier II instruction but indicate that the context in which children are identified may alter the nature of Tier II instruction that is required. Children identified as eligible for Tier II in an RTI framework likely require more intensive and more narrowly focused instruction than do children at general risk of later academic difficulties. PMID:26869730

  17. Higher 5-HT1A autoreceptor binding as an endophenotype for major depressive disorder identified in high risk offspring - A pilot study.

    Science.gov (United States)

    Milak, Matthew S; Pantazatos, Spiro; Rashid, Rain; Zanderigo, Francesca; DeLorenzo, Christine; Hesselgrave, Natalie; Ogden, R Todd; Oquendo, Maria A; Mulhern, Stephanie T; Miller, Jeffrey M; Burke, Ainsley K; Parsey, Ramin V; Mann, J John

    2018-04-13

    Higher serotonin-1A (5-HT 1A ) receptor binding potential (BP F ) has been found in major depressive disorder (MDD) during and between major depressive episodes. We investigated whether higher 5-HT 1A binding is a biologic trait transmitted to healthy high risk (HR) offspring of MDD probands. Data were collected contemporaneously from: nine HR, 30 depressed not-recently medicated (NRM) MDD, 18 remitted NRM MDD, 51 healthy volunteer (HV) subjects. Subjects underwent positron emission tomography (PET) using [ 11 C]WAY100635 to quantify 5-HT 1A BP F , estimated using metabolite, free fraction-corrected arterial input function and cerebellar white matter as reference region. Multivoxel pattern analyses (MVPA) of PET data evaluated group status classification of individuals. When tested across 13 regions of interest, an effect of diagnosis is found on BP F which remains significant after correction for sex, age, injected mass and dose: HR have higher BP F than HV (84.3% higher in midbrain raphe, 40.8% higher in hippocampus, mean BP F across all 13 brain regions is 49.9% ± 11.8% higher). Voxel-level BP F maps distinguish HR vs. HV. Elevated 5-HT 1A BP F appears to be a familially transmitted trait abnormality. Future studies are needed to replicate this finding in a larger cohort and demonstrate the link to the familial transmission of mood disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Prostate specific cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

    International Nuclear Information System (INIS)

    Lankford, S.P.; Pollack, A.; Zagars, G.K.

    1996-01-01

    Purpose: Although the pretreatment serum prostate specific antigen level (PSAL) is the single most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV) is an estimate of cancer volume based on PSA that was recently described by D'Amico and Propert (IJROBP 32:232, 1995) as providing significant and independent prognostic information in addition to PSAL. We report here a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4, Nx, M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV is a calculated parameter that takes into account PSAL (total PSA), ultrasonographic prostate volume (estimate of PSA from benign epithelium), and Gleason grade (estimate of PSA per tumor volume). The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, usually undertaken because of evidence of biochemical failure. Results: The distributions of PSACV and PSAL were similar and, when normalized by log-transformation, were highly correlated (p 4 cc, as compared to those with a PSACV ≤ 0.5 cc, was over 30%. Conclusion

  19. Do obese adults have a higher risk of asthma attack when exposed to indoor mold? A study based on the 2005 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Wen, Xiao-Jun; Balluz, Lina; Mokdad, Ali

    2009-01-01

    Some studies show an association between asthma and obesity, but it is unknown whether exposure to mold will increase the risk of asthma attacks among obese people. This study examined whether obese adults have a higher risk of asthma attacks than non-obese adults when exposed to indoor mold. We used data from the 2005 Behavioral Risk Factor Surveillance System to conduct a cross-sectional analysis among 9,668 respondents who reported exposure to indoor mold. With exposure to indoor mold, weighted prevalence of asthma attacks among obese respondents was 11.4% (95% confidence interval [CI] 6.0, 20.6], which was 2.3 times as high as among the exposed non-obese respondents (5.0%, 95% CI 2.8, 8.8). This ratio was almost the same as the ratio of 2.0:1 between the obese respondents (5.7%, 95% CI 4.6, 7.2) and the non-obese respondents (2.8%, 95% CI 2.3, 3.9) when neither group had exposure to mold. The odds ratio of asthma attack among obese people was 3.10 (95% CI 1.10, 8.67) for those with exposure to mold and 2.21 (95% CI 1.54, 3.17) for those without exposure to mold after adjusting for age, sex, race/ethnicity, and smoking status. Our study suggests that obese adults who have been exposed to indoor mold may not necessarily have a higher risk of asthma attack than obese adults who have not been exposed, even though obesity and exposure to indoor mold are both major risk factors for asthma attack. Medical professionals should not only incorporate weight-control or weight-reduction measures as the components of asthma treatment plans, but also advise asthma patients to avoid exposure to indoor mold.

  20. Risk-reducing Salpingo-Oophorectomy in Women at Higher Risk of Ovarian and Breast Cancer: A Single Institution Prospective Series.

    Science.gov (United States)

    Ricciardi, Enzo; Tomao, Federica; Aletti, Giovanni; Bazzurini, Luca; Bocciolone, Luca; Boveri, Sara; Landoni, Fabio; Lapresa, Maria Teresa; Maruccio, Matteo; Parma, Gabriella; Peccatori, Fedro; Petrella, Maria Cristina; Zanagnolo, Vanna; Colombo, Nicoletta; Maggioni, Angelo

    2017-09-01

    Occult cancers' reported rates vary from 2-12% and serous tubal intraepithelial carcinomas (STICs) have been identified in 3-12% of the prophylactically removed tubes of women carrying a BRCA mutation. The aim of this study was to evaluate the incidence of tubal minor epithelial atypia (STIL), STIC, and occult invasive cancer and to evaluate the cancer-specific mortality in a prospective series of women at higher risk of ovarian and breast cancer undergoing risk-reducing salpingo-oophorectomy (RRSO) n a tertiary cancer center. A series of RRSO specimens (including endometrial biopsy) from women carrying a BRCA mutation, BRCA-unknown and BRCA-negative were collected between January 1998 and April 2016 at the Division of Gynecology at the European Institute of Oncology. Inclusion criteria were: asymptomatic women who had a negative gynecologic screening within 3 months prior to RRSO. Exclusion criteria were: women with ovarian/tubal cancer prior to RRSO. A total of 411 women underwent RRSO. Median age at RRSO was 47.0 years (range=32-70 years); 75.2% had a history of breast cancer. Fifteen women were diagnosed with an occult cancer (7 STIC, 4 invasive cancers, 2 breast cancers metastatic to the adnexa, 2 endometrial cancer) (3.6%). Sixteen showed a STIL (3.9%). When excluding cases with preoperative positive markers, the occult invasive cancer rate drops to 1.5%. Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  1. Prostate cancer risk: the significance of differences in age related changes in serum conjugated and unconjugated steroid hormone concentrations between Arab and Caucasian men.

    Science.gov (United States)

    Kehinde, E O; Akanji, A O; Memon, A; Bashir, A A; Daar, A S; Al-Awadi, K A; Fatinikun, T

    2006-01-01

    Factors responsible for the low incidence of clinical prostate cancer (3-8/100,000 men/year) in the Arab population remain unclear, but may be related to changes in steroid hormone metabolism. We compared the levels of serum conjugated and unconjugated steroids between Arab and Caucasian populations, to determine if these can provide a rational explanation for differences in incidence of prostate cancer between the two populations. Venous blood samples were obtained from 329 unselected apparently healthy indigenous Arab men (Kuwaitis and Omanis) aged 15-80 years. Samples were also obtained from similar Arab men with newly diagnosed prostate cancer or benign prostatic hyperplasia (BPH). The samples were taken between 8:00 am and 12:00 noon. Serum levels of total testosterone, (TT), sex hormone binding globulin (SHBG), free androgen index (FAI); adrenal C19-steroids, dehydroepiandrosterone sulphate (DHEAS) and androstenedione (ADT) were determined using Immulite kits (Diagnostic Systems Laboratories Inc, Webster Texas, USA). The results obtained in Arab men were compared with those reported for similarly aged Chinese, German and White USA men. In all four ethnic groups, median TT and FAI declined with age, while SHBG increased with age. However, the mean TT and SHBG was significantly lower (p Arab men (p Arabs (p Arabs. There was no significant difference in mean serum levels of DHEAS between German and USA men. Similarly, there was no significant difference in the level of the hormones between Arab and Chinese men. Arab men with newly diagnosed prostate cancer had high serum TT, SHBG and DHEAS compared to those without the disease. The mean TT and SHBG was significantly lower in Arab men compared to Caucasian men especially in early adulthood. Caucasians have significantly higher serum levels of the precursor androgens DHEAS and ADT especially in early adulthood compared to Arab men. These observations of low circulating androgens and their adrenal precursors in

  2. Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status.

    Science.gov (United States)

    Aris, I M; Bernard, J Y; Chen, L-W; Tint, M T; Pang, W W; Soh, S E; Saw, S-M; Shek, L P-C; Godfrey, K M; Gluckman, P D; Chong, Y-S; Yap, F; Kramer, M S; Lee, Y S

    2018-01-01

    Many studies have identified early-life risk factors for subsequent childhood overweight/obesity, but few have evaluated how they combine to influence risk of childhood overweight/obesity. We examined associations, individually and in combination, of potentially modifiable risk factors in the first 1000 days after conception with childhood adiposity and risk of overweight/obesity in an Asian cohort. Six risk factors were examined: maternal pre-pregnancy overweight/obesity (body mass index (BMI) ⩾25 kg m -2 ), paternal overweight/obesity at 24 months post delivery, maternal excessive gestational weight gain, raised maternal fasting glucose during pregnancy (⩾5.1 mmol l -1 ), breastfeeding duration childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

  3. DMARD use is associated with a higher risk of dementia in patients with rheumatoid arthritis: A propensity score-matched case-control study.

    Science.gov (United States)

    Chou, Ming-Hsien; Wang, Jong-Yi; Lin, Cheng-Li; Chung, Wei-Sheng

    2017-11-01

    Patients with rheumatoid arthritis (RA) exhibit an increased risk of dementia. Disease-modifying antirheumatic drugs (DMARDs) are commonly used to slow RA progression, but studies investigating the relationship between DMARDs and dementia in patients with RA are lacking. We investigated the relationship between DMARDs and dementia in patients with RA. Using the National Health Insurance Research Database, patients aged ≥20years, who were newly diagnosed with RA between 2000 and 2011 were identified. Patients with RA who had dementia comprised the dementia group, and patients with RA who did not have dementia comprised the control group. The groups were matched at a 1:1 ratio by the propensity score. DMARDs were categorized into conventional synthetic DMARDs (csDMARDs) and biological DMARDs (bDMARDs). Logistic regression models were used to calculate the odds ratio and 95% confidence interval (CI) to evaluate the association between DMARD use and the risk of dementia in patients with RA. A total of 957 patients with RA and dementia, and 957 patients with RA but not dementia, were enrolled. The risk of dementia was determined to be 1.63-fold higher in patients with RA with csDMARD use than in those without csDMARD use (95% CI=1.33-2.00). No significant risk of dementia was observed in patients with RA who used bDMARDs compared with their counterparts. However, patients with RA who used hydroxychloroquine, methotrexate, and sulfasalazine exhibited significant risks of dementia, irrespective of cumulative exposure days. Patients with RA who used csDMARDs exhibit significant association with dementia. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. The presence of advanced lesions and associating risk factors for advanced cervical carcinoma in patients with atypical sguamous cells of undetermined significance.

    Science.gov (United States)

    Sun, L L; Chen, W; Fan, Y Y; Wang, M L; Wang, L N

    2015-01-01

    To characterize histopathological status, high-risk human papillomavirus (hr-HPV) infection status, and associated risk factors in patients with atypical squamous cells of undetermined significance (ASCUS). Cervical biopsies obtained from 130 ASCUS patients were subjected to histopathological examination and hr-HPV testing. Associations between advanced lesions and hr-HPV load or age were analyzed, and the confounding factors for high-grade cervical lesions were identified. Cervical biopsies from ASCUS patients had a wide range of pathological states, ranging from normal to invasive cervical carcinoma. High-risk HPV infection was significantly associated with advanced cervical lesions in ASCUS patients; hr-HPV infection and the number of gestations were risk factors for developing advanced cervical disease. A significant portion of ASCUS patients harbor advanced cervical lesions. The number of gestations and hr-HPV infection can increase the risk of developing advanced cervical lesions in ASCUS patients.

  5. Post-ischemic stroke rehabilitation is associated with a higher risk of fractures in older women: A population-based cohort study.

    Science.gov (United States)

    Huang, Huei Kai; Lin, Shu Man; Yang, Clement Shih Hsien; Liang, Chung Chao; Cheng, Hung Yu

    2017-01-01

    Rehabilitation can improve physical activity after stroke. However, patients may be more prone to falls and fractures because of balance and gait deficits. Few reports have studied the relationship between rehabilitation and subsequent fractures after ischemic stroke. To investigate whether post-stroke rehabilitation affects fracture risk. We conducted a population-based retrospective cohort study based on the Taiwan National Health Insurance Research Database. Patients with a newly diagnosed ischemic stroke between 2000 and 2012 were included. After propensity score matching, a total of 8,384 patients were enrolled. Half of the patients (4,192) received post-stroke rehabilitation within 1 month; the other half did not receive any post-stroke rehabilitation. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) for fractures among patients with and without rehabilitation within 1 year after ischemic stroke. Patients were further stratified by sex and age (20-64 and ≥65 years). Patients receiving post-stroke rehabilitation had a higher incidence of fracture (6.2 per 100 person-years) than those who did not (4.1 per 100 person-years) after adjustment for sociodemographic and coexisting medical conditions [HR = 1.53, 95% confidence interval (CI) = 1.25-1.87, p rehabilitation had a significantly higher risk of fracture (HR = 1.62, 95% CI = 1.21-2.17, p = 0.001). Rehabilitation after ischemic stroke is associated with an increased fracture risk in older women.

  6. Snacking between main meals is associated with a higher risk of metabolic syndrome in a Mediterranean cohort: the SUN Project (Seguimiento Universidad de Navarra).

    Science.gov (United States)

    Pimenta, Adriano M; Bes-Rastrollo, Maira; Gea, Alfredo; Sayón-Orea, Carmen; Zazpe, Itziar; Lopez-Iracheta, Roberto; Martinez-Gonzalez, Miguel A

    2016-03-01

    To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome. A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: 'Do you have the habit of snacking between main meals?' Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and their 95 % confidence intervals using Poisson regression models. An exploratory factor analysis was also used to identify patterns of snacking. University of Navarra, Spain. The study included 6851 university graduates, initially free of metabolic syndrome, and followed-up them for a median of 8·3 years. Among our participants, 34·6% reported usual snacking between main meals. The cumulative incidence of metabolic syndrome was 5·1 % (9·5% among men and 2·8% among women). Snacking between main meals was significantly associated with higher risk for developing metabolic syndrome after multivariable adjustment (RR=1·44; 95%CI 1·18, 1·77). Higher adherence to an 'unhealthy snacking pattern' was also independently associated with increased incidence of metabolic syndrome (fourth quartile of adherence compared with non-snacking: RR=1·68; 95% CI 1·23, 2·29; P for trend metabolic syndrome development, especially when snacks contain foods of poor nutritional quality.

  7. Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.

    Science.gov (United States)

    Liu, Chaoqun; Zhong, Chunrong; Zhou, Xuezhen; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

    2017-01-01

    Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.

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

    Directory of Open Access Journals (Sweden)

    Kim Khuc

    2012-01-01

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

  9. Weight patterns in children with higher risk ALL: A report from the Children's Oncology Group (COG) for CCG 1961.

    Science.gov (United States)

    Withycombe, Janice S; Post-White, Janice E; Meza, Jane L; Hawks, Ria G; Smith, Lynette M; Sacks, Nancy; Seibel, Nita L

    2009-12-15

    This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 x ln(BMI/median BMI). By the end of treatment, 23% of children were obese (BMI >or=95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5-9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5-9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. (c) 2009 Wiley-Liss, Inc.

  10. Significant vestibular system impairment is common in a cohort of elderly patients referred for assessment of falls risk.

    Science.gov (United States)

    Jacobson, Gary P; McCaslin, Devin L; Grantham, Sarah L; Piker, Erin G

    2008-01-01

    Falls in elderly patients are associated with morbidity, mortality, and cost to the healthcare system. The development of falls risk assessment programs have represented a method of responding to what is known about injurious falls. The multidimensional assessments involve the comparison against normative data of a patient's performance on metrics known to influence the likelihood of future falls. The factors assessed usually include falls and medication history, measures of mentation, depression, orthostatic hypotension, simple or choice reaction time, gait stability, postural stability, and the integrity of the patient's vision, somesthetic, and vestibular senses. This investigation was conducted to measure the proportion of patients referred for falls risk assessment who have evidence of vestibular system impairment. Qualitative, retrospective review of data collected from 2003 to 2007. The cohort was 185 consecutive patients referred for multidimensional assessments of falls risk. Patients underwent quantitative assessments of peripheral and central vestibular system function consisting of electro- or videonystagmography (i.e., ENG/VNG), and sinusoidal harmonic acceleration testing. Results of these tests were compared to normative data. We found that 73% of the sample who underwent vestibular system assessment had quantitative evidence of either peripheral or central vestibular system impairment. Our results suggest that quantitative assessments of the vestibulo-ocular reflex should be conducted on patients who are evaluated for falls risk. These examinations should include at least caloric testing and, where available, rotational testing.

  11. Higher Serum Direct Bilirubin Levels Were Associated with a Lower Risk of Incident Chronic Kidney Disease in Middle Aged Korean Men

    Science.gov (United States)

    Ryu, Seungho; Chang, Yoosoo; Zhang, Yiyi; Woo, Hee-Yeon; Kwon, Min-Jung; Park, Hyosoon; Lee, Kyu-Beck; Son, Hee Jung; Cho, Juhee; Guallar, Eliseo

    2014-01-01

    Background The association between serum bilirubin levels and incident chronic kidney disease (CKD) in the general population is unknown. We aimed to examine the association between serum bilirubin concentration (total, direct, and indirect) and the risk of incident CKD. Methods and Findings Longitudinal cohort study of 12,823 Korean male workers 30 to 59 years old without CKD or proteinuria at baseline participating in medical health checkup program in a large worksite. Study participants were followed for incident CKD from 2002 through 2011. Estimated glomerular filtration rate (eGFR) was estimated by using the CKD-EPI equation. CKD was defined as eGFR bilirubin were 0.93 (95% CI 0.67–1.28), 0.88 (0.60–1.27) and 0.60 (0.42–0.88), respectively. In multivariable models, the adjusted hazard ratio for CKD comparing the highest to the lowest quartile of serum direct bilirubin levels was 0.60 (95% CI 0.41–0.87; P trend = 0.01). Neither serum total nor indirect bilirubin levels were significantly associated with the incidence of CKD. Conclusions Higher serum direct bilirubin levels were significantly associated with a lower risk of developing CKD, even adjusting for a variety of cardiometabolic parameters. Further research is needed to elucidate the mechanisms underlying this association and to establish the role of serum direct bilirubin as a marker for CKD risk. PMID:24586219

  12. Web-based thyroid imaging reporting and data system: Malignancy risk of atypia of undetermined significance or follicular lesion of undetermined significance thyroid nodules calculated by a combination of ultrasonography features and biopsy results.

    Science.gov (United States)

    Choi, Young Jun; Baek, Jung Hwan; Shin, Jung Hee; Shim, Woo Hyun; Kim, Seon-Ok; Lee, Won-Hong; Song, Dong Eun; Kim, Tae Yong; Chung, Ki-Wook; Lee, Jeong Hyun

    2018-05-13

    The purpose of this study was to construct a web-based predictive model using ultrasound characteristics and subcategorized biopsy results for thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) to stratify the risk of malignancy. Data included 672 thyroid nodules from 656 patients from a historical cohort. We analyzed ultrasound images of thyroid nodules and biopsy results according to nuclear atypia and architectural atypia. Multivariate logistic regression analysis was performed to predict whether nodules were diagnosed as malignant or benign. The ultrasound features, including spiculated margin, marked hypoechogenicity, calcifications, biopsy results, and cytologic atypia, showed significant differences between groups. A 13-point risk scoring system was developed, and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the development and validation sets were 0.837 and 0.830, respectively (http://www.gap.kr/thyroidnodule_b3.php). We devised a web-based predictive model using the combined information of ultrasound characteristics and biopsy results for AUS/FLUS thyroid nodules to stratify the malignant risk. © 2018 Wiley Periodicals, Inc.

  13. Migration and Remittance Trends 2009 : A Better-Than-Expected Outcome So Far, But Significant Risks Ahead

    OpenAIRE

    Dilip Ratha; Sanket Mohapatra; Ani Silwal

    2009-01-01

    Newly available data show that officially recorded remittance flows to developing countries reached $338 billion in 2008, higher than our previous estimate of $328 billion. Based on monthly and quarterly data released by some central banks and in line with the World Bank's global economic outlook we estimate that remittance flows to developing countries will fall to $317 billion in 2009. T...

  14. Higher risk of death among MEN1 patients with mutations in the JunD interacting domain: a Groupe d'etude des Tumeurs Endocrines (GTE) cohort study.

    Science.gov (United States)

    Thevenon, Julien; Bourredjem, Abderrahmane; Faivre, Laurence; Cardot-Bauters, Catherine; Calender, Alain; Murat, Arnaud; Giraud, Sophie; Niccoli, Patricia; Odou, Marie-Françoise; Borson-Chazot, Françoise; Barlier, Anne; Lombard-Bohas, Catherine; Clauser, Eric; Tabarin, Antoine; Parfait, Béatrice; Chabre, Olivier; Castermans, Emilie; Beckers, Albert; Ruszniewski, Philippe; Le Bras, Morgane; Delemer, Brigitte; Bouchard, Philippe; Guilhem, Isabelle; Rohmer, Vincent; Goichot, Bernard; Caron, Philippe; Baudin, Eric; Chanson, Philippe; Groussin, Lionel; Du Boullay, Hélène; Weryha, Georges; Lecomte, Pierre; Penfornis, Alfred; Bihan, Hélène; Archambeaud, Françoise; Kerlan, Véronique; Duron, Françoise; Kuhn, Jean-Marc; Vergès, Bruno; Rodier, Michel; Renard, Michel; Sadoul, Jean-Louis; Binquet, Christine; Goudet, Pierre

    2013-05-15

    Multiple endocrine neoplasia syndrome type 1 (MEN1), which is secondary to mutation of the MEN1 gene, is a rare autosomal-dominant disease that predisposes mutation carriers to endocrine tumors. Although genotype-phenotype studies have so far failed to identify any statistical correlations, some families harbor recurrent tumor patterns. The function of MENIN is unclear, but has been described through the discovery of its interacting partners. Mutations in the interacting domains of MENIN functional partners have been shown to directly alter its regulation abilities. We report on a cohort of MEN1 patients from the Groupe d'étude des Tumeurs Endocrines. Patients with a molecular diagnosis and a clinical follow-up, totaling 262 families and 806 patients, were included. Associations between mutation type, location or interacting factors of the MENIN protein and death as well as the occurrence of MEN1-related tumors were tested using a frailty Cox model to adjust for potential heterogeneity across families. Accounting for the heterogeneity across families, the overall risk of death was significantly higher when mutations affected the JunD interacting domain (adjusted HR = 1.88: 95%-CI = 1.15-3.07). Patients had a higher risk of death from cancers of the MEN1 spectrum (HR = 2.34; 95%-CI = 1.23-4.43). This genotype-phenotype correlation study confirmed the lack of direct genotype-phenotype correlations. However, patients with mutations affecting the JunD interacting domain had a higher risk of death secondary to a MEN1 tumor and should thus be considered for surgical indications, genetic counseling and follow-up.

  15. Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2016-07-15

    Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

  16. Higher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children.

    Science.gov (United States)

    Tanaka, Keiko; Hitsumoto, Shinichi; Miyake, Yoshihiro; Okubo, Hitomi; Sasaki, Satoshi; Miyatake, Nobuyuki; Arakawa, Masashi

    2015-08-01

    The intrauterine environment, including maternal nutrition status, may affect the development, formation, and mineralization of children's teeth. We assessed the relationship between self-reported maternal dietary vitamin D intake during pregnancy and the risk of dental caries among young Japanese children. This study is based on a prospective analysis of 1210 Japanese mother-child pairs. Information on maternal intake during pregnancy was collected using a validated diet history questionnaire. Data on oral examination at 36-46 months of age were obtained from the mothers, who transcribed the information from their maternal and child health handbooks to our self-administered questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. Compared with the lowest quartile of maternal vitamin D intake during pregnancy, adjusted odds ratios (95% confidence intervals) for quartiles 2, 3, and 4 were 1.06 (0.72-1.56), 0.53 (0.34-0.81), and 0.67 (0.44-1.02), respectively (P for trend = .01). When maternal vitamin D intake was treated as a continuous variable, the adjusted odds ratio (95% confidence interval) was 0.94 (0.89-0.995). Higher maternal vitamin D intake during pregnancy may be associated with a lower risk of dental caries in children. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Evidence for higher tropical storm risks in Haiti due to increasing population density in hazard prone urban areas

    International Nuclear Information System (INIS)

    Klose, Christian D

    2011-01-01

    Since the 18th century, the Republic of Haiti has experienced numerous tropical cyclones. In 2011, the United Nations Global Assessment Report on Disaster Risk Reduction outlined that the worldwide physical exposure to natural hazards, which includes tropical storms and hurricanes in Haiti, increased by 192 per cent between 1970 and 2010. Now, it can be hypothesized that the increased physical exposure to cyclones that made landfall in Haiti has affected the country's development path. This study shows that tropical storm risks in Haiti increased due to more physical exposure of the population in urban areas rather than a higher cyclone frequency in the proximity of Hispaniola island. In fact, the population density accelerated since the second half of the 20th century in regions where historically more storms made landfall, such as in the departments Ouest, Artibonite, Nord and Nord-Ouest including Haiti's four largest cities: Port-au-Prince, Gonaïves, Cap-Haïtien and Port-de-Paix. Thus, urbanization in and migration into storm hazard prone areas could be considered as one of the major driving forces of Haiti's fragility.

  18. Semi-Professional Rugby League Players have Higher Concussion Risk than Professional or Amateur Participants: A Pooled Analysis.

    Science.gov (United States)

    King, Doug; Hume, Patria; Gissane, Conor; Clark, Trevor

    2017-02-01

    A combined estimate of injuries within a specific sport through pooled analysis provides more precise evidence and meaningful information about the sport, whilst controlling for between-study variation due to individual sub-cohort characteristics. The objective of this analysis was to review all published rugby league studies reporting injuries from match and training participation and report the pooled data estimates for rugby league concussion injury epidemiology. A systematic literature analysis of concussion in rugby league was performed on published studies from January 1990 to October 2015. Data were extracted and pooled from 25 studies that reported the number and incidence of concussions in rugby league match and training activities. Amateur rugby league players had the highest incidence of concussive injuries in match activities (19.1 per 1000 match hours) while semi-professional players had the highest incidence of concussive injuries in training activities (3.1 per 1000 training hours). This pooled analysis showed that, during match participation activities, amateur rugby league participants had a higher reported concussion injury rate than professional and semi-professional participants. Semi-professional participants had nearly a threefold greater concussion injury risk than amateur rugby league participants during match participation. They also had nearly a 600-fold greater concussion injury risk than professional rugby league participants during training participation.

