WorldWideScience

Sample records for single largest risk

  1. Foreign exchange risk management : how are the largest non-financial companies in Norway managing their foreign exchange rate exposure?

    OpenAIRE

    Eriksen, Krister; Wedøe, Ola

    2010-01-01

    The purpose of this thesis is to investigate how the largest non-financial companies in Norway manage their foreign exchange rate exposure. This is investigated through the use of a survey distributed to a sample the largest non-financial firms in Norway. According to our results, the largest non-financial companies in Norway have a predefined strategy for managing foreign exchange risk, which is defined by the board of directors or by the management in the organisation. The companies’ mai...

  2. Mauna Loa--history, hazards and risk of living with the world's largest volcano

    Science.gov (United States)

    Trusdell, Frank A.

    2012-01-01

    Mauna Loa on the Island Hawaiʻi is the world’s largest volcano. People residing on its flanks face many hazards that come with living on or near an active volcano, including lava flows, explosive eruptions, volcanic smog, damaging earthquakes, and local tsunami (giant seawaves). The County of Hawaiʻi (Island of Hawaiʻi) is the fastest growing County in the State of Hawaii. Its expanding population and increasing development mean that risk from volcano hazards will continue to grow. U.S. Geological Survey (USGS) scientists at the Hawaiian Volcano Observatory (HVO) closely monitor and study Mauna Loa Volcano to enable timely warning of hazardous activity and help protect lives and property.

  3. Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience.

    Science.gov (United States)

    Gorgen, Andre; Goldaracena, Nicolas; Zhang, Wei; Rosales, Roizar; Ghanekar, Anand; Lilly, Les; Cattral, Mark; Greig, Paul; McCluskey, Stuart; McGilvray, Ian; Selzner, Nazia; Bhat, Mamatha; Selzner, Markus; Levy, Gary; Grant, David; Sapisochin, Gonzalo

    2018-03-22

    The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy. Among those, 187 postoperative complications were diagnosed in 141 (24%) patients. One patient had >90-day morbidity, and there were no donor deaths. Overall complications were significantly higher in the first era, 2000 to 2008 (81 [57.4%]) versus the second era, 2009 to 2017 (60 [42.6%]) ( p  = 0.01). On multivariate analysis, the only predictor of postoperative complications was the center volume of RL live donor hepatectomy in the previous 12 months with an odds ratio of 0.97 (95% confidence interval: 0.95-0.99). In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Largest case series of Latin American eyelid tumors over 13-Years from a single center in Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Jéssica Carolinne Damasceno

    Full Text Available ABSTRACT Purpose: Malignant lesions of the eyelid are the most common eye cancers. Although rarely lethal, late diagnosis can lead to serious visual morbidity. Definitive diagnosis of neoplastic lesions is pathological. Indications and types of eyelid lesions in a single high-volume ophthalmic reference center in Sao Paulo, Brazil, were analyzed. Methods: The surgical pathological reports of patients who underwent eye removal procedures between January 2000 and December 2012 were retrieved from the electronic database of the Ophthalmology Department and retrospectively reviewed. Data regarding the final anatomopathological diagnosis, sex, and age were analyzed via the χ2 test with Yates' correction. Results: Of the 1,113 eyelid tumors resected over the 13-year study period, 324 (29% lesions were malignant. The most prevalent lesions were basal cell, squamous cell, and sebaceous gland carcinomas. The median ages of patients (females, n=165, 51%; males, n=159, 49% with a diagnosis of basal cell, squamous cell, and sebaceous gland carcinomas were 65, 75, and 70 years, respectively. Conclusion: This is the largest retrospective cohort analysis of eyelid tumors in a Latin American population. These findings are in agreement with those from large centers in other countries and regions.

  5. Estimating and analysing currency options implied risk-neutral density functions for the largest new EU member states

    OpenAIRE

    Castrén, Olli

    2005-01-01

    This paper uses data on currency options prices for the exchange rates of the three largest new EU member states Poland, Czech Republic and Hungary vis-à-vis the euro and the US dollar to estimate the risk-neutral density (RND) functions and the density interval bands. Analysing the RNDs, we find that only some of the implied moments on the Polish zloty exchange rate systematically move around policy events, while the implied moments on the RNDs on the Czech koruna and Hungarian forint show m...

  6. Long-term outcomes after allogeneic hematopoietic stem cell transplantation for metachromatic leukodystrophy: the largest single-institution cohort report

    OpenAIRE

    Boucher, Alexander A.; Miller, Weston; Shanley, Ryan; Ziegler, Richard; Lund, Troy; Raymond, Gerald; Orchard, Paul J.

    2015-01-01

    Background Metachromatic Leukodystrophy (MLD) is a rare, fatal demyelinating disorder with limited treatment options. Published outcomes after hematopoietic stem cell transplantation (HSCT) are scant and mixed. We report survival and function following HSCT for a large, single-center MLD cohort. Methods Transplant-related data, survival and serial measures (brain MRI, nerve conduction velocity (NCV), neurologic and neuropsychology evaluations) were reviewed. When possible, parental interviews...

  7. Long-term outcomes after allogeneic hematopoietic stem cell transplantation for metachromatic leukodystrophy: the largest single-institution cohort report.

    Science.gov (United States)

    Boucher, Alexander A; Miller, Weston; Shanley, Ryan; Ziegler, Richard; Lund, Troy; Raymond, Gerald; Orchard, Paul J

    2015-08-07

    Metachromatic Leukodystrophy (MLD) is a rare, fatal demyelinating disorder with limited treatment options. Published outcomes after hematopoietic stem cell transplantation (HSCT) are scant and mixed. We report survival and function following HSCT for a large, single-center MLD cohort. Transplant-related data, survival and serial measures (brain MRI, nerve conduction velocity (NCV), neurologic and neuropsychology evaluations) were reviewed. When possible, parental interviews informed current neurologic status, quality-of-life, and adaptive functioning. Gross motor and expressive functions for late-infantile (LI-MLD) and juvenile (J-MLD) patients were described using previously reported, MLD-specific scales. Forty patients with confirmed MLD have undergone HSCT at our center. Twenty-one (53 %) survive at a median 12 years post-HSCT. Most deaths (n = 17) were treatment-related; two died from disease progression. Survival did not depend upon MLD subtype or symptom status at transplant. LI-MLD patients survive beyond reported life expectancy in untreated disease. Abnormal brain MRI and peripheral nerve conduction velocities (NCV) were common before HSCT. Following transplant, fewer patients experienced MRI progression compared to NCV deterioration. Sixteen LI-MLD and J-MLD survivors were evaluable for long-term gross motor and/or expressive language functioning using existing MLD clinical scoring systems. While most J-MLD patients regressed, the aggregate cohort demonstrated superior retention of function compared to published natural history. Seventeen LI-MLD, J-MLD and adult subtype (A-MLD) survivors were evaluable for long-term adaptive functioning, activities of daily living, and/or cognition. Relative cognitive sparing was observed despite overall global decline. Five sibling pairs (one LI-MLD and four J-MLD), in which at least one underwent transplant in our cohort, were evaluable. Within each familial dyad, survival or function was superior for the treated

  8. Using Telepresence to Connect and Engage Classes and the Public in the Exploration of Tamu Massif, the World's Largest Single Volcano

    Science.gov (United States)

    Nanez-James, S. E.; Sager, W.

    2016-02-01

    Research published in 2013 showed that TAMU Massif, the largest mountain in the Shatsky Rise oceanic plateau, located approximately 1500 kilometers east of Japan, is the "World's Largest Single Volcano." This claim garnered widespread public interest and wonder concerning how something so big could remain so mysterious in the 21st century. This disconnect highlights the fact that oceans are still widely unexplored, especially the middle of the deep ocean. Because there is so much interest in TAMU Massif, a diverse outreach team lead by chief scientist Dr. William Sager from the University of Houston in partnership with the Texas State Aquarium and the Schmidt Ocean Institute (SOI) conducted a multifaceted ship-to-shore outreach project that included secondary school students, formal and informal educators, university students and professors, the aquarium and museum audience, and the general public. The objective was to work in conjunction with SOI and various other partners, including the Texas Regional Collaborative, the Aquarium of the Pacific, and the Houston Museum of Natural Science, to promote science and ocean literacy while inspiring future scientists - especially those from underserved and underrepresented groups - through ocean connections. Participants were connected through live ship-to-shore distance learning broadcasts of ongoing marine research and discovery of TAMU Massif aboard the R/V Falkor, allowing audiences to participate in real-time research and apply real world science to curriculum in the classrooms. These ship-to-shore presentations connected to existing curriculums and standards, lessons, and career interests of the students and educators with special teacher events and professional development workshops conducted from aboard the R/V Falkor.

  9. Early metabolic change in (18)F-FDG-PET by measuring the single largest lesion predicts chemotherapeutic effects and patients' survival: PEACH study.

    Science.gov (United States)

    Tanaka, Yusuke; Ueda, Yutaka; Egawa-Takata, Tomomi; Matsuzaki, Shinya; Kobayashi, Eiji; Yoshino, Kiyoshi; Enomoto, Takayuki; Tatsumi, Mitsuaki; Kimura, Tadashi

    2016-01-01

    The objective of this study was to investigate the predictive value of F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) for early assessment of tumor response to chemotherapy and for patient survival in gynecologic malignancies. We performed CT and FDG-PET scans before initiation of chemotherapy to determine baseline conditions. PET scan was repeated after the first cycle of chemotherapy. The tumor response was later evaluated by CT scans after three cycles of chemotherapy, using RECIST. The PET response was analyzed in terms of the difference in SUVmax for FDG of the patient's largest lesion between the baseline scan and after the first cycle of chemotherapy. The metabolic response for the tumor was defined as a 30% reduction in its SUVmax. Eleven patients received platinum-based regimens, and 20 patients received non-platinum-based regimens. The mean progression-free survival (PFS) for the patients with a metabolic response was 13 months (range 5-29). In contrast, the mean PFS of the patients with no metabolic response was only 4.3 months (range 1-18). There was a statistically significant difference between the metabolic response and PFS (p = 0.002, Mann-Whitney U test). There was a strong correlation between the metabolic response and RECIST, regardless of the chemotherapy regimens used (platinum-based group, p = 0.006; non-platinum group, p = 0.046, Fisher's exact test). The metabolic change in SUVmax was clearly predictive of tumor response in 93.5% of patients. Early FDG-PET assessment by measuring the single largest lesion is a very promising tool for rapidly predicting tumor responses and patient survival, regardless of the chemotherapy regimen.

  10. Mapping geological at risk areas in the city of São Paulo: issues and results from the largest risk survey in Brazil

    Science.gov (United States)

    Pascarelli, Luciana; Macedo, Eduardo

    2013-04-01

    In the City of São Paulo, the first reports of accidents resulting from landslides are directly related to urban expansion that has been recorded since the 30s. Areas of major environmental fragility, such as slopes and stream-banks, have also ended up being occupied without proper planning. The increased number of deaths due to landslides in the 80s already indicated the need for intervention at these sites by the public authorities. It was important to act to prevent these disasters, not only emergency assistance to victimized families. Therefore, in 1989 the first systematic and official survey on the City's at-risk areas was made. At the time, the at-risk sites had been still unknown, except for the occurrence records and press reports. While some areas were evaluated by experts, others appeared or expanded without any control. The surveys pace could not definitely follow the growth and the density of favelas, and some communities started to trigger the first records of accidents in areas hitherto stable. Considering the universe to be studied and the detail level of the work, it was necessary to use specific methodology to enable evaluation of the entire City in a relatively short period of time. For that purpose,mapping activities were carried out in five phases and involved about 80 professionals in the fields of geology, engineering, architecture, geography, civil defense, and housing, who participated directly or indirectly in all stages of work. Thus, the mapping that has recently been completed by the Municipality of São Paulo and by the Institute for Technological Research of São Paulo State is today the largest geological-risk database in the country. Besides technical information, the survey also shows the types of intervention to be implemented according to the degree of risk and the type of verified occupation, vital data to prioritizing the public-authorities actions. Currently, among the 1,602 favelas and informal settlements in the city, 407

  11. Single-use device reuse risks.

    Science.gov (United States)

    Lee, Robert C; Berzins, Sandy; Alfieri, Nancy

    2007-01-01

    Efforts to reduce both costs and medical waste have led many health systems to start reusing single-use medical devices (SUDs) after cleaning and sterilizing (i.e. reprocessing). There is a currently a wide range of SUD types being reused in many health systems. The objective of this paper is to provide a brief summary of risk issues associated with critical SUDs, based on a rapid review of the available literature. The specific focus is on risk issues, but includes discussion of economic and legal/ethical issues as well. The evidence in the literature regarding the safety of reuse of SUDs indicates that for certain devices (e.g. heart catheters) reuse can be safe (in terms of patient infection) and cost-effective as long as stringent reprocessing protocols are followed. However, potential risks associated with reusing SUDs are not just limited to infection of patients. There are staff and environmental risks, plus important legal, ethical, and financial issues to consider in a reuse policy. There are currently no Canadian guidelines on reuse or reprocessing SUDs, although a national Scientific Advisory Panel on Reprocessing of Medical Devices has made recommendations. Additionally, reuse of SUDs is interwoven with the issue of infection control and reprocessing procedures in general and as applied to multiple-use devices. With limited healthcare resources, there will always be a trade-off between the human resources and costs required to clean and sterilize reused devices with costs associated with purchasing and disposing of non-reused SUDs. Evaluation of complete operational pathways, especially for more expensive and commonly used SUDs, will be useful to properly determine the balance of benefits, risks, and costs under a reuse policy.

  12. Largest College Endowments, 2011

    Science.gov (United States)

    Chronicle of Higher Education, 2012

    2012-01-01

    Of all endowments valued at more than $250-million, the UCLA Foundation had the highest rate of growth over the previous year, at 49 percent. This article presents a table of the largest college endowments in 2011. The table covers the "rank," "institution," "market value as of June 30, 2011," and "1-year change" of institutions participating in…

  13. Prior high-risk HPV testing and Pap test results for 427 invasive cervical cancers in China's largest CAP-certified laboratory.

    Science.gov (United States)

    Zheng, Baowen; Li, Zaibo; Griffith, Christopher C; Yan, Shanshan; Chen, Congde; Ding, Xiangdong; Liang, Xiaoman; Yang, Huaitao; Zhao, Chengquan

    2015-07-01

    Cervical cancer and its precursor lesions are caused by a persistent high-risk human papillomavirus (hrHPV) infection. hrHPV testing has been reported to have higher sensitivity than Papanicolaou (Pap) testing for the detection of cervical precursor lesions. However, limited data are available for prior human papillomavirus (HPV) testing results for patients later diagnosed with invasive cervical cancer, especially in countries lacking a national cervical cancer screening program such as China. This study investigated prior hrHPV testing results for patients with invasive cervical cancer in China. Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from Guangzhou KingMed Diagnostics (the largest independent pathology laboratory in China); prior hrHPV and Pap test results obtained within the year before the cancer diagnosis were recorded. HPV testing was negative in 7.5% of 427 cases of invasive cervical carcinoma, including squamous cell carcinoma (5%) and adenocarcinoma (25%). In 155 cervical cancer cases with prior hrHPV and Pap testing, the negative rate for Pap testing was 1.9%, and the negative rate for HPV was 9.7%. Furthermore, when only cases of adenocarcinoma (n = 18) were examined, both the hrHPV-negative rate and the Pap-negative rate were higher at 33% and 5.6%, respectively. These data demonstrate a considerable prior hrHPV-negative rate and a lower prior Pap-negative rate in patients with invasive cervical carcinoma (especially adenocarcinoma) from a population of women without access to an established screening program. © 2015 American Cancer Society.

  14. Future water availability in the largest freshwater Mediterranean lake is at great risk as evidenced from simulations with the SWAT model.

    Science.gov (United States)

    Bucak, Tuba; Trolle, Dennis; Andersen, Hans Estrup; Thodsen, Hans; Erdoğan, Şeyda; Levi, Eti E; Filiz, Nur; Jeppesen, Erik; Beklioğlu, Meryem

    2017-03-01

    Inter- and intra-annual water level fluctuations and changes in water flow regime are intrinsic characteristics of Mediterranean lakes. Additionally, considering climate change projections for the water-limited Mediterranean region, increased air temperatures and decreased precipitation are anticipated, leading to dramatic declines in lake water levels as well as severe water scarcity problems. The study site, Lake Beyşehir, the largest freshwater lake in the Mediterranean basin, is - like other Mediterranean lakes - threatened by climatic changes and over-abstraction of water for irrigated crop farming. Therefore, implementation of strict water level management policies is required. In this study, an integrated modeling approach was used to predict the future water levels of Lake Beyşehir in response to potential future changes in climate and land use. Water level estimation was performed by linking the catchment model Soil and Water Assessment Tool (SWAT) with a Support Vector Regression model (ε-SVR). The projected increase in temperature and decrease in precipitation based on the climate change models led to an enhanced potential evapotranspiration and reduced total runoff. On the other hand, the effects of various land use scenarios within the catchment appeared to be comparatively insignificant. According to the ε-SVR model results, changes in hydrological processes caused a water level reduction for all scenarios. Moreover, the MPI-ESM-MR General Circulation Model outputs produced the most dramatic results by predicting that Lake Beyşehir may dry out by the 2040s with the current outflow regime. The results indicate that shallow Mediterranean lakes may face a severe risk of drying out and losing their ecosystem values in the near future if the current intensity of water abstraction is not reduced. In addition, the results also demonstrate that outflow management and sustainable use of water sources are vital to sustain lake ecosystems in water

  15. Single-shell tank interim stabilization risk analysis

    International Nuclear Information System (INIS)

    Basche, A.D.

    1998-01-01

    The purpose of the Single-Shell Tank (SST) Interim Stabilization Risk Analysis is to provide a cost and schedule risk analysis of HNF-2358, Rev. 1, Single-Shell Tank Interim Stabilization Project Plan (Project Plan) (Ross et al. 1998). The analysis compares the required cost profile by fiscal year (Section 4.2) and revised schedule completion date (Section 4.5) to the Project Plan. The analysis also evaluates the executability of the Project Plan and recommends a path forward for risk mitigation

  16. A Single Conjunction Risk Assessment Metric: the F-Value

    Science.gov (United States)

    Frigm, Ryan Clayton; Newman, Lauri K.

    2009-01-01

    The Conjunction Assessment Team at NASA Goddard Space Flight Center provides conjunction risk assessment for many NASA robotic missions. These risk assessments are based on several figures of merit, such as miss distance, probability of collision, and orbit determination solution quality. However, these individual metrics do not singly capture the overall risk associated with a conjunction, making it difficult for someone without this complete understanding to take action, such as an avoidance maneuver. The goal of this analysis is to introduce a single risk index metric that can easily convey the level of risk without all of the technical details. The proposed index is called the conjunction "F-value." This paper presents the concept of the F-value and the tuning of the metric for use in routine Conjunction Assessment operations.

  17. Temporal-spatial distributions and ecological risks of perfluoroalkyl acids (PFAAs) in the surface water from the fifth-largest freshwater lake in China (Lake Chaohu)

    DEFF Research Database (Denmark)

    Liu, Wen-Xiu; He, Wei; Qin, Ning

    2015-01-01

    To investigate the residues, compositions, distributions and potential ecological risks of perfluoroalkyl acids (PFAAs), water samples were collected seasonally between August 2011 and November 2012 from 20 sites in Lake Chaohu and its tributary rivers. The mean concentration of total PFAAs (TPFA...

  18. The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey.

    Science.gov (United States)

    Bayar, Göksel; Horasanlı, Kaya; Acinikli, Hüseyin; Tanrıverdi, Orhan; Dalkılıç, Ayhan; Arısan, Serdar

    2016-09-01

    To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005-2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens. Patients' median age was 61 years and PSA level was 5 (2.7-9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active surveillance criteria. Median follow time was 42 (24-117) months. Definitive treatment was performed in 9 (21%) patients. PSA recurrence was not detected in none of 9 patients during 38 months of follow up. Only the presence of tumor in re-biopsy specimens was found predictor of disease progression in multivariate analysis. We think that AS is safe method for low-risk localized prostate cancer patients, if it is performed in compliance with certain criteria and regular follow up, and early re-biopsy can be useful either during early period or long term follow-up.

  19. 31 CFR 223.14 - Schedules of single risks.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Schedules of single risks. 223.14 Section 223.14 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE...

  20. History of high-risk HPV and Pap test results in a large cohort of patients with invasive cervical carcinoma: experience from the largest women's hospital in China.

    Science.gov (United States)

    Tao, Xiang; Griffith, Christopher C; Zhou, Xiangrong; Wang, Zhiheng; Yan, Yabin; Li, Zaibo; Zhao, Chengquan

    2015-07-01

    Current cervical cancer screening guidelines recommend screening with a Papanicolaou (Pap) test or by cotesting (Pap and human papillomavirus [HPV]). Given the importance of high-risk HPV (hrHPV) infection in the development of cervical cancer, some studies are now suggesting the use of primary hrHPV testing as a possible screening modality. To gain further insight into the role of both Pap testing and hrHPV testing, the authors examined prior screening results in a population of Chinese patients with invasive cervical carcinoma. Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from the Obstetrics and Gynecology Hospital of Fudan University from January 2011 to October 2014. Prior hrHPV testing and Pap test results within 3 years before the cancer diagnosis were recorded. Of 3714 patients with invasive cervical carcinoma, over a 46-month period, 525 had prior hrHPV testing using Hybrid Capture 2 within 3 years and 238 patients had Pap cytology testing within 1 year before the histological diagnosis. Within the 1-year period before diagnosis, the overall hrHPV-negative rate was 15.5% (74 of 477 patients) and the Pap-negative rate was also 15.5% (37 of 238 patients). Only 9 of 231 patients with both hrHPV testing and Pap testing (3.9%) had a double-negative result. Compared with squamous cell carcinoma, adenocarcinoma has significantly higher rates of prior negative results with both hrHPV and Pap cytology. The results of the current study demonstrated prior results of hrHPV testing and Pap cytology in a population of women in China who had not undergone intensive prior screening. Both hrHPV testing and Pap cytology were found to have similar negative rates in this population and, not surprisingly, there were fewer women who had negative testing results using both testing modalities. © 2015 American Cancer Society.

  1. [Children of single mothers: health risks and environmental stress].

    Science.gov (United States)

    Scharte, M; Bolte, G

    2012-03-01

    In Germany the risk for relative poverty has increased profoundly during the last 15 years, especially among single parent families. As poverty is often associated with bad health we examined the physical and mental health as well as health-related behaviour, housing and environmental conditions in children with lone mothers versus children in couple families. In 3 cross-sectional surveys conducted during 2004-2007 in 3 cities and 3 rural areas in Bavaria data on 19 039 pre-school children (47% female) were collected. Health, behaviour and exposure assessment was based on parental reports. The 18 327 cases with complete information on family status were analysed. 10% of the children grew up with single mothers. Single mothers evaluated the general state of health of their children more often as moderate to very poor than couple parents (OR [95% CI]: male: 1.37 [1.07-1.77], female 1.77 [1.33-2.35]). Sons with single mothers were more often obese (1.44 [1.09-1.90]). They scored significantly higher in the SDQ total difficulties score (1.94 [1.44-2.62]), on the emotional problem scale (1.91 [1.40-2.59]) as well as on the hyperactivity scale (1.82 [1.35-2.47]) compared to boys from couple families. No difference was found in prosocial behaviour. Girls with single mothers revealed more often conduct problems 1.36 [1.02-1.81] compared to those from couple families. They also showed a significantly higher prevalence of asthma (2.06 [1.29-3.30]). Children living with their single mothers were less often members of sports clubs and the boys were less physical active. No difference was found regarding the consumption of fruits and vegetables. Single mother family was associated with children's environmental tobacco smoke exposure at home (2.03 [1.79-2.29]). Single mothers perceived higher environmental exposures to noise and air pollution, suffered more often from a lack of accessible green spaces in the neighbourhood and reported a higher traffic load on the residential

  2. Largest particle detector nearing completion

    CERN Multimedia

    2006-01-01

    "Construction of another part of the Large Hadron Collider (LHC), the worl's largest particle accelerator at CERN in Switzerland, is nearing completion. The Compact Muon Solenoid (CMS) is oner of the LHC project's four large particle detectors. (1/2 page)

  3. Risk factors for radiotherapy incidents: a single institutional experience.

    Science.gov (United States)

    Ishiyama, Hiromichi; Shuto, Nobuaki; Terazaki, Tsuyoshi; Noda, Shigetoshi; Ishigami, Minoru; Yogo, Katsunori; Hayakawa, Kazushige

    2018-01-30

    We aimed to analyze risk factors for incidents occurring during the practice of external beam radiotherapy (EBRT) at a single Japanese center. Treatment data for EBRT from June 2014 to March 2017 were collected. Data from incident reports submitted during this period were reviewed. Near-miss cases were not included. Risk factors for incidents, including patient characteristics and treatment-related factors, were explored using uni- and multivariate analyses. Factors contributing to each incident were also retrospectively categorized according to the recommendations of the American Association of Physicists in Medicine (AAPM). A total of 2887 patients were treated during the study period, and 26 incidents occurred (0.90% per patient). Previous history of radiotherapy and large fraction size were identified as risk factors for incidents by univariate analysis. Only previous history of radiotherapy was detected as a risk factor in multivariate analysis. Identified categories of contributing factors were human behavior (50.0%), communication (40.6%), and technical (9.4%). The incident rate of EBRT was 0.90% per patient in our institution. Previous history of radiotherapy and large fraction size were detected as risk factors for incidents. Human behavior and communication errors were identified as contributing factors for most incidents. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  4. Risk assessment of mortality for all-cause, ischemic heart disease, cardiopulmonary disease, and lung cancer due to the operation of the world's largest coal-fired power plant

    Science.gov (United States)

    Kuo, Pei-Hsuan; Tsuang, Ben-Jei; Chen, Chien-Jen; Hu, Suh-Woan; Chiang, Chun-Ju; Tsai, Jeng-Lin; Tang, Mei-Ling; Chen, Guan-Jie; Ku, Kai-Chen

    2014-10-01

    Based on recent understanding of PM2.5 health-related problems from fossil-fueled power plants emission inventories collected in Taiwan, we have determined the loss of life expectancy (LLE) and the lifetime (75-year) risks for PM2.5 health-related mortalities as attributed to the operation of the world's largest coal-fired power plant; the Taichung Power Plant (TCP), with an installed nominal electrical capacity of 5780 MW in 2013. Five plausible scenarios (combinations of emission controls, fuel switch, and relocation) and two risk factors were considered. It is estimated that the lifetime (75-y) risk for all-cause mortality was 0.3%-0.6% for males and 0.2%-0.4% for females, and LLE at 84 days in 1997 for the 23 million residents of Taiwan. The risk has been reduced to one-fourth at 0.05%-0.10% for males and 0.03%-0.06% for females, and LLE at 15 days in 2007, which was mainly attributed to the installation of desulfurization and de-NOx equipment. Moreover, additional improvements can be expected if we can relocate the power plant to a downwind site on Taiwan, and convert the fuel source from coal to natural gas. The risk can be significantly reduced further to one-fiftieth at 0.001%-0.002% for males and 0.001% for females, and LLE at 0.3 days. Nonetheless, it is still an order higher than the commonly accepted elevated-cancer risk at 0.0001% (10-6), indicating that the PM2.5 health-related risk for operating such a world-class power plant is not negligible. In addition, this study finds that a better-chosen site (involving moving the plant to the leeward side of Taiwan) can reduce the risk significantly as opposed to solely transitioning the fuel source to natural gas. Note that the fuel cost of using natural gas (0.11 USD/kWh in 2013) in Taiwan is about twice the price of using coal fuel (0.05 USD/kWh in 2013).

  5. The single-hospital county: is its hospital at risk?

    Science.gov (United States)

    Chang, C F; Tuckman, H P

    1991-01-01

    This article focuses on a hospital group that has not received adequate attention in the literature: the sole provider of short-term, acute hospital care located in a county. In Tennessee, SPHs (single provider hospitals) are fewer in number but are present in more counties than multiprovider hospitals (MPHs). They are smaller in size, less labor and capital intensive, more likely to be a government hospital, and more likely to be in a rural area with low income and limited health care resources. SPHs operate with lower costs, charge patients less, and have lower revenue write-offs than MPHs. As a result, their cash flow is sufficient to fund their depreciation and they consistently earn modest returns. Between 1982 and 1988, a total of 16 hospitals failed in Tennessee but only 3 were SPHs. While SPHs have not been profitable enough to make them ideal candidates for takeover by major hospital systems, they are not a population that is unduly at risk. PMID:1905685

  6. CT perfusion measurements of head and neck carcinoma from single section with largest tumor dimensions or average of multiple sections: Agreement between the two methods and effect on intra- and inter-observer agreement

    Energy Technology Data Exchange (ETDEWEB)

    Tawfik, Ahmed M., E-mail: ahm_m_tawfik@hotmail.com [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany); Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 Elgomhorya Street, Mansoura 35512 (Egypt); Nour-Eldin, Nour-Eldin A.; Naguib, Nagy N. [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany); Razek, Ahmed Abdel [Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 Elgomhorya Street, Mansoura 35512 (Egypt); Denewer, Adel T. [Surgical Oncology Department, Mansoura Oncology Centre, Mansoura Faculty of medicine (Egypt); Bisdas, Sotirios [Department of Neuroradiology, Eberhard Karls University, Tübingen (Germany); Vogl, Thomas J. [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany)

    2012-10-15

    Purpose: To evaluate the agreement between quantitative CT perfusion measurements of head and neck squamous cell carcinoma (SCC) obtained from single section with maximal tumor dimension and from average values of multiple sections, and to compare intra- and inter-observer agreement of the two methods. Methods: Perfusion was measured for 28 SCC cases using a region of interest (ROI) inserted in the single dynamic CT section showing maximal tumor dimension, then using average values of multiple ROIs inserted in all tumor-containing sections. Agreement between values of blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) calculated by the two methods was assessed. Intra-observer agreement was assessed by comparing repeated calculations done by the same radiologist using both methods after 2 months blinding period. Perfusion measurements were done by another radiologist independently to assess inter-observer agreement of both methods. Results: No significant differences were observed between the means of the 4 perfusion parameters calculated by both methods, all p values >0.05 The 95% limits of agreement between the two methods were (−33.9 to 43) ml/min/100 g for BF, (−2.5 to 2.8) ml/100 g for BV, (−4.9 to 3.9) s for MTT and (−17.5 to 18.6) ml/min/100 g for PS. Narrower limits of agreement were obtained using average of multiple sections than with single section denoting improved intra- and inter-observer agreement. Conclusion: Agreement between both methods is acceptable. Taking the average of multiple sections slightly improves intra- and inter-observer agreement.

  7. A Seasonal Trend of Single Scattering Albedo in Southern African Biomass-burning Particles: Implications for Satellite Products and Estimates of Emissions for the World's Largest Biomass-burning Source

    Science.gov (United States)

    Eck, T. F.; Holben, B. N.; Reid, J. S.; Mukelabai, M. M.; Piketh, S. J.; Torres, O.; Jethva, H. T.; Hyer, E. J.; Ward, D. E.; Dubovik, O.; hide

    2013-01-01

    As a representative site of the southern African biomass-burning region, sun-sky data from the 15 year Aerosol Robotic Network (AERONET) deployment at Mongu, Zambia, was analyzed. For the biomass-burning season months (July-November), we investigate seasonal trends in aerosol single scattering albedo (SSA), aerosol size distributions, and refractive indices from almucantar sky scan retrievals. The monthly mean single scattering albedo at 440 nm in Mongu was found to increase significantly from approx.. 0.84 in July to approx. 0.93 in November (from 0.78 to 0.90 at 675 nm in these same months). There was no significant change in particle size, in either the dominant accumulation or secondary coarse modes during these months, nor any significant trend in the Angstrom exponent (440-870 nm; r(exp 2) = 0.02). A significant downward seasonal trend in imaginary refractive index (r(exp 2) = 0.43) suggests a trend of decreasing black carbon content in the aerosol composition as the burning season progresses. Similarly, burning season SSA retrievals for the Etosha Pan, Namibia AERONET site also show very similar increasing single scattering albedo values and decreasing imaginary refractive index as the season progresses. Furthermore, retrievals of SSA at 388 nm from the Ozone Monitoring Instrument satellite sensor show similar seasonal trends as observed by AERONET and suggest that this seasonal shift is widespread throughout much of southern Africa. A seasonal shift in the satellite retrieval bias of aerosol optical depth from the Moderate Resolution Imaging Spectroradiometer collection 5 dark target algorithm is consistent with this seasonal SSA trend since the algorithm assumes a constant value of SSA. Multi-angle Imaging Spectroradiometer, however, appears less sensitive to the absorption-induced bias.

  8. A seasonal trend of single scattering albedo in southern African biomass-burning particles: Implications for satellite products and estimates of emissions for the world's largest biomass-burning source

    Science.gov (United States)

    Eck, T. F.; Holben, B. N.; Reid, J. S.; Mukelabai, M. M.; Piketh, S. J.; Torres, O.; Jethva, H. T.; Hyer, E. J.; Ward, D. E.; Dubovik, O.; Sinyuk, A.; Schafer, J. S.; Giles, D. M.; Sorokin, M.; Smirnov, A.; Slutsker, I.