  19. Higher Risk of Homicide Among Pregnant and Postpartum Females Aged 10-29 Years in Illinois, 2002-2011.

    Science.gov (United States)

    Koch, Abigail R; Rosenberg, Deborah; Geller, Stacie E

    2016-09-01

    To examine whether being pregnant or postpartum was associated with excess risk for homicide among females in Illinois and to describe the association between pregnancy status and homicide by race, ethnicity, and age group. This is a retrospective, multicohort, ecologic study of females of reproductive age in Illinois between 2002 and 2011 using Illinois Department of Public Health maternal mortality data and vital records data. We compared pregnancy-associated homicides with live births using χ tests. Among maternal deaths in the state, we calculated mortality rates per 100,000 live births for homicide and other violent causes and the leading direct obstetric causes. We calculated aggregate, pregnancy-associated, and nonpregnancy associated homicide rates stratified by race or ethnicity and age group. There were 636 pregnancy-associated deaths in Illinois from 2002 to 2011. Of these, 82 (13%) were the result of homicide (5.0 [95% confidence interval (CI) 4.0-6.2]/100,000 live births). There were 931 homicides among females of reproductive age not associated with pregnancy (2.88 [95% CI 2.70-3.07]/100,000 population). More than half of the homicides were women aged 20-29 years (n=53 [64.6%]), non-Hispanic black women (n=43 [52.4%]), women residing in Cook County (n=47 [57.3%]), and unmarried women (n=57 [69.5%]). Pregnant and postpartum females aged 10-29 years were at twice the risk of homicide compared with their nonpregnant or postpartum counterparts (relative risk 2.20 [95% CI 1.70-2.85]). Non-Hispanic black and Hispanic females experienced higher rates of homicide than non-Hispanic white females irrespective of pregnancy or age. Although all violence against women must be addressed, we recommend that state maternal mortality review committees, in addition to reviewing deaths resulting from obstetric and clinical causes, should conduct in-depth reviews of pregnancy-associated homicides and other violent deaths.

  20. High Dose Atorvastatin Associated with Increased Risk of Significant Hepatotoxicity in Comparison to Simvastatin in UK GPRD Cohort.

    Directory of Open Access Journals (Sweden)

    Alan T Clarke

    Full Text Available Occasional risk of serious liver dysfunction and autoimmune hepatitis during atorvastatin therapy has been reported. We compared the risk of hepatotoxicity in atorvastatin relative to simvastatin treatment.The UK GPRD identified patients with a first prescription for simvastatin [164,407] or atorvastatin [76,411] between 1997 and 2006, but with no prior record of liver disease, alcohol-related diagnosis, or liver dysfunction. Incident liver dysfunction in the following six months was identified by biochemical value and compared between statin groups by Cox regression model adjusting for age, sex, year treatment started, dose, alcohol consumption, smoking, body mass index and comorbid conditions.Moderate to severe hepatotoxicity [bilirubin >60μmol/L, AST or ALT >200U/L or alkaline phosphatase >1200U/L] developed in 71 patients on atorvastatin versus 101 on simvastatin. Adjusted hazard ratio [AHR] for all atorvastatin relative to simvastatin was 1.9 [95% confidence interval 1.4-2.6]. High dose was classified as 40-80mg daily and low dose 10-20mg daily. Hepatotoxicity occurred in 0.44% of 4075 patients on high dose atorvastatin [HDA], 0.07% of 72,336 on low dose atorvastatin [LDA], 0.09% of 44,675 on high dose simvastatin [HDS] and 0.05% of 119,732 on low dose simvastatin [LDS]. AHRs compared to LDS were 7.3 [4.2-12.7] for HDA, 1.4 [0.9-2.0] for LDA and 1.5 [1.0-2.2] for HDS.The risk of hepatotoxicity was increased in the first six months of atorvastatin compared to simvastatin treatment, with the greatest difference between high dose atorvastatin and low dose simvastatin. The numbers of events in the analyses were small.

  1. High Dose Atorvastatin Associated with Increased Risk of Significant Hepatotoxicity in Comparison to Simvastatin in UK GPRD Cohort

    Science.gov (United States)

    Clarke, Alan T.; Johnson, Paul C. D.; Hall, Gillian C.; Ford, Ian; Mills, Peter R.

    2016-01-01

    Background & Aims Occasional risk of serious liver dysfunction and autoimmune hepatitis during atorvastatin therapy has been reported. We compared the risk of hepatotoxicity in atorvastatin relative to simvastatin treatment. Methods The UK GPRD identified patients with a first prescription for simvastatin [164,407] or atorvastatin [76,411] between 1997 and 2006, but with no prior record of liver disease, alcohol-related diagnosis, or liver dysfunction. Incident liver dysfunction in the following six months was identified by biochemical value and compared between statin groups by Cox regression model adjusting for age, sex, year treatment started, dose, alcohol consumption, smoking, body mass index and comorbid conditions. Results Moderate to severe hepatotoxicity [bilirubin >60μmol/L, AST or ALT >200U/L or alkaline phosphatase >1200U/L] developed in 71 patients on atorvastatin versus 101 on simvastatin. Adjusted hazard ratio [AHR] for all atorvastatin relative to simvastatin was 1.9 [95% confidence interval 1.4–2.6]. High dose was classified as 40–80mg daily and low dose 10–20mg daily. Hepatotoxicity occurred in 0.44% of 4075 patients on high dose atorvastatin [HDA], 0.07% of 72,336 on low dose atorvastatin [LDA], 0.09% of 44,675 on high dose simvastatin [HDS] and 0.05% of 119,732 on low dose simvastatin [LDS]. AHRs compared to LDS were 7.3 [4.2–12.7] for HDA, 1.4 [0.9–2.0] for LDA and 1.5 [1.0–2.2] for HDS. Conclusions The risk of hepatotoxicity was increased in the first six months of atorvastatin compared to simvastatin treatment, with the greatest difference between high dose atorvastatin and low dose simvastatin. The numbers of events in the analyses were small. PMID:26983033

  2. Increased Risk of Clinically Significant Gallstones following an Appendectomy: A Five-Year Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Shiu-Dong Chung

    Full Text Available Although the vermiform appendix is commonly considered a vestigial organ, adverse health consequences after an appendectomy have garnered increasing attention. In this study, we investigated the risks of gallstone occurrence during a 5-year follow-up period after an appendectomy, using a population-based dataset. We used data from the Taiwan Longitudinal Health Insurance Database 2005. The exposed cohort included 4916 patients who underwent an appendectomy. The unexposed cohort was retrieved by randomly selecting 4916 patients matched with the exposed cohort in terms of sex, age, and year. We individually tracked each patient for a 5-year period to identify those who received a diagnosis of gallstones during the follow-up period. Cox proportional hazard regressions were performed for the analysis. During the 5-year follow-up period, the incidence rate per 1000 person-years was 4.71 for patients who had undergone an appendectomy, compared to a rate of 2.59 for patients in the unexposed cohort (p<0.001. Patients who had undergone an appendectomy were independently associated with a 1.79 (95% CI = 1.29~2.48-fold increased risk of being diagnosed with gallstones during the 5-year follow-up period. We found that among female patients, the adjusted hazard ratio of gallstones was 2.25 (95% CI = 1.41~3.59 for patients who underwent an appendectomy compared to unexposed patients. However, for male patients, we failed to observe an increased hazard for gallstones among patients who underwent an appendectomy compared to unexposed patients. We found an increased risk of a subsequent gallstone diagnosis within 5 years after an appendectomy.

  3. Contextual factors associated with treatment-seeking and higher-risk sexual behaviour in Botswana among men with symptoms of sexually transmitted infections.

    Science.gov (United States)

    Langeni, Tabitha

    2007-11-01

    This study investigates contextual factors associated with treatment-seeking behaviour and higher-risk sexual conduct of men symptomatic of sexually transmitted infections (STIs) in Botswana. Data were drawn from a randomly selected, nationally representative sample of 8 222 men, aged 15-64 years, who had reported having symptoms suggestive of an STI during the previous twelve months. Higher-risk behaviour continues to sustain the HIV epidemic in Botswana. At the heart of Botswana's epidemic lies men's reluctance to seek medical treatment, engaging in unprotected sex, and having sex with multiple partners while symptomatic of an STI. The odds of engaging in unprotected sex while symptomatic of an STI were significantly higher among teenage males and males in urban households. For every year's increase in the age difference between partners there was a 28% increase in the odds of the male having had unprotected sex. Being married and having had more than one sexual partner in the last year multiplied the odds of having unprotected sex while symptomatic of an STI by three times. The longer an infected man remained with symptoms before seeking help, the more likely it was to have unprotected sex while infected and the more likely to seek treatment from a traditional healer. Notably, having sought medical treatment from hospitals, clinics and health workers, as opposed to consulting traditional healers, significantly reduced the odds of having had unprotected sex while infected with an STI by 48%. The results indicate the need to encourage men to utilise public healthcare services. The public health sector in Botswana needs to provide healthcare services that are user-friendly for men. Increasing the number of treatment sites may also contribute to preventing onward transmission of STIs. Special attention needs to be paid to boys' socialisation towards gender norms, and men are to be encouraged to play a responsible role in HIV prevention.

  4. Female medical students are estimated to have a higher risk for developing eating disorders than male medical students

    DEFF Research Database (Denmark)

    Dissing, Nete; Bak, Nanna Hasle; Pedersen, Laura Erna Toftegaard

    2011-01-01

    Studies show that university students are at risk for eating disorders. However, risk behaviour has not been studied among Danish medical students, nor have the gender differences in risk behaviour been described in a Danish context....

  5. One-Hour Postload Hyperglycemia Confers Higher Risk of Hepatic Steatosis to HbA1c-Defined Prediabetic Subjects.

    Science.gov (United States)

    Fiorentino, Teresa Vanessa; Andreozzi, Francesco; Mannino, Gaia Chiara; Pedace, Elisabetta; Perticone, Maria; Sciacqua, Angela; Perticone, Francesco; Sesti, Giorgio

    2016-11-01

    Individuals with glycated hemoglobin (HbA1c)-defined prediabetes (HbA1c value of 5.7-6.4%) and 1-hour plasma glucose ≥155 mg/dL during an oral glucose tolerance test have an increased risk of developing type 2 diabetes. To evaluate the degree to which HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL individually and jointly associate with hepatic steatosis and related biomarkers. A cross-sectional analysis was performed on 1108 White individuals. Ambulatory care. Anthropometric and metabolic characteristics including hepatic steatosis assessed by ultrasonography. Compared with the normal group (HbA1c prediabetic and diabetic individuals exhibit higher values of fasting, 1-hour, and 2-hour postload glucose; fasting and 2-hour postload insulin; triglycerides; uric acid; homeostasis model of assessment for insulin resistance; liver insulin resistance index; liver enzymes; and inflammatory biomarkers; and lower levels of high-density lipoprotein cholesterol and IGF-1. Prediabetic and diabetic subjects have increased risk of hepatic steatosis (1.5- and 2.46-fold, respectively). Stratifying participants according to HbA1c and 1-hour postload glucose, we found that individuals with HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL have significantly higher risk of hepatic steatosis as compared with individuals with HbA1c-defined prediabetes but 1-hour postload glucose prediabetes and 1-hour postload glucose ≥155 mg/dL exhibit higher values of liver enzymes; fasting, 1-hour, and 2-hour postload glucose; insulin; triglycerides; uric acid; and inflammatory biomarkers; and lower levels of high-density lipoprotein and IGF-1. These data suggest that a value of 1-hour postload glucose ≥155 mg/dL may be helpful to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of hepatic steatosis.

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

    Science.gov (United States)

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

    2014-04-01

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

  7. Longer Sleep Duration and Midday Napping Are Associated with a Higher Risk of CHD Incidence in Middle-Aged and Older Chinese: the Dongfeng-Tongji Cohort Study.

    Science.gov (United States)

    Yang, Liangle; Yang, Handong; He, Meian; Pan, An; Li, Xiulou; Min, Xinwen; Zhang, Ce; Xu, Chengwei; Zhu, Xiaoyan; Yuan, Jing; Wei, Sheng; Miao, Xiaoping; Hu, Frank B; Wu, Tangchun; Zhang, Xiaomin

    2016-03-01

    To analyze the independent and combined relations of sleep duration and midday napping with coronary heart diseases (CHD) incidence along with the underlying changes of cardiovascular disease (CVD) risk factors among Chinese adults. We included 19,370 individuals aged 62.8 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Cox proportional hazards models and general linear models were used for multivariate longitudinal analyses. Compared with sleeping 7- napping > 90 min compared with 1-30 min. When sleep duration and midday napping were combined, individuals having sleep duration ≥ 10 h and midday napping > 90 min were at a greater risk of CHD than those with sleeping 7- napping 1-30 min: the HR was 1.67 (95% CI = 1.04 to 2.66; P for trend = 0.017). In addition, longer sleep duration ≥ 10 h was significantly associated with increases in triglycerides and waist circumference, and a reduction in HDL-cholesterol; while longer midday napping > 90 min was related to increased waist circumference. Both longer sleep duration and midday napping were independently and jointly associated with a higher risk of CHD incidence, and altered lipid profile and waist circumference may partially explain the relationships. © 2016 Associated Professional Sleep Societies, LLC.

  8. Higher fish intake is associated with a lower risk of hip fractures in Chinese men and women: a matched case-control study.

    Directory of Open Access Journals (Sweden)

    Fan Fan

    Full Text Available OBJECTIVES: Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. METHODS: A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years, were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates. RESULTS: Univariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: <0.001-0.016. After adjusting for covariates, the associations were slightly attenuated but remained significant for all (p-trend: <0.001-0.017 except for fresh-water fish (p = 0.553. The ORs (95%CI of hip fractures for the highest (vs. lowest quartile were 0.80 (0.48-1.31 for fresh-water fish, 0.31 (0.18-0.52 for sea fish, 0.55 (0.34-0.88 for mollusca and shellfish, and 0.47 (0.28-0.79 for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052. CONCLUSION: Higher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.

  9. Night Owl Women are Similar to Men in Their Relationship Orientation, Risk-taking Propensities, and Cortisol Levels: Implications for the Adaptive Significance and Evolution of Eveningness

    Directory of Open Access Journals (Sweden)

    Dario Maestripieri

    2014-01-01

    Full Text Available Individual differences in morningness/eveningness are relatively stable over time and, in part, genetically based. The night-owl pattern is more prevalent in men than in women, particularly after puberty and before women reach menopause. It has been suggested that eveningness evolved relatively recently in human evolutionary history and that this trait may be advantageous to individuals pursuing short-term mating strategies. Consistent with this hypothesis, eveningness is associated with extraversion, novelty-seeking, and in males, with a higher number of sexual partners. In this study, I investigated whether eveningness is associated with short-term relationship orientation, higher risk-taking, and higher testosterone or cortisol. Both female and male night-owls were more likely to be single than in long-term relationships than early morning individuals. Eveningness was associated with higher risk-taking in women but not in men; this association was not testosterone-dependent but mediated by cortisol. Female night-owls had average cortisol profiles and risk-taking tendencies more similar to those of males than to those of early-morning females. Taken together, these findings provide some support to the hypothesis that eveningness is associated with psychological and behavioral traits that are instrumental in short-term mating strategies, with the evidence being stronger for women than for men.

  10. A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

    Science.gov (United States)

    Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

    2011-10-01

    The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative

  11. Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age.

    Science.gov (United States)

    Höglund, Berit; Lindgren, Peter; Larsson, Margareta

    2012-12-01

    To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden. Population-based register study. National registers; the National Patient Register linked to the Medical Birth Register. Children of first-time mothers with ID (n = 326; classified in the International Classification of Diseases 8-10) were identified and compared with 340 624 children of first-time mothers without ID or any other psychiatric diagnosis between 1999 and 2007. Population-based data were extracted from the National Patient Register and the Medical Birth Register. Mode of birth, preterm birth, small for gestational age, Apgar score, stillbirth and perinatal death. Children born to mothers with ID were more often stillborn (1.2 vs. 0.3%) or died perinatally (1.8 vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5 vs. 17.7%) and preterm birth (12.2 vs. 6.1%), were small for gestational age (8.4 vs. 3.1%) and had lower Apgar scores (mothers without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small for gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID. Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Endogenously generated DNA nucleobase modifications source, and significance as possible biomarkers of malignant transformation risk, and role in anticancer therapy.

    Science.gov (United States)

    Olinski, Ryszard; Gackowski, Daniel; Cooke, Marcus S

    2018-01-01

    The DNA of all living cells undergoes continuous structural and chemical alteration, which may be derived from exogenous sources, or endogenous, metabolic pathways, such as cellular respiration, replication and DNA demethylation. It has been estimated that approximately 70,000 DNA lesions may be generated per day in a single cell, and this has been linked to a wide variety of diseases, including cancer. However, it is puzzling why potentially mutagenic DNA modifications, occurring at a similar level in different organs/tissue, may lead to organ/tissue specific cancers, or indeed non-malignant disease - what is the basis for this differential response? We suggest that it is perhaps the precise location of damage, within the genome, that is a key factor. Finally, we draw attention to the requirement for reliable methods for identification and quantification of DNA adducts/modifications, and stress the need for these assays to be fully validated. Once these prerequisites are satisfied, measurement of DNA modifications may be helpful as a clinical parameter for treatment monitoring, risk group identification and development of prevention strategies. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. The Montreal Cognitive Assessment is superior to the Mini-Mental State Examination in detecting patients at higher risk of dementia.

    Science.gov (United States)

    Dong, YanHong; Lee, Wah Yean; Basri, Nur Adilah; Collinson, Simon Lowes; Merchant, Reshma A; Venketasubramanian, Narayanaswamy; Chen, Christopher Li-Hsian

    2012-11-01

    To examine the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting patients with cognitive impairment at higher risk for dementia at a memory clinic setting. Memory clinic patients were administered the MoCA, MMSE, and a comprehensive formal neuropsychological battery. Mild cognitive impairment (MCI) subtypes were dichotomized into two groups: single domain-MCI (sd-MCI) and multiple domain-MCI (md-MCI). Area under the receiver operating characteristic curve (ROC) analysis was used to compare the discriminatory ability of the MoCA and the MMSE. Two hundred thirty patients were recruited, of which 136 (59.1%) were diagnosed with dementia, 61 (26.5%) with MCI, and 33 (14.3%) with no cognitive impairment (NCI). The majority of MCI patients had md-MCI (n = 36, 59%). The MoCA had significantly larger AUCs than the MMSE in discriminating md-MCI from the lower risk group for incident dementia (NCI and sd-MCI) [MoCA 0.92 (95% CI, 0.86-0.98) vs. MMSE 0.84 (95% CI, 0.75-0.92), p = 0.02). At their optimal cut-off points, the MoCA (19/20) remained superior to the MMSE (23/24) in detecting md-MCI [sensitivity: 0.83 vs. 0.72; specificity: 0.86 vs. 0.83; PPV: 0.79 vs. 0.72; NPV: 0.89 vs. 0.83; correctly classified: 85.1% vs. 78.7%]. The MoCA is superior to the MMSE in the detection of patients with cognitive impairment at higher risk for incident dementia at a memory clinic setting.

  14. Cardiovascular disease and ABO blood-groups in Africans. Are blood-group A individuals at higher risk of ischemic disease?: A pilot study.

    Science.gov (United States)

    Ba, Djibril Marie; Sow, Mamadou Saidou; Diack, Aminata; Dia, Khadidiatou; Mboup, Mouhamed Cherif; Fall, Pape Diadie; Fall, Moussa Daouda

    2017-12-01

    Since the discovery of the ABO blood group system by Karl Landsteiner in 1901, several reports have suggested an important involvement of the ABO blood group system in the susceptibility to thrombosis. Assessing that non-O blood groups in particular A blood group confer a higher risk of venous and arterial thrombosis than group O.Epidemiologic data are typically not available for all racial and ethnics groups.The purpose of this pilot study was to identify a link between ABO blood group and ischemic disease (ID) in Africans, and to analyze whether A blood group individuals were at higher risk of ischemic disease or not. A total of 299 medical records of patients over a three-year period admitted to the cardiology and internal medicine department of military hospital of Ouakam in Senegal were reviewed. We studied data on age, gender, past history of hypertension, diabetes, smoking, sedentarism, obesity, hyperlipidemia, use of estrogen-progestin contraceptives and blood group distribution.In each blood group type, we evaluated the prevalence of ischemic and non-ischemic cardiovascular disease. The medical records were then stratified into two categories to evaluate incidence of ischemic disease: Group 1: Patients carrying blood-group A and Group 2: Patients carrying blood group non-A (O, AB and B). Of the 299 patients whose medical records were reviewed, 92 (30.8%) were carrying blood group A, 175 (58.5%) had blood group O, 13 (4.3%) had blood group B, and 19 (6.4%) had blood group AB.The diagnosis of ischemic disease (ID) was higher in patients with blood group A (61.2%) than in other blood groups, and the diagnosis of non-ischemic disease (NID) was higher in patients with blood group O (73.6%) compared to other groups. In patients with blood group B or AB compared to non-B or non-AB, respectively there was no statistically significant difference in ID incidence.Main risk factor for ID was smoking (56.5%), hypertension (18.4%) and diabetes (14.3%).In our study

  15. Increased hsCRP is associated with higher risk of aortic valve replacement in patients with aortic stenosis

    DEFF Research Database (Denmark)

    Blyme, Adam; Nielsen, Olav W.; Asferg, Camilla

    2016-01-01

    Objective To investigate relations between inflammation and aortic valve stenosis (AS) by measuring high-sensitivity C-reactive protein, at baseline (hsCRP0) and after 1 year (hsCRP1) and exploring associations with aortic valve replacement (AVR). Design We examined 1423 patients from...... the Simvastatin and Ezetimibe in Aortic Stenosis study. Results During first year of treatment, hsCRP was reduced both in patients later receiving AVR (2.3 [0.9–4.9] to 1.8 [0.8–5.4] mg/l, p CRP1...... predicted later AVR (HR = 1.17, p CRP0 (HR = 0.96, p = 0.33), aortic valve area (AVA) and other risk factors. A higher rate of AVR was observed in the group with high hsCRP0 and an increase during the first year (AVRhighCRP0CRP1inc=47.3% versus AVRhighCRP0CRP1dec=27.5%, p

  16. Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes.

    Science.gov (United States)

    Holubcikova, Jana; Kolarcik, Peter; Madarasova Geckova, Andrea; Joppova, Eva; van Dijk, Jitse P; Reijneveld, Sijmen A

    2017-04-01

    To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent. We analysed data on a representative sample of Slovak adolescents 8502 adolescents (mean age 13.21, 49.4 % boys) from the 2014 Health Behaviour in School-aged Children cross-sectional study. We assessed the associations of alcohol and energy drinks consumption with negative outcomes and their potential synergy, as measured by the synergy index (SI). Adolescents consuming both alcohol and energy drinks were at higher risk of negative behavioural outcomes than their peers who drank only alcohol or energy drinks or were non-consumers. Consumers of alcohol and energy drinks were highly prone to be involved in fighting-the joint association of alcohol and energy drinks consumption was greater than sum of its associations separately in relation to fighting (SI 1.49; 95 % confidence interval 1.03-2.16). Preventive strategies should aim at increasing awareness of negative behavioural outcomes-especially aggressive behaviour associated with alcohol and energy drinks consumption among young adolescents.

  17. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta-analysis.

    Science.gov (United States)

    Wang, Ping-Yu; Fang, Jun-Chao; Gao, Zong-Hua; Zhang, Can; Xie, Shu-Yang

    2016-01-01

    Some previous studies reported no significant association of consuming fruit or vegetables, or fruit and vegetables combined, with type 2 diabetes. Others reported that only a greater intake of green leafy vegetables reduced the risk of type 2 diabetes. To further investigate the relationship between them, we carried out a meta-analysis to estimate the independent effects of the intake of fruit, vegetables and fiber on the risk of type 2 diabetes. Searches of MEDLINE and EMBASE for reports of prospective cohort studies published from 1 January 1966 to 21 July 2014 were carried out, checking reference lists, hand-searching journals and contacting experts. The primary analysis included a total of 23 (11 + 12) articles. The pooled maximum-adjusted relative risk of type 2 diabetes for the highest intake vs the lowest intake were 0.91 (95% confidence interval [CI] 0.87-0.96) for total fruits, 0.75 (95% CI 0.66-0.84) for blueberries, 0.87 (95% CI 0.81-0.93) for green leafy vegetables, 0.72 (95% CI 0.57-0.90) for yellow vegetables, 0.82 (95% CI 0.67-0.99) for cruciferous vegetables and 0.93 (95% CI 0.88-0.99) for fruit fiber in these high-quality studies in which scores were seven or greater, and 0.87 (95% CI 0.80-0.94) for vegetable fiber in studies with a follow-up period of 10 years or more. A higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, cruciferous vegetables or their fiber is associated with a lower risk of type 2 diabetes.

  18. The prevalence and significance of a short QT interval in 18,825 low-risk individuals including athletes.

    Science.gov (United States)

    Dhutia, Harshil; Malhotra, Aneil; Parpia, Sameer; Gabus, Vincent; Finocchiaro, Gherardo; Mellor, Greg; Merghani, Ahmed; Millar, Lynne; Narain, Rajay; Sheikh, Nabeel; Behr, Elijah R; Papadakis, Michael; Sharma, Sanjay

    2016-01-01

    The short QT syndrome is a cardiac channelopathy characterised by accelerated repolarisation which manifests as a short QT interval on the ECG. The definition of a short QT interval is debated, ranging from <390 to ≤320 ms, and its clinical significance in healthy young individuals is unknown. We assessed the prevalence and medium-term significance of an isolated short QT interval in a diverse young British population. Between 2005 and 2013, 18 825 apparently healthy people aged 14-35 years underwent cardiovascular evaluation with history, physical examination and ECG. QT intervals were measured by cardiologists using 4 recommended guidelines (Seattle 2013, Heart Rhythm Society 2013, European Society of Cardiology 2010 and American Heart Association 2009). The prevalence of a short QT interval was 0.1% (26 patients, ≤320 ms), 0.2% (44 patients, ≤330 ms), 7.9% (1478 patients, <380 ms), 15.8% (2973 patients, <390 ms). Male gender and Afro-Caribbean ethnicity had the strongest association with short QT intervals. Athletes had shorter QT intervals than non-athletes but athletic status did not predict short QT intervals. Individuals with short QT intervals ≤320 ms did not report syncope or a sinister family history, and during a follow-up period of 5.3±1.2 years, there were no deaths in this group. The prevalence of a short QT interval depends on the recommended cut-off value. Even at values ≤320 ms, there was an excellent medium-term prognosis among 14 people followed. We conclude that a definition of ≤320 ms is realistic to prevent overdiagnosis and excessive investigations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. High infiltration of tumor-associated macrophages in triple-negative breast cancer is associated with a higher risk of distant metastasis

    Directory of Open Access Journals (Sweden)

    Yuan ZY

    2014-08-01

    Full Text Available Zhong-Yu Yuan,1–3* Rong-Zhen Luo,1,2,4,* Rou-Jun Peng,1–3 Shu-Sen Wang,1–3 Cong Xue1–3 1State Key Laboratory of Oncology in South China, 2Collaborative Innovation Center for Cancer Medicine, 3Departments of Medical Oncology, Sun Yat-Sen University Cancer Center, 4Departments of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China  *These authors contributed equally to this work Background: Triple-negative breast cancer (TNBC is associated with poor prognosis and high probability of distant metastases. Tumor microenvironments play a pivotal role in tumor metastasis. Tumor-associated macrophages (TAMs are one of the main cell components, and they are correlated with increasing metastatic risk. The aim of this study is to analyze the prognostic significance of the infiltration of TAMs in patients with TNBC. Materials and methods: Immunohistochemical staining for cluster of differentiation (CD68 (a marker for macrophages was performed on tissue microarrays of operable breast cancer among 287 patients with TNBC, and the number of infiltrating TAMs was correlated with clinicopathological parameters. Results: We found that TNBC with a large number of infiltrating TAMs had a significantly higher risk of distant metastasis, as well as lower rates of disease-free survival and overall survival than those with a smaller number of infiltrating TAMs. Multivariate analysis indicated that the number of infiltrating TAMs was a significant independent prognostic factor of disease-free survival (P=0.001 in all patients. Conclusion: Our results suggested that high infiltrating TAMs are a significantly unfavorable prognostic factor for patients with TNBC, and they could become a potentially useful prognostic marker for TNBC. Keywords: breast carcinoma, triple-negative, tumor-associated macrophages, prognosis

  20. Higher fish intake is associated with a lower risk of hip fractures in Chinese men and women: a matched case-control study.