    2013-06-01

    As a representative site of the southern African biomass-burning region, sun-sky data from the 15 year Aerosol Robotic Network (AERONET) deployment at Mongu, Zambia, was analyzed. For the biomass-burning season months (July-November), we investigate seasonal trends in aerosol single scattering albedo (SSA), aerosol size distributions, and refractive indices from almucantar sky scan retrievals. The monthly mean single scattering albedo at 440 nm in Mongu was found to increase significantly from 0.84 in July to 0.93 in November (from 0.78 to 0.90 at 675 nm in these same months). There was no significant change in particle size, in either the dominant accumulation or secondary coarse modes during these months, nor any significant trend in the Ångström exponent (440-870 nm; r2 = 0.02). A significant downward seasonal trend in imaginary refractive index (r2 = 0.43) suggests a trend of decreasing black carbon content in the aerosol composition as the burning season progresses. Similarly, burning season SSA retrievals for the Etosha Pan, Namibia AERONET site also show very similar increasing single scattering albedo values and decreasing imaginary refractive index as the season progresses. Furthermore, retrievals of SSA at 388 nm from the Ozone Monitoring Instrument satellite sensor show similar seasonal trends as observed by AERONET and suggest that this seasonal shift is widespread throughout much of southern Africa. A seasonal shift in the satellite retrieval bias of aerosol optical depth from the Moderate Resolution Imaging Spectroradiometer collection 5 dark target algorithm is consistent with this seasonal SSA trend since the algorithm assumes a constant value of SSA. Multi-angle Imaging Spectroradiometer, however, appears less sensitive to the absorption-induced bias.

  9. Overheating risk barriers to energy renovations of single family houses

    DEFF Research Database (Denmark)

    Psomas, Theofanis Ch.; Heiselberg, Per Kvols; Duer, Karsten

    2016-01-01

    Highlights •Energy renovations of houses in moderate climates increase overheating risk. •Critical measures are the floor insulation and the improvement of the airtightness. •Decrease of the g value of windows diminishes the intensity and the period of it. •Static method of assessment shows highe...

  10. broken magnet highlights largest collider's engineering challenges

    CERN Multimedia

    Inman, Mason

    2007-01-01

    "Even at the world's soon-to-be largest particle accelerator - a device that promises to push the boundaries of physics - scientists need to be mindful of one of the most fundamental laws in the universe: Murphy's Law. (2 pages)

  11. Can combining different risk interventions into a single formulation contribute to improved cardiovascular disease risk reduction? The single pill of amlodipine/atorvastatin

    Directory of Open Access Journals (Sweden)

    FD Richard Hobbs

    2007-11-01

    Full Text Available FD Richard HobbsUniversity of Birmingham, Edgbaston, Birmingham B15 2TT, UK.Abstract: In order to prevent cardiovascular events, it is essential to effectively manage overall risk of cardiovascular disease. However, despite guideline recommendations to this effect, current management of the major, modifiable cardiovascular risk factors such as hypertension and dyslipidemia is disconnected and patient adherence to therapy is poor. This is particularly important for patients with multiple cardiovascular risk factors, who are often prescribed multiple medications. The JEWEL study program investigated the use of single-pill amlodipine/atorvastatin as a strategy to improve management of these patients. The JEWEL program consisted of two 16-week, international, openlabel, multicenter, titration-to-goal studies in patients with hypertension and dyslipidemia. The two studies differed based on country of enrollment and certain tertiary endpoints, but the overall designs were very similar. Patients were enrolled from 255 centers across Canada and 13 European countries. The study was designed to assess the efficacy, safety, and utility of amlodipine/atorvastatin single pill therapy in a real-world setting. Patients were initiated at a dose of amlodipine 5 mg/atorvastatin 10 mg, unless previously treated, and were uptitrated as necessary. The primary efficacy parameter was the percentage of patients, at different levels of cardiovascular risk, achieving country-specific guideline-recommended target levels for blood pressure and lipids. A secondary analysis of efficacy measured attainment of the same single goal for blood pressure across all study participants (JEWEL I and II and the same single goal for LDL-C across all study participants (JEWEL I and II. The program utilized a newly developed questionnaire to gain better understanding of participants’ beliefs and behaviors towards medical treatment of their multiple risk factors. Approximately 2850

  12. CERN tests largest superconducting solenoid magnet

    CERN Multimedia

    2006-01-01

    "CERN's Compacts Muon Solenoid (CMS) - the world's largest superconducting solenoid magnet - has reached full field in testing. The instrument is part of the proton-proton Large Hadron Collider (LHC) project, located in a giant subterranean chamber at Cessy on the Franco-Swiss border." (1 page)

  13. The Largest and Oldest Living Organism

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 10; Issue 4. The Largest and Oldest Living Organism. Ramesh Maheshwari. General Article Volume 10 Issue 4 April 2005 pp 4-9. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/010/04/0004-0009. Keywords.

  14. World's largest particle accelerator almost ready

    CERN Multimedia

    2007-01-01

    "With nearly all the pieces in place, the world's largest particle accelerator is set for start-up in November. It was announced on Saturday that the last quadripolar magnet was brought down into the tunnel of the accelerator." (1 page)

  15. Single particle effects, Biostack, and risk evaluation - Studies on the radiation risk from Galactic cosmic rays

    Science.gov (United States)

    Curtis, Stanley B.

    1993-01-01

    The possible health risks posed by Galactic cosmic rays, especially the possible heightened cancer risk, are examined. The results of the Biostack studies of the biological effects of high-energy cosmic rays are discussed. The biological mechanisms involved in possible harm due to cosmic rays are considered.

  16. Modelling the contribution of family history and variation in single nucleotide polymorphisms to risk of schizophrenia

    DEFF Research Database (Denmark)

    Agerbo, Esben; Mortensen, Preben Bo; Wiuf, Carsten

    2012-01-01

    Epidemiological studies indicate that having any family member with schizophrenia increases the risk of schizophrenia in the probands. However, genome-wide association studies (GWAS) have accounted for little of this variation. The aim of this study was to use a population-based sample to explore...... the influence of single-nucleotide polymorphisms (SNPs) on the excess schizophrenia risk in offspring of parents with a psychotic, bipolar affective or other psychiatric disorder....

  17. The world's largest time projection chamber

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    Peter Glassel, the technical coordinator for the ALICE time projection chamber, is seen sitting inside the detector; the largest in the world at nearly 100 cubic metres. Thousands of wires are connected to read out electronic data produced as particles are created in lead-lead collisions at the centre of the detector. These particles will cause the medium within the time projection chamber to ionise along their tracks allowing the particle paths to be recreated.

  18. Lupus-related single nucleotide polymorphisms and risk of diffuse large B-cell lymphoma

    NARCIS (Netherlands)

    Bernatsky, Sasha; Velásquez García, Héctor A; Spinelli, John; Gaffney, Patrick; Smedby, Karin E; Ramsey-Goldman, Rosalind; Wang, Sophia S.; Adami, Hans-Olov; Albanes, Demetrius; Angelucci, Emanuele; Ansell, Stephen M.; Asmann, Yan W.; Becker, Nikolaus; Benavente, Yolanda; Berndt, Sonja I.; Bertrand, Kimberly A.; Birmann, Brenda M.; Boeing, Heiner; Boffetta, Paolo; Bracci, Paige M.; Brennan, Paul; Brooks-Wilson, Angela R.; Cerhan, James R.; Chanock, Stephen J.; Clavel, Jacqueline; Conde, Lucia; Cotenbader, Karen H; Cox, David G; Cozen, Wendy; Crouch, Simon; De Roos, Anneclaire J.; De Sanjose, Silvia; Di Lollo, Simonetta; Diver, W. Ryan; Dogan, Ahmet; Foretova, Lenka; Ghesquières, Hervé; Giles, Graham G.; Glimelius, Bengt; Habermann, Thomas M.; Haioun, Corinne; Hartge, Patricia; Hjalgrim, Henrik; Holford, Theodore R.; Holly, Elizabeth A.; Jackson, Rebecca D.; Kaaks, Rudolph; Kane, Eleanor; Kelly, Rachel S.; Klein, Robert J.; Kraft, Peter; Kricker, Anne; Lan, Qing; Lawrence, Charles; Liebow, Mark; Lightfoot, Tracy; Link, Brian K.; Maynadie, Marc; McKay, James; Melbye, Mads; Molina, Thierry Jo; Monnereau, Alain; Morton, Lindsay M.; Nieters, Alexandra; North, Kari E.; Novak, Anne J.; Offit, Kenneth; Purdue, Mark P.; Rais, Marco; Riby, Jacques; Roman, Eve; Rothman, Nathaniel; Salles, Gilles; Severi, Gianluca; Severson, Richard K.; Skibola, Christine F.; Slager, Susan L.; Smith, Alex; Smith, Martyn T.; Southey, Melissa C.; Staines, Anthony; Teras, Lauren R.; Thompson, Carrie A.; Tilly, Hervé; Tinker, Lesley F.; Tjonneland, Anne; Turner, Jenny; Vajdic, Claire M.; Vermeulen, Roel C H; Vijai, Joseph; Vineis, Paolo; Virtamo, Jarmo; Wang, Zhaoming; Weinstein, Stephanie; Witzig, Thomas E.; Zelenetz, Andrew; Zeleniuch-Jacquotte, Anne; Zhang, Yawei; Zheng, Tongzhang; Zucca, Mariagrazia; Clarke, Ann E

    2017-01-01

    Objective: Determinants of the increased risk of diffuse large B-cell lymphoma (DLBCL) in SLE are unclear. Using data from a recent lymphoma genome-wide association study (GWAS), we assessed whether certain lupus-related single nucleotide polymorphisms (SNPs) were also associated with DLBCL.

  19. Doulas' Perceptions on Single Mothers' Risk and Protective Factors, and Aspirations Relative to Child-Birth

    Science.gov (United States)

    Arat, Gizem

    2013-01-01

    This study the author aims to explore the perceptions of doulas on single mothers' risk and protective factors, and aspirations relative to child-birth in the postpartum care. The current study was conducted by semi-structured questions, case file reviews, field notes, and twelve home visits via utilizing Grounded Theory. These mothers receive…

  20. Siting analysis and risk assessment for small single-purpose heating reactors

    International Nuclear Information System (INIS)

    Tarjanne, R.

    1979-04-01

    Two alternative sites both 10km away from the centre of Helsinki are considered for reactor unit sizes of 400mw and 800mw. The risks associated with a small single-purpose heating reactor is evaluated for normal operation and accident conditions. The evaluation for accident condition is performed for three characteristics accidents. Three pathways are considered in the calculation of the radiation exposure: direct external gamma dose from the release plume, direct gamma radiation from deposited activity on the ground and dose due to inhalation. The risks are compared with the risks from alternative conventional fossil fuelled district heat production methods. The results show that the heating reactor alternative causes an unsignificant risk, which is far less than the risk caused by the fossil-fuelled alternatives

  1. Gender Differences in Risk Factors for Single and Recurrent Falls Among the Community-Dwelling Elderly

    Directory of Open Access Journals (Sweden)

    Yu Mei O

    2015-08-01

    Full Text Available The purpose of this study was to identify gender differences in risk factors of fall accidents among older people, and whether these factors differ between single and recurrent fallers. A total of 4,426 individuals aged ≥65 years from two large-scale health surveys provided data. Logistic regression analyses were used to identify risk factors and to determine the risk model for falling and recurrent falling in men and women separately. Three major risk factors for falling regardless of gender or fall history are fear of falling, limitations in activities of daily living (ADL, and age ≥75 years. Fear of falling remains one of the common modifiable risk factors. Among those without a fall history, the use of sedatives or tranquilizers increases the risk of falling. Regarding gender differences, ADL limitations and fear of falling appear to be stronger fall risk factors for men than for women. Among women, alcohol use and educational level are significant risk factors for falling, while loneliness is associated with recurrent falling. Men with fear of falling or ADL limitations are at higher risk to have a recurrent fall accident than women with these conditions. Having a visual impairment or living with someone is associated with recurrent falling among men. Our findings emphasize the importance of multifactorial fall interventions, taking into account a variety of subgroup characteristics such as gender and fall history.

  2. Quantifying riverine and storm-surge flood risk by single-family residence: application to Texas.

    Science.gov (United States)

    Czajkowski, Jeffrey; Kunreuther, Howard; Michel-Kerjan, Erwann

    2013-12-01

    The development of catastrophe models in recent years allows for assessment of the flood hazard much more effectively than when the federally run National Flood Insurance Program (NFIP) was created in 1968. We propose and then demonstrate a methodological approach to determine pure premiums based on the entire distribution of possible flood events. We apply hazard, exposure, and vulnerability analyses to a sample of 300,000 single-family residences in two counties in Texas (Travis and Galveston) using state-of-the-art flood catastrophe models. Even in zones of similar flood risk classification by FEMA there is substantial variation in exposure between coastal and inland flood risk. For instance, homes in the designated moderate-risk X500/B zones in Galveston are exposed to a flood risk on average 2.5 times greater than residences in X500/B zones in Travis. The results also show very similar average annual loss (corrected for exposure) for a number of residences despite their being in different FEMA flood zones. We also find significant storm-surge exposure outside of the FEMA designated storm-surge risk zones. Taken together these findings highlight the importance of a microanalysis of flood exposure. The process of aggregating risk at a flood zone level-as currently undertaken by FEMA-provides a false sense of uniformity. As our analysis indicates, the technology to delineate the flood risks exists today. © 2013 Society for Risk Analysis.

  3. Risk factors for failure of a single surgical debridement in adults with acute septic arthritis.

    Science.gov (United States)

    Hunter, Joshua G; Gross, Jonathan M; Dahl, Jason D; Amsdell, Simon L; Gorczyca, John T

    2015-04-01

    Acute septic arthritis in a native joint may require more than one surgical debridement to eradicate the infection. Our objectives were to determine the prevalence of failure of a single surgical debridement for acute septic arthritis, to identify risk factors for failure of a single debridement, and to develop a prognostic probability algorithm to predict failure of a single surgical debridement for acute septic arthritis in adults. We collected initial laboratory and medical comorbidity data of 128 adults (132 native joints) with acute septic arthritis who underwent at least one surgical debridement at our institution between 2000 and 2011. Univariate and logistic regression analyses were used to identify potential risk factors for failure of a single surgical debridement. Stepwise variable selection was used to develop a prediction model and identify probabilities of failure of a single surgical debridement. Of the 128 patients (132 affected joints) who underwent surgical debridement for acute septic arthritis, forty-nine (38%) of the patients (fifty joints) experienced failure of a single debridement and required at least two debridements (range, two to four debridements). Staphylococcus aureus was the most common bacterial isolate (in sixty, or 45%, of the 132 joints). Logistic regression analysis identified five independent clinical predictors for failure of a single surgical debridement: a history of inflammatory arthropathy (odds ratio [OR], 7.3; 95% confidence interval [CI], 2.4 to 22.6; p 85.0 x 10(9) cells/L (OR, 4.7; 95% CI, 1.8 to 17.7; p = 0.002), S. aureus as the bacterial isolate (OR, 4.6; 95% CI, 1.8 to 11.9; p = 0.002), and a history of diabetes (OR, 2.6; 95% CI, 1.1 to 6.2; p = 0.04). Most (62%) of the septic joints were managed effectively with a single surgical debridement. Adults with a history of inflammatory arthropathy, involvement of a large joint, a synovial-fluid nucleated cell count of >85.0 x 10(9) cells/L, an infection with S. aureus

  4. Collapse of the world's largest herbivores.

    Science.gov (United States)

    Ripple, William J; Newsome, Thomas M; Wolf, Christopher; Dirzo, Rodolfo; Everatt, Kristoffer T; Galetti, Mauro; Hayward, Matt W; Kerley, Graham I H; Levi, Taal; Lindsey, Peter A; Macdonald, David W; Malhi, Yadvinder; Painter, Luke E; Sandom, Christopher J; Terborgh, John; Van Valkenburgh, Blaire

    2015-05-01

    Large wild herbivores are crucial to ecosystems and human societies. We highlight the 74 largest terrestrial herbivore species on Earth (body mass ≥100 kg), the threats they face, their important and often overlooked ecosystem effects, and the conservation efforts needed to save them and their predators from extinction. Large herbivores are generally facing dramatic population declines and range contractions, such that ~60% are threatened with extinction. Nearly all threatened species are in developing countries, where major threats include hunting, land-use change, and resource depression by livestock. Loss of large herbivores can have cascading effects on other species including large carnivores, scavengers, mesoherbivores, small mammals, and ecological processes involving vegetation, hydrology, nutrient cycling, and fire regimes. The rate of large herbivore decline suggests that ever-larger swaths of the world will soon lack many of the vital ecological services these animals provide, resulting in enormous ecological and social costs.

  5. Largest clinic in the world? (Bogota).

    Science.gov (United States)

    1971-01-01

    The IPPF member, the Asociacion Pro-Bienestar de la Familia Colombiana (Profamilia), is discussed and its clinic, the Pilot Center in Bogota, reputed to be the largest family clinic in the world, is described. From January 1966 until the end of 1970, the Pilot Center served 59,469 new acceptors. Of the 31 Profamilia clinics in Colombia, the Pilot Center was visited by 22% of all new acceptors during 1970. Profamilia established the first vasectomy clinic in Latin America in February 1970. By the end of 1970, 92 vasectomies had been performed. Profamilia has expanded its family planning program, and part of this expansion is a result of Profamilia's extensive use of mass media in its education campaign. In 1970, there was a 24% increase in new acceptors over 1969 and a 66% increase in follow-up visits. 62,292 radio spots and 7 television programs were broadcast and announcements about family planning were shown in public cinemas in the latter half of 1970. Nearly 300,000 women attended talks, meetings, and film shows on family planning, and approximately 2 million leaflets and information sheets were distributed. To increase community involvement, Profamilia held 26 short courses for various groups including religious and community leaders. Profamilia also conducted a training course for doctors and sociologists from Colombia and other Latin American countries.

  6. The Largest and Oldest Living Organism

    Indian Academy of Sciences (India)

    confrontation with 'killed' cells in between (a 'barrage reac- tion'), The results showed that a single individual had parasit- ized trees in approximately 15 hectare area. The nucleotide sequence of DNA is a constant feature of the genome of a particular organism. To confirm that all isolates were genetically the same, ...

  7. A pharmacoeconomic analysis of the use of single MMC instillation in low risk NMIBC in Italy

    Directory of Open Access Journals (Sweden)

    Renzo Colombo

    2013-03-01

    Full Text Available BACKGROUND: Bladder cancer accounts for 5-10% of all cancers in Europe and up to 85% patients presents a noninvasive tumor, whose treatment of choice is the transurethral bladder resection (TURB paired with adjuvant intravesical chemotherapy or immunotherapy. Despite several clinical trials showed that this treatment is safe and decreases recurrences by 17% to 44% this practice is limited for many reasons. The study objective is to analyze the economical advantages of the single immediate post operative Mitomycin C instillation in Non Muscle-invasive Bladder Cancer (NMIBC low-risk patients.METHODS: A cost-benefit analysis was performed evaluating the economical gain that would raised from a scenario with a single immediate post operative mitomycin C instillation in each low-risk NMIBC patient who underwent to TURB. Net present value and cost-benefit ratio were calculated and sensitivity analyses were performed. Base case analysis was performed considering tumor recurrence rate reduction of 11.7% and a TURB costs of 2,167.0 €, while sensitivity analyses were performed using a recurrence rate reduction of 19.2% and 15.0% and a TURB cost of 2,472.93 €. The discount rate was 2%.RESULTS: The single immediate post operative instillation of mitomycin C resulted to be cost-beneficial with a cost-benefit ratio that goes from 0.48 to 0.79 when compared to TURB alone raising a Net Present Value that goes from 660,284.39 € to 2,650,530.79 €.CONCLUSION: This study demonstrates that even assuming conservative parameters for recurrence rates reduction, a single immediate post operative mitomycin C instillation in low risk NMIBC patients would lower not only the recurrence rate but also the caring cost for bladder cancer.

  8. Effective detection of human leukocyte antigen risk alleles in celiac disease using tag single nucleotide polymorphisms.

    Directory of Open Access Journals (Sweden)

    Alienke J Monsuur

    Full Text Available BACKGROUND: The HLA genes, located in the MHC region on chromosome 6p21.3, play an important role in many autoimmune disorders, such as celiac disease (CD, type 1 diabetes (T1D, rheumatoid arthritis, multiple sclerosis, psoriasis and others. Known HLA variants that confer risk to CD, for example, include DQA1*05/DQB1*02 (DQ2.5 and DQA1*03/DQB1*0302 (DQ8. To diagnose the majority of CD patients and to study disease susceptibility and progression, typing these strongly associated HLA risk factors is of utmost importance. However, current genotyping methods for HLA risk factors involve many reactions, and are complicated and expensive. We sought a simple experimental approach using tagging SNPs that predict the CD-associated HLA risk factors. METHODOLOGY: Our tagging approach exploits linkage disequilibrium between single nucleotide polymorphism (SNPs and the CD-associated HLA risk factors DQ2.5 and DQ8 that indicate direct risk, and DQA1*0201/DQB1*0202 (DQ2.2 and DQA1*0505/DQB1*0301 (DQ7 that attribute to the risk of DQ2.5 to CD. To evaluate the predictive power of this approach, we performed an empirical comparison of the predicted DQ types, based on these six tag SNPs, with those executed with current validated laboratory typing methods of the HLA-DQA1 and -DQB1 genes in three large cohorts. The results were validated in three European celiac populations. CONCLUSION: Using this method, only six SNPs were needed to predict the risk types carried by >95% of CD patients. We determined that for this tagging approach the sensitivity was >0.991, specificity >0.996 and the predictive value >0.948. Our results show that this tag SNP method is very accurate and provides an excellent basis for population screening for CD. This method is broadly applicable in European populations.

  9. Performance and risk assessment of subsurface barriers for single-shell tank waste retrieval

    Energy Technology Data Exchange (ETDEWEB)

    Bazinet, G.D.; Cruse, J.M.; Hampsten, K.L. [Westinghouse Hanford Co., Richland, WA (United States); Treat, R.L.

    1995-02-01

    Subsurface barriers are among various alternatives under evaluation to mitigate the threat of leakage from the Hanford Site`s 149 single-shell high-level radioactive waste tanks. The Tank Waste Remediation System (TWRS) division of Westinghouse Hanford Company is conducting this evaluation of subsurface barriers and other alternatives, focusing on risk and cost as performance measures. A number of alternative retrieval/closure approaches were evaluated in terms of risks (carcinogenic and toxicological) to a postulated maximally exposed individual. In addition, worker and accident risks were evaluated and factors developed for each alternative on a relative basis. The work performed to date indicates the use of subsurface barriers may potentially reduce public risk by limiting contamination of groundwater below the Hanford Site; however, the cost in terms of actual funding and in elevated worker risk is significant. The analyses also assume certain performance levels for technologies that have not been demonstrated in field conditions similar to Hanford Site tank farms. The evaluations summarized herein are being used to support a decision by representatives of the US Department of Energy, Richland Operations Office, the Washington State Department of Ecology (Ecology), and the US Environmental Protection Agency (EPA) regarding potential further development of subsurface barrier technology.

  10. Performance and risk assessment of subsurface barriers for single-shell tank waste retrieval

    International Nuclear Information System (INIS)

    Bazinet, G.D.; Cruse, J.M.; Hampsten, K.L.; Treat, R.L.

    1995-02-01

    Subsurface barriers are among various alternatives under evaluation to mitigate the threat of leakage from the Hanford Site's 149 single-shell high-level radioactive waste tanks. The Tank Waste Remediation System (TWRS) division of Westinghouse Hanford Company is conducting this evaluation of subsurface barriers and other alternatives, focusing on risk and cost as performance measures. A number of alternative retrieval/closure approaches were evaluated in terms of risks (carcinogenic and toxicological) to a postulated maximally exposed individual. In addition, worker and accident risks were evaluated and factors developed for each alternative on a relative basis. The work performed to date indicates the use of subsurface barriers may potentially reduce public risk by limiting contamination of groundwater below the Hanford Site; however, the cost in terms of actual funding and in elevated worker risk is significant. The analyses also assume certain performance levels for technologies that have not been demonstrated in field conditions similar to Hanford Site tank farms. The evaluations summarized herein are being used to support a decision by representatives of the US Department of Energy, Richland Operations Office, the Washington State Department of Ecology (Ecology), and the US Environmental Protection Agency (EPA) regarding potential further development of subsurface barrier technology

  11. The MCRA model for probabilistic single-compound and cumulative risk assessment of pesticides.

    Science.gov (United States)

    van der Voet, Hilko; de Boer, Waldo J; Kruisselbrink, Johannes W; Goedhart, Paul W; van der Heijden, Gerie W A M; Kennedy, Marc C; Boon, Polly E; van Klaveren, Jacob D

    2015-05-01

    Pesticide risk assessment is hampered by worst-case assumptions leading to overly pessimistic assessments. On the other hand, cumulative health effects of similar pesticides are often not taken into account. This paper describes models and a web-based software system developed in the European research project ACROPOLIS. The models are appropriate for both acute and chronic exposure assessments of single compounds and of multiple compounds in cumulative assessment groups. The software system MCRA (Monte Carlo Risk Assessment) is available for stakeholders in pesticide risk assessment at mcra.rivm.nl. We describe the MCRA implementation of the methods as advised in the 2012 EFSA Guidance on probabilistic modelling, as well as more refined methods developed in the ACROPOLIS project. The emphasis is on cumulative assessments. Two approaches, sample-based and compound-based, are contrasted. It is shown that additional data on agricultural use of pesticides may give more realistic risk assessments. Examples are given of model and software validation of acute and chronic assessments, using both simulated data and comparisons against the previous release of MCRA and against the standard software DEEM-FCID used by the Environmental Protection Agency in the USA. It is shown that the EFSA Guidance pessimistic model may not always give an appropriate modelling of exposure. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  12. Opportunities for biodiversity gains under the world's largest reforestation programme.

    Science.gov (United States)

    Hua, Fangyuan; Wang, Xiaoyang; Zheng, Xinlei; Fisher, Brendan; Wang, Lin; Zhu, Jianguo; Tang, Ya; Yu, Douglas W; Wilcove, David S

    2016-09-06

    Reforestation is a critical means of addressing the environmental and social problems of deforestation. China's Grain-for-Green Program (GFGP) is the world's largest reforestation scheme. Here we provide the first nationwide assessment of the tree composition of GFGP forests and the first combined ecological and economic study aimed at understanding GFGP's biodiversity implications. Across China, GFGP forests are overwhelmingly monocultures or compositionally simple mixed forests. Focusing on birds and bees in Sichuan Province, we find that GFGP reforestation results in modest gains (via mixed forest) and losses (via monocultures) of bird diversity, along with major losses of bee diversity. Moreover, all current modes of GFGP reforestation fall short of restoring biodiversity to levels approximating native forests. However, even within existing modes of reforestation, GFGP can achieve greater biodiversity gains by promoting mixed forests over monocultures; doing so is unlikely to entail major opportunity costs or pose unforeseen economic risks to households.

  13. First Light for World's Largest 'Thermometer Camera'

    Science.gov (United States)

    2007-08-01

    LABOCA in Service at APEX The world's largest bolometer camera for submillimetre astronomy is now in service at the 12-m APEX telescope, located on the 5100m high Chajnantor plateau in the Chilean Andes. LABOCA was specifically designed for the study of extremely cold astronomical objects and, with its large field of view and very high sensitivity, will open new vistas in our knowledge of how stars form and how the first galaxies emerged from the Big Bang. ESO PR Photo 35a/07 ESO PR Photo 35a/07 LABOCA on APEX "A large fraction of all the gas in the Universe has extremely cold temperatures of around minus 250 degrees Celsius, a mere 20 degrees above absolute zero," says Karl Menten, director at the Max Planck Institute for Radioastronomy (MPIfR) in Bonn, Germany, that built LABOCA. "Studying these cold clouds requires looking at the light they radiate in the submillimetre range, with very sophisticated detectors." Astronomers use bolometers for this task, which are, in essence, thermometers. They detect incoming radiation by registering the resulting rise in temperature. More specifically, a bolometer detector consists of an extremely thin foil that absorbs the incoming light. Any change of the radiation's intensity results in a slight change in temperature of the foil, which can then be registered by sensitive electronic thermometers. To be able to measure such minute temperature fluctuations requires the bolometers to be cooled down to less than 0.3 degrees above absolute zero, that is below minus 272.85 degrees Celsius. "Cooling to such low temperatures requires using liquid helium, which is no simple feat for an observatory located at 5100m altitude," says Carlos De Breuck, the APEX instrument scientist at ESO. Nor is it simple to measure the weak temperature radiation of astronomical objects. Millimetre and submillimetre radiation opens a window into the enigmatic cold Universe, but the signals from space are heavily absorbed by water vapour in the Earth

  14. Patients with single ventricle physiology undergoing noncardiac surgery are at high risk for adverse events.

    Science.gov (United States)

    Brown, Morgan L; DiNardo, James A; Odegard, Kirsten C

    2015-08-01

    Patients with single ventricle physiology are at increased anesthetic risk when undergoing noncardiac surgery. To review the outcomes of anesthetics for patients with single ventricle physiology undergoing noncardiac surgery. This study is a retrospective chart review of all patients who underwent a palliative procedure for single ventricle physiology between January 1, 2007 and January 31, 2014. Anesthetic and surgical records were reviewed for noncardiac operations that required sedation or general anesthesia. Any noncardiac operation occurring prior to completion of a bidirectional Glenn procedure was included. Diagnostic procedures, including cardiac catheterization, insertion of permanent pacemaker, and procedures performed in the ICU, were excluded. During the review period, 417 patients with single ventricle physiology had initial palliation. Of these, 70 patients (16.7%) underwent 102 anesthetics for 121 noncardiac procedures. The noncardiac procedures included line insertion (n = 23); minor surgical procedures such as percutaneous endoscopic gastrostomy or airway surgery (n = 38); or major surgical procedures including intra-abdominal and thoracic operations (n = 41). These interventions occurred on median day 60 of life (1-233 days). The procedures occurred most commonly in the operating room (n = 79, 77.5%). Patients' median weight was 3.4 kg (2.4-15 kg) at time of noncardiac intervention. In 102 anesthetics, 26 patients had an endotracheal tube or tracheostomy in situ, 57 patients underwent endotracheal intubation, and 19 patients had a natural or mask airway. An intravenous induction was performed in 77 anesthetics, an inhalational induction in 17, and a combination technique in 8. The median total anesthetic time was 126 min (14-594 min). In 22 anesthetics (21.6%), patients were on inotropic support upon arrival; an additional 24 patients required inotropic support (23.5%), of which dopamine was the most common medication. There were 10

  15. Single ABCA3 Mutations Increase Risk for Neonatal Respiratory Distress Syndrome

    Science.gov (United States)

    Wegner, Daniel J.; DePass, Kelcey; Heins, Hillary; Druley, Todd E.; Mitra, Robi D.; An, Ping; Zhang, Qunyuan; Nogee, Lawrence M.; Cole, F. Sessions; Hamvas, Aaron

    2012-01-01

    BACKGROUND AND OBJECTIVE: Neonatal respiratory distress syndrome (RDS) due to pulmonary surfactant deficiency is heritable, but common variants do not fully explain disease heritability. METHODS: Using next-generation, pooled sequencing of race-stratified DNA samples from infants ≥34 weeks’ gestation with and without RDS (n = 513) and from a Missouri population-based cohort (n = 1066), we scanned all exons of 5 surfactant-associated genes and used in silico algorithms to identify functional mutations. We validated each mutation with an independent genotyping platform and compared race-stratified, collapsed frequencies of rare mutations by gene to investigate disease associations and estimate attributable risk. RESULTS: Single ABCA3 mutations were overrepresented among European-descent RDS infants (14.3% of RDS vs 3.7% of non-RDS; P = .002) but were not statistically overrepresented among African-descent RDS infants (4.5% of RDS vs 1.5% of non-RDS; P = .23). In the Missouri population-based cohort, 3.6% of European-descent and 1.5% of African-descent infants carried a single ABCA3 mutation. We found no mutations among the RDS infants and no evidence of contribution to population-based disease burden for SFTPC, CHPT1, LPCAT1, or PCYT1B. CONCLUSIONS: In contrast to lethal neonatal RDS resulting from homozygous or compound heterozygous ABCA3 mutations, single ABCA3 mutations are overrepresented among European-descent infants ≥34 weeks’ gestation with RDS and account for ∼10.9% of the attributable risk among term and late preterm infants. Although ABCA3 mutations are individually rare, they are collectively common among European- and African-descent individuals in the general population. PMID:23166334

  16. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

    Directory of Open Access Journals (Sweden)

    Deborah M. Whitley

    2015-01-01

    Full Text Available Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis. Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents’ physical and emotional capacities.

  17. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

    Science.gov (United States)

    Whitley, Deborah M.