    Science.gov (United States)

    Fan, Fan; Xue, Wen-Qiong; Wu, Bao-Hua; He, Ming-Guang; Xie, Hai-Li; Ouyang, Wei-Fu; Tu, Su-Lan; Chen, Yu-Ming

    2013-01-01

    Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years), were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years) were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates. Univariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: water fish (p = 0.553). The ORs (95%CI) of hip fractures for the highest (vs. lowest) quartile were 0.80 (0.48-1.31) for fresh-water fish, 0.31 (0.18-0.52) for sea fish, 0.55 (0.34-0.88) for mollusca and shellfish, and 0.47 (0.28-0.79) for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052). Higher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.

  1. Hallmarks of Alzheimer disease are evolving relentlessly in Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk and higher odds of reaching NFT stage V at ≤ 40 years of age.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Gónzalez-Maciel, Angélica; Reynoso-Robles, Rafael; Delgado-Chávez, Ricardo; Mukherjee, Partha S; Kulesza, Randy J; Torres-Jardón, Ricardo; Ávila-Ramírez, José; Villarreal-Ríos, Rodolfo

    2018-07-01

    Exposures to fine particulate matter (PM 2.5 ) and ozone (O 3 ) above USEPA standards are associated with Alzheimer's disease (AD) risk. Metropolitan Mexico City (MMC) residents have life time exposures to PM 2.5 and O 3 above USEPA standards. We investigated AD intra and extracellular protein aggregates and ultrastructural neurovascular pathology in 203 MMC residents age 25.36 ± 9.23 y. Immunohistochemical methods were used to identify AT8 hyperphosphorilated tau (Htau) and 4G8 (amyloid β 17-24). Primary outcomes: staging of Htau and amyloid, per decade and cumulative PM 2.5 (CPM 2.5 ) above standard. Apolipoprotein E allele 4 (APOE4), age and cause of death were secondary outcomes. Subcortical pretangle stage b was identified in an 11month old baby. Cortical tau pre-tangles, neurofibrillary tangles (NFT) Stages I-II, amyloid phases 1-2, Htau in substantia nigrae, auditory, oculomotor, trigeminal and autonomic systems were identified by the 2nd decade. Progression to NFT stages III-V was present in 24.8% of 30-40 y old subjects. APOE4 carriers have 4.92 times higher suicide odds (p = 0.0006), and 23.6 times higher odds of NFT V (p < 0.0001) v APOE4 non-carriers having similar CPM 2.5 exposure and age. Age (p = 0.0062) and CPM 2.5 (p = 0.0178) were significant for developing NFT V. Combustion-derived nanoparticles were associated with early and progressive damage to the neurovascular unit. Alzheimer's disease starting in the brainstem of young children and affecting 99.5% of young urbanites is a serious health crisis. Air pollution control should be prioritised. Childhood relentless Htau makes a fundamental target for neuroprotective interventions and the first two decades are critical. We recommend the concept of preclinical AD be revised and emphasize the need to define paediatric environmental, nutritional, metabolic and genetic risk factor interactions of paramount importance to prevent AD. AD evolving from childhood is threating the

  2. A significantly joint effect between arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of urothelial carcinoma

    International Nuclear Information System (INIS)

    Wang, Y.-H.; Yeh, S.-D.; Shen, K.-H.; Shen, Cheng-Huang; Juang, G.-D.; Hsu, L.-I; Chiou, H.-Y.; Chen, C.-J.

    2009-01-01

    Cigarette smoking, arsenic and occupational exposures are well-known risk factors for the development of urothelial carcinoma (UC). Therefore, the aim of this study is to investigate whether the effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures on risk of UC could be modified by genetic polymorphisms of cytochrome P450 2E1 and glutathione S-transferase omega. A hospital-based case-control study consisted of 520 histologically confirmed UC cases, and 520 age- and gender-matched cancer-free controls were carried out from September 1998 to December 2007. Genotyping of CYP2E1, GSTO1 and GSTO2 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Subjects with both of cigarette smoking and alcohol consumption have a significantly increased UC risk (odds ratio [OR] = 2.9; 95% confidence interval [CI] = 1.9-4.4). Significantly increased UC risks of 1.5 and 1.9 were found for study subjects with high arsenic exposure and those who have been exposed to two or more occupational exposures, respectively. A significantly increased UC risk of 3.9 was observed in study subjects with H2-H2 diplotype of GSTO1 and GSTO2. The significantly highest UC risk of 9.0 was found for those with all environmental risk factors of cigarette smoking, alcohol consumption, arsenic and occupational exposures and two or more risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2. Our findings suggest that a significantly joint effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of UC was found.

  3. Significance of common variants on human chromosome 8q24 in relation to the risk of prostate cancer in native Japanese men

    Directory of Open Access Journals (Sweden)

    Hosoi Takayuki

    2009-07-01

    Full Text Available Abstract Background Common variants on human chromosome 8q24, rs1447295 (C/A and rs6983267 (T/G, have been recently linked to the prevalence of prostate cancer in European and American populations. Here, we evaluated whether the single-nucleotide polymorphisms rs1447295 and rs6983267 were associated with the risk of sporadic prostate cancer as well as latent prostate cancer in a native Japanese population. Results We analyzed genomic DNA samples from 391 sporadic prostate cancer patients, 323 controls who had died from causes unrelated to cancer and 112 Japanese men who were diagnosed as having latent prostate cancer based on autopsy results. The polymorphisms were determined by allelic discrimination using a fluorescent-based TaqMan assay. The A allele of rs1447295 was significantly associated with the risk of sporadic prostate cancer (p = 0.04; age-adjusted OR, 1.34, while the G allele of rs6983267 showed a trend towards being a high-risk allele (p = 0.06; age-adjusted OR, 1.27. No significant difference between these two polymorphisms and the risk of latent prostate cancer was observed in the present Japanese population. Conclusion Known variants on human chromosome 8q24 may be risk factors for sporadic prostate cancer in native Japanese men.

  4. Three or more preoperative injections is the most significant risk factor for revision surgery after operative treatment of lateral epicondylitis: an analysis of 3863 patients.

    Science.gov (United States)

    Degen, Ryan M; Cancienne, Jourdan M; Camp, Christopher L; Altchek, David W; Dines, Joshua S; Werner, Brian C

    2017-04-01

    This study was conducted to identify the rate of failure of operative treatment of lateral epicondylitis, defined as progression to ipsilateral revision surgery, and associated patient-specific risk factors for failure. A national database was used to identify patients undergoing surgical treatment of lateral epicondylitis from 2005 to 2012. Patients undergoing concomitant procedures were excluded. Patients who then required subsequent ipsilateral extensor carpi radialis brevis débridement or release within 2 years were identified using similar methods. A multivariate binomial logistic regression analysis was used to evaluate patient-related risk factors for revision surgery. In addition, the number of preoperative injections (1, 2, or ≥3) in the ipsilateral elbow was identified and included in the regression analysis. Adjusted odds ratios (OR) and 95% confidence intervals were calculated for each risk factor. Of 3863 patients who underwent operative treatment of lateral epicondylitis, 58 (1.5%) required ipsilateral revision surgery. Risk factors for revision surgery included age lateral epicondylitis in the studied population is low (1.5%). Risk factors for revision surgery include younger age, male gender, morbid obesity, tobacco use, and inflammatory arthritis. The most significant risk factor for revision surgery is having ≥3 ipsilateral preoperative injections. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  5. Does antimicrobial usage before meningitis lead to a higher risk of adult postsurgical Acinetobacter baumannii meningitis than that of Enterobacteriaceae meningitis?

    Science.gov (United States)

    Demiraslan, Hayati; Ulutabanca, Halil; Ercal, Baris Derya; Metan, Gokhan; Alp, Emine

    2016-12-01

    Acinetobacter baumannii and Enterobacteriaceae are two pathogens responsible for postneurosurgical meningitis. The aim of this retrospective study was to evaluate the factors that influenced the outcomes in patients with postneurosurgical meningitis caused by A. baumannii and Enterobacteriaceae. Patients with post-surgical meningitis were identified from infection control committee charts between 2007 and 2015. Subjects over 16 years old who had positive cerebral spinal fluid cultures for A. baumannii or Enterobacteriaceae were enrolled in the study. Clinical and laboratory data for 30 patients with A. baumannii meningitis were compared with those of 12 patients with Enterobacteriaceae meningitis. The mean age of patients was 51.9 years and 57.1% were male. Eleven patients had comorbidities, the most common being diabetes mellitus. Most patients were due to intracranial haemorrhage (78.6%). The rate of the patients who received an appropriate antimicrobial therapy was 35.7%, and the crude mortality rate was 64.3%. In univariate analysis, previous antibiotic use, an infection before meningitis and mechanical ventilation had an increased risk of A. baumannii meningitis. Moreover, intrathecal antimicrobial use, inappropriate empirical antimicrobial use, antimicrobial resistance and alanine aminotransferase elevation were significantly higher in patients with A. baumannii meningitis than in those with Enterobacteriaceae meningitis. Antimicrobial use before meningitis (8.84 times) and mechanical ventilation (7.28 times) resulted in an increased risk of A. baumannii meningitis. None of the results affected 30-day mortality. Avoidance of unnecessarily prolonged antimicrobial usage may help to prevent a selection of A. baumannii.

  6. Increase of EEG spectral theta power indicates higher risk of the development of severe cognitive decline in Parkinson’s disease after 3 years

    Directory of Open Access Journals (Sweden)

    Vitalii V Cozac

    2016-11-01

    Full Text Available Objective: We investigated quantitative electroencephalography (qEEG and clinical parameters as potential risk factors of severe cognitive decline in Parkinson’s disease.Methods: We prospectively investigated 37 patients with Parkinson’s disease at baseline and follow-up (after 3 years. Patients had no severe cognitive impairment at baseline. We used a summary score of cognitive tests as the outcome at follow-up. At baseline we assessed motor, cognitive, and psychiatric factors; qEEG variables (global relative median power spectra were obtained by a fully automated processing of high-resolution EEG (256-channels. We used linear regression models with calculation of the explained variance to evaluate the relation of baseline parameters with cognitive deterioration.Results: The following baseline parameters significantly predicted severe cognitive decline: global relative median power theta (4-8 Hz, cognitive task performance in executive functions and working memory.Conclusions: Combination of neurocognitive tests and qEEG improves identification of patients with higher risk of cognitive decline in PD.

  7. Stunting, poor iron status and parasite infection are significant risk factors for lower cognitive performance in Cambodian school-aged children.

    Directory of Open Access Journals (Sweden)

    Marlene Perignon

    Full Text Available BACKGROUND: Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children <5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development. OBJECTIVE: To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine of Cambodian schoolchildren and their associations with cognitive performance. METHODS: School children aged 6-16 y (n = 2443 from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socio-economic data were collected in a sub-group of children (n = 616. Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III. RESULTS: The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05. In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067 or without anemia (-0.49; p = 0.064. Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p<0.05, and with lower scores in other tests, for girls only (both p<0.05. CONCLUSION: Poor cognitive performance of Cambodian school-children was multifactorial and

  8. STAT3 polymorphism and Helicobacter pylori CagA strains with higher number of EPIYA-C segments independently increase the risk of gastric cancer

    International Nuclear Information System (INIS)

    Rocha, Gifone A; Rocha, Andreia MC; Gomes, Adriana D; Faria, César LL Jr; Melo, Fabrício F; Batista, Sérgio A; Fernandes, Viviane C; Almeida, Nathálie BF; Teixeira, Kádima N; Brito, Kátia S; Queiroz, Dulciene Maria Magalhães

    2015-01-01

    Because to date there is no available study on STAT3 polymorphism and gastric cancer in Western populations and taking into account that Helicobacter pylori CagA EPIYA-C segment deregulates SHP-2/ERK-JAK/STAT3 pathways, we evaluated whether the two variables are independently associated with gastric cancer. We included 1048 subjects: H. pylori-positive patients with gastric carcinoma (n = 232) and with gastritis (n = 275) and 541 blood donors. Data were analyzed using logistic regression model. The rs744166 polymorphic G allele (p = 0.01; OR = 1.76; 95 % CI = 1.44-2.70), and CagA-positive (OR = 12.80; 95 % CI = 5.58-19.86) status were independently associated with gastric cancer in comparison with blood donors. The rs744166 polymorphism (p = 0.001; OR = 1.64; 95 % CI = 1.16-2.31) and infection with H. pylori CagA-positive strains possessing higher number of EPIYA-C segments (p = 0.001; OR = 2.28; 95 % CI = 1.41-3.68) were independently associated with gastric cancer in comparison with gastritis. The association was stronger when host and bacterium genotypes were combined (p < 0.001; OR = 3.01; 95 % CI = 2.29-3.98). When stimulated with LPS (lipopolysaccharide) or Pam3Cys, peripheral mononuclear cells of healthy carriers of the rs744166 GG and AG genotypes expressed higher levels of STAT3 mRNA than those carrying AA genotype (p = 0.04 for both). The nuclear expression of phosphorylated p-STAT3 protein was significantly higher in the antral gastric tissue of carriers of rs744166 GG genotype than in carriers of AG and AA genotypes. Our study provides evidence that STAT3 rs744166 G allele and infection with CagA-positive H. pylori with higher number of EPIYA-C segments are independent risk factors for gastric cancer. The odds ratio of having gastric cancer was greater when bacterium and host high risk genotypes were combined

  9. Correlation between therapy and lipid profile of leprosy patients: is there a higher risk for developing cardiovascular diseases after treatment?

    Science.gov (United States)

    Silva, Rosalba V G; de Araújo, Rafael S; Aarão, Tinara L S; da Silva Costa, Paulo Diovanne; Sousa, Jorge R; Quaresma, Juarez A S

    2017-05-01

    The impact of leprosy reduces health-related quality of life of affected patients, interfering with different factors such as nutrition. This study investigated the lipid profile, nutritional status, and risk for cardiovascular disease (CVD) in patients who underwent leprosy treatment in Brazil. Eighty-four adult patients of both genders ranging in age from 20 to 60 years and diagnosed with paucibacillary (PB) or multibacillary (MB) leprosy were selected after undergoing multidrug treatment. The following data were collected: sociodemographic and clinical data; food intake; anthropometric measures (weight, height, and waist circumference); and lipid profile components (total cholesterol, high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], and triglycerides). Among the study population, there was a predominance of males (65.48%) aged 50 to 60 years, patients with an income of 248-496 American dollars (63.10%), patients who completed elementary school (65.48%), inactive patients (76.19%), non-smokers (46.43%), and non-drinking patients (69.05%). The levels (mean ± standard deviation) of total cholesterol were 193.8 ± 29.4 mg/dL in the PB form and 203.5 ± 41.7 mg/dL in the MB form. The mean LDL-c was 116.9 ± 22.7 mg/dL in PB patients and 121 ± 31.3 mg/dL in MB patients. Mean triglyceride levels were 123.4 ± 45.2 mg/dL in the PB form and 147.4 ± 88.9 mg/dL in the MB form. The evaluation of nutritional status showed that 41.67% of the patients were eutrophic, while 55.96% had excess weight. Food intake was significantly associated with HDL-c in male patients (P = 0.0264) and with triglycerides in patients above the ideal weight (P = 0.0049). The risk of acquiring CVDs was observed to be high due to patients' excess weight and increased waist circumference. This study will guide clinicians in the adequate treatment of patients with leprosy in order to avoid adverse cardiovascular

  10. Detection of high-sensitivity troponin in outpatients with stable pulmonary hypertension identifies a subgroup at higher risk of adverse outcomes.

    Science.gov (United States)

    Roy, Andrew K; McCullagh, Brian N; Segurado, Ricardo; McGorrian, Catherine; Keane, Elizabeth; Keaney, John; Fitzgibbon, Maria N; Mahon, Niall G; Murray, Patrick T; Gaine, Sean P

    2014-01-01

    The detection of elevations in cardiorenal biomarkers, such as troponins, B-type natriuretic peptides (BNPs), and neutrophil gelatinase-associated lipocalins, are associated with poor outcomes in patients hospitalized with acute heart failure. Less is known about the association of these markers with adverse events in chronic right ventricular dysfunction due to pulmonary hypertension, or whether their measurement may improve risk assessment in the outpatient setting. We performed a cohort study of 108 patients attending the National Pulmonary Hypertension Unit in Dublin, Ireland, from 2007 to 2009. Cox proportional hazards analysis and receiver operating characteristic curves were used to determine predictors of mortality and hospitalization. Death or hospitalization occurred in 50 patients (46.3%) during the median study period of 4.1 years. Independent predictors of mortality were: 1) decreasing 6-minute walk test (6MWT; hazard ratio [HR] 12.8; P < .001); 2) BNP (HR 6.68; P < .001); and 3) highly sensitive troponin (hsTnT; HR 5.48; P < .001). Adjusted hazard analyses remained significant when hsTnT was added to a model with BNP and 6MWT (HR 9.26, 95% CI 3.61-23.79), as did the predictive ability of the model for death and rehospitalization (area under the receiver operating characteristic curve 0.81, 95% CI 0.73-0.90). Detection of troponin using a highly sensitive assay identifies a pulmonary hypertension subgroup with a poorer prognosis. hsTnT may also be used in a risk prediction model to identify patients at higher risk who may require escalation of targeted pulmonary vasodilator therapies and closer clinical surveillance. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon.

    Science.gov (United States)

    Jomaa, Lamis; Naja, Farah; Cheaib, Ruba; Hwalla, Nahla

    2017-06-12

    Mixed evidence exists with respect to the association between household food insecurity (HFIS) and obesity in low-to-middle income countries (LMICs), particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition. A cross-sectional study was conducted among a representative sample of households (n = 378) in Beirut, Lebanon. Surveys were completed with mothers of children Food Insecurity Access Scale (HFIAS). Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure) and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2) and at-risk waist circumference (WC ≥ 80 cm) among mothers. HFIS was found among 50% of study sample and was inversely associated with household income and mother's educational level, even after adjusting for other socioeconomic variables (p food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming food insecure mothers had 1.73 odds of obesity (95% CI: 1.02-2.92) compared to food secure mothers. High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure households had a high risk of dietary inadequacy and obesity. Adequate evidence-based public health strategies are needed to reduce the vulnerability of mothers to food insecurity in LMIC settings and alleviate their risk of a high burden of nutrient insecurity and obesity.

  12. Through the Eyes of Higher Education Attorneys: How Department Chairs Are Navigating the Waters of Legal Issues and Risk Management

    Science.gov (United States)

    Hustoles, Carol L. J.

    2012-01-01

    Legal and risk management issues substantially impact the operations of colleges and universities, which face escalating compliance requirements in an increasingly litigious environment. Failing to assess legal liability issues and to constructively address them with risk management processes create vulnerability to claims and litigation,…

  13. Prognostic significance of repeat biopsy in lupus nephritis: Histopathologic worsening and a short time between biopsies is associated with significantly increased risk for end stage renal disease and death.

    Science.gov (United States)

    Arriens, Cristina; Chen, Sixia; Karp, David R; Saxena, Ramesh; Sambandam, Kamalanathan; Chakravarty, Eliza; James, Judith A; Merrill, Joan T

    2017-12-01

    histopathology had died compared to 2 (3.2%) of non-worsening patients. Biopsy worsening was associated with a significantly greater 15-year risk of ESRD (Hazard Ratio 4.2, p=0.0001) and death (Hazard Ratio 4.3, p=0.022), adjusting for age, gender, race, biopsy class, and treatment. Time between first and second biopsies was 5years in 28. Over a 15-year period, those with <1year between first and second biopsies (presumably enriched for patients with early clinical signs of progression) had a significantly greater risk of ESRD (Hazard Ratio 13.7, p<0.0001) and death (Hazard Ratio 16.9, p=0.0022) after adjusting for age, gender, race, biopsy class, and treatment. A repeat renal biopsy demonstrating worsening pathology increases the risk of ESRD and death more than four-fold compared to non-worsening patients. Given known potential mismatch between biopsy and clinical data, repeat biopsies may add important information and justify changes in treatment not considered on clinical grounds. Earlier detection of poor prognostic signs in those without early clinical deterioration might improve outcomes in enough patients to reconsider cost effectiveness of routine repeat biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Carbohydrates from Sources with a Higher Glycemic Index during Adolescence: Is Evening Rather than Morning Intake Relevant for Risk Markers of Type 2 Diabetes in Young Adulthood?

    Science.gov (United States)

    Diederichs, Tanja; Herder, Christian; Roßbach, Sarah; Roden, Michael; Wudy, Stefan A; Nöthlings, Ute; Alexy, Ute; Buyken, Anette E

    2017-06-10

    This study investigated whether glycemic index (GI) or glycemic load (GL) of morning or evening intake and morning or evening carbohydrate intake from low- or higher-GI food sources (low-GI-CHO, higher-GI-CHO) during adolescence are relevant for risk markers of type 2 diabetes in young adulthood. Methods: Analyses included DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study participants who had provided at least two 3-day weighed dietary records (median: 7 records) during adolescence and one blood sample in young adulthood. Using multivariable linear regression analyses, estimated morning and evening GI, GL, low-GI-CHO (GI adolescence were not associated with any of the adult risk markers. A higher evening GI during adolescence was related to an increased HSI in young adulthood ( p = 0.003). A higher consumption of higher-GI-CHO in the evening was associated with lower insulin sensitivity ( p = 0.046) and an increased HSI ( p = 0.006), while a higher evening intake of low-GI-CHO was related to a lower HSI ( p = 0.009). Evening intakes were not related to FLI or the pro-inflammatory-score (all p > 0.1). Conclusion: Avoidance of large amounts of carbohydrates from higher-GI sources in the evening should be considered in preventive strategies to reduce the risk of type 2 diabetes in adulthood.

  15. Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C

    International Nuclear Information System (INIS)

    Takahashi, Hirokazu; Mizuta, Toshihiko; Eguchi, Yuichiro

    2011-01-01

    Several epidemiological studies have reported that diabetes mellitus is a risk factor for hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-positive patients. However, it is unclear whether or not post-challenge hyperglycemia is a risk factor. The purpose of this study was to determine the association between post-challenge hyperglycemia and hepatocarcinogenesis in HCV-positive patients. A total of 203 HCV-RNA-positive subjects (108 males, mean age 54.3±10.8 years; 95 females, mean age 56.6±10.3 years; genotype 1b/2a/2b/3a: 152/38/12/1) who underwent liver biopsy and a 75-g oral glucose tolerance test, and who were treated with interferon (IFN) were enrolled in this study. None of the subjects had been treated with antidiabetic drugs. The subjects underwent ultrasonography and/or computed tomography every 6 months after the end of the IFN therapy. Thirteen patients, including one patient who achieved a sustained viral response (SVR) with IFN, developed HCC. On multivariate analysis, male sex, age >65 years, excessive alcohol consumption, non-SVR, liver steatosis area >5% in liver specimens, and 120-min post-challenge hyperglycemia were risk factors for the development of HCC. After matching subjects for sex, age, alcohol intake, and response to the IFN therapy, advanced fibrosis stages [hazard ratio (HR) 2.8], liver steatosis (HR 5.4), and 120-min post-challenge hyperglycemia (HR 4.9) were significant risk factors for the development of HCC. Furthermore, after matching for the fibrosis stage, liver steatosis (HR 5.7) and 120-min post-challenge hyperglycemia (HR 6.9) remained as significant factors for HCC development. Post-challenge hyperglycemia is an independent risk factor for HCC in HCV-positive patients. (author)

  16. Prognostic significance of several histological features in intermediate and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Narayan, K.; Bernshaw, D.; Quinn, M.; Allen, D.; Rejeki, V.; Herschtal, A.; Jobling, T.

    2009-01-01

    Full text: The purpose of the present study was to explore the prognostic significance of several histological features with respect to lymph node metastasis, failure-free survival (FeS), and overall survival (Os) in intermediate and high-risk endometrial cancer patients treated with curative intent. One hundred and eighty patients with endometrial cancer were treated with hysterectomy with or without lymphadenectomy and received external beam radiotherapy (EBRT). The mean follow-up period was 4.25 years (range 0.44-10.45 years). In multifactor analysis, fractional myometrial invasion (MI) (P = 0.047), histology (P < 0.001) and lymph-vascular space invasion (LVSI) (P = 0.025) were significant predictors for FFS when nodal status was not included. When lymph node status was known, histology (P - 0.007) and LVSI (P = 0.014) remained significant factors for FFS. For OS, histology (P < 0.001) and fractional MI (P = 0.004) were the significant factors. Lymph node status could be predicted by tumour grading (P = 0.016) and absolute MI (P 0.002). Histology type and the presence of LVSI were the most important prognostic factors in high-risk endometrial cancer patients treated by surgery and postoperative radiotherapy. Absolute MI and tumour grading were useful predictors of nodal spread.

  17. 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

  18. Epidemiology of bovine fascioliasis in the Nile Delta region of Egypt: Its prevalence, evaluation of risk factors, and its economic significance

    Directory of Open Access Journals (Sweden)

    Abdelgawad S. El-Tahawy

    2017-10-01

    Full Text Available Aim: This study focuses on the risk factors associated with the prevalence of Fasciola affecting cattle population in three provinces belonging to the Nile Delta of Egypt and to estimate the economic losses as a result of fascioliasis. Materials and Methods: From January 2015 to end of December 2015, records of 21 farms (4976 cattle were analyzed to screen the prevalence of fascioliasis among cattle farms, to identify its associated risk factors and its economic impacts on Nile Delta region of Egypt. Results: The overall prevalence of fascioliasis in the Nile Delta region of Egypt was 9.77%. The prevalence of fascioliasis was found to be statistically significantly associated with age, sex, breed, and type of farms. The highest prevalence was observed in 3 age groups (8.35%. In terms of body condition scores, cattle with medium and poor conditions were associated with fascioliasis more than those with good body condition. Besides, cattle raised in organic farms were associated with lower risk of fascioliasis than those in conventional farms. The prevalence of fascioliasis was noted more prominent in districts with moderate temperatures and with relative humidity (>60%. The annual overall costs for fascioliasis were estimated to be 221.2 USD/cow due to the significant reduction in body weight, reduction in milk production, and the treatment costs for fascioliasis. Conclusion: The results provided could be helpful for improving the control and preventive strategies.