    2015-01-01

    Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents' physical and emotional capacities. PMID:26448744

  18. Single-nucleotide polymorphisms of microRNA processing machinery genes and risk of colorectal cancer

    Directory of Open Access Journals (Sweden)

    Zhao Y

    2015-02-01

    Full Text Available Yufei Zhao, Yanming Du, Shengnan Zhao, Zhanjun GuoDepartment of Gastroenterology and Hepatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of ChinaObjective: MicroRNA (miRNA-related single-nucleotide polymorphisms (miR-SNPs in miRNA processing machinery genes can affect cancer risk, treatment efficacy, and patient prognosis. We genotyped 6 miR-SNPs of miRNA processing machinery genes including XPO5 (rs11077, RAN (rs14035, Dicer (rs3742330, TNRC6B (rs9623117, GEMIN3 (rs197412, and GEMIN4 (rs2740348 in a case-control study to evaluate their impact on colorectal cancer (CRC risk.Materials and methods: miR-SNPs were genotyped using the polymerase chain reaction–ligase detection reaction. The Χ2 test was used to analyze dichotomous values, such as the presence or absence of any individual SNP in CRC patients and healthy controls.Results: Two of these SNPs were identified for their association with cancer risk in the Dicer and GEMIN3 genes. The AA allele of rs3742330 located in the Dicer gene exhibited a significantly increased risk of CRC (odds ratio, 2.11; 95% confidence interval: 1.33–3.34; P=0.001; the TT allele of rs197412 located in GEMIN3 also exhibited a significantly increased risk of CRC (odds ratio, 1.68; 95% confidence interval: 1.07–2.65; P=0.024.Conclusion: Our results suggest that the specific genetic variants in miRNA machinery genes may affect CRC susceptibility.Keywords: miR-SNP, CRC, GEMIN3, Dicer

  19. Single nucleotide polymorphisms in ZNF208 are associated with increased risk for HBV in Chinese people.

    Science.gov (United States)

    Li, Hengxin; Chen, Jun; Zhang, RuiZhi; Xu, Ran; Zhang, Zhe; Ren, Le; Yang, Qi; Tian, Yumei; Li, Daxu

    2017-12-22

    Single nucleotide polymorphisms (SNPs) in ZNF208 may be associated with susceptibility to Hepatitis B virus (HBV). In the current study, we analyzed the association between ZNF208 SNPs and risk of HBV in 242 HBV patients and 300 healthy subjects from the Xi'an area of Chinese Han Population. Of the five SNPs examined, rs2188971 (OR: 1.36, 95% CI: 1.04-1.76, P = 0.022), rs8103163 (OR: 1.40, 95% CI: 1.08-1.82, P = 0.010) and rs7248488 (OR: 1.38, 95% CI: 1.07-1.79, P = 0.014) were correlated with HBV susceptibility based on Chi-square tests. After the P -values were adjusted by Bonferroni correction, there only rs8103163 ( P = 0.050) was slightly with increased HBV risk. Additionally, haplotype A rs2188972 T rs2188971 A rs8103163 A rs7248488 (OR = 1.42; 95% C I, 1.10-1.85; P = 0.008) was found to increase susceptibility of suffering from HBV. These findings suggest that ZNF208 polymorphisms may contribute to the development of HBV.

  20. Risk Factors for Cryptococcal Meningitis: A Single United States Center Experience.

    Science.gov (United States)

    Henao-Martínez, Andrés F; Gross, Lilyana; Mcnair, Bryan; McCollister, Bruce; DeSanto, Kristen; Montoya, Jose G; Shapiro, Leland; Beckham, J David

    2016-12-01

    Cryptococcal meningitis carries a high mortality. Further understanding of immune suppression factors associated with neuroinvasive infection will improve risk stratification and enhance early diagnosis and treatment with antifungal therapy. The aim of the study was to corroborate established or find novel clinical predictors for cryptococcal meningitis. We performed a matched case-control study of Cryptococcus infection in immunocompromised patients with or without cryptococcal meningitis. Data of all patients with a diagnosis of cryptococcal disease were collected at University of Colorado Hospital between 2000 and 2015 (n = 51). Thirty patients were diagnosed with cryptococcal meningitis. We built a logistic regression model for risk factors associated with cryptococcal meningitis. The single-predictor univariate model found that a positive blood culture, positive serum cryptococcal antigen, current malignancy, and headaches were significantly associated with cryptococcal meningitis (p = 0.02). In the adjusted multivariate model, central nervous system disease was significantly associated with a diagnosis of HIV infection (OR 24.45, 95 % CI 1.62-350.37; p = 0.022) and a positive serum cryptococcal antigen test (OR 42.92, 95 % CI 3.26-555.55; p = 0.0055). In patients with HIV infection or a positive serum cryptococcal antigen, the pretest probability of neuroinvasive Cryptococcus infection is increased and an aggressive diagnostic evaluation should be conducted to exclude infection and consider empiric therapy.

  1. RISK FACTORS FOR CRYPTOCOCCAL MENINGITIS — A SINGLE UNITED STATES CENTER EXPERIENCE

    Science.gov (United States)

    Henao-Martínez, Andrés F.; Gross, Lilyana; Mcnair, Bryan; McCollister, Bruce; DeSanto, Kristen; Montoya, Jose G.; Shapiro, Leland; Beckham, J. David

    2016-01-01

    Cryptococcal meningitis carries a high mortality. Further understanding of immune suppression factors associated with neuroinvasive infection will improve risk stratification and enhance early diagnosis and treatment with antifungal therapy. The aim of the study was to corroborate established or find novel clinical predictors for cryptococcal meningitis. We performed a matched case-control study of Cryptococcus infection in immunocompromised patients with or without cryptococcal meningitis. All patients with a diagnosis of cryptococcal disease were collected at University of Colorado Hospital between 2000 and 2015 (n=51). Thirty patients were diagnosed with cryptococcal meningitis. We built a logistic regression model for risk factors associated with cryptococcal meningitis. The single predictor univariate model found that a positive blood culture, positive serum cryptococcal antigen, current malignancy, and headaches were significantly associated with cryptococcal meningitis (p= 0.02). In the adjusted multivariate model, central nervous system disease was significantly associated with a diagnosis of HIV infection (OR: 24.45, 95% CI: 1.62 – 350.37; p=0.022) and a positive serum cryptococcal antigen test (OR: 42.92, 95% CI: 3.26 – 555.55; p=0.0055). In patients with HIV infection or a positive serum cryptococcal antigen, the pre-test probability of neuroinvasive Cryptococcus infection is increased and an aggressive diagnostic evaluation should be conducted to exclude infection and consider empiric therapy. PMID:27502502

  2. The incidence and risk factors for retained placenta after vaginal delivery - a single center experience.

    Science.gov (United States)

    Ashwal, Eran; Melamed, Nir; Hiersch, Liran; Wiznitzer, Arnon; Yogev, Yariv; Peled, Yoav

    2014-12-01

    We aimed to determine the incidence and risk factors for retained placenta immediately after vaginal delivery in a single, university-affiliated tertiary center. A case-control study. Women who delivered vaginally and diagnosed with suspected retained placenta were compared to control group of women with spontaneous vaginal delivery with spontaneous non-complicated placental separation between the years 2007 and 2012. Eligibility was limited to singleton fetuses in vertex presentation with no history of more than one cesarean section, stillbirth or major fetal anomaly. Overall, 33,925 women delivered vaginally, of them, 491 (1.4%) underwent revision of uterine cavity due to suspected retained placenta. Women with retained placenta were characterized by a higher rate of previous cesarean section (OR 1.71, 95% CI 1.23-2.36), previous abortions, lower parity (OR 0.79, 95% CI 0.68-0.91), lower gestational age at delivery. Hypertensive disorders, oligohydramnios and labor and delivery interventions as induction of labor (OR 1.84, 95% CI 1.30-2.59), neuro-axial analgesia (OR 1.60, 95% CI 1.27-2.00) and vacuum delivery (OR 1.89, 95% CI 1.48-2.41) were independently associated with uterine revision for retained placenta. Risk factors for manual revision due to retained placenta can be recognized. This data should be taken into consideration in the assessment of women immediately after delivery.

  3. Isolated single umbilical artery poses neonates at increased risk of long-term respiratory morbidity.

    Science.gov (United States)

    Beharier, Ofer; Sheiner, Eyal; Sergienko, Ruslan; Landau, Daniela; Szaingurten-Solodkin, Irit; Walfisch, Asnat

    2017-12-01

    To investigate whether children born with isolated single umbilical artery (iSUA) at term are at an increased risk for long-term pediatric hospitalizations due to respiratory morbidity. Design: a population-based cohort study compared the incidence of long-term, pediatric hospitalizations due to respiratory morbidity in children born with and without iSUA at term. Soroka University Medical Center. all singleton pregnancies of women who delivered between 1991 and 2013. hospitalization due to respiratory morbidity. Kaplan-Meier survival curves were used to estimate cumulative incidence of respiratory morbidity. A Cox hazards model analysis was used to establish an independent association between iSUA and pediatric respiratory morbidity of the offspring while controlling for clinically relevant confounders. The study included 232,281 deliveries. 0.3% were of newborns with iSUA (n = 766). Newborns with iSUA had a significantly higher rate of long-term respiratory morbidity compared to newborns without iSUA (7.6 vs 5.5%, p = 0.01). Using a Kaplan-Meier survival curve, newborns with iSUA had a significantly higher cumulative incidence of respiratory hospitalizations (log rank = 0.006). In the Cox model, while controlling for the maternal age, gestational age, and birthweight, iSUA at term was found to be an independent risk factor for long-term respiratory morbidity (adjusted HR = 1.39, 95% CI 1.08-1.81; p = 0.012). Newborns with iSUA are at an increased risk for long-term respiratory morbidity.

  4. Correlation of matrix metalloproteinase-2 single nucleotide polymorphisms with the risk of small vessel disease (SVD).

    Science.gov (United States)

    Zhang, Min; Zhu, Wusheng; Yun, Wenwei; Wang, Qizhang; Cheng, Maogang; Zhang, Zhizhong; Liu, Xinfeng; Zhou, Xianju; Xu, Gelin

    2015-09-15

    Maladjustment of matrix metalloproteinases (MMPs) results in cerebral vasculature and blood-brain barrier dysfunction, which is associated with small vessel disease (SVD). This study was to aim at evaluating correlations between matrix metalloproteinase-2 and 9 single nucleotide polymorphisms and the risk of SVD. A total of 178 patients with SVD were enrolled into this study via Nanjing Stroke Registry Program (NSRP) from January 2010 to November 2011. SVD patients were further subtyped as isolated lacunar infarction (ILI, absent or with mild leukoaraiosis) and ischemic leukoaraiosis (ILA, with moderate or severe leukoaraiosis) according to the Fazekas scale. 100 age- and gender-matched individuals from outpatient medical examination were recruited as the control group. The genotypes of MMP-2-1306 T/C and MMP-9-1562 C/T were determined by the TaqMan method. Of 178 SVD patients, 86 and 92 patients were classified as ILI and ILA, respectively. Comparison analysis between SVD patients and controls revealed a significant correlation between SVD and hypertension, as well as a prevalence of hypertension in ILA. Further genotype analysis showed that the frequency of MMP-2-1306 CC genotype was higher in ILA patients than in controls (P=0.009, χ(2) test; P=0.027, the multiple test with Bonferroni correction). Finally, logistic regression analysis with adjustment of age, sex and vascular risk factors showed that the MMP-2-1306 T/C polymorphism was an independent predictor for ILA (OR: 2.605; 95% confidence interval [CI], 1.067-6.364; P=0.036). Our findings suggest that the MMP-2-1306 T/C polymorphism is a direct risk factor for ILA. Copyright © 2015. Published by Elsevier B.V.

  5. A single hospital study on portal vein thrombosis in cirrhotic patients - clinical characteristics & risk factors

    Directory of Open Access Journals (Sweden)

    Huisong Chen

    2014-01-01

    Full Text Available Background & objectives: Discrepancies exist in the reported prevalence of portal vein thrombosis (PVT, and its clinical characteristics and sites of occurrence need to be elucidated. The risk factors for PVT are also poorly understood. This single centre study was undertaken to determine the clinical characteristics, sites of occurrence, and risk factors associated with PVT in patients with liver cirrhosis. Methods: Hospitalized cirrhotic patients (N = 162 were segregated into the PVT and non-PVT groups. Indices possibly associated with PVT were measured and PVT was detected by both Doppler ultrasonography and computed tomography portal angiography. The portal vein diameter and flow velocity and splenic thickness were measured by ultrasonography. Results: PVT was found in 40 patients (24.7%; in 34 PVT patients (85%, the liver cirrhosis resulted from hepatitis B virus infections. Most (90% patients were Child-Pugh classes B and C, with similar distribution between the groups. PVT was seen in 20 patients in the portal and superior mesenteric veins; ascites, abdominal pain, gastrointestinal bleeding, and jaundice were common findings in PVT patients. Haemoglobin levels and blood platelet counts (BPCs were significantly lower and splenic thickness was greater in PVT than in non-PVT patients (P<0.01. There was a significant positive correlation between BPCs and platelet aggregation rates (R = 0.533, P<0.01. Interpretation & conclusions: The occurrence of PVT was 24.7 per cent, primarily in post-hepatitis B liver cirrhosis patients. PVT occurred mainly in the portal vein trunk and superior mesenteric vein. Different PVT sites may account for the differing clinical presentations. The lower levels of haemoglobin and BPCs as well as splenic thickening were associated with PVT. Splenic thickening may be a risk factor for PVT.

  6. Risk of ectopic pregnancy lowest with transfer of single frozen blastocyst.

    Science.gov (United States)

    Li, Z; Sullivan, E A; Chapman, M; Farquhar, C; Wang, Y A

    2015-09-01

    What type of transferred embryo is associated with a lower rate of ectopic pregnancy? The lowest risk of ectopic pregnancy was associated with the transfer of blastocyst, frozen and single embryo compared with cleavage stage, fresh and multiple embryos. Ectopic pregnancy is a recognized complication following assisted reproductive technology (ART) treatment. It has been estimated that the rate of ectopic pregnancy is doubled in pregnancies following ART treatment compared with spontaneous pregnancies. However, it was not clear whether the excess rate of ectopic pregnancy following ART treatment is related to the underlying demographic factors of women undergoing ART treatment, the number of embryos transferred or the developmental stage of the embryo. A population-based cohort study of pregnancies following autologous treatment cycles between January 2009 and December 2011 were obtained from the Australian and New Zealand Assisted Reproduction Technology Database (ANZARD). The ANZARD collects ART treatment information and clinical outcomes annually from all fertility centres in Australia and New Zealand. Between 2009 and 2011, a total of 44 102 pregnancies were included in the analysis. The rate of ectopic pregnancy was compared by demographic and ART treatment factors. Generalized linear regression of Poisson distribution was used to estimate the likelihood of ectopic pregnancy. Odds ratios, adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. The overall rate of ectopic pregnancy was 1.4% for women following ART treatment in Australia and New Zealand. Pregnancies following single embryo transfers had 1.2% ectopic pregnancies, significantly lower than double embryo transfers (1.8%) (P ectopic pregnancy rate was 1.9% for pregnancies from transfers of fresh cleavage embryo, followed by transfers of frozen cleavage embryo (1.7%), transfers of fresh blastocyst (1.3%), and transfers of frozen blastocyst (0.8%). Compared with fresh blastocyst

  7. Neuro-developmental outcome in single-ventricle patients: is the Norwood procedure a risk factor?

    Science.gov (United States)

    Rotermann, Ina; Logoteta, Jana; Falta, Janine; Wegner, Philip; Jung, Olaf; Dütschke, Peter; Scheewe, Jens; Kramer, Hans-Heiner; Hansen, Jan Hinnerk

    2017-09-01

    Complex neonatal surgery is considered a risk factor for neuro-developmental impairment in single-ventricle patients. Neuro-developmental outcome was compared between preschool-aged Fontan patients who underwent a Norwood procedure and single-ventricle patients not requiring neonatal surgery with cardiopulmonary bypass. Verbal, performance and full-scale intelligence quotient (IQ) were evaluated with the Wechsler Preschool and Primary Scale of Intelligence. Cognitive functions were assessed with the German 'Kognitiver Entwicklungstest für das Kindergartenalter' (KET-KID). Risk factors for impaired neuro-development were evaluated. Neuro-developmental assessment was completed in 95 patients (Norwood: n = 69; non-Norwood: n = 26). Median (interquartile range) IQ and KET-KID scores were in the normal range. Except for verbal KET-KID, scores did not differ between Norwood and non-Norwood patients (verbal IQ: 98 (86-105) vs 93 (85-102), P = 0.312; performance IQ: 91 (86-100) vs 96 (86-100), P = 0.932; full-scale IQ: 93 (86-101) vs 89 (84-98), P = 0.314; KET-KID verbal: 48 (17-72) vs 25 (2-54), P = 0.020; KET-KID non-verbal: 33 (18-62) vs 45 (15-54), P = 0.771; KET-KID global: 42 (14-65) vs 28 (6-63), P = 0.208). Full-scale IQ was below average (<85 points) in 14 (20%) Norwood and 9 (35%) non-Norwood cases (P = 0.181). Global KET-KID was below average (<16th percentile) in 19 (28%) and 10 (38%) patients (P = 0.326). Smaller head circumference z-score and complications before neonatal surgery were independently associated with lower scores. Neuro-developmental outcome of preschool-aged Fontan patients was in the normal range. The Norwood procedure was not a risk factor for neuro-developmental impairment. Preoperative condition and patient-related factors were more important determinants than variables related to surgical palliation. © The Author 2017. Published by Oxford University Press on behalf of the European Association for

  8. Single nucleotide polymorphisms of cathepsin S and the risks of asthma attack induced by acaroid mites.

    Science.gov (United States)

    Li, Chaopin; Chen, Qi; Jiang, Yuxin; Liu, Zhiming

    2015-01-01

    To investigate association between the three single nucleotide polymorphisms (SNPs, rs146456111, rs143154304 and rs147260142) in cathepsin S (Cat S) and the risks of allergic asthma attack induced by the acaroid mites in the Chinese population. A case-control study was performed in 412 cases and 454 volunteers/controls to evaluate the effects of three SNPs in Cat S on the risks of asthma attack. The genotypes were determined using polymerase chain reaction (PCR) and cleaved amplification polymorphism sequence-tagged sites (PCR-RFLP). The frequencies of genotypes and alleles in these SNPs in the asthmatic group were also analyzed between the two groups. The locus of rs146456111 in Cat S gene, the allele frequency of A and C in asthmatic group were significantly different from the control group (χ(2) = 184.425, P = 0.000), and the difference was significant regarding the distribution of the genotypes (AA, AC, and CC) between asthmatic subjects and normal controls (χ(2) = 177.915, P = 0.000). Logistic regression analysis revealed that the AC, CC, and AC + CC genotypes were significantly increased with the risk of asthma (AC vs. AA, OR = 4.013, 95% CI = 2.989-4.751, P = 0.000; CC vs. AA, OR = 3.167, 95% CI = 2.483-3.785, P = 0.000; AC + CC vs. AA, OR = 3.418, 95% CI = 2.381-4.214, P = 0.000, respectively), compared with AA genotype. Moreover, by comparison with allele A, allele C (OR = 2.187, 95% CI = 1.743-2.281, P asthma; For the locus of rs143154304, compared with the allele frequency G with A in control group, there was no difference (χ(2) = 1.434, P = 0.231) in that of asthmatic group, as well as the distributions of the genotypes (AA, AG, and GG) between asthmatic subjects and normal controls (χ(2) = 1.997, P = 0.369); Logistic regression analysis showed that the AG, GG, and AG + GG genotypes were no risk to asthma (AG vs. AA, OR = 0.991, 95% CI = 0.625-1.507, P = 0.968; GG vs. AA, OR = 0.812, 95% CI = 0.525-1.258, P = 0.352; AG + GG vs. AA, OR = 0.914, 95

  9. Oceans of Opportunity. Harnessing Europe's largest domestic energy resource

    International Nuclear Information System (INIS)

    Fichaux, N.; Wilkes, J.

    2009-09-01

    Europe's offshore wind potential is enormous and able to power Europe seven times over. Over 100 GW of offshore wind projects are already in various stages of planning. If realised, these projects would produce 10% of the EU's electricity whilst avoiding 200 million tonnes of CO2 emissions each year. EWEA has a target of 40 GW of offshore wind in the EU by 2020, implying an average annual market growth of 28% over the coming 12 years. The EU market for onshore wind grew by an average 32% per year in the 12-year period from 1992-2004 - what the wind energy industry has achieved on land can be repeated at sea. EWEA's proposed offshore grid builds on the 11 offshore grids currently operating and 21 offshore grids currently being considered by the grid operators in the Baltic and North Seas to give Europe a truly pan-European electricity super highway. Strong political support and action from Europe's policy-makers will allow a new, multi-billion euro industry to be built. This new industry will deliver thousands of green collar jobs and a new renewable energy economy and establish Europe as world leader in offshore wind power technology. A single European electricity market with large amounts of wind power will bring affordable electricity to consumers, reduce import dependence, cut CO2 emissions and allow Europe to access its largest domestic energy source.

  10. Male gender is not a risk factor for the outcome of laparoscopiccholecystectomy: A single surgeon experience

    International Nuclear Information System (INIS)

    Al-Mulhim, Abdulmohsen A.

    2008-01-01

    Previous studies regarding the outcome of laparoscopic cholecystectomy(LC) in men have reported inconsistent findings. We conducted thisprospective study to test the hypothesis that the outcome of LC is worse inmen than women. Between 1997 and 2002, a total of 391 consecutive LCs wereperformed by a single surgeon at King Fahd Hospital of the University. Wecollected and analyzed data including age, gender, body mass index (kg/m2),the American Society of Anesthesiologists (ASA) class, mode of admission(elective or emergency), indication for LC (chronic or acute) cholecystitis[AC]), comorbid disease, previous abdominal surgery, conversion to opencholecystectomy, complications, operation time and length of postoperativehospital stay. Bivariate analysis showed that both genders were matched forage, ASA class and mode of admission. The incidence of AC (P=0.003) andcomobrid disease (P=0.031) were significantly higher in men. Women weresignificantly more obese than men (P<0.001) and had a higher incidence ofprevious abdominal surgery (P=0.017). There were no statistical differencesbetween genders with regards to rate of conversion (P=0.372) andcomplications (P=0.647) and operation time (P=0.063). The postoperative staywas significantly longer in men than women (P=0.001). Logistic regressionanalysis showed that male gender was not an independent predictor ofconversion (Odds ratio [or] = 0.37 and P=0.43) or complications (OR=0.42,P=0.42). Linear regression analysis showed that male gender was not anindependent predictor of the operation time, but was associated with a longerpostoperative stay (P=0.02). Male gender is not an independent risk factorfor satisfactory outcome of LC in the experience of a single surgeon. (author)

  11. Single nucleotide polymorphisms of Toll-like receptor 4 decrease the risk of development of hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Shi Minmin

    Full Text Available BACKGROUND: Toll-like receptor 4 (TLR4 is a key innate immunity receptor that initiates an inflammatory response. Growing evidence suggests that mutation of TLR4 gene may play a role in the development of cancers. This study aimed to investigate the temporal relationship of single nucleotide polymorphisms of TLR4 and the risk of hepatocellular carcinoma, a single center-based case-control study was conducted. METHODS: A systematic genetic analysis of sequence variants of TLR4 by evaluating ten single-nucleotide polymorphisms was performed from 216 hepatocellular carcinoma cases and 228 controls. RESULTS: Six single nucleotide polymorphisms of the TLR4 in the 5'-untranslated region and intron were associated with risk of hepatocellular carcinoma. Individuals carrying the heterozygous genotypes for the rs10759930, rs2737190, rs10116253, rs1927914, rs12377632 and rs1927911 had significantly decreased risk of hepatocellular carcinoma (adjusted odds ratio [OR], from 0.527 to 0.578, P<0.01 comparing with those carrying wild-type homozygous genotypes. In haplotype analysis, one haplotype (GCCCTTAG of TLR4 was associated significantly with decrease of the occurrence of hepatocellular carcinoma (OR, 0.556, 95% confidence interval [CI], 0.407-0.758, P = 0.000. CONCLUSIONS: Collectively, these results suggested that the risk of hepatocellular carcinoma was associated with TLR4 sequence variation. TLR4 single nucleotide polymorphisms may play an important protective role in the development of hepatocellular carcinoma.

  12. Single nucleotide polymorphism barcoding to evaluate oral cancer risk using odds ratio-based genetic algorithms

    Directory of Open Access Journals (Sweden)

    Cheng-Hong Yang

    2012-07-01

    Full Text Available Cancers often involve the synergistic effects of gene–gene interactions, but identifying these interactions remains challenging. Here, we present an odds ratio-based genetic algorithm (OR-GA that is able to solve the problems associated with the simultaneous analysis of multiple independent single nucleotide polymorphisms (SNPs that are associated with oral cancer. The SNP interactions between four SNPs—namely rs1799782, rs2040639, rs861539, rs2075685, and belonging to four genes (XRCC1, XRCC2, XRCC3, and XRCC4—were tested in this study, respectively. The GA decomposes the SNPs sets into different SNP combinations with their corresponding genotypes (called SNP barcodes. The GA can effectively identify a specific SNP barcode that has an optimized fitness value and uses this to calculate the difference between the case and control groups. The SNP barcodes with a low fitness value are naturally removed from the population. Using two to four SNPs, the best SNP barcodes with maximum differences in occurrence between the case and control groups were generated by GA algorithm. Subsequently, the OR provides a quantitative measure of the multiple SNP synergies between the oral cancer and control groups by calculating the risk related to the best SNP barcodes and others. When these were compared to their corresponding non-SNP barcodes, the estimated ORs for oral cancer were found to be great than 1 [approx. 1.72–2.23; confidence intervals (CIs: 0.94–5.30, p < 0.03–0.07] for various specific SNP barcodes with two to four SNPs. In conclusion, the proposed OR-GA method successfully generates SNP barcodes, which allow oral cancer risk to be evaluated and in the process the OR-GA method identifies possible SNP–SNP interactions.

  13. Single-leg balance and core motor control in children: when does the risk for ACL injury occurs?

    OpenAIRE

    Hutchinson, Allison B; Yao, Paul; Hutchinson, Mark R

    2016-01-01

    Introduction While numerous publications have demonstrated the correlation of poor single-leg balance and core motor control with an increased risk of anterior cruciate ligament (ACL) injuries in skeletally mature female athletes, few have analysed the preadolescent population regarding when indeed comparative deficits in balance and core control actually occur. The purpose of this study was to assess whether the neuromotor factors that place mature females at increased risk of ACL injury act...

  14. Negligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy

    NARCIS (Netherlands)

    Mieras, L. (Liesbeth); R. Anthony (Richard); W.H. van Brakel (Wim); Bratschi, M.W. (Martin W.); van den Broek, J. (Jacques); Cambau, E. (Emmanuelle); Cavaliero, A. (Arielle); Kasang, C. (Christa); Perera, G. (Geethal); Reichman, L. (Lee); J.H. Richardus (Jan Hendrik); P. Saunderson (Paul); Steinmann, P. (Peter); Yew, W.W. (Wing Wai)

    2016-01-01

    textabstractPost-exposure prophylaxis (PEP) for leprosy is administered as one single dose of rifampicin (SDR) to the contacts of newly diagnosed leprosy patients. SDR reduces the risk of developing leprosy among contacts by around 60 % in the first 2-3 years after receiving SDR. In countries where

  15. Air pollution and hospitalizations in the largest Brazilian metropolis.

    Science.gov (United States)

    Gouveia, Nelson; Corrallo, Flavia Prado; Leon, Antônio Carlos Ponce de; Junger, Washington; Freitas, Clarice Umbelino de

    2017-12-04

    To evaluate the impact of air pollution on hospitalizations for respiratory and cardiovascular diseases in the largest Brazilian metropolis. This study was carried out at the Metropolitan Region of São Paulo, Brazil. Environmental data were obtained from the network of monitoring stations of nine municipalities. Air pollution exposure was measured by daily means of PM10 (particles with a nominal mean aerodynamic diameter ≤ 10 μm) per municipality, while daily counts of hospitalizations for respiratory and cardiovascular diseases within the Brazilian Unified Health System were the outcome. For each municipality a time series analysis was carried out in which a semiparametric Poisson regression model was the framework to explain the daily fluctuations on counts of hospitalizations over time. The results were combined in a meta-analysis to estimate the overall risk of PM10 in hospitalizations for respiratory and cardiovascular diseases at the Metropolitan Region of São Paulo. Regarding hospitalizations for respiratory diseases, the effect estimates were statistically significant (p < 0.05) for all municipalities, except Santo André and Taboão da Serra. The RR (Relative Risk) of this outcome for an increase of 10 µg/m3 in the levels of PM10 ranged from 1.011 (95%CI 1.009-1.013) for São Paulo to 1.032 (95%CI 1.024-1.040) in São Bernardo do Campo. The RR of hospitalization for respiratory diseases in children for an increase of 10 µg/m3 of PM10 ranged from 1.009 (95%CI 1.001-1.017) in Santo André to 1.077 (95%CI 1.056-1.098) in Mauá. Only São Paulo and São Bernardo do Campo presented positive and statistically significant results for hospitalizations for cardiovascular diseases. This is the first study to estimate the risk of illness from air pollution in the set of municipalities of the Metropolitan Region of São Paulo, Brazil. Global estimates of the effect of exposure to pollution in the region indicated associations only with respiratory diseases

  16. Association of BAK1 single nucleotide polymorphism with a risk for dengue hemorrhagic fever.

    Science.gov (United States)

    Dang, Tran Ngoc; Naka, Izumi; Sa-Ngasang, Areerat; Anantapreecha, Surapee; Wichukchinda, Nuanjun; Sawanpanyalert, Pathom; Patarapotikul, Jintana; Tsuchiya, Naoyuki; Ohashi, Jun

    2016-07-11

    Dengue hemorrhagic fever (DHF) is a severe life-threatening form of dengue infection. Low platelet count is one of the characteristic clinical manifestations in patients with severe dengue. However, little is known about genetic factors in the host that cause low platelet count in patients with dengue. A previous genome-wide association study of hematological and biochemical traits identified single nucleotide polymorphisms (SNPs) associated with low platelet count in healthy subjects. To examine the possible association of these SNPs with DHF, 918 Thai patients with dengue [509 patients with DHF and 409 with dengue fever (DF)] were genotyped for five SNPs: rs5745568 in BAK1, rs6141 in THPO, rs6065 in GP1BA, rs739496 in SH2B3, and rs385893 in RCL1. In addition, rs4804803 in CD209, that has been reported to be associated with dengue infection, was also genotyped to examine if rs4804803 affects the association detected in this study. The allele frequencies of each SNP were compared between the DHF and DF groups. Among the five SNPs, the G allele of rs5745568 in BAK1 was significantly associated with a risk for DHF [P = 0.006 and crude odd ratio (95 % confidence interval) = 1.32 (1.09-1.60)]. The association of this allele with DHF was also significant in a logistic regression analysis adjusted for age, sex, hospital (i.e., geographic region), immune status (i.e., primary or secondary infection), and virus serotype [P = 0.016 and adjusted odd ratio (95 % confidence interval) = 1.29 (1.05-1.58)]. The result was not influenced by rs4804803 [P = 0.0167 and adjusted OR (95 % CI) = 1.29 (1.05-1.58)]. No other SNPs including rs4804803 showed significant association. The low-level constitutive production of platelets caused by the G allele of rs5745568 seems to increase the risk of bleeding in dengue infection. Our results suggest that BCL-2 homologous antagonist/killer (BAK) protein, encoded by BAK1, plays a crucial role in the pathogenesis of DHF.

  17. Tornado risk analysis at Savannah River Plant using windspeed damage thresholds and single building strike frequencies

    International Nuclear Information System (INIS)

    Taylor, D.H.; McDonald, J.R.; Twisdale, L.A.

    1985-01-01

    Tornado risk analysis at the Savannah River Plant has taken a two pronged approach: (1) developing a catalogue of damage thresholds as a function of windspeed for processing buildings and other representative site structures; (2) developing a method of estimating, for each building, the probability of a tornado exceeding each damage threshold. Wind resistance of building construction at SRP varies widely depending on the function of the structure. It was recognized that all tornadoes do not necessarily seriously damage buildings, but the damage thresholds were unknown. In order to evaluate the safety of existing structures and properly design new structures, an analysis of tornado resistance was conducted by J.R. McDonald on each process building at SRP and other buildings by type. Damage estimates were catalogued for each Fujita class windspeed interval and windspeeds were catalogued as a function of increased levels of damage. Tornado single point and structure specific strike probabilities for the SRP site were determined by L.A. Twisdale using the TORRISK computer code. To calculate the structure specific strike probability, a correction factor is determined from a set of curves using building area and aspect ratio (length/width relative to north) as parameters. The structure specific probability is then the product of the correction factor and the point probability. The correction factor increases as a function of building size and windspeed. For large buildings (10 5 ft 2 ) and very intense storms (250 mph), the correction factor is equal to or greater than 4. The cumulative probability of a tornado striking any building type (process, personnel, etc.) was also calculated

  18. Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised Coverage

    International Nuclear Information System (INIS)

    Roper, Justin; Chanyavanich, Vorakarn; Betzel, Gregory; Switchenko, Jeffrey; Dhabaan, Anees

    2015-01-01

    Purpose: To determine the dosimetric effects of rotational errors on target coverage using volumetric modulated arc therapy (VMAT) for multitarget stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). Both PTVs were planned for simultaneous treatment to 21 Gy using a single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5°, 1.0°, and 2.0° were simulated about all axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using multivariate analysis to determine how PTV coverage was related to PTV volume, PTV separation, and rotational error. Results: At 0.5° rotational error, D95 values and V95 coverage rates were ≥95% in all cases. For rotational errors of 1.0°, 7% of targets had D95 and V95 values <95%. Coverage worsened substantially when the rotational error increased to 2.0°: D95 and V95 values were >95% for only 63% of the targets. Multivariate analysis showed that PTV volume and distance to isocenter were strong predictors of target coverage. Conclusions: The effects of rotational errors on target coverage were studied across a broad range of SRS cases. In general, the risk of compromised coverage increased with decreasing target volume, increasing rotational error and increasing distance between targets. Multivariate regression models from this study may be used to quantify the dosimetric effects of rotational errors on target coverage given patient-specific input parameters of PTV volume and distance to isocenter.