  19. Epidemiology of bovine fascioliasis in the Nile Delta region of Egypt: Its prevalence, evaluation of risk factors, and its economic significance

    Science.gov (United States)

    El-Tahawy, Abdelgawad S.; Bazh, Eman K.; Khalafalla, Reda E.

    2017-01-01

    Aim: This study focuses on the risk factors associated with the prevalence of Fasciola affecting cattle population in three provinces belonging to the Nile Delta of Egypt and to estimate the economic losses as a result of fascioliasis. Materials and Methods: From January 2015 to end of December 2015, records of 21 farms (4976 cattle) were analyzed to screen the prevalence of fascioliasis among cattle farms, to identify its associated risk factors and its economic impacts on Nile Delta region of Egypt. Results: The overall prevalence of fascioliasis in the Nile Delta region of Egypt was 9.77%. The prevalence of fascioliasis was found to be statistically significantly associated with age, sex, breed, and type of farms. The highest prevalence was observed in 3 age groups (8.35%). In terms of body condition scores, cattle with medium and poor conditions were associated with fascioliasis more than those with good body condition. Besides, cattle raised in organic farms were associated with lower risk of fascioliasis than those in conventional farms. The prevalence of fascioliasis was noted more prominent in districts with moderate temperatures and with relative humidity (>60%). The annual overall costs for fascioliasis were estimated to be 221.2 USD/cow due to the significant reduction in body weight, reduction in milk production, and the treatment costs for fascioliasis. Conclusion: The results provided could be helpful for improving the control and preventive strategies. PMID:29184371

  20. Epidemiology of bovine fascioliasis in the Nile Delta region of Egypt: Its prevalence, evaluation of risk factors, and its economic significance.

    Science.gov (United States)

    El-Tahawy, Abdelgawad S; Bazh, Eman K; Khalafalla, Reda E

    2017-10-01

    This study focuses on the risk factors associated with the prevalence of Fasciola affecting cattle population in three provinces belonging to the Nile Delta of Egypt and to estimate the economic losses as a result of fascioliasis. From January 2015 to end of December 2015, records of 21 farms (4976 cattle) were analyzed to screen the prevalence of fascioliasis among cattle farms, to identify its associated risk factors and its economic impacts on Nile Delta region of Egypt. The overall prevalence of fascioliasis in the Nile Delta region of Egypt was 9.77%. The prevalence of fascioliasis was found to be statistically significantly associated with age, sex, breed, and type of farms. The highest prevalence was observed in 3 age groups (8.35%). In terms of body condition scores, cattle with medium and poor conditions were associated with fascioliasis more than those with good body condition. Besides, cattle raised in organic farms were associated with lower risk of fascioliasis than those in conventional farms. The prevalence of fascioliasis was noted more prominent in districts with moderate temperatures and with relative humidity (>60%). The annual overall costs for fascioliasis were estimated to be 221.2 USD/cow due to the significant reduction in body weight, reduction in milk production, and the treatment costs for fascioliasis. The results provided could be helpful for improving the control and preventive strategies.

  1. Decision Making under Ambiguity and Objective Risk in Higher Age - A Review on Cognitive and Emotional Contributions.

    Science.gov (United States)

    Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

    2017-01-01

    The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors - responsible for age-related differences in decision making - are additionally pointed out.

  2. Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

    Directory of Open Access Journals (Sweden)

    Magnus Liebherr

    2017-12-01

    Full Text Available The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors – responsible for age-related differences in decision making – are additionally pointed out.

  3. Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

    Science.gov (United States)

    Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

    2017-01-01

    The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors – responsible for age-related differences in decision making – are additionally pointed out. PMID:29270145

  4. First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases.

    Science.gov (United States)

    Richter-Schrag, Hans-Jürgen; Glatz, Torben; Walker, Christine; Fischer, Andreas; Thimme, Robert

    2016-11-07

    To evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB). A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 ( n = 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC placement. Primary hemostasis and clinical success of bleeding lesions (without rebleeding) was achieved in 88/100 (88%) and 78/100 (78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET (4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET (OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7 (35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated mortality. Our data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure.

  5. Higher intake of carotenoid is associated with a lower risk of colorectal cancer in Chinese adults: a case-control study.

    Science.gov (United States)

    Lu, Min-Shan; Fang, Yu-Jing; Chen, Yu-Ming; Luo, Wei-Ping; Pan, Zhi-Zhong; Zhong, Xiao; Zhang, Cai-Xia

    2015-06-01

    The associations between specific carotenoid intake and colorectal cancer risk remain inconsistent. The aim of this study was to examine the association between specific dietary carotenoid intake with colorectal cancer risk in Chinese adults. From July 2010 to October 2013, 845 eligible colorectal cancer cases and 845 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate logistical regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (95% CIs) of colorectal cancer risk after adjusting for various confounders. A strong inverse association was found between β-cryptoxanthin intake and colorectal cancer risk. Compared with the lowest quartile, the highest quartile intake showed a risk reduction of 77% (OR 0.23, 95% CI 0.17-0.33, P trend colorectal cancer risk. These findings were consistent across cancer site, sources of controls, and smoking status. The inverse associations between dietary α-carotene, β-cryptoxanthin, and lycopene intake and colorectal cancer risk were found in both males and females, while inverse associations between β-carotene intake and colorectal cancer risk were only observed in males. Consumption of α-carotene, β-carotene, β-cryptoxanthin, and lycopene was inversely associated with colorectal cancer risk. No significant association was found between lutein/zeaxanthin intake and colorectal cancer risk.

  6. Significance of Cooking Oil to Bioaccessibility of Dichlorodiphenyltrichloroethanes (DDTs) and Polybrominated Diphenyl Ethers (PBDEs) in Raw and Cooked Fish: Implications for Human Health Risk.

    Science.gov (United States)

    Mi, Xiu-Bo; Su, Yang; Bao, Lian-Jun; Tao, Shu; Zeng, Eddy Y

    2017-04-26

    The present study examined the bioacessibility of DDTs and PBDEs in cooked fish (yellow grouper; Epinephelus awoara) with and without heating using the colon extended physiologically based extraction test. The bioaccessibility of DDTs and PBDEs increased from 60 and 26% in raw fish to 83 and 63%, respectively, after the addition of oil to raw fish. However, they decreased from 83 to 66% and from 63 to 40%, respectively, when oil-added fish were cooked. Human health risk assessment based on bioaccessible concentrations of DDTs and PBDEs in fish showed that the maximum allowable daily fish consumption rates decreased from 25, 59, and 86 g day -1 to 22, 53, and 77 g day -1 for children, youths, and adults, respectively, after fish were cooked with oil. These findings indicated that the significance of cooking oil to the bioaccessibility of DDTs and PBDEs in food should be considered in assessments of human health risk.

  7. Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil

    Directory of Open Access Journals (Sweden)

    Leonardo Hideto Nagaya

    2017-11-01

    Conclusion: This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified.

  8. Kidney Transplant Recipients With Primary Membranous Glomerulonephritis Have a Higher Risk of Acute Rejection Compared With Other Primary Glomerulonephritides

    Directory of Open Access Journals (Sweden)

    Tripti Singh, MD

    2017-11-01

    Conclusions. Patients with MN have higher incidence of acute rejection after kidney transplant but have similar 10-year allograft survival in comparison to the other glomerular diseases like IgAN, FSGS, and LN.

  9. Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children's Study.

    Science.gov (United States)

    Yajnik, Chittaranjan S; Katre, Prachi A; Joshi, Suyog M; Kumaran, Kalyanaraman; Bhat, Dattatray S; Lubree, Himangi G; Memane, Nilam; Kinare, Arun S; Pandit, Anand N; Bhave, Sheila A; Bavdekar, Ashish; Fall, Caroline H D

    2015-07-01

    The Pune Children's Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood. We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima-media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years. Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10-0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose-insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28). Prepubertal glucose-insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose-insulin metabolism in childhood to reduce cardiovascular risk in later life.

  10. Significant association between asthma risk and the GSTM1 and GSTT1 deletion polymorphisms: an updated meta-analysis of case-control studies.

    Science.gov (United States)

    Liang, Siqiao; Wei, Xuan; Gong, Chen; Wei, Jinmei; Chen, Zhangrong; Chen, Xiaoli; Wang, Zhibo; Deng, Jingmin

    2013-07-01

    Polymorphisms in GSTM1 and GSTT1 may be associated with asthma risk, yet several studies and meta-analyses have reported inconclusive results. Therefore, an updated meta-analysis was conducted. Literature searches were performed using the Pubmed, Embase and Web of Science databases until October 2012. Variant 'null' genotype was compared with wild-type 'present' in the pooled data. All statistical analyses were performed using STATA 11.0. A total of 26 case-control studies were suitable for inclusion in the meta-analysis. In the overall population, a significant association was found for both the GSTM1 (odds ratio (OR) = 1.452; 95% confidence interval (CI): 1.192-1.770) and GSTT1 polymorphism (OR = 1.792; 95% CI:1.293-2.483). For subgroup analysis by age, GSTM1 significantly increased risk for both children (OR = 1.368; 95% CI: 1.051-1.781) and adults (OR = 1.859; 95% CI: 1.183-2.921). For GSTT1, a significant association was only found in the adult population (OR = 2.312; 95%CI: 1.204-4.439). Based on subgroup analysis by ethnicity, a significant association for GSTM1 was found in Europe (OR = 1.303; 95% CI: 1.018-1.667), Africa (OR = 2.175; 95%CI: 1.560-3.031) and Latin America (OR = 2.265; 95%CI: 1.375-3.729). For GSTT1, significantly increased risk was found only for Asian (OR = 2.105; 95% CI: 1.101-4.025) and Russian (OR = 2.747; 95% CI: 1.071-7.046) populations. This meta-analysis provides evidence that GSTM1 and GSTT1 polymorphisms may be risk factors for asthma. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  11. Is Group Sex a Higher-Risk Setting for HIV and Other Sexually Transmitted Infections Compared With Dyadic Sex Among Men Who Have Sex With Men?

    NARCIS (Netherlands)

    van den Boom, Wijnand; Davidovich, Udi; Heuker, José; Lambers, Femke; Prins, Maria; Sandfort, Theo; Stolte, Ineke G.

    2016-01-01

    Group sex has been suggested as a potential high-risk setting for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM). We investigated whether group sex is associated with lower condom use during anal sex and higher proportions of STIs compared with dyadic sex

  12. Higher intake of omega-3 polyunsaturated fatty acids is associated with a decreased risk of a first clinical diagnosis of central nervous system demyelination: Results from the Ausimmune Study.

    Science.gov (United States)

    Hoare, Samuel; Lithander, Fiona; van der Mei, Ingrid; Ponsonby, Anne-Louise; Lucas, Robyn

    2016-06-01

    There is contradictory evidence for a role of dietary fat in risk of multiple sclerosis (MS). To examine the association between usual fat intake (total, saturated, monounsaturated (MUFA), polyunsaturated (PUFA), omega-3 and omega-6) and risk of a first clinical diagnosis of CNS demyelination (FCD). Multi-centre incident case-control study in four regions of Australia during 2003-2006. Cases were aged 18-59 years and had a FCD; controls were matched to a case on age, sex and location. Dietary data were collected using a validated food frequency questionnaire. In 267 cases and 517 controls with dietary data, higher intake (per g/day) of omega-3 PUFA (adjusted odds ratio, AOR=0.61 (95% CI 0.40-0.93)), and particularly that derived from fish (AOR=0.54 (95% CI 0.31-0.93)) rather than from plants (AOR=0.75 (95% CI 0.39-1.43)) was associated with a decreased risk of FCD. Total fat intake and intake of other types of fat were not associated with FCD risk. There was a significant decrease in FCD risk with higher intake of omega-3 PUFA, particularly that originating from fish. There was no evidence to indicate that the intake of other types of dietary fat or fat quantity in the previous 12 months was associated with an altered risk of FCD. © The Author(s), 2015.

  13. Accounting for Risk of Non-Completion in Private and Social Rates of Return to Higher Education

    Science.gov (United States)

    Toutkoushian, Robert K.; Shafiq, M. Najeeb; Trivette, Michael J.

    2013-01-01

    Conventional studies of the private and social rates of return to a Bachelor's degree focus on the earnings difference between Bachelor degree holders and high school graduates, and find that there are large rates of return for degree recipients. The estimates in these studies, however, do not take into account the risk of not completing a degree.…

  14. Children with ADHD symptoms have a higher risk for reading, spelling and math difficulties in the GINIplus and LISAplus cohort studies.

    Directory of Open Access Journals (Sweden)

    Darina Czamara

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD and dyslexia belong to the most common neuro-behavioral childhood disorders with prevalences of around 5% in school-aged children. It is estimated that 20-60% of individuals affected with ADHD also present with learning disorders. We investigated the comorbidity between ADHD symptoms and reading/spelling and math difficulties in two on-going population-based birth cohort studies. Children with ADHD symptoms were at significantly higher risk of also showing reading/spelling difficulties or disorder (Odds Ratio (OR = 2.80, p = 6.59×10⁻¹³ as compared to children without ADHD symptoms. For math difficulties the association was similar (OR = 2.55, p = 3.63×10⁻⁰⁴. Our results strengthen the hypothesis that ADHD and learning disorders are comorbid and share, at least partially, the same underlying process. Up to date, it is not clear, on which exact functional processes this comorbidity is based.

  15. Carbohydrates from Sources with a Higher Glycemic Index during Adolescence: Is Evening Rather than Morning Intake Relevant for Risk Markers of Type 2 Diabetes in Young Adulthood?

    Directory of Open Access Journals (Sweden)

    Tanja Diederichs

    2017-06-01

    Full Text Available Background: This study investigated whether glycemic index (GI or glycemic load (GL of morning or evening intake and morning or evening carbohydrate intake from low- or higher-GI food sources (low-GI-CHO, higher-GI-CHO during adolescence are relevant for risk markers of type 2 diabetes in young adulthood. Methods: Analyses included DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD study participants who had provided at least two 3-day weighed dietary records (median: 7 records during adolescence and one blood sample in young adulthood. Using multivariable linear regression analyses, estimated morning and evening GI, GL, low-GI-CHO (GI < 55 and higher-GI-CHO (GI ≥ 55 were related to insulin sensitivity (N = 252, hepatic steatosis index (HSI, fatty liver index (FLI (both N = 253, and a pro-inflammatory-score (N = 249. Results: Morning intakes during adolescence were not associated with any of the adult risk markers. A higher evening GI during adolescence was related to an increased HSI in young adulthood (p = 0.003. A higher consumption of higher-GI-CHO in the evening was associated with lower insulin sensitivity (p = 0.046 and an increased HSI (p = 0.006, while a higher evening intake of low-GI-CHO was related to a lower HSI (p = 0.009. Evening intakes were not related to FLI or the pro-inflammatory-score (all p > 0.1. Conclusion: Avoidance of large amounts of carbohydrates from higher-GI sources in the evening should be considered in preventive strategies to reduce the risk of type 2 diabetes in adulthood.

  16. Editorial Commentary: Big Data Suggest That Because of a Significant Increased Risk of Postoperative Infection, Steroid Injection Is Not Recommended After Ankle Arthroscopy.

    Science.gov (United States)

    Brand, Jefferson C

    2016-02-01

    A recent study addressing infection rate after intra-articular steroid injection during ankle arthroscopy gives pause to this practice, with an odds ratio of 2.2 in the entire population that was injected with a steroid simultaneously with ankle arthroscopy compared with patients who did not receive an ankle injection. Big data, used in the study upon which the Editor comments here, suggest that because of a significant increased risk of postoperative infection, steroid injection is not recommended after ankle arthroscopy. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Exchanging Catheters Over a Single Transseptal Sheath During Left Atrial Ablation is Associated with a Higher Risk for Silent Cerebral Events

    Directory of Open Access Journals (Sweden)

    Thomas Deneke, MD

    2014-09-01

    Conclusions: Exchanging catheters over a single transseptal access to perform left atrial ablation is associated with a significantly higher incidence of SCE compared to an ablation technique using different transseptal accesses for therapeutic and diagnostic catheters.

  18. Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon

    Directory of Open Access Journals (Sweden)

    Lamis Jomaa

    2017-06-01

    Full Text Available Abstract Background Mixed evidence exists with respect to the association between household food insecurity (HFIS and obesity in low-to-middle income countries (LMICs, particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition. Methods A cross-sectional study was conducted among a representative sample of households (n = 378 in Beirut, Lebanon. Surveys were completed with mothers of children <18 years. HFIS was measured using a locally-validated, Arabic-translated Household Food Insecurity Access Scale (HFIAS. Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming <2/3rd Dietary Reference Intakes (DRIs for nutrients among mothers from food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2 and at-risk waist circumference (WC ≥ 80 cm among mothers. Results HFIS was found among 50% of study sample and was inversely associated with household income and mother’s educational level, even after adjusting for other socioeconomic variables (p < 0.01. Mothers in food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming <2/3rd the DRI’s for key micronutrients (potassium, folate, and vitamin C compared to secure ones. Adjusting for socioeconomic correlates, food insecure mothers had 1.73 odds of obesity (95% CI: 1.02–2.92 compared to food secure mothers. Conclusions High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure

  19. Balance and gait performance after maximal and submaximal endurance exercise in seniors: is there a higher fall-risk?

    Science.gov (United States)

    Donath, Lars; Zahner, Lukas; Roth, Ralf; Fricker, Livia; Cordes, Mareike; Hanssen, Henner; Schmidt-Trucksäss, Arno; Faude, Oliver

    2013-03-01

    Impaired balance and gait performance increase fall-risk in seniors. Acute effects of different exercise bouts on gait and balance were not yet addressed. Therefore, 19 healthy seniors (10 women, 9 men, age: 64.6 ± 3.2 years) were examined on 3 days. After exhaustive treadmill testing, participants randomly completed a 2-km treadmill walking test (76 ± 8 % VO(2max)) and a resting control condition. Standing balance performance (SBALP) was assessed by single limb-eyes opened (SLEO) and double limb-eyes closed (DLEC) stance. Gait parameters were collected at comfortable walking velocity. A condition × time interaction of center of pressure path length (COP(path)) was observed for both balance tasks (p fall-risk in seniors. Balance changes upon 2-km testing might be of minor relevance. Gait is not affected during single task walking at given velocities.

  20. Female medical students are estimated to have a higher risk for developing eating disorders than male medical students.

    Science.gov (United States)

    Dissing, Agnete Skovlund; Bak, Nanna Hasle; Pedersen, Laura Erna Toftegaard; Petersson, Birgit H

    2011-01-01

    Studies show that university students are at risk for eating disorders. However, risk behaviour has not been studied among Danish medical students, nor have the gender differences in risk behaviour been described in a Danish context. All first-year medical students (n = 979) received a questionnaire related to body perception, exercise habits, eating habits, height and weight in the fall of 2006 and 2007. The response rate was 57% (n = 561). The gender distribution of the study population was 71.8% females and 28.2% males and the average age was 21.5 years. More males (89.8%) than females (73.1%) were satisfied with their body and more females (34.8%) than males (10.9%) felt too fat. More females (42.7%) than males (19.9%) felt guilty when eating unhealthy food. 2.3% (all females) claimed to feel anxiety when they were about to eat. More males (48.4%) than females (28.6%) stated that they could not keep themselves from exercising. 13.5% of the underweight females (body mass index eating disorders than male students. Future research in this area should address the causes of such behaviour.

  1. Lower Plasma Fetuin-A Levels Are Associated With a Higher Mortality Risk in Patients With Coronary Artery Disease.

    Science.gov (United States)

    Chen, Xuechen; Zhang, Yuan; Chen, Qian; Li, Qing; Li, Yanping; Ling, Wenhua

    2017-11-01

    The present study was designed to evaluate the association of circulating fetuin-A with cardiovascular disease (CVD) and all-cause mortality. We measured plasma fetuin-A in 1620 patients using an enzyme-linked immunosorbent assay kit. The patients were members of the Guangdong coronary artery disease cohort and were recruited between October 2008 and December 2011. Cox regression models were used to estimate the association between plasma fetuin-A and the risk of mortality. A total of 206 deaths were recorded during a median follow-up of 5.9 years, 146 of whom died from CVD. The hazard ratios for the second and third tertiles of the fetuin-A levels (using the first tertile as a reference) were 0.65 (95% confidence interval, 0.44-0.96) and 0.51 (95% confidence interval, 0.33-0.78) for CVD mortality ( P =0.005) and 0.65 (95% confidence interval, 0.47-0.91) and 0.48 (95% confidence interval, 0.33-0.70) for all-cause mortality ( P <0.001), respectively. Lower plasma fetuin-A levels were associated with an increased risk of all-cause and CVD mortality in patients with coronary artery disease independently of traditional CVD risk factors. © 2017 American Heart Association, Inc.

  2. Prognostic significance of P2RY8-CRLF2 and CRLF2 overexpression may vary across risk subgroups of childhood B-cell acute lymphoblastic leukemia.

    Science.gov (United States)

    Dou, Hu; Chen, Xi; Huang, Yi; Su, Yongchun; Lu, Ling; Yu, Jie; Yin, Yibing; Bao, Liming

    2017-02-01

    The cytokine receptor-like factor 2 (CRLF2) gene plays an important role in early B-cell development. Aberrations in CRLF2 activate the JAK-STAT signaling pathway that contributes to B-cell acute lymphoblastic leukemia (B-ALL). The prognostic significance of CRLF2 overexpression and P2RY8-CRLF2 fusion in various B-ALL risk subgroups has not been well established. Two hundred seventy-one patients with newly diagnosed childhood B-ALL were enrolled from a Chinese population. The prevalence of CRLF2 overexpression, CRLF2-P2RY8 fusion, CRLF2 F232C mutation, and JAK2 and IL7R mutational status were analyzed, and the prognostic impact of CRLF2 overexpression and P2RY8-CRLF2 on B-ALL was evaluated by assessing their influence on overall survival and event-free survival. CRLF2 overexpression and P2RY8-CRLF2 were found in 19% and 10%, respectively, in the whole cohort. No correlation between CRLF2 overexpression and P2RY8-CRLF2 was observed. CRLF2 F322C and IL7R mutations were not detected in B-ALL cases overexpressing CRLF2, and no JAK2 mutations were found in the whole cohort either. The results showed that CRLF2 overexpression and P2RY8-CRLF2 were associated with a poor outcome in unselected B-ALL. Moreover, in an intermediate risk B-ALL subgroup P2RY8-CRLF2 was correlated with worse survival, whereas in high- and low-risk subgroups, CRLF2 overexpression predicted a poor outcome. Our findings suggest that P2RY8-CRLF2 is an independent prognostic indicator in intermediate risk B-ALL, while CRLF2 overexpression is correlated with an inferior outcome in high- or low-risk B-ALL. Our study demonstrates that the impact of P2RY8-CRLF2 and CRLF2 overexpression on B-ALL survival may differ across risk subgroups. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Soluble CD36 and risk markers of insulin resistance and atherosclerosis are elevated in polycystic ovary syndrome and significantly reduced during pioglitazone treatment

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Højlund, Kurt; Andersen, Marianne

    2007-01-01

    Objective: We investigated the relation between soluble CD36 (sCD36), risk markers of atherosclerosis and body composition, and glucose and lipid metabolism in polycystic ovary syndrome (PCOS) Research Design and Methods: Thirty PCOS patients were randomized to pioglitazone, 30 mg/day or placebo...... units), oxLDL (44.9 (26.9 - 75.1) vs. 36.1 (23.4 - 55.5) U/l), and hsCRP (0.26 (0.03 - 2.41) vs. 0.12 (0.02 - 0.81) mg/dl) were significantly increased in PCOS patients vs. controls (geometric mean (+/- 2SD)). In PCOS, positive correlations were found between central fat mass and sCD36 (r=0.43), hs......CRP (r=0.43), and IL-6 (r=0.42), all pPCOS patients and controls (n=44). sCD36 and oxLDL were significant...

  4. Oxidative damage markers are significantly associated with the carotid artery intima-media thickness after controlling for conventional risk factors of atherosclerosis in men.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

    Full Text Available This study aimed to assess the association between oxidative damage markers and carotid artery intima-media thickness (CIMT after controlling for conventional risk factors of atherosclerosis in multiple logistic regression models.Fifty-one case male participants (CIMT ≥ 0.9 mm were enrolled during their visits to Korean Genomic Rural Cohort Study of Wonju centers between May 1 and August 31, 2011, along with 51 control participants (CIMT < 0.9 mm selected using frequency matching by age group. The levels of oxidative damage markers, 8-hydroxy-2'-deoxyquuanosine (8-OHdG, malondialdehyde (MDA, and 8-iso-prostaglandin F2α (Isoprostane, were measured. Conditional logistic regression models were used to evaluate relative relationships between the oxidative damage markers and the risk of high CIMT.The markers of oxidative lipid (Isoprostane and MDA and DNA (8-OHdG damage were associated with CIMT after controlling for the conventional risk factors, including age, low density lipoprotein, body mass index, smoking history, alcohol consumption, and metabolic syndrome (ORs [95% CI] for Isoprostane: 3rd tertile, 8.47 [2.59-27.67]; for MDA: 3rd tertile, 8.47 [2.59-27.67]; for 8-OHdG: 3rd tertile, 5.58 [1.79-17.33]. When all the oxidative damage markers were incorporated in the same logistic regression model, only Isoprostane was significantly related to CIMT (OR [95% CI]: 4.22 [1.31-13.53] in 2nd tertile and 14.21 [3.34-60.56] in 3rd tertile.In this nested case-control study, the oxidative damage markers of lipid and DNA were associated with CIMT even after controlling for the conventional risk factors of cardiovascular diseases.

  5. Is Anesthesia Technique Associated With a Higher Risk of Mortality or Complications Within 90 Days of Surgery for Geriatric Patients With Hip Fractures?

    Science.gov (United States)

    Desai, Vimal; Chan, Priscilla H; Prentice, Heather A; Zohman, Gary L; Diekmann, Glenn R; Maletis, Gregory B; Fasig, Brian H; Diaz, Diana; Chung, Elena; Qiu, Chunyuan

    2018-06-01

    Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry. A total of 1995 (11%) of the surgically treated patients with hip fracture were excluded as a result of missing anesthesia information. The final study sample consisted of 16,695 patients. Of these, 2027 (12%) died and 98 (< 1%) terminated membership during followup, which were handled as competing events and censoring events, respectively. Ninety-day mortality, emergency department returns, hospital readmission, deep vein thrombosis (DVT) or pulmonary embolism (PE), myocardial infarction (MI), and pneumonia were evaluated using multivariable competing risk proportional subdistribution hazard regression according to type of anesthesia technique: general anesthesia, regional anesthesia, or conversion from regional to general. Of the 16,695 patients, 58% (N = 9629) received general anesthesia, 40% (N = 6597) received regional anesthesia, and 2.8% (N = 469) patients were converted from regional to general. Compared with regional anesthesia, patients treated with general anesthesia had a higher likelihood of overall 90-day mortality (hazard ratio [HR], 1.22; 95

  6. Proposal of a new preliminary scoring tool for early identification of significant blunt bowel and mesenteric injuries in patients at risk after road traffic crashes.

    Science.gov (United States)

    Raharimanantsoa, Mahery; Zingg, Tobias; Thiery, Alicia; Brigand, Cécile; Delhorme, Jean-Baptiste; Romain, Benoît

    2017-12-14

    Blunt bowel and mesenteric injuries (BBMI) are regularly missed by abdominal computed tomography (CT) scans. The aim of this study was to develop a risk assessment tool for BBMI to help clinicians in decision-making for blunt trauma after road traffic crashes (RTCs). Single-center retrospective study of trauma patients from January 2010 to April 2015. All patients admitted to our hospital after blunt trauma following RTCs and CT scan at admission were assessed. Of the 394 patients included, 78 (19.8%) required surgical exploration and 34 (43.6%) of these had a significant BBMI. A univariate and multivariate analysis were performed comparing patients with BBMI (n = 34) and patients without BBMI (n = 360). A score with a range from 0 to 13 was created. Scores from 8 to 9 were associated with 5-25% BBMI risk. The power of this new score ≥ 8 to predict a surgically significant BBMI had a sensitivity of 96%, specificity of 86.4%, positive predictive value (PPV) of 48% and negative predictive value (NPV) of 99.4%. This score could be a valuable tool for the management of blunt trauma patients after RTA without a clear indication for laparotomy but at risk for BBMI. The outcome of this study suggests selective diagnostic laparoscopy for a score ≥ 8 in obtunded patients and ≥ 10 in all other. To assess the value and accuracy of this new score, a prospective validation of these retrospective findings is due.

  7. High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease.

    Science.gov (United States)

    Minicozzi, Pamela; Berrino, Franco; Sebastiani, Federica; Falcini, Fabio; Vattiato, Rosa; Cioccoloni, Francesca; Calagreti, Gioia; Fusco, Mario; Vitale, Maria Francesca; Tumino, Rosario; Sigona, Aurora; Budroni, Mario; Cesaraccio, Rosaria; Candela, Giuseppa; Scuderi, Tiziana; Zarcone, Maurizio; Campisi, Ildegarda; Sant, Milena

    2013-12-01

    We investigated the effect of fasting blood glucose and body mass index (BMI) at diagnosis on risk of breast cancer death for cases diagnosed in five Italian cancer registries in 2003-2005 and followed up to the end of 2008. For 1607 Italian women (≥15 years) with information on BMI or blood glucose or diabetes, we analysed the risk of breast cancer death in relation to glucose tertiles (≤84.0, 84.1-94.0, >94.0 mg/dl) plus diabetic and unspecified categories; BMI tertiles (≤23.4, 23.5-27.3, >27.3 kg/m(2), unspecified), stage (T1-3N0M0, T1-3N+M0 plus T4anyNM0, M1, unspecified), oestrogen (ER) and progesterone (PR) status (ER+PR+, ER-PR-, ER and PR unspecified, other), age, chemotherapy and endocrine therapy, using multiple regression models. Separate models for ER+PR+ and ER-PR- cases were also run. Patients often had T1-3N0M0, ER+PR+ cancers and received chemotherapy or endocrine therapy; only 6% were M1 and 17% ER-PR-. Diabetic patients were older and had more often high BMI (>27 kg/m(2)), ER-PR-, M1 cancers than other patients. For ER+PR+ cases, with adjustment for other variables, breast cancer mortality was higher in women with high BMI than those with BMI 23.5-27.3 kg/m(2) (hazard ratio (HR)=2.9, 95% confidence interval (CI) 1.2-6.9). Breast cancer mortality was also higher in women with high (>94 mg/dl) blood glucose compared to those with glucose 84.1-94.0mg/dl (HR=2.6, 95% CI 1.2-5.7). Our results provide evidence that in ER+PR+ patients, high blood glucose and high BMI are independently associated with increased risk of breast cancer death. Detection and correction of these factors in such patients may improve prognosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Oral Presentations Have a Significantly Higher Publication Rate, But Not Impact Factors, Than Poster Presentations at the International Society for Study of Lumbar Spine meeting: Review of 1126 Abstracts From 2010 to 2012 Meetings.

    Science.gov (United States)

    Ohtori, Seiji; Orita, Sumihisa; Eguchi, Yawara; Aoki, Yasuchika; Suzuki, Miyako; Kubota, Gou; Inage, Kazuhide; Shiga, Yasuhiro; Abe, Koki; Kinoshita, Hideyuki; Inoue, Masahiro; Kanamoto, Hirohito; Norimoto, Masaki; Umimura, Tomotaka; Furuya, Takeo; Masao, Koda; Maki, Satoshi; Akazawa, Tsutomu; Takahashi, Kazuhisa

    2018-03-05

    A retrospective study. The aim of this study was to determine the publication rate and impact factors (IFs) among all abstracts presented at the 2010 and 2012 meetings of the International Society for the Study of Lumbar Spine (ISSLS). The publication rate of abstracts presented at overseas meetings was reported to be around 50%. However, the publication rate and IFs of oral and poster presentations made at ISSLS meetings were unclear. Moreover, whether the publication rates and IFs differed for papers associated with oral or poster presentations at ISSLS meetings was unknown. We investigated all 1126 abstracts (oral, special posters, general posters) presented at ISSLS meetings held between 2010 and 2012. PubMed was searched to identify publications and IFs were determined using journal citation reports. We also compared the publication rates and IFs between oral and poster presentations. The overall publication rate was 50.1% for three ISSLS meetings (564 publications/1126 abstracts). The overall publication rate for oral presentations, special posters, and general posters given in the 2010 to 2012 meetings was 62.0%, 48.3, and 46.6%, respectively. Overall, papers related to oral presentations had significantly higher publication rates than those of special and general posters (P = 0.0002). The average IFs of publications associated with abstracts presented at three ISSLS meetings was 2.802 for oral presentations, 2.593 for special posters, and 2.589 for general posters. There were no significant differences in average IFs between oral and poster presentations (P > 0.05). The publication rate for abstracts presented at ISSLS meetings was high and similar to publication rates for abstracts presented at other meetings concerning orthopedic and spine research. However, there was no significant difference in IFs between oral and poster presentations, suggesting that abstract evaluations cannot predict IFs of the eventual publication. 4.

  9. Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients

    DEFF Research Database (Denmark)

    Nexo, M A; Watt, T; Pedersen, J

    2014-01-01

    CONTEXT: Little is known about how thyroid diseases affect work ability. OBJECTIVE: The objective of this study was to evaluate the risk of work disability for patients with thyroid disease compared with the general population. DESIGN, SETTING, AND PARTICIPANTS: In a longitudinal register study, ...

  10. Long sleep duration and afternoon napping are associated with higher risk of incident diabetes in middle-aged and older Chinese: the Dongfeng-Tongji cohort study.

    Science.gov (United States)

    Han, Xu; Liu, Bing; Wang, Jing; Pan, An; Li, Yaru; Hu, Hua; Li, Xiulou; Yang, Kun; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Yang, Handong; Hu, Frank B; Wu, Tangchun; He, Meian

    2016-01-01

    In this study, we investigated the independent and combined effects of sleep duration and afternoon napping on the risk of incident diabetes among a cohort of middle-aged and older Chinese adults. Information of sleep and napping was obtained by questionnaires during face-to-face interviews. We categorized sleep duration into napping was divided into no napping (0 min) (reference), 1-30 min, 31-60 min, 61-90 min, and > 90 min. Cox proportional hazard regression models were used. Compared with referential sleeping group, subjects sleeping ≥10 h had a 42% higher risk of developing diabetes. The HR was 1.28 for napping > 90 min when compared with no napping. These associations were more pronounced in individuals without hypertension. Combined effects of long sleep duration and afternoon napping were further identified. Individuals with both sleep duration ≥ 10 h and napping > 60 min had a 72% higher risk of incident diabetes than those with sleeping 7∼napping 0 min (all above p napping were independently and jointly associated with higher risk of incident diabetes. Key messages Sleep duration was associated with diabetes, but whether it is a real cause of incident diabetes especially in Chinese still remains to be elucidated. The association of afternoon napping and diabetes was not consistent and definite, we clarified this association in a large prospective study. Long sleep duration and afternoon napping were independently and jointly associated with higher risk of incident diabetes.

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

    Science.gov (United States)

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

    2017-05-30

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

  12. Initial Steps to inform selection of continuation cognitive therapy or fluoxetine for higher risk responders to cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

    Vittengl, Jeffrey R; Anna Clark, Lee; Thase, Michael E; Jarrett, Robin B

    2017-07-01

    Responders to acute-phase cognitive therapy (A-CT) for major depressive disorder (MDD) often relapse or recur, but continuation-phase cognitive therapy (C-CT) or fluoxetine reduces risks for some patients. We tested composite moderators of C-CT versus fluoxetine's preventive effects to inform continuation treatment selection. Responders to A-CT for MDD judged to be at higher risk for relapse due to unstable or partial remission (N=172) were randomized to 8 months of C-CT or fluoxetine with clinical management and assessed, free from protocol treatment, for 24 additional months. Pre-continuation-treatment characteristics that in survival analyses moderated treatments' effects on relapse over 8 months of continuation-phase treatment (residual symptoms and negative temperament) and on relapse/recurrence over the full observation period's 32 months (residual symptoms and age) were combined to estimate the potential advantage of C-CT versus fluoxetine for individual patients. Assigning patients to optimal continuation treatment (i.e., to C-CT or fluoxetine, depending on patients' pre-continuation-treatment characteristics) resulted in absolute reduction of relapse or recurrence risk by 16-21% compared to the other non-optimal treatment. Although these novel results require replication before clinical application, selecting optimal continuation treatment (i.e., personalizing treatment) for higher risk A-CT responders may decrease risks of MDD relapse and recurrence substantively. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS: a qualitative study.

    Science.gov (United States)

    Pease, Anna; Ingram, Jenny; Blair, Peter S; Fleming, Peter J

    2017-01-01

    Qualitative interviews with mothers of babies at higher risk of sudden infant death syndrome (SIDS) were carried out to understand their views and decision-making process on the infant sleep environment and safe sleep messages. Twenty semi-structured interviews were conducted between February and November 2014 in deprived areas of Bristol, UK. Mothers were asked about their decision-making for the infant sleep environment and safe sleep messages including infant sleep position, co-sleeping, smoking, dummy use, feeding and disrupted routines. The interviews were transcribed, coded and thematic analysis carried out. Participants were invited based on an algorithm developed in a previous SIDS case control study that identified an increased risk of SIDS from four demographic characteristics: young maternal age, smoking during pregnancy, three or more children, and a measure of deprivation. The presence of three, or more characteristics led to being invited to take part in the qualitative study. Factors influencing mothers' adherence to the safe sleep messages included previous experience and the credibility of the advice given. They described disrupted routines that led to risky scenarios with a belief that occasional risks were acceptable. Where circumstances made following the advice more difficult they found alternative strategies to reduce the risk, including the use of movement monitors, regular checking and a belief that lighter maternal sleep in the presence of a baby was protective. Safer sleep messages should be tailored to fit with the lived realities of mothers, especially those at higher risk. The traditional list of 'do's' and 'don'ts' was not well accepted by this group. Interventions that seek to influence this higher-risk group should acknowledge mothers' own protective instincts and consider their beliefs and understanding behind the safer sleep messages if they are to be effective and encourage this group to change.

  14. Azacitidine in the 'real-world': an evaluation of 1101 higher-risk myelodysplastic syndrome/low blast count acute myeloid leukaemia patients in Ontario, Canada.

    Science.gov (United States)

    Mozessohn, Lee; Cheung, Matthew C; Fallahpour, Saber; Gill, Tripat; Maloul, Asmaa; Zhang, Liying; Lau, Olivia; Buckstein, Rena

    2018-06-01

    The outcome of myelodysplastic syndrome (MDS) patients with uniformly higher-risk disease treated with azacitidine (AZA) in the 'real-world' remains largely unknown. We evaluated 1101 consecutive higher-risk MDS patients (International Prognostic Scoring System intermediate-2/high) and low-blast count acute myeloid leukaemia (AML; 21-30% blasts) patients treated in Ontario, Canada. By dosing schedule, 24·7% received AZA for seven consecutive days, 12·4% for six consecutive days and 62·9% by 5-2-2. Overall, median number of cycles was 6 (range 1-67) and 8 (range 6-14) when restricted to the 692 (63%) patients who received at least 4 cycles. The actuarial median survival was 11·6 months [95% confidence interval (CI) 10·7-12·4) for the entire cohort and 18·0 months (landmark analysis; 95% CI 16·6-19·1 months) for those receiving at least 4 cycles. There was no difference in overall survival (OS) between the 3 dosing schedules (P = 0·87). In our large 'real-world' evaluation of AZA in higher-risk MDS/low-blast count AML, we demonstrated a lower than expected OS. Reassuringly, survival did not differ by dosing schedules. The OS was higher in the 2/3 of patients who received at least 4 cycles of treatment, reinforcing the necessity of sustained administration until therapeutic benefits are realised. This represents the largest 'real-world' evaluation of AZA in higher-risk MDS/low-blast count AML. © 2018 John Wiley & Sons Ltd.

  15. Diversity of apolipoprotein E genetic polymorphism significance on cardiovascular risk is determined by the presence of metabolic syndrome among hypertensive patients.

    Science.gov (United States)

    Teixeira, Andrei Alkmim; Marrocos, Mauro Sergio; Quinto, Beata Marie Redublo; Dalboni, Maria Aparecida; Rodrigues, Cassio Jose de Oliveira; Carmona, Silmara de Melo; Kuniyoshi, Mariana; Batista, Marcelo Costa

    2014-11-20

    Hypertension has a significant relevance as a cardiovascular risk factor. A consistent increase on world's Metabolic Syndrome (MetS) incidence has been associated with an epidemic cardiovascular risk in different populations. Dislipidemia plays a major role determining the epidemic CV burden attributed to MetS. Apolipoprotein E (ApoE) is involved on cholesterol and triglycerides metabolism regulation. Once ApoE polymorphism may influence lipid metabolism, it is possible that it brings on individual susceptibility consequences for the development of MetS and cardiovascular risk. The objective of the study is to measure the discriminatory power of ApoE polymorphism in determining cardiovascular risk stratification based on the presence MetS in a cohort of hypertensive patients. It was enrolled 383 patients, divided in two groups, classified by MetS presence (IDF criteria): Group 1: 266 patients with MetS (MetS +) and Group 2: 117 patients without Mets (MetS -). Patient's data were collected by clinical evaluation, physical exam, file reviews and laboratory testing. Polymorphic ApoE analysis was performed by PCR amplification. Groups were compared on clinical and laboratory characteristics as well as allele and genotype distribution towards ApoE polymorphism. Mets CVD prevalence was analysed according to E4 allele prevalence. The results evidenced 184 men (48%), 63,7% whites, 45,1% diabetics and 11,7% of patients were smokers. Mean age was 64,0 ± 12,0 years. When genotypic distribution was analyzed, E3/3 genotype and E3 allele frequencies were more prevalent. Among patients with MetS, we observed an independent association between CVD prevalence and E4 allele frequency (OR 2.42 (1.17- 5.0, p < 0,05)). On the opposite direction, in those without MetS, there was lesser CVD burden in E4 allele carriers (OR 0,14 (0,02-0,75)). These associations remained significant even after confounding factor corrections. The results presented demonstrate that the association

  16. Homocysteinemia is Associated with a Lower Degree of PBMC LINE-1 Methylation and a Higher Risk of CIN 2C in the U.S. Post-Folic Acid Fortification Era.

    Science.gov (United States)

    Badiga, Suguna; Siddiqui, Nuzhat R; Macaluso, Maurizio; Johanning, Gary L; Piyathilake, Chandrika J

    2016-01-01

    The primary aim of the study was to determine whether plasma concentrations of homocysteine (Hcy), a functional indicator of methyl donor nutrients, are associated with altered risk of higher grades of cervical intraepithelial neoplasia (CIN 2+) and the degree of methylation in long interspersed nucleotide elements (LINE-1s) of peripheral blood mononuclear cells, a potential biomarker of CIN 2+ in a population of women exposed to the United States folic acid fortification program. The secondary aim was to assess the determinants of plasma Hcy in the same population. The study included 457 women diagnosed with either CIN 2+ (cases, n = 132) or ≤ CIN 1 (non-cases, n = 325). Unconditional logistic regression models were used to test the associations after adjusting for relevant risk factors of cervical cancer. Women with higher Hcy concentrations were at a greater risk of being diagnosed with CIN 2+ [odds ratio (OR) = 1.86, P = 0.005]. Higher plasma folate concentrations were a significant determinant of lower Hcy (OR = 0.40, P = 0.0002). Women with higher Hcy concentrations were more likely to have a lower degree of LINE-1 methylation (OR = 2.30, P = 0.0007). These results suggested that further improvement in folate status in this population may be beneficial for lowering Hcy and improving the degree of LINE-1 methylation.

  17. 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.

  18. Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations.

    Science.gov (United States)

    Ohlsson, Bodil; Orho-Melander, Marju; Nilsson, Peter M

    2017-03-08

    Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI) symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring ( n = 363) of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV) were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference ( p = 0.003), diastolic blood pressure ( p = 0.003), and glucose levels ( p = 0.036). Higher zonulin levels were associated with increased risk of overweight ( p zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

  19. Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations

    Directory of Open Access Journals (Sweden)

    Bodil Ohlsson

    2017-03-01

    Full Text Available Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring (n = 363 of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS. Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference (p = 0.003, diastolic blood pressure (p = 0.003, and glucose levels (p = 0.036. Higher zonulin levels were associated with increased risk of overweight (p < 0.001, obesity (p = 0.047, and hyperlipidemia (p = 0.048. We cannot detect altered zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

  20. Loss of breast epithelial marker hCLCA2 promotes epithelial to mesenchymal transition and indicates higher risk of metastasis

    Science.gov (United States)

    Walia, Vijay; Yu, Yang; Cao, Deshou; Sun, Miao; McLean, Janel R.; Hollier, Brett G.; Cheng, Jiming; Mani, Sendurai A.; Rao, Krishna; Premkumar, Louis; Elble, Randolph

    2013-01-01

    Transition between epithelial and mesenchymal states is a feature of both normal development and tumor progression. We report that expression of chloride channel accessory protein hCLCA2 is a characteristic of epithelial differentiation in the immortalized MCF10A and HMLE models, while induction of EMT by cell dilution, TGFbeta, or mesenchymal transcription factors sharply reduces hCLCA2 levels. Attenuation of hCLCA2 expression by lentiviral shRNA caused cell overgrowth and focus formation, enhanced migration and invasion, and increased mammosphere formation in methylcellulose. These changes were accompanied by downregulation of E-cadherin and upregulation of mesenchymal markers such as vimentin and fibronectin. Moreover, hCLCA2 expression is greatly downregulated in breast cancer cells with a mesenchymal or claudin-low profile. These observations suggest that loss of hCLCA2 may promote metastasis. We find that higher-than-median expression of hCLCA2 is associated with a one-third lower rate of metastasis over an 18 year period among breast cancer patients compared to lower-than-median (n=344, unfiltered for subtype). Thus, hCLCA2 is required for epithelial differentiation, and its loss during tumor progression contributes to metastasis. Overexpression of hCLCA2 has been reported to inhibit cell proliferation and is accompanied by increases in chloride current at the plasma membrane and reduced intracellular pH (pHi). We found that knockdown cells have sharply reduced chloride current and higher pHi, both characteristics of tumor cells. These results suggest a mechanism for the effects on differentiation. Loss of hCLCA2 may allow escape from pHi homeostatic mechanisms, permitting the higher intracellular and lower extracellular pH that are characteristic of aggressive tumor cells. PMID:21909135

  1. Higher freshwater fish and sea fish intake is inversely associated with colorectal cancer risk among Chinese population: a case-control study.

    Science.gov (United States)

    Xu, Ming; Fang, Yu-Jing; Chen, Yu-Ming; Lu, Min-Shan; Pan, Zhi-Zhong; Yan, Bo; Zhong, Xiao; Zhang, Cai-Xia

    2015-08-12

    The association between specific fish intake and colorectal cancer risk remains controversial. This study aimed to examine the association between specific fish intake and colorectal cancer risk in Chinese population in a large case control study. During July 2010 to November 2014, 1189 eligible colorectal cancer cases and 1189 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate logistical regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) after adjusting for various confounders. A strong inverse association was found between freshwater fish intake and colorectal cancer risk. Compared with the lowest quartile, the highest quartile intake showed a risk reduction of 53% (OR 0.47, 95% CI = 0.36-0.60, Ptrend colorectal cancer risk. These results indicate that higher consumption of freshwater fish, sea fish and fresh fish is associated with a lower risk of colorectal caner.

  2. What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2007-06-01

    Full Text Available Abstract Background Despite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care. Methods We identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases – Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria. Results From an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51% but the remainder showed no correlation (16/51 31% or a paradoxical correlation (9/51 18%. Conclusion The general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.

  3. Delay of surgery after stent placement for resectable malignant colorectal obstruction is associated with higher risk of recurrence

    DEFF Research Database (Denmark)

    Broholm, Malene; Kobborg, Martin; Frostberg, Erik

    2017-01-01

    BACKGROUND: Self-expanding metal stents can be used as bridge to elective surgery for acute malignant colonic obstruction. However, the impact on long-term oncological outcome and the optimal timing of surgery are still unknown. METHOD: This was a retrospective multicenter study performed at four...... colorectal centers. Patients undergoing stent placement as bridge to surgery, between January 2010 and December 2013, were included in the study. Primary outcomes were survival and recurrence rates along with location of the metastases. Additionally, we recorded time from stent placement to elective surgery....... Secondary outcomes were postoperative complication rates. Complications were classified according to the Clavien-Dindo classification score. A logistic regression model was used to describe impact of delayed stent removal on risk of recurrence. RESULTS: This study included 112 patients, with a median follow...

  4. Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report.

    Science.gov (United States)

    Gómez-Reino, Juan J; Carmona, Loreto; Valverde, Vicente Rodríguez; Mola, Emilio Martín; Montero, Maria Dolores

    2003-08-01

    The long-term safety of therapeutic agents that neutralize tumor necrosis factor (TNF) is uncertain. Recent evidence based on spontaneous reporting shows an association with active tuberculosis (TB). We undertook this study to determine and describe the long-term safety of 2 of these agents, infliximab and etanercept, in rheumatic diseases based on a national active-surveillance system following the commercialization of the drugs. We analyzed the safety data actively collected in the BIOBADASER (Base de Datos de Productos Biológicos de la Sociedad Española de Reumatología) database, which was launched in February 2000 by the Spanish Society of Rheumatology. For the estimation of TB risk, the annual incidence rate in patients treated with these agents was compared with the background rate and with the rate in a cohort of patients with rheumatoid arthritis (RA) assembled before the era of anti-TNF treatment. Seventy-one participating centers sent data on 1,578 treatments with infliximab (86%) or etanercept (14%) in 1,540 patients. Drug survival rates (reported as the cumulative percentage of patients still receiving medication) for infliximab and etanercept pooled together were 85% and 81% at 1 year and 2 years, respectively. Instances of discontinuation were essentially due to adverse events. Seventeen cases of TB were found in patients treated with infliximab. The estimated incidence of TB associated with infliximab in RA patients was 1,893 per 100,000 in the year 2000 and 1,113 per 100,000 in the year 2001. These findings represent a significant increased risk compared with background rates. In the first 5 months of 2002, after official guidelines were established for TB prevention in patients treated with biologics, only 1 new TB case was registered (in January). Therapy with infliximab is associated with an increased risk of active TB. Proper measures are needed to prevent and manage this adverse event.

  5. Targeted Resequencing and Functional Testing Identifies Low-Frequency Missense Variants in the Gene Encoding GARP as Significant Contributors to Atopic Dermatitis Risk.

    Science.gov (United States)

    Manz, Judith; Rodríguez, Elke; ElSharawy, Abdou; Oesau, Eva-Maria; Petersen, Britt-Sabina; Baurecht, Hansjörg; Mayr, Gabriele; Weber, Susanne; Harder, Jürgen; Reischl, Eva; Schwarz, Agatha; Novak, Natalija; Franke, Andre; Weidinger, Stephan

    2016-12-01

    Gene-mapping studies have consistently identified a susceptibility locus for atopic dermatitis and other inflammatory diseases on chromosome band 11q13.5, with the strongest association observed for a common variant located in an intergenic region between the two annotated genes C11orf30 and LRRC32. Using a targeted resequencing approach we identified low-frequency and rare missense mutations within the LRRC32 gene encoding the protein GARP, a receptor on activated regulatory T cells that binds latent transforming growth factor-β. Subsequent association testing in more than 2,000 atopic dermatitis patients and 2,000 control subjects showed a significant excess of these LRRC32 variants in individuals with atopic dermatitis. Structural protein modeling and bioinformatic analysis predicted a disruption of protein transport upon these variants, and overexpression assays in CD4 + CD25 - T cells showed a significant reduction in surface expression of the mutated protein. Consistently, flow cytometric (FACS) analyses of different T-cell subtypes obtained from atopic dermatitis patients showed a significantly reduced surface expression of GARP and a reduced conversion of CD4 + CD25 - T cells into regulatory T cells, along with lower expression of latency-associated protein upon stimulation in carriers of the LRRC32 A407T variant. These results link inherited disturbances of transforming growth factor-β signaling with atopic dermatitis risk. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS:a qualitative study

    OpenAIRE

    Pease, Anna; Ingram, Jenny; Blair, Pete; Fleming, Peter

    2017-01-01

    Objective: Qualitative interviews with mothers of babies at higher risk of sudden infant death syndrome (SIDS) were carried out to understand their views and decision-making process on the infant sleep environment and safe sleep messages.Design and setting: Twenty semi-structured interviews were conducted between February and November 2014 in deprived areas of Bristol, UK. Mothers were asked about their decision-making for the infant sleep environment and safe sleep messages including infant ...

  7. Imatinib as the first and only treatment in Europe for adult patients at significant risk of relapse following gastrointestinal stromal tumor removal

    Science.gov (United States)

    Duffaud, F; Salas, S; Huyn, T; Deville, JL

    2010-01-01

    Mutations of the KIT gene are the molecular hallmark of most gastrointestinal stromal tumors (GISTs). GIST has become a model for targeted treatment of solid tumors, imatinib becoming the standard first-line treatment of these tumors in the advanced/metastatic phase. Because of the efficacy of imatinib treatment in the advanced setting, its role following resection of a primary non-metastatic GIST was investigated. The recently published phase III, double-blind, placebo-controlled, multicenter ACOSOG Z9001 study showed that adjuvant therapy is safe, and significantly improves recurrence-free survival compared to placebo when given after resection. To what extent imatinib will improve overall survival has yet to be answered. What is clear is that high-risk GIST patients definitely need adjuvant therapy, and that 1 year of imatinib is not enough for the patients who do need it. The questions of optimal duration of imatinib treatment in the adjuvant setting, adequate selection of risk patients and effect of imatinib on overall survival are currently being studied. PMID:21694845

  8. Plastic Surgery Overseas: How Much Should a Physician Risk in the Pursuit of Higher-Quality Continuity of Care?

    Science.gov (United States)

    Schweikart, Scott

    2018-04-01

    In this article I discuss medical tourism, whereby patients go overseas for plastic surgery treatment in order to save money. However, if malpractice occurs abroad, there are several barriers that make it difficult for patients to recover damages. I explain these legal barriers and then discuss the possible causes of action patients can have over their "domestic physician" (their personal physician who might have referred surgery abroad or who gives postoperative follow-up care) and how these causes of action can create avenues of legal recovery not otherwise available. The possible liability of the domestic physician in the context of surgical malpractice abroad creates an ethical tension in the pursuit of higher-quality continuity of care, as the more involved the physician becomes in the process, the more likely he or she will assume liability. © 2018 American Medical Association. All Rights Reserved.