  19. Workers' voice in the 100 largest European companies

    OpenAIRE

    Hassel, Anke; Helmerich, Nicole

    2017-01-01

    Workers' Voice is widely present among the largest 100 firms in Europe. 90 % of the largest firms participate in collective bargaining (CBA), 73 % have a European Works Council (EWC) and 44 % have Board-Level Employee Representation (BLER). 27 % have a European Company Agreement (ECA), and 23 % an International Framework Agreement (IFA). The data set allows three broad conclusions: - First, Workers' Voice is mostly cumulative. Companieswith BLER always participate in collective bargaining and...

  20. Increased health risks of children with single mothers: the impact of socio-economic and environmental factors.

    Science.gov (United States)

    Scharte, Marion; Bolte, Gabriele

    2013-06-01

    Adverse effects of single parenthood on children's health have been reported before. Socio-economic difficulties are discussed as mediating factors. As child health also depends on environmental conditions, we investigated the impact of environmental exposures and socio-economic factors on differences in health outcomes of children with single mothers vs. couple families. Data on 17,218 pre-school children (47% female) from three cross-sectional surveys conducted during 2004-07 in Germany were analysed. Health and exposure assessment were primarily based on parental report. Effects of socio-economic indicators (maternal education, household income) and environmental factors (traffic load at the place of residence, perceived environmental quality) on associations of four health outcomes (parent-reported health status, asthma, overweight, psychological problems) with single parenthood were determined by logistic regression analyses. Children with single mothers showed an increased risk regarding parent-reported poor health status [boys: odds ratio (OR) 1.39 (95% confidence interval (CI): 1.06-1.82), girls: 1.73 (1.28-2.33)], psychological problems [boys: 1.90 (1.38-2.61), girls: 1.58 (1.03-2.42)], overweight [only boys: OR 1.23 (1.01-1.50) and asthma [only girls: OR 1.90 (1.15-3.15)]. Adjusting for socio-economic factors attenuated the strength of the association of family type with child health. Although environmental factors were associated with most health outcomes investigated and children of single mothers were more often exposed, these environmental factors did not alter the differences between children with single mothers and couple families. The increased health risks of children from single-mother families vs. couple families are partly explained by socio-economic factors, but not by the environmental exposures studied.

  1. Association between maternal single nucleotide polymorphisms in genes regulating glucose metabolism and risk for neural tube defects in offspring.

    Science.gov (United States)

    Fu, Yunting; Wang, Lin-lin; Yi, Deqing; Jin, Lei; Liu, Jufen; Zhang, Yali; Ren, Aiguo

    2015-06-01

    Maternal pregestational hyperglycemia, diabetes, and obesity are well-established risk factors for neural tube defects (NTDs). As a common underlying mechanism, the imbalance of glucose homeostasis is directly related to the development of NTDs. Polymorphisms in genes regulating glucose metabolism in women may impact their chance of having an NTD-affected pregnancy. We conducted a two-stage case-control study to investigate the association between maternal genetic variants in genes regulating glucose metabolism and risk for NTDs. The cases were 547 women who gave birth to a child with an NTD (anencephaly, spina bifida, or encephalocele); the controls were 543 women who gave birth to a full-term healthy infant. In the first stage, 12 single nucleotide polymorphisms were genotyped in 160 cases and 162 controls. In the second stage, five single nucleotide polymorphisms found in the first stage and potentially associated with NTD risk were genotyped for validation, in an additional 387 cases and 381 controls. Combined analysis of data from the two stages showed an association between maternal AA genotype of GCKR rs780094 and increased risk for total NTDs [odds ratio, 1.73; 95% confidence interval, 1.16-2.59) and spina bifida subtype [odds ratio, 1.83; 95% confidence interval, 1.16-2.88). No association was found between the other four single nucleotide polymorphisms (LEPR rs1137100, HK1 rs748235, HHEX rs5015480, KCNQ1 rs2237892) and NTD risk. The AA genotype in maternal GCKR rs780094 is associated with an increased risk for NTDs and spina bifida in the Chinese population. © 2014 Wiley Periodicals, Inc.

  2. Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion: Incidence and risk factors.

    Science.gov (United States)

    Wang, Feng; Hou, Hong-Tao; Wang, Peng; Zhang, Jing-Tao; Shen, Yong

    2017-11-01

    The purpose of this study was to determine the incidence and risk factors of symptomatic adjacent segment disease (ASD) following single-lever anterior cervical discectomy and fusion (ACDF) for cervical degenerative diseases.From January 2000 to December 2010, a total of 582 patients with cervical radiculopathy and myelopathy who had undergone single-lever ACDF surgery in the authors' institution were reviewed retrospectively. Patients who had a revision surgery for symptomatic ASD were selected for this study. The authors analyzed the incidence for ASD after single-lever ACDF. And univariate analysis and logistic regression analysis were performed to identify the risk factors of ASD.Among the 582 patients, 36 patients received subsequent surgical management for ASD after initial single-lever ACDF for an overall prevalence of 6.2%. The average onset time of ASD was 8.5 (2-15) years. The univariate analysis showed that there were no significant differences in sex, duration of disease, BMI, DM, smoking, operative levels, and follow-up period (P > .05) between the 2 groups with and without ASD. There were statistically significant differences in age at the time of operation (χ = 4.361, P = .037), and developmental canal stenosis (χ = 4.181, P = .041) between patients with and without ASD. The variables of age at the time of operation and developmental canal stenosis were included in a logistic regression model. The logistic regression analysis revealed that age at the time of operation ≤50 years (P = .045, OR = 3.015, 95% CI = 1.024-8.882) and developmental canal stenosis (P = .042, OR = 2.797, 95% CI = 1.039-7.527) were the risk factors for ASD after single-lever ACDF.In the present study, the incidence of symptomatic ASD after single-lever ACDF was 6.2%. And the age at the time of operation ≤50 years and developmental canal stenosis were the risk factors for ASD. The patients ≤50 years old at the time of operation

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  4. Retrospective evaluation of pediatric inpatients admitted with thrombosis according to risk factors: single center experience

    Directory of Open Access Journals (Sweden)

    Buket Kilicaslan

    2016-06-01

    Conclusion: We conclude and strongly emphasize that lipoprotein (a elevation is one of the important genetic risk factors, which might prove a major risk indicator, as valuable as other mutation screening tests performed by molecular genetics [Cukurova Med J 2016; 41(2.000: 285-290

  5. A hybrid approach of gene sets and single genes for the prediction of survival risks with gene expression data.

    Science.gov (United States)

    Seok, Junhee; Davis, Ronald W; Xiao, Wenzhong

    2015-01-01

    Accumulated biological knowledge is often encoded as gene sets, collections of genes associated with similar biological functions or pathways. The use of gene sets in the analyses of high-throughput gene expression data has been intensively studied and applied in clinical research. However, the main interest remains in finding modules of biological knowledge, or corresponding gene sets, significantly associated with disease conditions. Risk prediction from censored survival times using gene sets hasn't been well studied. In this work, we propose a hybrid method that uses both single gene and gene set information together to predict patient survival risks from gene expression profiles. In the proposed method, gene sets provide context-level information that is poorly reflected by single genes. Complementarily, single genes help to supplement incomplete information of gene sets due to our imperfect biomedical knowledge. Through the tests over multiple data sets of cancer and trauma injury, the proposed method showed robust and improved performance compared with the conventional approaches with only single genes or gene sets solely. Additionally, we examined the prediction result in the trauma injury data, and showed that the modules of biological knowledge used in the prediction by the proposed method were highly interpretable in biology. A wide range of survival prediction problems in clinical genomics is expected to benefit from the use of biological knowledge.

  6. Challenges with the largest commercial hydrogen station in the world

    Energy Technology Data Exchange (ETDEWEB)

    Charbonneau, Thomas; Gauthier, Pierre [Air Liquide Canada (Canada)

    2010-07-01

    This abstract's objective is to share with the participants the story of the largest hydrogen fueling station made to this date and to kick-start the story, we will cover the challenges; first the technical ones; the operational ones; the distribution ones and; the financial ones. We will then move on to review the logistic (geographic) issues raised by the project and conclude our presentation by sharing the output values of the largest fueling station built so far in the world. (orig.)

  7. Single-living is associated with increased risk of long-term mortality among employed patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Finn Erl

    2010-05-01

    Full Text Available Finn Erland Nielsen, Shan MardDepartment of Cardiology S, Herlev University Hospital, DenmarkObjective: There is conflicting evidence about the impact of social support on adverse outcome after acute myocardial infarction (MI. We examined the relation between single-living and long-term all-cause mortality after MI.Design: A prospective cohort study of 242 employed patients with MI followed up to 16 years after MI.Results: A total of 106 (43.8% patients died during the follow-up. Single-living nearly doubled the risk of death; after adjusting for potential confounding factors, single-living was an independent predictor of death, with a hazard ratio of 2.55 (95% confidence interval: 1.52–4.30. Other predictors of death were diabetes mellitus, atrial fibrillation, age, and ejection fraction less than 35%.Conclusion: Single-living is a prognostic determinant of long-term all-cause mortality after MI.Keywords: acute myocardial infarction, social support, single-living, prognosis.

  8. Inflammatory single nucleotide polymorphisms and the risk of atrial fibrillation: a case control study

    DEFF Research Database (Denmark)

    Henningsen, Kristoffer M; Olesen, Morten S; Ravn, Lasse S

    2011-01-01

    Systemic inflammation is associated with atrial fibrillation (AF) and inflammatory processes are involved in the pathophysiology of AF. We hypothesized that genetic polymorphisms, which determine the rate of inflammatory cytokines, are associated with increased risk of AF.......Systemic inflammation is associated with atrial fibrillation (AF) and inflammatory processes are involved in the pathophysiology of AF. We hypothesized that genetic polymorphisms, which determine the rate of inflammatory cytokines, are associated with increased risk of AF....

  9. Synchrotron Emission on the Largest Scales: Radio Detection of the ...

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Abstract. Shocks and turbulence generated during large-scale structure formation are predicted to produce large-scale, low surface-brightness synchrotron emission. On the largest scales, this emission is globally correlated with the thermal baryon distribution, and constitutes the `synchrotron cosmic-web'.

  10. starting a laparoscopic surgery programme in the second largest ...

    African Journals Online (AJOL)

    2014-04-01

    Apr 1, 2014 ... East African Medical Journal Vol. 91 No. 4 April 2014. STARTING A LAPAROSCOPIC SURGERY PROGRAMME IN THE SECOND LARGEST TEACHING HOSPITAL IN. GHANA. A. Gyedu, MD, Department of Surgery, Kwame Nkrumah University of Science and Technology, Directorate of. Surgery, Komfo ...

  11. Analysis of Human Standing Balance by Largest Lyapunov Exponent

    Directory of Open Access Journals (Sweden)

    Kun Liu

    2015-01-01

    Full Text Available The purpose of this research is to analyse the relationship between nonlinear dynamic character and individuals’ standing balance by the largest Lyapunov exponent, which is regarded as a metric for assessing standing balance. According to previous study, the largest Lyapunov exponent from centre of pressure time series could not well quantify the human balance ability. In this research, two improvements were made. Firstly, an external stimulus was applied to feet in the form of continuous horizontal sinusoidal motion by a moving platform. Secondly, a multiaccelerometer subsystem was adopted. Twenty healthy volunteers participated in this experiment. A new metric, coordinated largest Lyapunov exponent was proposed, which reflected the relationship of body segments by integrating multidimensional largest Lyapunov exponent values. By using this metric in actual standing performance under sinusoidal stimulus, an obvious relationship between the new metric and the actual balance ability was found in the majority of the subjects. These results show that the sinusoidal stimulus can make human balance characteristics more obvious, which is beneficial to assess balance, and balance is determined by the ability of coordinating all body segments.

  12. International team successfully launches world's largest superconducting magnet

    CERN Multimedia

    2006-01-01

    "The world's largest superconducting magnet was successfully brought online recently as part of CERN's Large Hadron Collider (LHC), the new particle accelerator scheduled for full scale use in November 2007. The magnet charged and operated successfully on its first attempt. The magnet, called Barrel Toroid, provides the powerful magnetic fiedl for ATLAS, one of the major particle detectors for LHC." (2/3 page)

  13. Worlds largest particle physics laboratory selects Proxim Wireless Mesh

    CERN Multimedia

    2007-01-01

    "Proxim Wireless has announced that the European Organization for Nuclear Research (CERN), the world's largest particle physics laboratory and the birthplace of the World Wide Web, is using it's ORiNOCO AP-4000 mesh access points to extend the range of the laboratory's Wi-Fi network and to provide continuous monitoring of the lab's calorimeters" (1/2 page)

  14. The Power of Nature. World's Largest Math Event 5.

    Science.gov (United States)

    National Council of Teachers of Mathematics, Inc., Reston, VA.

    The theme of the fifth annual World's Largest Math Event (WLME 5) is "The Power of Nature." This theme encourages students to explore natural forces that affect humankind, including phenomena such as hurricanes, earthquakes, and snowstorms, and the mathematics that underlies their study. The 15 activities for WLMES have been grouped into five…

  15. Determinants of International Banking: Evidence from the World's Largest Banks

    NARCIS (Netherlands)

    Schoenmaker, D.; van Laecke, C.

    2007-01-01

    : Banks have expanded their foreign activities due to deregulation and advances in technology. Using a new approach, we measure the level of internationalization of the world's largest commercial banks. The degree of internationalization is found to be uneven across the three main continents.

  16. Toward sustainable harvesting of Africa's largest medicinal plant ...

    African Journals Online (AJOL)

    Global demand for treating prostate disorders with Prunus africana bark extract has made P. africana Africa's largest medicinal plant export. Unsustainable harvesting practices can lead to local extirpations of this multipurpose tree. Survey research targeting P. africana harvesters in a Tanzania forest reserve revealed that ...

  17. Largest recorded non-invasive true intrathoracic desmoid tumour ...

    African Journals Online (AJOL)

    Largest recorded non-invasive true intrathoracic desmoid tumour. G R Alexander. Abstract. Intrathoracic desmoid tumours are rare soft-tissue neoplasms arising from fascial or musculo-aponeurotic structures, accounting for less than 0.03% of all neoplasms. Most cases in fact represent intrathoracic extension of chest wall ...

  18. PNNL supercomputer to become largest computing resource on the Grid

    CERN Multimedia

    2002-01-01

    Hewlett Packard announced that the US DOE Pacific Northwest National Laboratory will connect a 9.3-teraflop HP supercomputer to the DOE Science Grid. This will be the largest supercomputer attached to a computer grid anywhere in the world (1 page).

  19. NAFTA: The World's Largest Trading Zone Turns 20

    Science.gov (United States)

    Ferrarini, Tawni Hunt; Day, Stephen

    2014-01-01

    Everyone under the age of 20 who has grown up in North America has lived in the common market created by NAFTA--the North American Free Trade Agreement. In a zone linking the United States, Canada, and Mexico, most goods and investments flow freely across borders to users, consumers, and investors. In 1994, NAFTA created the largest relatively…

  20. Feasibility and Safety of Bariatric Surgery in High-Risk Patients: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Yusef Moulla

    2018-01-01

    Full Text Available Introduction. Despite the feasibility and safety of bariatric procedures nowadays, high-risk patients with vast obesity and severe comorbidities demonstrate relatively high perioperative morbidity and mortality rates and, therefore, form a distinguished challenge for the bariatric surgeons. Methods. We retrospectively analyzed high-risk patients, who underwent bariatric surgery in University Hospital Leipzig between May 2012 and December 2016. High-risk patients were defined when (Bergeat et al., 2016 at least one of the following risk factors was met: age ≥ 70 years, body mass index (BMI > 70 kg/m2, liver cirrhosis, end-organ failure, or immunosuppression by status after organ transplantation along with (Birkmeyer et al., 2010 at least two comorbidities associated with obesity. Our analysis included early postoperative complications. Results. A total of 25 high-risk obese patients were identified. All patients had a standardized postoperative management with a mean length of hospital stay of 4 ± 1.4 days. One patient required an operative revision due to a stapler line leak after sleeve gastrectomy. No other major postoperative complications occurred. Conclusion. Bariatric surgery for severe high-risk patients can be performed safely in high-volume centers following standardized procedures.