  9. Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

    International Nuclear Information System (INIS)

    Fan, Kang-Hsing; Wang, Hung-Ming; Kang, Chung-Jan

    2010-01-01

    Purpose: The aim of this study was to investigate the treatment results of postoperative radiotherapy (PORT) on squamous cell carcinoma of the oral cavity (OSCC). Materials and Methods: This study included 302 OSCC patients who were treated by radical surgery and PORT. Indications for PORT include Stage III or IV OSCC according to the 2002 criteria of the American Joint Committee on Cancer, the presence of perineural invasion or lymphatic invasion, the depth of tumor invasion, or a close surgical margin. Patients with major risk factors, such as multiple nodal metastases, a positive surgical margin, or extracapsular spreading, were excluded. The prescribed dose of PORT ranged from 59.4 to 66.6Gy (median, 63Gy). Results: The 3-year overall and recurrence-free survival rates were 73% and 70%, respectively. Univariate analysis revealed that differentiation, perineural invasion, lymphatic invasion, bone invasion, location (hard palate and retromolar trigone), invasion depths ≥10mm, and margin distances ≤4mm were significant prognostic factors. The presence of multiple significant factors of univariate analysis correlated with disease recurrence. The 3-year recurrence-free survival rates were 82%, 76%, and 45% for patients with no risk factors, one or two risk factors, and three or more risk factors, respectively. After multivariate analysis, the number of risk factors and lymphatic invasion were significant prognostic factors. Conclusion: PORT may be an adequate adjuvant therapy for OSCC patients with one or two risk factors of recurrence. The presence of multiple risk factors and lymphatic invasion correlated with poor prognosis, and more aggressive treatment may need to be considered.

  10. Highway proximity and black carbon from cookstoves as a risk factor for higher blood pressure in rural China.

    Science.gov (United States)

    Baumgartner, Jill; Zhang, Yuanxun; Schauer, James J; Huang, Wei; Wang, Yuqin; Ezzati, Majid

    2014-09-09

    Air pollution in China and other parts of Asia poses large health risks and is an important contributor to global climate change. Almost half of Chinese homes use biomass and coal fuels for cooking and heating. China's economic growth and infrastructure development has led to increased emissions from coal-fired power plants and an expanding fleet of motor vehicles. Black carbon (BC) from incomplete biomass and fossil fuel combustion is the most strongly light-absorbing component of particulate matter (PM) air pollution and the second most important climate-forcing human emission. PM composition and sources may also be related to its human health impact. We enrolled 280 women living in a rural area of northwestern Yunnan where biomass fuels are commonly used. We measured their blood pressure, distance from major traffic routes, and daily exposure to BC (pyrolytic biomass combustion), water-soluble organic aerosol (organic aerosol from biomass combustion), and, in a subset, hopane markers (motor vehicle emissions) in winter and summer. BC had the strongest association with systolic blood pressure (SBP) (4.3 mmHg; P water-soluble organic mass. The effect of BC on SBP was almost three times greater in women living near the highway [6.2 mmHg; 95% confidence interval (CI), 3.6 to 8.9 vs. 2.6 mmHg; 95% CI, 0.1 to 5.2]. Our findings suggest that BC from combustion emissions is more strongly associated with blood pressure than PM mass, and that BC's health effects may be larger among women living near a highway and with greater exposure to motor vehicle emissions.

  11. No Higher Risk of CRPS After External Fixation of Distal Radial Fractures - Subgroup Analysis Under Randomised Vitamin C Prophylaxis.

    Science.gov (United States)

    Zollinger, Paul E; Kreis, Robert W; van der Meulen, Hub G; van der Elst, Maarten; Breederveld, Roelf S; Tuinebreijer, Wim E

    2010-02-17

    Operative and conservative treatment of wrist fractures might lead to complex regional pain syndrome (CRPS) type I.In our multicenter dose response study in which patients with distal radial fractures were randomly allocated to placebo or vitamin C in a daily dose of 200mg, 500mg or 1500mg during 50 days, an operated subgroup was analyzed.48 (of 427) fractures) were operated (11.2%). Twenty-nine patients (60%) were treated with external fixation, 14 patients (29%) with K-wiring according to Kapandji and five patients (10%) with internal plate fixation. The 379 remaining patients were treated with a plaster.In the operated group of patients who received vitamin C no CRPS (0/37) was seen in comparison with one case of CRPS (Kapandji technique) in the operated group who received placebo (1/11 = 9%, p=.23). There was no CRPS after external fixation.In the conservatively treated group 17 cases of CRPS (17/379 = 4.5%) occurred in comparison with one in case of CRPS in the operated group (1/48 = 2.1%, p=.71).External fixation doesn't necessarily lead to a higher incidence of CRPS in distal radial fractures. Vitamin C may also play a role in this. This subgroup analysis in operated distal radial fractures showed no CRPS occurrence with vitamin C prophylaxis.

  12. Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

    Science.gov (United States)

    Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

    2016-08-01

    A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries.

    Science.gov (United States)

    Damsgaard, Camilla T; Papadaki, Angeliki; Jensen, Signe M; Ritz, Christian; Dalskov, Stine-Mathilde; Hlavaty, Petr; Saris, Wim H M; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Andersen, Malene R; Stender, Steen; Larsen, Thomas M; Astrup, Arne; Mølgaard, Christian; Michaelsen, Kim F

    2013-06-01

    Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1 mo, and/or 6 mo. Protein intake was higher in the HP groups (19.9 ± 1.3% energy) than in the LP groups at 6 mo (16.8 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P pressure (P children, particularly in those undergoing most intensive intervention.

  14. Clinical significance of cerebral microbleeds on MRI : A comprehensive meta-analysis of risk of intracerebral hemorrhage, ischemic stroke, mortality, and dementia in cohort studies (vI)

    NARCIS (Netherlands)

    A. Charidimou (Andreas); S. Shams (Sara); J.R. Romero (Jose Rafael); J. Ding (Jie); R. Veltkamp (Roland); S. Horstmann (Solveig); G. Eiriksdottir (Gudny); M.A. van Buchem (Mark); V. Gudnason (Vilmundur); J.J. Himali (Jayandra); M.E. Gurol (Edip); A. Viswanathan (Anand); T. Imaizumi (Toshio); M.W. Vernooij (Meike); S. Seshadri (Sudha); S.M. Greenberg (Steven); O.R. Benavente (Oscar); L.J. Launer (Lenore); A. Shoamanesh (Ashkan)

    2018-01-01

    markdownabstract__Background:__ Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a

  15. Longer habitual afternoon napping is associated with a higher risk for impaired fasting plasma glucose and diabetes mellitus in older adults: results from the Dongfeng-Tongji cohort of retired workers.

    Science.gov (United States)

    Fang, Weimin; Li, Zhongliang; Wu, Li; Cao, Zhongqiang; Liang, Yuan; Yang, Handong; Wang, Youjie; Wu, Tangchun

    2013-10-01

    Afternoon napping is a common habit in China. We used data obtained from the Dongfeng-Tongji cohort to examine if duration of habitual afternoon napping was associated with risks for impaired fasting plasma glucose (IFG) and diabetes mellitus (DM) in a Chinese elderly population. A total of 27,009 participants underwent a physical examination, laboratory tests, and face-to-face interview. They were categorized into four groups according to nap duration (no napping, or =90 min). Logistic regression models were used to examine the odds ratios (ORs) of napping duration with IFG and DM. Of the participants, 18,515 (68.6%) reported regularly taking afternoon naps. Those with longer nap duration had considerably higher prevalence of IFG and DM. Napping duration was associated in a dose-dependent manner with IFG and DM (Pnap duration (>60 min; all Pnap duration (>30 min) was associated with increased risk for DM; however, this finding was not significant in the group with a nap duration of 60-90 min. Longer habitual afternoon napping was associated with a moderate increase for DM risk, independent of several covariates. This finding suggests that longer nap duration may represent a novel risk factor for DM and higher blood glucose levels. Copyright © 2013. Published by Elsevier B.V.

  16. Efficacy of adjuvant therapy with 3.7 GBq radioactive iodine in intermediate-risk patients with 'higher risk features' and predictive value of postoperative nonstimulated thyroglobulin.

    Science.gov (United States)

    Rosario, Pedro W; Mourão, Gabriela F; Calsolari, Maria Regina

    2016-11-01

    This study evaluated the efficacy of adjuvant therapy with 3.7 GBq radioactive iodine (RAI) in patients with papillary thyroid carcinoma (PTC) of intermediate risk with higher risk features and determined the predictive value of postoperative nonstimulated thyroglobulin (Tg). This was a prospective study including 85 patients with PTC of intermediate risk and higher risk features: tumor greater than 1 cm and aggressive histological subtype or vascular invasion; and/or more than three positive lymph node (LN) or LN greater than 1.5 cm or showing macroscopic extracapsular extension; and/or a combination of tumor greater than 4 cm, microscopic extrathyroidal extension, aggressive histology, and LN metastases (cN1). After thyroidectomy, all patients had nonstimulated Tg of at least 0.3 ng/ml and ultrasonography showed no anomalies. When evaluated 12 months after RAI therapy, an excellent response to initial therapy was achieved in 61 patients (71.7%). Structural disease was detected in five patients (5.9%). During follow-up, 6/80 patients (7.5%) without structural disease 1 year after RAI developed relapse. In the last assessment, 80 patients (94.1%) had nonstimulated Tg less than 1 ng/ml and no evidence of structural disease. There was no case of death because of the tumor. Postoperative nonstimulated Tg was a predictive factor of the main outcome (structural disease 1 year after RAI or recurrence) and the best cut-off was 1.8 ng/ml (sensitivity: 72.7%, specificity: 83.4%, negative predictive value: 95.4%). In patients with PTC of intermediate risk with higher risk features treated with 3.7 GBq RAI, postoperative nonstimulated Tg up to 1.8 ng/ml was a predictor of low risk of structural disease 1 year after therapy or recurrence.

  17. Comparison of a sentinel lymph node mapping algorithm and comprehensive lymphadenectomy in the detection of stage IIIC endometrial carcinoma at higher risk for nodal disease.

    Science.gov (United States)

    Ducie, Jennifer A; Eriksson, Ane Gerda Zahl; Ali, Narisha; McGree, Michaela E; Weaver, Amy L; Bogani, Giorgio; Cliby, William A; Dowdy, Sean C; Bakkum-Gamez, Jamie N; Soslow, Robert A; Keeney, Gary L; Abu-Rustum, Nadeem R; Mariani, Andrea; Leitao, Mario M

    2017-12-01

    To determine if a sentinel lymph node (SLN) mapping algorithm will detect metastatic nodal disease in patients with intermediate-/high-risk endometrial carcinoma. Patients were identified and surgically staged at two collaborating institutions. The historical cohort (2004-2008) at one institution included patients undergoing complete pelvic and paraaortic lymphadenectomy to the renal veins (LND cohort). At the second institution an SLN mapping algorithm, including pathologic ultra-staging, was performed (2006-2013) (SLN cohort). Intermediate-risk was defined as endometrioid histology (any grade), ≥50% myometrial invasion; high-risk as serous or clear cell histology (any myometrial invasion). Patients with gross peritoneal disease were excluded. Isolated tumor cells, micro-metastases, and macro-metastases were considered node-positive. We identified 210 patients in the LND cohort, 202 in the SLN cohort. Nodal assessment was performed for most patients. In the intermediate-risk group, stage IIIC disease was diagnosed in 30/107 (28.0%) (LND), 29/82 (35.4%) (SLN) (P=0.28). In the high-risk group, stage IIIC disease was diagnosed in 20/103 (19.4%) (LND), 26 (21.7%) (SLN) (P=0.68). Paraaortic lymph node (LN) assessment was performed significantly more often in intermediate-/high-risk groups in the LND cohort (P<0.001). In the intermediate-risk group, paraaortic LN metastases were detected in 20/96 (20.8%) (LND) vs. 3/28 (10.7%) (SLN) (P=0.23). In the high-risk group, paraaortic LN metastases were detected in 13/82 (15.9%) (LND) and 10/56 (17.9%) (SLN) (%, P=0.76). SLN mapping algorithm provides similar detection rates of stage IIIC endometrial cancer. The SLN algorithm does not compromise overall detection compared to standard LND. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Glycemic control paradox: Poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes.

    Science.gov (United States)

    Li, Tsai-Chung; Kardia, Sharon L R; Li, Chia-Ing; Chen, Ching-Chu; Liu, Chiu-Shong; Yang, Sing-Yu; Muo, Chin-Shin; Peyser, Patricia A; Lin, Cheng-Chieh

    2015-09-01

    The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. After multivariate adjustment, one-year risk was higher for cases with HbA1c level risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Using forum-based competitions to improve sustainability and motivation in higher education GNSS learning - Chances and risks

    Science.gov (United States)

    Mayer, M.

    2012-04-01

    . During the semesters, the motivation and the amount of effort (e.g., time requirement of learning and teaching) were examined regularly. These parameters are going to be discussed as well. Based on the gained experiences, the forum-based sustainability competition has proofed to be an effective tool, which can contribute significantly to an increased sustainability of students' learning. In addition, the developed forum-based competition concept can be easily transferred to other lecture courses, especially focusing on factual knowledge.

  20. Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries.

    Science.gov (United States)

    Díez-Campelo, María; Lorenzo, Jose I; Itzykson, Raphael; Rojas, Silvia M; Berthon, Céline; Luño, Elisa; Beyne-Rauzy, Odile; Perez-Oteyza, Jaime; Vey, Norbert; Bargay, Joan; Park, Sophie; Cedena, Teresa; Bordessoule, Dominique; Muñoz, Juan A; Gyan, Emmanuel; Such, Esperanza; Visanica, Sorin; López-Cadenas, Félix; de Botton, Stéphane; Hernández-Rivas, Jesús M; Ame, Shanti; Stamatoullas, Aspasia; Delaunay, Jacques; Salanoubat, Celia; Isnard, Françoise; Guieze, Romain; Pérez Guallar, Joan; Badiella, Llorenc; Sanz, Guillermo; Cañizo, Consuelo; Fenaux, Pierre

    2018-05-01

    Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n = 115) versus best supportive care (BSC; n = 120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK. © 2018 John Wiley & Sons Ltd.

  1. Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study.

    Science.gov (United States)

    Magnussen, Robert A; Borchers, James R; Pedroza, Angela D; Huston, Laura J; Haas, Amanda K; Spindler, Kurt P; Wright, Rick W; Kaeding, Christopher C; Allen, Christina R; Anderson, Allen F; Cooper, Daniel E; DeBerardino, Thomas M; Dunn, Warren R; Lantz, Brett A; Mann, Barton; Stuart, Michael J; Albright, John P; Amendola, Annunziato; Andrish, Jack T; Annunziata, Christopher C; Arciero, Robert A; Bach, Bernard R; Baker, Champ L; Bartolozzi, Arthur R; Baumgarten, Keith M; Bechler, Jeffery R; Berg, Jeffrey H; Bernas, Geoffrey A; Brockmeier, Stephen F; Brophy, Robert H; Bush-Joseph, Charles A; Butler, J Brad; Campbell, John D; Carey, James L; Carpenter, James E; Cole, Brian J; Cooper, Jonathan M; Cox, Charles L; Creighton, R Alexander; Dahm, Diane L; David, Tal S; Flanigan, David C; Frederick, Robert W; Ganley, Theodore J; Garofoli, Elizabeth A; Gatt, Charles J; Gecha, Steven R; Giffin, James Robert; Hame, Sharon L; Hannafin, Jo A; Harner, Christopher D; Harris, Norman Lindsay; Hechtman, Keith S; Hershman, Elliott B; Hoellrich, Rudolf G; Hosea, Timothy M; Johnson, David C; Johnson, Timothy S; Jones, Morgan H; Kamath, Ganesh V; Klootwyk, Thomas E; Levy, Bruce A; Ma, C Benjamin; Maiers, G Peter; Marx, Robert G; Matava, Matthew J; Mathien, Gregory M; McAllister, David R; McCarty, Eric C; McCormack, Robert G; Miller, Bruce S; Nissen, Carl W; O'Neill, Daniel F; Owens, Brett D; Parker, Richard D; Purnell, Mark L; Ramappa, Arun J; Rauh, Michael A; Rettig, Arthur C; Sekiya, Jon K; Shea, Kevin G; Sherman, Orrin H; Slauterbeck, James R; Smith, Matthew V; Spang, Jeffrey T; Svoboda, Steven J; Taft, Timothy N; Tenuta, Joachim J; Tingstad, Edwin M; Vidal, Armando F; Viskontas, Darius G; White, Richard A; Williams, James S; Wolcott, Michelle L; Wolf, Brian R; York, James J

    2018-03-01

    had 4.8-times greater odds of progression of articular cartilage injury than those with an intact medial meniscus ( P = .02). Odds of significant chondral surface change increased by 5% in the lateral compartment and 6% in the medial compartment for each increased year of age ( P ≤ .02). For the patellofemoral compartment, the use of allograft in primary reconstruction was associated with a 15-fold increased odds of progression of articular cartilage damage relative to a patellar tendon autograft ( P < .001). Each 1-unit increase in BMI at the time of revision surgery was associated with a 10% increase in the odds of progression of articular cartilage damage ( P = .046) in the patellofemoral compartment. Excision of the medial and lateral meniscus at primary ACL reconstruction increases the odds of articular cartilage damage in the corresponding compartment at the time of revision ACL reconstruction. Increased age is a risk factor for deterioration of articular cartilage in both tibiofemoral compartments, while increased BMI and the use of allograft for primary ACL reconstruction are associated with an increased risk of progression in the patellofemoral compartment.

  2. Higher risks when working unusual times? A cross-validation of the effects on safety, health, and work-life balance.

    Science.gov (United States)

    Greubel, Jana; Arlinghaus, Anna; Nachreiner, Friedhelm; Lombardi, David A

    2016-11-01

    Replication and cross-validation of results on health and safety risks of work at unusual times. Data from two independent surveys (European Working Conditions Surveys 2005 and 2010; EU 2005: n = 23,934 and EU 2010: n = 35,187) were used to examine the relative risks of working at unusual times (evenings, Saturdays, and Sundays) on work-life balance, work-related health complaints, and occupational accidents using logistic regression while controlling for potential confounders such as demographics, work load, and shift work. For the EU 2005 survey, evening work was significantly associated with an increased risk of poor work-life balance (OR 1.69) and work-related health complaints (OR 1.14), Saturday work with poor work-life balance (OR 1.49) and occupational accidents (OR 1.34), and Sunday work with poor work-life balance (OR 1.15) and work-related health complaints (OR 1.17). For EU 2010, evening work was associated with poor work-life balance (OR 1.51) and work-related health complaints (OR 1.12), Saturday work with poor work-life balance (OR 1.60) and occupational accidents (OR 1.19) but a decrease in risk for work-related health complaints (OR 0.86) and Sunday work with work-related health complaints (OR 1.13). Risk estimates in both samples yielded largely similar results with comparable ORs and overlapping confidence intervals. Work at unusual times constitutes a considerable risk to social participation and health and showed structurally consistent effects over time and across samples.

  3. Breastfeeding woman are at higher risk of vitamin D deficiency than non-breastfeeding women - insights from the German VitaMinFemin study.

    Science.gov (United States)

    Gellert, Sandra; Ströhle, Alexander; Hahn, Andreas

    2016-01-01

    Despite increased awareness of the adverse health effects of vitamin D deficiency, only a few studies have evaluated the vitamin D status (25-hydroxyvitamin D [25(OHD)]) of breastfeeding women and up to now, no information exits for German breastfeeding women. Therefore, the aim of study was to determine the vitamin D status of breastfeeding women compared to non-pregnant and non-breastfeeding (NPNB) women. This cross-sectional study investigated 124 breastfeeding women and 124 age and season matched NPNB women from the German "Vitamin and mineral status among German women" study. The study participants were recruited from April 2013 to March 2015 and did not take vitamin D supplements. Serum 25(OH)D was analyzed by chemiluminescent immunoassay. Vitamin D deficiency (risk of vitamin D deficiency was higher in the winter and spring months (OR: 2.6, 95% CI 1.1, 6.3) and increased with lower longitude per one unit (OR 0.7, 95% CI 0.6, 0.9). Breastfeeding women in Germany had a higher risk of deficient vitamin D levels than NPNB women. In further studies, the optimal vitamin D status for breastfeeding women should be investigated and also the required vitamin D doses to ensure this vitamin D status. German Clinical Trial Register (identification number: DRKS00004789).

  4. Higher risk sexual behaviour is associated with unawareness of HIV-positivity and lack of viral suppression - implications for Treatment as Prevention.

    Science.gov (United States)

    Huerga, Helena; Venables, Emilie; Ben-Farhat, Jihane; van Cutsem, Gilles; Ellman, Tom; Kenyon, Chris

    2017-11-23

    Efficacy of Treatment as Prevention Strategy depends on a variety of factors including individuals' likelihood to test and initiate treatment, viral load and sexual behaviour. We tested the hypothesis that people with higher risk sexual behaviour are less likely to know their HIV-positive status and be virologically suppressed. A cross-sectional population-based survey of individuals aged 15-59 years old was conducted in 2013 in KwaZulu-Natal, South Africa. A two-stage cluster probability sampling was used. After adjustment for age and sex, lack of awareness of HIV-positivity was strongly associated with having more than one sexual partner in the preceding year (aOR: 2.1, 95%CI: 1.5-3.1). Inconsistent condom use was more common in individuals with more than one sexual partner (aOR: 16.6, 95%CI: 7.6-36.7) and those unaware (aOR: 3.7, 95%CI: 2.6-5.4). Among people aware of their HIV-positivity, higher risk sexual behaviour was associated with lack of viral suppression (aOR: 2.2, 95%CI: 1.1-4.5). Risky sexual behaviour seems associated with factors linked to poor health-seeking behaviour which may have negative implications for HIV testing and Treatment as Prevention. Innovative strategies, driven by improved epidemiological and anthropological understanding, are needed to enable comprehensive approaches to HIV prevention.

  5. Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study.

    Science.gov (United States)

    Pedrero-Chamizo, R; Gómez-Cabello, A; Meléndez, A; Vila-Maldonado, S; Espino, L; Gusi, N; Villa, G; Casajús, J A; González-Gross, M; Ara, I

    2015-02-01

    To evaluate the associations between physical fitness levels, health related quality of life (HRQoL) and sarcopenic obesity (SO) and to analyze the usefulness of several physical fitness tests as a screening tool for detecting elderly people with an increased risk of suffering SO. Cross-sectional analysis of a population-based sample. Non-institutionalized Spanish elderly participating in the EXERNET multi-centre study. 2747 elderly subjects aged 65 and older. Body weight, height and body mass index were evaluated in each subject. Body composition was measured by bioelectrical impedance. Four SO groups were created based on percentage of body fat and relative muscle mass; 1) normal group, 2) sarcopenic group, 3) obesity group and 4) SO group. Physical fitness was evaluated using 8 tests (balance, lower and upper body strength, lower and upper body flexibility, agility, walking speed and aerobic capacity). Three tertiles were created for each test based on the calculated scores. HRQoL was assessed using the EuroQol visual analogue scale. Participants with SO showed lower physical fitness levels compared with normal subjects. Better balance, agility, and aerobic capacity were associated to a lower risk of suffering SO in the fittest men (odds ratio health was associated with better physical fitness performance. Higher levels of physical fitness were associated with a reduced risk of suffering SO and better perceived health among elderly. SO elderly people have lower physical functional levels than healthy counterparts.

  6. A higher risk of acute rejection of human kidney allografts can be predicted from the level of CD45RC expressed by the recipients' CD8 T cells.

    Directory of Open Access Journals (Sweden)

    Laurence Ordonez

    Full Text Available Although transplantation is the common treatment for end-stage renal failure, allograft rejection and marked morbidity from the use of immunosuppressive drugs remain important limitations. A major challenge in the field is to identify easy, reliable and noninvasive biomarkers allowing the prediction of deleterious alloreactive immune responses and the tailoring of immunosuppressive therapy in individuals according to the rejection risk. In this study, we first established that the expression of the RC isoform of the CD45 molecule (CD45RC on CD4 and CD8 T cells from healthy individuals identifies functionally distinct alloreactive T cell subsets that behave differently in terms of proliferation and cytokine secretion. We then investigated whether the frequency of the recipients CD45RC T cell subsets before transplantation would predict acute graft rejection in a cohort of 89 patients who had undergone their first kidney transplantation. We showed that patients exhibiting more than 54.7% of CD8 CD45RC(high T cells before transplantation had a 6 fold increased risk of acute kidney graft rejection. In contrast, the proportions of CD4 CD45RC T cells were not predictive. Thus, a higher risk of acute rejection of human kidney allografts can be predicted from the level of CD45RC expressed by the recipients' CD8 T cells.

  7. The Expected Cardiovascular Benefit of Plasma Cholesterol Lowering with or Without LDL-C Targets in Healthy Individuals at Higher Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Fernando Henpin Yue Cesena

    Full Text Available Abstract Background: There is controversy whether management of blood cholesterol should be based or not on LDL-cholesterol (LDL-c target concentrations. Objectives: To compare the estimated impact of different lipid-lowering strategies, based or not on LDL-c targets, on the risk of major cardiovascular events in a population with higher cardiovascular risk. Methods: We included consecutive individuals undergoing a routine health screening in a single center who had a 10-year risk for atherosclerotic cardiovascular disease (ASCVD ≥ 7.5% (pooled cohort equations, ACC/AHA, 2013. For each individual, we simulated two strategies based on LDL-c target (≤ 100 mg/dL [Starget-100] or ≤ 70 mg/dL [Starget-70] and two strategies based on percent LDL-c reduction (30% [S30%] or 50% [S50%]. Results: In 1,897 subjects (57 ± 7 years, 96% men, 10-year ASCVD risk 13.7 ± 7.1%, LDL-c would be lowered from 141 ± 33 mg/dL to 99 ± 23 mg/dL in S30%, 71 ± 16 mg/dL in S50%, 98 ± 9 mg/dL in Starget-100, and 70 ± 2 mg/dL in Starget-70. Ten-year ASCVD risk would be reduced to 8.8 ± 4.8% in S50% and 8.9 ± 5.2 in Starget-70. The number of major cardiovascular events prevented in 10 years per 1,000 individuals would be 32 in S30%, 31 in Starget-100, 49 in S50%, and 48 in Starget-70. Compared with Starget-70, S50% would prevent more events in the lower LDL-c tertile and fewer events in the higher LDL-c tertile. Conclusions: The more aggressive lipid-lowering approaches simulated in this study, based on LDL-c target or percent reduction, may potentially prevent approximately 50% more hard cardiovascular events in the population compared with the less intensive treatments. Baseline LDL-c determines which strategy (based or not on LDL-c target is more appropriate at the individual level.

  8. Report: EPA’s Information Systems and Data Are at Risk Due to Insufficient Training of Personnel With Significant Information Security Responsibilities

    Science.gov (United States)

    Report #14-P-0142, March 21, 2014. The EPA places its information systems and data at risk due to an organizational structure that has not specified required duties and responsibilities to ensure personnel are trained on key information security roles.

  9. Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer

    DEFF Research Database (Denmark)

    Johansson, Robert; Damber, Jan Erik; Hagerman, Inger

    2011-01-01

    This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin®) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular...

  10. Protocol for the melatools skin self-monitoring trial: a phase II randomised controlled trial of an intervention for primary care patients at higher risk of melanoma.

    Science.gov (United States)

    Mills, Katie; Emery, Jon; Lantaff, Rebecca; Radford, Michael; Pannebakker, Merel; Hall, Per; Burrows, Nigel; Williams, Kate; Saunders, Catherine L; Murchie, Peter; Walter, Fiona M

    2017-11-28

    Melanoma is the fifth most common cancer in the UK. Incidence rates have quadrupled over the last 30 years and continue to rise, especially among younger people. As routine screening of the general population is not currently recommended in the UK, a focus on secondary prevention through early detection and prompt treatment in individuals at increased risk of melanoma could make an important contribution to improve melanoma outcomes. This paper describes the protocol for a phase II, multisite, randomised controlled trial, in the primary care setting, for patients at increased risk of melanoma. A skin self-monitoring (SSM) smartphone 'App' was used to improve symptom appraisal and encourage help seeking in primary care, thereby promoting early presentation with skin changes suspicious of melanoma. We aim to recruit 200 participants from general practice waiting rooms in the East of England. Eligible patients are those identified at higher melanoma risk (using a real-time risk assessment tool), without a personal history of melanoma, aged 18 to 75 years. Participants will be invited to a primary care nurse consultation, and randomised to the intervention group (standard written advice on skin cancer detection and sun protection, loading of an SSM 'App' onto the participant's smartphone and instructions on use including self-monitoring reminders) or control group (standard written advice alone). The primary outcomes are consultation rates for changes to a pigmented skin lesion, and the patient interval (time from first noticing a skin change to consultation). Secondary outcomes include patient sun protection behaviours, psychosocial outcomes, and measures of trial feasibility and acceptability. NHS ethical approval has been obtained from Cambridgeshire and Hertfordshire research ethics committee (REC reference 16/EE/0248). The findings from the MelaTools SSM Trial will be disseminated widely through peer-reviewed publications and scientific conferences. ISCTRN16061621

  11. Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort.

    Science.gov (United States)

    Tracy, Daniel; Hahn, Judith A; Fuller Lewis, Crystal; Evans, Jennifer; Briceño, Alya; Morris, Meghan D; Lum, Paula J; Page, Kimberly

    2014-05-29

    Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively. Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection. Young women's riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women's risk behaviour is warranted. 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. Risk of Japanese carriers of hyperphosphorylated paratarg-7, the first autosomal-dominantly inherited risk factor for hematological neoplasms, to develop monoclonal gammopathy of undetermined significance and multiple myeloma.

    Science.gov (United States)

    Grass, Sandra; Iida, Shinsuke; Wikowicz, Aleksandra; Preuss, Klaus-Dieter; Inagaki, Atsushi; Shimizu, Kazuyuki; Ziepert, Marita; Ueda, Ryuzo; Pfreundschuh, Michael

    2011-03-01

    Hyperphosphorylated paratarg-7 (pP-7) is a frequent target of paraproteins in German patients with monoclonal gammopathy of undetermined significance (MGUS)/multiple myeloma (MM). The frequency of MGUS/MM is lower in Japan than in Europe. As pP-7, the first molecularly defined autosomal-dominant risk factor for any hematological neoplasm, is inherited in a dominant fashion, we determined the incidence of the pP-7 carrier state in a Japanese population, and compared the frequency of pP-7-specific paraproteins and the pP-7 carrier state in Japanese and German patients with MGUS/MM. Peripheral blood from 111 Japanese patients with MGUS/MM and 278 healthy blood donors was analyzed for the pP-7 carrier state by isoelectric focusing and for pP-7-specific antibodies by ELISA. The Japanese group was compared with 252 German MGUS/MM patients and 200 healthy controls. Five of 111 (4.5%) Japanese and 35/252 (13.9%) German IgA/IgG MGUS/MM patients had a pP-7-specific paraprotein (P=0.009). The prevalence of healthy pP-7 carriers in the Japanese study group was 1/278 (0.36%), whereas it was 4/200 in the German group (P=0.166). The relative risk for pP-7 carriers developing MGUS/MM had an odds ratio of 13.1 in the Japanese and 7.9 in the German group. In conclusion, the fraction of pP-7 carriers with a pP-7-specific paraprotein is lower among Japanese than in German patients with MGUS/MM, but pP-7 carriers in both ethnic groups have a high risk of developing MGUS/MM. © 2011 Japanese Cancer Association.

  13. Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus.

    Science.gov (United States)

    Lacroix, Marilyn; Battista, Marie-Claude; Doyon, Myriam; Ménard, Julie; Ardilouze, Jean-Luc; Perron, Patrice; Hivert, Marie-France

    2013-06-01

    To evaluate the associations between adiponectin levels and 1) the risk of developing gestational diabetes mellitus (GDM), and 2) insulin resistance/sensitivity, β-cell function, and compensation indices in a prospective cohort representative of the general population of pregnant women. We performed anthropometric measurements and collected blood samples at 1st (6-13 weeks) and 2nd (24-28 weeks) trimesters. Diagnosis of GDM was made at 2nd trimester based on a 75-g oral glucose tolerance test (International Association of the Diabetes and Pregnancy Study Groups criteria). Insulin was measured (ELISA; Luminex) to estimate homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-B), insulin sensitivity (Matsuda index), insulin secretion (AUC(insulin/glucose)), and β-cell compensation (insulin secretion sensitivity index-2). Adiponectin was measured by radioimmunoassay. Among the 445 participants included in this study, 38 women developed GDM. Women who developed GDM had lower 1st-trimester adiponectin levels (9.67 ± 3.84 vs. 11.92 ± 4.59 µg/mL in women with normal glucose tolerance). Lower adiponectin levels were associated with higher risk of developing GDM (OR, 1.12 per 1 µg/mL decrease of adiponectin levels; P = 0.02, adjusted for BMI and HbA1c at 1st trimester). Adiponectin levels at 1st and 2nd trimesters were associated with HOMA-IR (both: r = -0.22, P insulin/glucose). Pregnant women with lower adiponectin levels at 1st trimester have higher levels of insulin resistance and are more likely to develop GDM independently of adiposity or glycemic measurements.

  14. Leukocyte-depletion of blood components does not significantly reduce the risk of infectious complications. Results of a double-blinded, randomized study

    DEFF Research Database (Denmark)

    Titlestad, I. L.; Ebbesen, L. S.; Ainsworth, A. P.

    2001-01-01

    Allogeneic blood transfusions are claimed to be an independent risk factor for postoperative infections in open colorectal surgery due to immunomodulation. Leukocyte-depletion of erythrocyte suspensions has been shown in some open randomized studies to reduce the rate of postoperative infection t...

  15. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Directory of Open Access Journals (Sweden)

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  16. Consumption of meat is associated with higher fasting glucose and insulin concentrations regardless of glucose and insulin genetic risk scores: a meta-analysis of 50,345 Caucasians12

    Science.gov (United States)

    Fretts, Amanda M; Follis, Jack L; Nettleton, Jennifer A; Lemaitre, Rozenn N; Ngwa, Julius S; Wojczynski, Mary K; Kalafati, Ioanna Panagiota; Varga, Tibor V; Frazier-Wood, Alexis C; Houston, Denise K; Lahti, Jari; Ericson, Ulrika; van den Hooven, Edith H; Mikkilä, Vera; Kiefte-de Jong, Jessica C; Mozaffarian, Dariush; Rice, Kenneth; Renström, Frida; North, Kari E; McKeown, Nicola M; Feitosa, Mary F; Kanoni, Stavroula; Smith, Caren E; Garcia, Melissa E; Tiainen, Anna-Maija; Sonestedt, Emily; Manichaikul, Ani; van Rooij, Frank JA; Dimitriou, Maria; Raitakari, Olli; Pankow, James S; Djoussé, Luc; Province, Michael A; Hu, Frank B; Lai, Chao-Qiang; Keller, Margaux F; Perälä, Mia-Maria; Rotter, Jerome I; Hofman, Albert; Graff, Misa; Kähönen, Mika; Mukamal, Kenneth; Johansson, Ingegerd; Ordovas, Jose M; Liu, Yongmei; Männistö, Satu; Uitterlinden, André G; Deloukas, Panos; Seppälä, Ilkka; Psaty, Bruce M; Cupples, L Adrienne; Borecki, Ingrid B; Franks, Paul W; Arnett, Donna K; Nalls, Mike A; Eriksson, Johan G; Orho-Melander, Marju; Franco, Oscar H; Lehtimäki, Terho; Dedoussis, George V; Meigs, James B; Siscovick, David S

    2015-01-01

    Background: Recent studies suggest that meat intake is associated with diabetes-related phenotypes. However, whether the associations of meat intake and glucose and insulin homeostasis are modified by genes related to glucose and insulin is unknown. Objective: We investigated the associations of meat intake and the interaction of meat with genotype on fasting glucose and insulin concentrations in Caucasians free of diabetes mellitus. Design: Fourteen studies that are part of the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium participated in the analysis. Data were provided for up to 50,345 participants. Using linear regression within studies and a fixed-effects meta-analysis across studies, we examined 1) the associations of processed meat and unprocessed red meat intake with fasting glucose and insulin concentrations; and 2) the interactions of processed meat and unprocessed red meat with genetic risk score related to fasting glucose or insulin resistance on fasting glucose and insulin concentrations. Results: Processed meat was associated with higher fasting glucose, and unprocessed red meat was associated with both higher fasting glucose and fasting insulin concentrations after adjustment for potential confounders [not including body mass index (BMI)]. For every additional 50-g serving of processed meat per day, fasting glucose was 0.021 mmol/L (95% CI: 0.011, 0.030 mmol/L) higher. Every additional 100-g serving of unprocessed red meat per day was associated with a 0.037-mmol/L (95% CI: 0.023, 0.051-mmol/L) higher fasting glucose concentration and a 0.049–ln-pmol/L (95% CI: 0.035, 0.063–ln-pmol/L) higher fasting insulin concentration. After additional adjustment for BMI, observed associations were attenuated and no longer statistically significant. The association of processed meat and fasting insulin did not reach statistical significance after correction for multiple comparisons. Observed associations were not modified by genetic

  17. Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

    Science.gov (United States)

    Kuenzli, Esther; Juergensen, David; Kling, Kerstin; Jaeger, Veronika K; DeCrom, Susan; Steffen, Robert; Widmer, Andreas F; Battegay, Manuel; Hatz, Christoph; Neumayr, Andreas

    2017-09-01

    Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent. An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression. Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea. Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  18. The Active Management of Risk in Multiparous Pregnancy at Term: association between a higher preventive labor induction rate and improved birth outcomes

    Science.gov (United States)

    Nicholson, James M.; Caughey, Aaron; Stenson, Ms. Morghan H.; Cronholm, Peter; Kellar, Lisa; Bennett, Ian; Margo, Katie; Stratton, Joseph

    2009-01-01

    Objective To determine if exposure of multiparous women to a high rate of preventive labor induction was associated with a significantly lower cesarean delivery rate. Study Design Retrospective cohort study involving 123 multiparas, who were exposed to the frequent use of preventive labor induction, and 304 multiparas, who received standard management. Rates of cesarean delivery and other adverse birth outcomes were compared in the two groups. Logistic regression controlled for confounding covariates. Results The exposed group had a lower cesarean delivery rate (aOR 0.09, 0.8% vs. 9.9%, p = 0.02) and a higher uncomplicated vaginal delivery rate (OR 0.53, 78.9% vs. 66.4%, p=0.01). Exposure was not associated with higher rates of other adverse birth outcomes. Conclusion Exposure of multiparas to a high rate of preventive labor induction was significantly associated with improved birth outcomes including a very low cesarean delivery rate. A prospective randomized trial is needed to determine causality. PMID:19254584

  19. Different Levels in Orexin Concentrations and Risk Factors Associated with Higher Orexin Levels: Comparison between Detoxified Opiate and Methamphetamine Addicts in 5 Chinese Cities

    Directory of Open Access Journals (Sweden)

    Haoran Zhang

    2013-01-01

    Full Text Available This study sought to explore the degree of orexin levels in Chinese opiate and methamphetamine addicts and the differences between them. The cross-sectional study was conducted among detoxified drug addicts from Mandatory Detoxification Center (MDC in five Chinese cities. Orexin levels were assayed with radioimmunoassay (RIA. Mann-Whitney U test and Kruskal-Wallis test were used to detect differences across groups, and logistic regression was used to explore the association between orexin levels and characteristics of demographic and drug abuse. Between November 2009 and January 2011, 285 opiates addicts, 112 methamphetamine addicts, and 79 healthy controls were enrolled. At drug withdrawal period, both opiate and methamphetamine addicts had lower median orexin levels than controls, and median orexin levels in opiate addicts were higher than those in methamphetamine addicts (all above P<0.05. Adjusted odds of the above median concentration of orexin were higher for injection than “chasing the dragon” (AOR = 3.1, 95% CI = 1.2–7.9. No significant factors associated with orexin levels of methamphetamine addicts were found. Development of intervention method on orexin system by different administration routes especially for injected opiate addicts at detoxification phase may be significant and was welcome.

  20. Diabetes mellitus, metabolic syndrome and obesity are not significant risk factors for hepatocellular carcinoma in an HBV- and HCV-endemic area of Southern Taiwan

    Directory of Open Access Journals (Sweden)

    Chao-Tung Chen

    2013-08-01

    Full Text Available A prominent factor in hepatocellular carcinoma (HCC is chronic infection with hepatitis B virus (HBV and hepatitis C virus (HCV. Diabetes mellitus (DM, metabolic syndrome (MetS, and obesity have also been implicated in HCC development, but these associations are not observed in all HBV- and HCV-endemic areas. We attempted to clarify the role of these factors in HCC development in an HBV- and HCV-endemic area in southern Taiwan. A community-based health examination was conducted in 2004 in Tainan County. After individuals with incomplete data and those with known HCC were excluded, there were 56,231 participants who were over 40 years of age. A further 262 HCC cases were identified from the National Cancer Registration Database records from 2005 to 2007. The hepatitis B surface antigen (HBsAg seropositivity, anti-HCV seropositivity, platelet count, serum biochemical data, blood pressure, sociodemographic information, and anthropometric measurements were analyzed. Survival analyses were used to identify the associations between these factors and HCC. For the 262 HCC cases, male gender and age greater than 65 years were risk factors. Furthermore, a high alanine aminotransferase level, chronic HBV and/or HCV infection, and liver cirrhosis were also risk factors for HCC. However, DM, MetS and obesity were not associated with HCC development in the non-HBV-/non-HCV-infected, HBV, HCV, or dual B/C groups. In this HBV- and HCV- endemic area, DM, MetS and obesity were not risk factors for developing HCC.

  1. Patients With and Without Diabetes Without Significant Angiographic Coronary Artery Disease Have the Same Risk of Myocardial Infarction in a Real-World Population Receiving Appropriate Prophylactic Treatment

    DEFF Research Database (Denmark)

    Olesen, Kevin K W; Madsen, Morten; Egholm, Gro

    2017-01-01

    without CAD were more often treated with statins (75.3% vs. 46.0 and aspirin (65.7% vs. 52.7 than patients without diabetes and CAD. CONCLUSIONS In a real-world population, patients with diabetes with high rates of statin and aspirin treatment had the same risk of cardiovascular events as patientswithout...... events in patients with and without diabetes with and without coronary artery disease (CAD) after coronary angiography (CAG). RESEARCH DESIGN AND METHODS A population-based cohort of patients registered in the Western Denmark Heart Registry who underwent CAG between 1 January 2003 and 31 December 2012...

  2. Higher Education

    African Journals Online (AJOL)

    Kunle Amuwo: Higher Education Transformation: A Paradigm Shilt in South Africa? ... ty of such skills, especially at the middle management levels within the higher ... istics and virtues of differentiation and diversity. .... may be forced to close shop for lack of capacity to attract ..... necessarily lead to racial and gender equity,.

  3. 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.

  4. Food insecurity is associated with high risk glycemic control and higher health care utilization among youth and young adults with type 1 diabetes.

    Science.gov (United States)

    Mendoza, Jason A; Haaland, Wren; D'Agostino, Ralph B; Martini, Lauren; Pihoker, Catherine; Frongillo, Edward A; Mayer-Davis, Elizabeth J; Liu, Lenna L; Dabelea, Dana; Lawrence, Jean M; Liese, Angela D

    2018-04-01

    Household food insecurity (FI), i.e., limited availability of nutritionally adequate foods, is associated with poor glycemic control among adults with type 2 diabetes. We evaluated the association of FI among youth and young adults (YYA) with type 1 diabetes to inform recent clinical recommendations from the American Diabetes Association for providers to screen all patients with diabetes for FI. Using data from the Washington and South Carolina SEARCH for Diabetes in Youth Study sites, we conducted an observational, cross-sectional evaluation of associations between FI and glycemic control, hospitalizations, and emergency department (ED) visits among YYA with type 1 diabetes. FI was assessed using the Household Food Security Survey Module, which queries conditions and behaviors typical of households unable to meet basic food needs. Participants' HbA 1c were measured from blood drawn at the research visit; socio-demographics and medical history were collected by survey. The prevalence of FI was 19.5%. In adjusted logistic regression analysis, YYAs from food-insecure households had 2.37 higher odds (95% CI: 1.10, 5.09) of high risk glycemic control, i.e., HbA 1c >9.0%, vs. peers from food-secure households. In adjusted binomial regression analysis for ED visits, YYAs from food-insecure households had an adjusted prevalence rate that was 2.95 times (95% CI [1.17, 7.45]) as great as those from food secure households. FI was associated with high risk glycemic control and more ED visits. Targeted efforts should be developed and tested to alleviate FI among YYA with type 1 diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Occurrence of Malnutrition and Associated Factors in Community-Dwelling Older Adults: Those with a Recent Diagnosis of Cancer Are at Higher Risk.

    Science.gov (United States)

    Van Den Broeke, C; De Burghgraeve, T; Ummels, M; Gescher, N; Deckx, L; Tjan-Heijnen, V; Buntinx, F; van den Akker, M

    2018-01-01

    In older adults, nutritional health is essential for good quality of life and living independently at home. Especially in cancer patients, malnutrition is common and known to complicate treatment. This study aims to evaluate the nutritional status and its associated factors in community-dwelling older adults with and without cancer. This is an observational study. This study focuses on older community-dwelling people. This study included older people with and without cancer (≥70 years). Cancer patients included patients with a new diagnosis of breast, lung, prostate, or colorectal cancer. Data collection included measures of nutritional status, quality of life, depression, fatigue, distress and functional status. We used multivariate logistic regression analysis to assess the association between personal characteristics and malnutrition. Data were available for 657 people; 383 people without cancer and 274 with a cancer diagnosis. Overall, malnutrition was detected in 245 (37.5%) people; in cancer patients this was 66.1%. Multivariate analysis showed that having cancer (OR 14.4, 95% CI: 8.01 - 23.3), being male (OR 2.38, 95% CI: 1.49 - 3.70), having depression (OR 13.5, 95% CI: 6.02-30.0), distress (OR 2.60, 95% CI: 1.55 - 4.37) and impaired instrumental activities of daily living (IADL) (OR 2.63, 95% CI: 1.63 - 4.24) were associated with a higher risk of malnutrition. The prevalence of malnutrition in community-dwelling older people is high, particularly in patients with cancer. Benchmarking and routine screening of older patients may be helpful strategies to increase awareness of (risk of) malnutrition among professionals.

  6. In Patients with a Soft Pancreas, a Thick Parenchyma, a Small Duct, and Fatty Infiltration Are Significant Risks for Pancreatic Fistula After Pancreaticoduodenectomy.

    Science.gov (United States)

    Sugimoto, Motokazu; Takahashi, Shinichiro; Kojima, Motohiro; Kobayashi, Tatsushi; Gotohda, Naoto; Konishi, Masaru

    2017-05-01

    This study sought to characterize soft and hard pancreatic textures radiologically and histologically, and to identify specific risks in a soft pancreas associated with postoperative pancreatic fistula (POPF) formation after pancreaticoduodenectomy (PD). Consecutive 145 patients who underwent PD at a single institution between January 2010 and May 2013 were studied. Pancreatic consistency was intraoperatively judged as soft or hard. Pancreatic configuration was assessed using preoperative CT. Histologic components of the pancreatic stump were evaluated using a morphometric analysis. Clinicopathologic parameters were then analyzed for the risk of clinically relevant POPF. Compared with patients with a hard pancreas (n = 66), those with a soft pancreas (n = 79) had a smaller main pancreatic duct (MPD) diameter and a larger parenchymal thickness on CT, had a smaller fibrosis ratio and a larger lobular ratio histologically, and developed clinically relevant POPF more frequently (P pancreas, an MPD diameter pancreas, a thick parenchyma, a small MPD, and fatty infiltration were strongly associated with clinically relevant POPF after PD.

  7. Antioxidant defence-related genetic variants are not associated with higher risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence

    International Nuclear Information System (INIS)

    Vodusek, Ana Lina; Goricar, Katja; Gazic, Barbara; Dolzan, Vita; Jazbec, Janez

    2016-01-01

    Thyroid cancer is one of the most common secondary cancers after treatment of malignancy in childhood or adolescence. Thyroid gland is very sensitive to the carcinogenic effect of ionizing radiation, especially in children. Imbalance between pro- and anti-oxidant factors may play a role in thyroid carcinogenesis. Our study aimed to assess the relationship between genetic variability of antioxidant defence-related genes and the risk of secondary thyroid cancer after treatment of malignancy in childhood or adolescence. In a retrospective study, we compared patients with childhood or adolescence primary malignancy between 1960 and 2006 that developed a secondary thyroid cancer (cases) with patients (controls), with the same primary malignancy but did not develop any secondary cancer. They were matched for age, gender, primary diagnosis and treatment (especially radiotherapy) of primary malignancy. They were all genotyped for SOD2 p.Ala16Val, CAT c.-262C>T, GPX1 p.Pro200Leu, GSTP1 p.Ile105Val, GSTP1 p.Ala114Val and GSTM1 and GSTT1 deletions. The influence of polymorphisms on occurrence of secondary cancer was examined by McNemar test and Cox proportional hazards model. Between 1960 and 2006 a total of 2641 patients were diagnosed with primary malignancy before the age of 21 years in Slovenia. Among them 155 developed a secondary cancer, 28 of which were secondary thyroid cancers. No significant differences in the genotype frequency distribution were observed between cases and controls. Additionally we observed no significant influence of investigated polymorphisms on time to the development of secondary thyroid cancer. We observed no association of polymorphisms in antioxidant genes with the risk for secondary thyroid cancer after treatment of malignancy in childhood or adolescence. However, thyroid cancer is one of the most common secondary cancers in patients treated for malignancy in childhood or adolescence and the lifelong follow up of these patients is of utmost

  8. Higher Education

    Science.gov (United States)

    & Development (LDRD) National Security Education Center (NSEC) Office of Science Programs Richard P Databases National Security Education Center (NSEC) Center for Nonlinear Studies Engineering Institute Scholarships STEM Education Programs Teachers (K-12) Students (K-12) Higher Education Regional Education

  9. Do telomeres have a higher plasticity than thought? Results from the German Chronic Kidney Disease (GCKD) study as a high-risk population.

    Science.gov (United States)

    Raschenberger, Julia; Kollerits, Barbara; Titze, Stephanie; Köttgen, Anna; Bärthlein, Barbara; Ekici, Arif B; Forer, Lukas; Schönherr, Sebastian; Weissensteiner, Hansi; Haun, Margot; Wanner, Christoph; Eckardt, Kai-Uwe; Kronenberg, Florian

    2015-12-01

    Telomere length is considered as a biological marker for aging. It is expected that telomeres shorten with age and with conditions associated with oxidative stress and inflammation. Both are present in patients with chronic kidney disease (CKD) who have a very high cardiovascular risk. We investigated whether CKD duration is associated with relative telomere length (RTL) in 4802 patients from the German Chronic Kidney Disease (GCKD) study. We measured RTL in each sample in quadruplicates using a quantitative polymerase chain reaction (qPCR). We observed a U-shaped association of RTL with CKD duration: the longest RTL was found in those 339 patients who reported the shortest disease duration (study these surprising results have to be considered with caution and as hypothesis-generating. Whether the longer RTL in patients with long-lasting disease is caused by an activation of telomerase to counteract the shortening of RTL due to oxidative stress and inflammation or whether they are caused by a survival bias needs to be investigated in longitudinal studies. Our data are in support of a higher plasticity of shortening and elongations of RTL as until recently anticipated. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. The Significance of the Cardiac Peptide NT-proBNP in the Assessment of Risk for Myocardial Revascularization in Patients with Decreased Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to substantiate a procedure for predicting the severity of postperfusion acute heart failure (AHF from the baseline level of NT-proBNP during myocardial revascularization in patients with a left ventricular ejection fraction (LVEF of less than 35%. Subjects and materials. Fifty-six patients with a LVEF of less than 35% were examined. A total of 3.5±0.1 (range 2—4 coronary arteries were shunted under cardio-pulmonary bypass (CPB (71.0±5.5 min. The concentration of NT-proBNP was measured before surgery (Cardiac Reader®, Roche. Mortality rates, sympathomimetic agents’ dosages required after EC, and the frequency of use of intraaortic balloon pumping (IABP were analyzed. Results. A good clinical course was observed in 47 cases (Group 1. AHF was recorded in 9 patients (Group 2. Comparative analysis demonstrated that the preoperative concentration of NT-proBNP (871±111 pg/ml in Group 1 and 1946±236 pg/ml in Group 2 was of the highest prognostic value as compared with the traditional indicators (p=0.0015. Patients with a NT-proBNP concentration of less than 600 pg/ml did not virtually need inotropic therapy after EC. In a group with a biomarker level of 600—1200 mg/ml, the infusion of dopamine and dobutamine achieved the traditional cardiotonic dosages and every three patients needed epinephrine. With NT-proBNP of 1200-2000 pg/ml, mortality from AHF was 15.4%; a need for epinephrine and IABC was 46.4 and 7.7%, respectively. The peptide concentration of more than 2000 pg/ml indicated the extremely high risk of severe AHF. In the postperfusion period, each patient was given epinephrine and an IABC system was installed in half of them. In this group mortality achieved 50%. Conclusion. It is expedient to determine a preoperative NT-proBNP concentration in a LVEF of less than 35% to predict AHF to be occurred after myocardial revascularization. The concentration of less than 1200 pg/ml may be considered to be a safe level of the

  11. A Pilot Study Providing Evidence for a Relationship between a Composite Lifestyle Score and Risk of Higher Carotid Intima-Media Thickness: Is There a Link to Oxidative Stress?

    Directory of Open Access Journals (Sweden)

    Neda Seyedsadjadi

    2018-01-01

    Full Text Available Lifestyle behaviours have been closely linked to the progressive cell damage associated with oxidative stress (OS and the development of cardiovascular disease (CVD. Early detection of lifestyle-linked OS may therefore be useful in the early identification of prodromal disease. To test this hypothesis, this study assessed the relationship between a comprehensive redox balance lifestyle score (RBLS and carotid intima-media thickness (CIMT, a recognized marker for CVD, and plasma biomarkers of OS. In a cross-sectional study design, 100 apparently healthy middle-aged participants were asked to complete a comprehensive lifestyle questionnaire, followed by DXA scanning, CIMT ultrasonography, and blood collection. The RBLS was composed of lifestyle components with pro- and antioxidant properties with a higher score indicative of lower oxidative activity. Multiple linear regression and logistic regression analysis were performed for statistical analysis. The RBLS was significantly associated with the risk for increased CIMT that was independent of conventional CVD risk factors (χ29=35.60, P≤0.001. The adjusted model explained 42.4% of the variance in CIMT. Participants with RBLS below the median were at significantly increased risk of higher CIMT compared to participants with RBLS above the median (OR=3.60, 95% CI: 1.19–10.88, P=0.023. Significant associations were also observed between the RBLS, plasma total antioxidant capacity (TAC (r99=0.28, P=0.006, hydroperoxide (HPX (rs99=−0.28, P=0.005, TAC/HPX ratio (r98=0.41, P≤0.001, γ-glutamyltransferase (r97=−0.23, P=0.024, uric acid (r98=−0.20, P=0.045, and inflammatory C-reactive protein (rs97=−0.25, P=0.012 and interleukin-1β (r97=−0.21, P=0.040. These findings highlight the importance of identifying the collective influence of lifestyle behaviours on OS activity and its potential to remodel the vascular endothelium.

  12. The rs3957357C>T SNP in GSTA1 Is Associated with a Higher Risk of Occurrence of Hepatocellular Carcinoma in European Individuals.

    Directory of Open Access Journals (Sweden)

    Hanane Akhdar

    Full Text Available Glutathione S-transferases (GSTs detoxify toxic molecules by conjugation with reduced glutathione and regulate cell signaling. Single nucleotide polymorphisms (SNPs of GST genes have been suggested to affect GST functions and thus to increase the risk of human hepatocellular carcinoma (HCC. As GSTA1 is expressed in hepatocytes and the rs3957357C>T (TT SNP is known to downregulate GSTA1 mRNA expression, the aims of this study were: (i to explore the relationship between the TT SNP in GSTA1 and the occurrence of HCC; (ii to measure GSTA1 mRNA expression in HCCs. For that purpose, we genotyped non-tumor-tissue-derived DNA from 48 HCC patients and white-blood-cell-derived DNA from 37 healthy individuals by restriction fragment length polymorphism (RFLP. In addition, expression of GSTA1 mRNA was assessed by real-time PCR in 18 matching pairs of HCCs and non-tumor livers. Survival analysis was performed on an annotated microarray dataset containing 247 HCC patients (GSE14520. The GSTA1 TT genotype was more frequent in HCC than in non-HCC patients (27% versus 5%, respectively, suggesting that individuals carrying this genotype could be associated with 2-fold higher risk of developing HCCs (odds ratio = 2.1; p = 0.02. Also, we found that GSTA1 mRNA expression was lower in HCCs than in non-tumor livers. HCCs expressing the highest GSTA1 mRNA levels were the smallest in size (R = -0.67; p = 0.007, expressed the highest levels of liver-enriched genes such as ALB (albumin, R = -0.67; p = 0.007 and COL18A1 (procollagen type XVIII, R = -0.50; p = 0.03 and showed the most favorable disease-free (OR = 0.54; p<0.001 and overall (OR = 0.56; p = 0.006 outcomes. Moreover, GSTA1 was found within a 263-gene network involved in well-differentiated hepatocyte functions. In conclusion, HCCs are characterized by two GSTA1 features: the TT SNP and reduced GSTA1 gene expression in a context of hepatocyte de-differentiation.

  13. Higher Education.

    Science.gov (United States)

    Hendrickson, Robert M.

    This chapter reports 1982 cases involving aspects of higher education. Interesting cases noted dealt with the federal government's authority to regulate state employees' retirement and raised the questions of whether Title IX covers employment, whether financial aid makes a college a program under Title IX, and whether sex segregated mortality…

  14. Basal Subtype of Invasive Breast Cancer Is Associated With a Higher Risk of True Recurrence After Conventional Breast-Conserving Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi-Gluth, Jona A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Wo, Jennifer Y. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Nguyen, Paul L. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Abi Raad, Rita F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Sreedhara, Meera [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Freer, Phoebe E. [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Georgian-Smith, Dianne [Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bellon, Jennifer R.; Wong, Julia S. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Harris, Jay R. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2012-03-01

    Purpose: To determine whether breast cancer subtype is associated with patterns of ipsilateral breast tumor recurrence (IBTR), either true recurrence (TR) or elsewhere local recurrence (ELR), among women with pT1-T2 invasive breast cancer (IBC) who receive breast-conserving therapy (BCT). Methods and Materials: From Jan 1998 to Dec 2003, 1,223 women with pT1-T2N0-3 IBC were treated with BCT (lumpectomy plus whole-breast radiation). Ninety percent of patients received adjuvant systemic therapy, but none received trastuzumab. Biologic cancer subtypes were approximated by determining estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), and human epidermal growth factor receptor-2-positive (HER-2+) expression, classified as luminal A (ER+ or PR+ and HER-2 negative [HER-2-]), luminal B (ER+ or PR+ and HER-2+), HER-2 (ER- and PR- and HER-2+), and basal (ER- and PR- and HER-2- ) subtypes. Imaging, pathology, and operative reports were reviewed by two physicians independently, including an attending breast radiologist. Readers were blinded to subtype and outcome. TR was defined as IBTR within the same quadrant and within 3 cm of the primary tumor. All others were defined as ELR. Results: At a median follow-up of 70 months, 24 patients developed IBTR (5-year cumulative incidence of 1.6%), including 15 TR and 9 ELR patients. At 5 years, basal (4.4%) and HER-2 (9%) subtypes had a significantly higher incidence of TR than luminal B (1.2%) and luminal A (0.2%) subtypes (p < 0.0001). On multivariate analysis, basal subtype (hazard ratio [HR], 4.8, p = 0.01), younger age at diagnosis (HR, 0.97; p = 0.05), and increasing tumor size (HR, 2.1; p = 0.04) were independent predictors of TR. Only younger age (HR, 0.95; p = 0.01) significantly predicted for ELR. Conclusions: Basal and HER-2 subtypes are significantly associated with higher rates of TR among women with pT1-T2 IBC after BCT. Younger age predicts for both TR and ELR. Strategies to reduce TR in basal

  15. Greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in a population of elderly Japanese men with relatively low dietary calcium intake: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study.

    Science.gov (United States)

    Sato, Y; Iki, M; Fujita, Y; Tamaki, J; Kouda, K; Yura, A; Moon, J-S; Winzenrieth, R; Iwaki, H; Ishizuka, R; Amano, N; Tomioka, K; Okamoto, N; Kurumatani, N

    2015-05-01

    The effects of milk intake on bone health are not clear in elderly Asian men with low dietary calcium intake. This study showed that greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in community-dwelling elderly Japanese men. The consumption of milk or dairy products is widely recommended for maintaining bone health regardless of gender or age. However, little evidence exists on the beneficial effects of milk intake on bone health in elderly Japanese men characterized with relatively low dietary calcium intake. Here we examined whether or not greater milk intake was associated with lower bone turnover, higher bone density, and stronger bone microarchitecture in community-dwelling elderly Japanese men. Interviews were conducted to obtain information on medical history and lifestyle, including the amount of habitual milk intake, nutrient intake calculations based on a 1-week food diary, and measurements of areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy x-ray absorptiometry (DXA), trabecular bone score (TBS) using DXA images at LS, and biochemical markers of bone turnover in sera. Participants with a history of diseases or medications that affect bone metabolism, or with missing data, were excluded from the analysis. The median intake of milk in the 1479 participants (mean age, 73.0 ± 5.1 years) was one glass of milk per day. Bone turnover markers showed a decreasing trend (p turnover, higher aBMD, and higher TBS in community-dwelling elderly Japanese men.

  16. Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey.

    Science.gov (United States)

    Commodore-Mensah, Yvonne; Ukonu, Nwakaego; Obisesan, Olawunmi; Aboagye, Jonathan Kumi; Agyemang, Charles; Reilly, Carolyn M; Dunbar, Sandra B; Okosun, Ike S

    2016-11-04

    Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010-2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10-1.29), diabetic (OR, 1.43; 95% CI, 1.17-1.73), and hypertensive (OR, 1.18; 95% CI, 1.05-1.32) than those residing in the United States for <10 years. In an ethnically diverse sample of US immigrants, acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. Higher risk of renal impairment associated with tenofovir use amongst people living with HIV in India: a comparative cohort analysis between Western India and United Kingdom.

    Science.gov (United States)

    Pujari, Sanjay N; Smith, Colette; Makane, Abhimanyu; Youle, Mike; Johnson, Margaret; Bele, Vivek; Joshi, Kedar; Dabhade, Digamber; Bhagani, Sanjay

    2014-03-29

    Data on the renal safety of Tenofovir (TDF) in Low and Middle Income Countries (LMICs) is scarce. We compared development of various forms of renal impairment with use of TDF-containing antiretroviral therapy (ART) between a cohort from the Institute of Infectious Diseases (IID) Pune, Western India and the Royal Free Hospital (RFH) London, UK. This is a retrospective analysis of change in estimated glomerular filtration rates (eGFRs) at 6, 12 and 24 months post TDF initiation using the Modification of Diet in Renal Disease (MDRD) equation. In people living with Human Immunodeficiency virus (PLHIV) with pre-TDF eGFR > 90 ml/min/1.73 m2 time to development of and factors associated with progression to eGFR  90 ml/min/1.73 m2 PLHIV at IID were more likely to develop an eGFR < 60 ml/min/1.73 m2 (aHR = 7.6 [95% CI 3.4, 17.4] p < 0.0001) and had a faster rate of progression estimated using Kaplan Meier methods. Risk factors included age (per 10 years older: aHR = 2.21 [1.6, 3.0] p < 0.0001) and receiving concomitant ritonavir boosted Protease Inhibitor (PI/r) (aHR = 2.4 [1.2, 4.8] p = 0.01). There is higher frequency of treatment limiting renal impairment events amongst PLHIV receiving TDF in Western India. As TDF scale up progresses, programs need to develop capacity for monitoring and treatment of renal impairment associated with TDF.

  18. Tumor Volume Changes on 1.5 Tesla Endorectal MRI During Neoadjuvant Androgen Suppression Therapy for Higher-Risk Prostate Cancer and Recurrence in Men Treated Using Radiation Therapy Results of the Phase II CALGB 9682 Study

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Halabi, Susan; Tempany, Clare; Titelbaum, David; Philips, George K.; Loffredo, Marian; McMahon, Elizabeth; Sanford, Ben; Vogelzang, Nicholas J.; Small, Eric J.

    2008-01-01

    Purpose: We prospectively determined whether the change in tumor volume (TV) during 2 months of neoadjuvant androgen suppression therapy (nAST) measured using conventional 1.5 Tesla endorectal magnetic resonance imaging (eMRI) was associated with the risk of recurrence after radiation (RT) and 6 months of AST. Patients and Methods: Between 1997 and 2001, 180 men with clinical stage T1c-T3cN0M0 adenocarcinoma of the prostate were registered. Fifteen were found to be ineligible and the institutional MR radiologist could not assess the TV in 32, leaving 133 for analysis. Multivariable Cox regression analysis was used to assess whether a significant association existed between eMRI-defined TV progression during nAST and time to recurrence adjusting for prostate-specific antigen (PSA) level, Gleason score (8 to 10 or 7 vs. 6 or less) and stage (T3 vs. T1-2). Results: After a median follow up of 6.7 years and adjusting for known prognostic factors, there was a significant increase in the risk of PSA failure (HR, 2.3 [95% CI, 1.1-4.5; p = 0.025) in men with eMRI-defined TV progression during nAST. Specifically, adjusted estimates of PSA failure were significantly higher (p = 0.032) in men with, compared with men without, eMRI-defined TV progression reaching 38% vs. 19%, respectively, by 5 years. Conclusion: Eradicating intraprostatic hormone refractory prostate cancer (HRPC) by maximizing local control and randomized trials assessing whether survival is improved when agents active against HRPC are combined with maximal local therapy are needed in men who progress based on eMRI during nAST

  19. Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

    Science.gov (United States)

    Caissutti, Claudia; Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

    2018-02-01

    The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus (GDM) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM-negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM-positive by the One Step, but not the Two Step. Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM-negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Cold-knife conisation and large loop excision of transformation zone significantly increase the risk for spontaneous preterm birth: a population-based cohort study.

    Science.gov (United States)

    Jančar, Nina; Mihevc Ponikvar, Barbara; Tomšič, Sonja

    2016-08-01

    Our aim was to explore the association between cold-knife conisation and large loop excision of transformation zone (LLETZ) with spontaneous preterm birth in a large 10-year national sample. We wanted to explore further the association of these procedures with preterm birth according to gestation. We conducted a population based retrospective cohort study, using data from national Medical Birth Registry. The study population consisted of all women giving birth to singletons in the period 2003-2012 in Slovenia, excluding all induced labors and elective cesarean sections before 37 weeks of gestation (N=192730). We compared the prevalence of spontaneous preterm births (before 28 weeks, before 32 weeks, before 34 weeks and before 37 weeks of gestation) in women with cold-knife conisation or LLETZ compared to women without history of conisation, calculating odds ratios (OR), adjusted for potential confounders. Chi-square test was used for descriptive analysis. Logistic regression analyses were performed to estimate crude odds ratio (OR) and adjusted odds ratio (aOR) and their 95% confidence intervals (95% CI) with two-sided probability (p) values. A total of 8420 (4.4%) women had a preterm birth before 37 weeks of gestation, 2250 (1.2%) before 34 weeks of gestation, 1333 (0.7%) before 32 weeks of gestation and 603 (0.3%) before 28 weeks of gestation. A total of 4580 (2.4%) women had some type of conisation in their medical history: 2083 (1.1%) had cold-knife conisation and 2498 (1.3%) had LLETZ. In women with history of cold-knife conisation, the adjusted OR for preterm birth before 37 weeks of gestation was 3.13 (95% CI; 2.74-3.57) and for preterm birth before 28 weeks of gestation 5.96 (95% CI; 4.3-8.3). In women with history of LLETZ, the adjusted OR was 1.95 (95% CI; 1.68-2.25) and 2.88 (95% CI; 1.87-4.43), respectively. Women with cervical excision procedure of any kind have significantly increased odds for preterm birth, especially for preterm birth before 28

  1. Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women

    Science.gov (United States)

    Both testosterone and vitamin D levels affect muscle and thus may also affect risk of falling. The aim of this study was to investigate the association between sex hormone levels and the risk of falling in older men and women. 199 men and 246 women age 65 or older living at home followed for 3 years...

  2. Azacitidine-lenalidomide (ViLen) combination yields a high response rate in higher risk myelodysplastic syndromes (MDS)-ViLen-01 protocol.

    Science.gov (United States)

    Mittelman, Moshe; Filanovsky, Kalman; Ofran, Yishai; Rosenbaum, Hanna; Raanani, Pia; Braester, Andrei; Goldschmidt, Neta; Kirgner, Ilya; Herishanu, Yair; Perri, Chava; Ellis, Martin; Oster, Howard S

    2016-10-01

    Azacitidine treatment is effective in higher risk MDS (HR-MDS), with less than 50 % response, lasting 2 years. Aza and lenalidomide (Len) have a potential synergistic effect. ViLen-01 phase IIa trial includes 6-month induction (Aza 75 mg/m(2)/day, days 1-5, Len 10 mg/day, days 6-21, every 28 days), 6-month consolidation (Aza 75 mg/m(2)/day, days 1-5, every 28 days), and 12-month maintenance (Len 10 mg/day, days 1-21, every 28 days). Response was evaluated according to IWG criteria. Totally, 25 patients enrolled, with an average of 76.3 years old (60-87), and 88 % with major comorbidities. Thirteen patients completed induction, 7 proceeded for consolidation, and 2 for maintenance. The overall response rate (ORR) was 72 % (18/25), with 6 (24 %) for CR, 3 (12 %) for marrow CR, and 9 (36 %) for hematologic improvement (HI). The 7 non-responding patients were on the study 3 days to 4.1 months. At 6 months, 4 of 6 evaluable patients achieved complete cytogenetic response and 2 with del (5q) at diagnosis. Adverse events (AEs) were as expected in these patients: grades III-IV, mainly hematologic-thrombocytopenia (20 patients) and neutropenia (13 patients). The common non-hematologic AEs were infections (14 patients), nausea (7), vomiting (7), diarrhea (7), and skin reactions (5). The median progression-free survival (PFS) was 12 ± 1.36 months, with median overall survival (OS) of 12 ± 1.7 months. Quality of life (FACT questionnaire) data were available for 12 patients with a tendency towards improved QoL. This trial with elderly HR-MDS patients with an expected poor prognosis demonstrates a high (72 %) response rate and a reasonable expected safety profile but a relatively short PFS and OS.

  3. Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis.

    Science.gov (United States)

    Dukas, L; Schacht, E; Runge, M

    2010-07-01

    We assessed in a cross-sectional study in elderly men and women with osteoporosis, the association between the creatinine clearance (CrCl) and the performance in different balance and muscle power and function tests and found that a decreasing creatinine clearance was significantly associated with lower balance and muscle power. To determine if a creatinine clearance of balance and an increased risk for falls and fractures. We assessed in a cross-sectional-study in 1781 German osteoporotic patients, the association between the CrCl, the physical performance, and the number of falls and fractures. Controlling for age, gender, BMI, and osteoporosis treatment (fracture analysis only), a decreasing CrCl was associated with lower physical performance in the timed-up-and-go test (corr -0.2337, P risk for falls (47.7% vs. 36.2%, P = 0.0008) and fall-related fractures (33.1% vs. 22.9%, P = 0.0003) compared with a CrCl of >or=65 ml/min. In this study, we found a significant gender-independent correlation between decreasing CrCl and lower performance in balance and muscle power tests. Reduced muscle power and balance may therefore be involved in the low creatinine clearance associated increased risk for falls and fall-related fractures. Furthermore, we found that a CrCl balance tests, is a significant risk factor for falls and fractures.

  4. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  5. To determine whether first-degree male relatives of women with polycystic ovary syndrome are at higher risk of developing cardiovascular disease and type II diabetes mellitus.

    Science.gov (United States)

    Hunter, A; Vimplis, S; Sharma, A; Eid, N; Atiomo, W

    2007-08-01

    The aim of this study was to determine whether first-degree male relatives of women with polycystic ovary syndrome (PCOS) were at increased risk of cardiovascular disease (CVD) and diabetes mellitus (type II DM). In a cross-sectional study, 60 women with PCOS and 112 controls were given a questionnaire. The prevalence of heart disease, stroke, diabetes and associated risk factors among fathers and brothers of women with PCOS and controls, were measured. The percentage of women with PCOS with at least one brother with a risk factor for CVD was 47.5%, around twice that seen in control women (24.71%). The prevalence of heart disease, stroke and diabetes were similar in brothers of women with PCOS and controls. In conclusion, brothers of women with PCOS may be at increased risk of CVD. They form an easily identified group, which can be targeted for primary prevention.

  6. Higher freshwater fish and sea fish intake is inversely associated with colorectal cancer risk among Chinese population: a case-control study

    OpenAIRE

    Xu, Ming; Fang, Yu-Jing; Chen, Yu-Ming; Lu, Min-Shan; Pan, Zhi-Zhong; Yan, Bo; Zhong, Xiao; Zhang, Cai-Xia

    2015-01-01

    The association between specific fish intake and colorectal cancer risk remains controversial. This study aimed to examine the association between specific fish intake and colorectal cancer risk in Chinese population in a large case control study. During July 2010 to November 2014, 1189 eligible colorectal cancer cases and 1189 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate log...

  7. Snacking between main meals is associated with a higher risk of metabolic syndrome in a Mediterranean cohort: the SUN Project (Seguimiento Universidad de Navarra)

    OpenAIRE

    Martinez-Gonzalez, M.A. (Miguel Ángel); Lopez-Iracheta, R. (Roberto); Zazpe, I. (Itziar); Sayon-Orea, C. (Carmen); Gea, A. (Alfredo); Bes-Rastrollo, M. (Maira); Pimenta, A.M. (Adriano Marçal)

    2015-01-01

    OBJECTIVE: To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome. DESIGN: A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: 'Do you have the habit of snacking between main meals?' Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and th...

  8. 慢性乙型肝炎患者肝纤维化的危险因素分析%Risk factors for significant fiver fibrosis in patients with chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    郝洁; 田小军; 段树鹏; 宋新文; 王宏伟

    2017-01-01

    Objective To investigate the risk factors forsignificant liver fibrosis in patients with chronic hepatitis B.Methods 80 patients with chronic hepatitis B were recruited in our hospital between January 2015 and August 2016,and all patients underwent liver biopsy.Significant liver fibrosis was defined as fibrosis stage equal to or greater than S2.Serum HBV DNA levels,HBV markers,liver function indexes,routine blood and coagulation function indexes were assayed.Results 58 patients (72.50%) were found having significant liver fibrosis in this series;In patients with significant liver fibrosis,serum HBV DNA,alanine aminotransferase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),prothrombin time (PT),red blood cell volume distribution width (RDW) and mean platelet volume (MPV) levels were (9.32:t:1.20) log10 IU/ml,(49.50±12.48) U/L,(48.91±10.11) U/L,(60.38±21.21) U/L,(15.52±1.28) s,(15.51±2.33) % and (12.20±3.05) fl,significant higher than those in 22 patients without significant liver fibrosis [(6.49±1.18) log10 IU/ml,(31.29±8.50) U/L,(28.47±6.77) U/L,(26.35±17.49) U/L,(14.10±2.31) s,(13.29±3.20) % and (10.13±3.22) fl,respectively,P<0.05];White blood cell (WBC) counts,hemoglobin (Hb) and platelet (PLT) counts were(5.10±1.73)×109/L,(123.47±12.10) g/L and(120.76±20.85)×109/L,much lower than those in patients without significant liver fibrosis [(6.51±1.52)×109/L,(130.85±13.10) g/L,(213.75 ±23.48) ×109/L,respectively,P <0.05];HBV DNA,ALT,AST,GGT,PT,RDW and MPV were correlated positively with liver fibrosis stages (r=0.642,r=0.411,r=0.411,r=0.447,r=0.397,r=0.538 and r=0.486,P<0.05),while WBC,Hb and PLT were correlated negatively with liver fibrosis stages (r=-0.375,r=-0.362 and r=-0.543,P<0.05);The regression analysis revealed that decreased PLT counts (OR=0.93,P<0.05) was significantly associated with significant liver fibrosis.Conclusion Abnorrnal blood cell counts and liver function indexes hints a higher

  9. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  10. Girls may have lower levels of maternal measles antibodies and higher risk of subclinical measles infection before the age of measles vaccination.

    Science.gov (United States)

    Martins, Cesario; Bale, Carlitos; Garly, May-Lill; Rodrigues, Amabelia; Lisse, Ida M; Andersen, Andreas; Eriksson, Mia; Benn, Christine S; Whittle, Hilton; Aaby, Peter

    2009-08-20

    Previous studies have suggested that girls may have lower maternal measles antibody levels than boys. Girls might therefore be more likely to contract measles infection before the normal age of measles vaccination at 9 months of age. In connection with a clinical trial of different measles vaccination strategies, we collected pre-measles vaccination blood samples at 4.5 months of age from two subgroups of children. Samples from these children were used to assess possible differences in maternal antibody levels for boys and girls. At 9 months of age another subgroup of children was sampled before the normal measles vaccination; these samples were used to assess the frequency of subclinical measles infection among boys and girls. We determined measles-specific antibody levels for 812 children at 4.5 months of age and for 896 children at 9 months of age. At 4.5 months of age girls were less likely to have protective maternal antibody levels, the male-female ratio for protective antibody level being 1.23 (1.00-1.51). Among children sampled at 9 months of age, girls were more likely to have protective levels, the female-male ratio for having protective antibody levels being 1.65 (0.98-2.78) (p=0.054) and the geometric mean titre was significantly higher for girls (p=0.007). Children who lived in houses with known measles cases were more likely to have protective levels at 9 months of age even though they had not reported measles infection. Since we had excluded children with known measles infection, girls may have been more likely to have had subclinical measles infection. Combining clinical and possible subclinical measles infection, girls tended to be more likely than boys to contract measles infection before 9 months of age, the RR being 1.36 (0.97-1.90). Girls lost maternal measles antibodies more rapidly than boys and well before 9 months of age. They may be more likely to contract subclinical measles infection before the current age of measles vaccination.

  11. Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure

    DEFF Research Database (Denmark)

    Rørth, Rasmus; Fosbøl, Emil L; Mogensen, Ulrik M

    2018-01-01

    AIMS: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nation......AIMS: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization...

  12. Cardiovascular disease and ABO blood-groups in Africans. Are blood-group A individuals at higher risk of ischemic disease?: A pilot study

    Directory of Open Access Journals (Sweden)

    Djibril Marie BA

    2017-12-01

    In African countries, where most of health facilities are understaffed, more rigorous studies with a larger population are needed to give a high level of evidence to confirm this association in order to establish the need to be more aggressive in risk factor control in these individuals.

  13. Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation

    DEFF Research Database (Denmark)

    Alhede, Christina; Johannessen, Arne; Dixen, Ulrik

    2018-01-01

    AIMS: Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF...

  14. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts

    NARCIS (Netherlands)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C.; Woodward, Mark; Levey, Andrew S.; de Jong, Paul E.; Gansevoort, Ron T.

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative

  15. The prognostic value of monosomal karyotype (MK) in higher-risk patients with myelodysplastic syndromes treated with 5-Azacitidine. A retrospective analysis of the Hellenic (Greek) MDS Study Group.

    Science.gov (United States)

    Papageorgiou, Sotirios G; Vasilatou, Diamantina; Kontos, Christos K; Kotsianidis, Ioannis; Symeonidis, Argiris; Galanopoulos, Athanasios G; Hatzimichael, Eleftheria; Megalakaki, Aekaterini; Poulakidas, Elias; Diamantopoulos, Panagiotis; Vassilakopoulos, Theodoros; Zikos, Panagiotis; Papadaki, Helen; Mparmparousi, Despoina; Bouronikou, Eleni; Panayiotidis, Panayiotis; Viniou, Nora-Athina; Pappa, Vassiliki

    2018-04-16

    In this study, we investigated the incidence and prognostic impact of monosomal karyotype (MK) in 405 higher-risk MDS patients treated with 5-AZA. The MK was present in 66 out of 405 (16.3%) patients, most of whom had complex karyotype (CK). MK was strongly associated with CK and the cytogenetic risk defined according to IPSS-R, as well as with high-risk disease, according to IPSS (P=0.029), IPSS-R (PMDS treated with 5-AZA. Furthermore, we showed that in MDS with high or very-high IPSS-R risk score, MK can further distinguish patients with worse outcome. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  16. Higher adherence to Mediterranean diet prior to pregnancy is associated with decreased risk for deviation from the maternal recommended gestational weight gain.

    Science.gov (United State