  1. Risk assessment for Helicoverpa zea (Lepidoptera: Noctuidae) resistance on dual-gene versus single-gene corn.

    Science.gov (United States)

    Edwards, Kristine T; Caprio, Michael A; Allen, K Clint; Musser, Fred R

    2013-02-01

    Recent Environmental Protection Agency (EPA) decisions regarding resistance management in Bt-cropping systems have prompted concern in some experts that dual-gene Bt-corn (CrylA.105 and Cry2Ab2 toxins) may result in more rapid selection for resistance in Helicoverpa zea (Boddie) than single-gene Bacillus thuringiensis (Bt)-corn (CrylAb toxin). The concern is that Bt-toxin longevity could be significantly reduced with recent adoption of a natural refuge for dual-gene Bt-cotton (CrylAc and Cry2Ab2 toxins) and concurrent reduction in dual-gene corn refuge from 50 to 20%. A population genetics framework that simulates complex landscapes was applied to risk assessment. Expert opinions on effectiveness of several transgenic corn and cotton varieties were captured and used to assign probabilities to different scenarios in the assessment. At least 350 replicate simulations with randomly drawn parameters were completed for each of four risk assessments. Resistance evolved within 30 yr in 22.5% of simulations with single-gene corn and cotton with no volunteer corn. When volunteer corn was added to this assessment, risk of resistance evolving within 30 yr declined to 13.8%. When dual-gene Bt-cotton planted with a natural refuge and single-gene corn planted with a 50% structured refuge was simulated, simultaneous resistance to both toxins never occurred within 30 yr, but in 38.5% of simulations, resistance evolved to toxin present in single-gene Bt-corn (CrylAb). When both corn and cotton were simulated as dual-gene products, cotton with a natural refuge and corn with a 20% refuge, 3% of simulations evolved resistance to both toxins simultaneously within 30 yr, while 10.4% of simulations evolved resistance to CrylAb/c toxin.

  2. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery.

    Science.gov (United States)

    Landon, Mark B; Spong, Catherine Y; Thom, Elizabeth; Hauth, John C; Bloom, Steven L; Varner, Michael W; Moawad, Atef H; Caritis, Steve N; Harper, Margaret; Wapner, Ronald J; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan M; O'sullivan, Mary J; Sibai, Baha M; Langer, Oded; Thorp, John M; Ramin, Susan M; Mercer, Brian M; Gabbe, Steven G

    2006-07-01

    To determine whether the risk for uterine rupture is increased in women attempting vaginal birth after multiple cesarean deliveries. We conducted a prospective multicenter observational study of women with prior cesarean delivery undergoing trial of labor and elective repeat operation. Maternal and perinatal outcomes were compared among women attempting vaginal birth after multiple cesarean deliveries and those with a single prior cesarean delivery. We also compared outcomes for women with multiple prior cesarean deliveries undergoing trial of labor with those electing repeat cesarean delivery. Uterine rupture occurred in 9 of 975 (0.9%) women with multiple prior cesarean compared with 115 of 16,915 (0.7%) women with a single prior operation (P = .37). Multivariable analysis confirmed that multiple prior cesarean delivery was not associated with an increased risk for uterine rupture. The rates of hysterectomy (0.6% versus 0.2%, P = .023) and transfusion (3.2% versus 1.6%, P cesarean deliveries compared with women with a single prior cesarean delivery attempting trial of labor. Similarly, a composite of maternal morbidity was increased in women with multiple prior cesarean deliveries undergoing trial of labor compared with those having elective repeat cesarean delivery (odds ratio 1.41, 95% confidence interval 1.02-1.93). A history of multiple cesarean deliveries is not associated with an increased rate of uterine rupture in women attempting vaginal birth compared with those with a single prior operation. Maternal morbidity is increased with trial of labor after multiple cesarean deliveries, compared with elective repeat cesarean delivery, but the absolute risk for complications is small. Vaginal birth after multiple cesarean deliveries should remain an option for eligible women. II-2.

  3. Risk factors for febrile urinary tract infection in infants with prenatal hydronephrosis: comprehensive single center analysis.

    Science.gov (United States)

    Zareba, Piotr; Lorenzo, Armando J; Braga, Luis H

    2014-05-01

    We assessed risk factors for urinary tract infection in children with prenatal hydronephrosis We identified 376 infants with prenatal hydronephrosis in an institutional database. The occurrence of febrile urinary tract infection in the first 2 years of life was ascertained by chart review. Febrile urinary tract infection was defined as a positive culture from a catheterized urine specimen in a patient with a fever of 38.0C or greater. Multivariate logistic regression was used to assess gender, circumcision status, hydronephrosis grade, vesicoureteral reflux grade and antibiotic prophylaxis as predictors of the risk of urinary tract infection. Included in analysis were 277 males and 99 females. Hydronephrosis was high grade in 128 infants (34.0%) and vesicoureteral reflux was present in 79 (21.0%). Antibiotic prophylaxis was prescribed in 60.4% of patients, preferentially to females vs males (70.7% vs 56.7%), those with high vs low grade hydronephrosis (70.3% vs 55.2%) and those with vs without vesicoureteral reflux (96.2% vs 50.8%). On multivariate analysis there was an association between high grade hydronephrosis and an increased risk of urinary tract infection (adjusted OR 2.40, 95% CI 1.26-4.56). Females (adjusted OR 3.16, 95% CI 0.98-10.19) and uncircumcised males (adjusted OR 3.63, 95% CI 1.18-11.22) were also at higher risk than circumcised males. Antibiotic prophylaxis was not associated with a decreased risk of urinary tract infection (adjusted OR 0.93, 95% CI 0.45-1.94). High grade hydronephrosis, female gender and uncircumcised status in males are independent risk factors for febrile urinary tract infection in infants with prenatal hydronephrosis. Antibiotic prophylaxis did not reduce the risk of urinary tract infection in the study group. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Smart-Geology for the World's largest fossil oyster reef

    Science.gov (United States)

    Dorninger, Peter; Nothegger, Clemens; Djuricic, Ana; Rasztovits, Sascha; Harzhauser, Mathias

    2014-05-01

    The geo-edutainment park "Fossilienwelt Weinviertel" at Stetten in Lower Austria exposes the world's largest fossil oyster biostrome. In the past decade, significant progress has been made in 3D digitizing sensor technology. To cope with the high amount of data, processing methods have been automated to a high degree. Consequently, we formulated the hypothesis that appropriate application of state-of-the-art 3D digitizing, data processing, and visualization technologies allows for a significant automation in paleontological prospection, making an evaluation of huge areas commercially feasible in both time and costs. We call the necessary processing steps "Smart Geology", being characterized by automation and large volumes of data. The Smart Geology project (FWF P 25883-N29) investigates three topics, 3D digitizing, automated geological and paleontological analysis and interpretation and finally investigating the applicability of smart devices for on-site accessibility of project data in order to support the two scientific hypotheses concerning the emerging process of the shell bed, i.e. was it formed by a tsunami or a major storm, and does it preserve pre- and post-event features. This contribution concentrates on the innovative and sophisticated 3D documentation and visualization processes being applied to virtualise approximately 15.000 fossil oysters at the approximately 25 by 17 m accessible shell bad. We decided to use a Terrestrial Laserscanner (TLS) for the determination of the geometrical 3D structures. The TLS achieves about 2 mm single point measurement accuracy. The scanning campaign provides a "raw" point cloud of approximately 1 bio. points at the respective area. Due to the scanning configuration used, the occurrence of occluded ares is minimized hence the full 3D structure of this unique site can be modelled. In addition, approximately 300 photos were taken with a nominal resolution of 0.6 mm per pixel. Sophisticated artificial lightning (close to

  5. Single-dose benzathine penicillin in infants at risk of congenital ...

    African Journals Online (AJOL)

    1997-01-01

    Jan 1, 1997 ... benzathine penicillin G in infants at high risk of congenital syphilis. Design. Randomised study comparing benzathine penicillin with no therapy. Setting. Peninsula Maternal and Neonatal Service, Cape. Town. Subjects. Asymptomatic infants born to mothers with untreated syphilis whose VORl titre was 32 ...

  6. Temporal properties of seismicity and largest earthquakes in SE Carpathians

    Directory of Open Access Journals (Sweden)

    S. Byrdina

    2006-01-01

    Full Text Available In order to estimate the hazard rate distribution of the largest seismic events in Vrancea, South-Eastern Carpathians, we study temporal properties of historical and instrumental catalogues of seismicity. First, on the basis of Generalized Extreme Value theory we estimate the average return period of the largest events. Then, following Bak et al. (2002 and Corral (2005a, we study scaling properties of recurrence times between earthquakes in appropriate spatial volumes. We come to the conclusion that the seismicity is temporally clustered, and that the distribution of recurrence times is significantly different from a Poisson process even for times largely exceeding corresponding periods of foreshock and aftershock activity. Modeling the recurrence times by a gamma distributed variable, we finally estimate hazard rates with respect to the time elapsed from the last large earthquake.

  7. Synchrotron Emission on the Largest Scales: Radio Detection of the ...

    Indian Academy of Sciences (India)

    many short baselines as possible, while insuring the least amount of corruption from. RFI – not an easy task. The nominal largest-scale that the EVLA can detect with a short integration at 1.4 GHz in its most compact configuration (D-array) is roughly. 15 (e.g., Rudnick & Brown 2009), which is 1 Mpc at z ∼ 0.06. Thus, smooth ...

  8. Collapse of the world?s largest herbivores

    OpenAIRE

    Ripple, William J.; Newsome, Thomas M.; Wolf, Christopher; Dirzo, Rodolfo; Everatt, Kristoffer T.; Galetti, Mauro; Hayward, Matt W.; Kerley, Graham I. H.; Levi, Taal; Lindsey, Peter A.; Macdonald, David W.; Malhi, Yadvinder; Painter, Luke E.; Sandom, Christopher J.; Terborgh, John

    2015-01-01

    Large wild herbivores are crucial to ecosystems and human societies. We highlight the 74 largest terrestrial herbivore species on Earth (body mass ≥100 kg), the threats they face, their important and often overlooked ecosystem effects, and the conservation efforts needed to save them and their predators from extinction. Large herbivores are generally facing dramatic population declines and range contractions, such that ~60% are threatened with extinction. Nearly all threatened species are in ...

  9. Rare gas record in the largest Apollo 15 rock.

    Science.gov (United States)

    Marti, K.; Lightner, B. D.

    1972-01-01

    The results obtained from mass-spectrometry analyses of the noble gases He, Ne, Ar, Kr, and Xe in a 182-mg chip of the largest Apollo 15 rock 15555 are presented. The spallation krypton data indicate a well-shielded location through most of the time during which the rock was exposed to cosmic rays. Gas retention ages are estimated. No evidence for the presence of products from plutonium-244 or iodine-129 was found.

  10. Upgrade and modernization of the six largest HPPs in Macedonia

    International Nuclear Information System (INIS)

    Hadzievska, M.

    2002-01-01

    In 1998, Electric Power Company of Macedonia and the International Bank for Development and Reconstruction, started the Power System Improvement Project a part of which is the Project for rehabilitation of the six largest Hydro Power Plants (HPPs) in the Republic of Macedonia. The six largest Hydro Power Plants (HPP Vrutok, HPP Raven, HPP Globocica, HPP Tikves and HPP Spilje and HPP Vrben) represent 91% of the country's hydropower capacity. The rehabilitation program is divided in five parts (contracts) and covers the refurbishment of: turbine runners, turbine and generator bearings, governors, inlet valves; butterfly valves, including accessories and control systems; generators, excitation system and voltage regulation; control system, protection and LV auxiliaries; switch gears and control gears in 220 kV, 110 kV and 35 kV substations. At the moment, only the implementation of switch gears has started, the first phase is already finished, and 50 % of the rehabilitation works for HPP Vrutok, the largest HPP, has been finished. With the realization of this project, greater hydropower production is expected. It also expected that HPPs will become a more vital part of the Macedonian power system

  11. Danish singles have a twofold risk of acute coronary syndrome: data from a cohort of 138 290 persons

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Færgeman, Ole; Larsen, Mogens Lytken

    2006-01-01

    -69 years. Information on population members' individual age, sex, social background, and eventual death was obtained from Danish Population Registers. SETTING: University hospital. PATIENTS: The study prospectively identified 646 victims of ACS from 1 April 2000 to 31 March 2002. MAIN RESULTS: Based...... on multiple logistic regression, age and single living were found to be positively associated with incident ACS in both sexes. Women >60 years living alone and men >50 years living alone were at especially high risk. They constituted only 5.4% and 7.7% of the source population, respectively...

  12. Effects of four single nucleotide polymorphisms of EZH2 on cancer risk: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ling Z

    2018-02-01

    Full Text Available Zhixin Ling,1,2,* Zonghao You,1,2,* Ling Hu,3 Lei Zhang,1,2 Yiduo Wang,1,2 Minhao Zhang,1,2 Guangyuan Zhang,1,2 Shuqiu Chen,1,2 Bin Xu,1,2 Ming Chen1,2 1Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; 2Surgical Research Center, Institute of Urology, Medical School of Southeast University, Nanjing, China; 3Department of Nephrology, People’s Hospital of Wuxi City, Wuxi, China *These authors contributed equally to this work Background: Although the relationship between several single nucleotide polymorphisms (SNPs of the oncogene EZH2 and cancer risk has been assessed by some case–control studies, results of subsequent studies are controversial. Sample sizes from single-center studies are also limited, thereby providing unreliable findings. Hence, we conducted a comprehensive search and meta-analysis to evaluate the associations between EZH2 SNPs and cancer risk.Materials and methods: A comprehensive literature search for studies focusing on EZH2 SNPs and cancer risk was conducted on PubMed, Web of Science, Embase, and China National Knowledge Infrastructure online databases. Genotype data were extracted and examined through a meta-analysis, and pooled odds ratios (ORs with 95% CIs were used to assess the corresponding associations. Sensitivity analysis, publication bias assessment, and heterogeneity test were performed using STATA 12.0.Results: Twelve eligible studies were included in this meta-analysis. The association of 4 SNPs, namely, rs887569, rs2302427, rs3757441, and rs41277434, in the EZH2 locus with cancer risk was evaluated. Five studies (1,794 cases and 1,878 controls indicated that rs887569 was related to a decreased cancer risk (CTTT/CC: OR =0.849, 95% CI: [0.740 to 0.973], P=0.019; TT/CCCT: OR =0.793, 95% CI: [0.654 to 0.962], P=0.019. Seven studies (2,408 cases and 2,910 controls showed that rs2302427 was linked to a decreased cancer risk (GG/CC: OR =0.562, 95% CI: [0.400 to 0.792], P

  13. False Low-Risk Single Nucleotide Polymorphism-Based Noninvasive Prenatal Screening in Pentasomy 49,XXXXY.

    Science.gov (United States)

    Putra, Manesha; Hicks, Melissa A; Abramowicz, Jacques S

    2018-01-01

    Introduction  Pentasomy 49,XXXXY is a sex chromosome anomaly difficult to be diagnosed prenatally. We describe a patient of pentasomy 49,XXXXY with false low-risk results using a noninvasive prenatal screening (NIPS). A 30-year-old G1P0 woman presented at 33 6/7 weeks, secondary to sonographic fetal anomalies. She had low-risk NIPS at 13 6/7 weeks. Anatomy survey showed bilateral clubfeet, clinodactyly of the left fifth digit, micropenis, and echogenic bowel. Cytogenetics analysis revealed pentasomy 49,XXXXY syndrome. We report third-trimester sonographic features of a fetus with pentasomy 49,XXXXY and the importance of thorough pre- and posttest counseling for NIPS.

  14. A single center clinical analysis of children with high-risk neuroblastoma.

    Science.gov (United States)

    Tian, Xiangdong; Cao, Yanna; Wang, Jingfu; Yan, Jie; Tian, Yao; Li, Zhongyuan; Wang, Huijuan; Duan, Xiaofeng; Jin, Yan; Zhao, Qiang

    2017-05-02

    The current multidisciplinary treatment for patients with high-risk neuroblastoma (NB) is the common census. However, protocols and opinions are different in different regions and institutions. We aimed to assess the protocol formulated by Chinese Children's Cancer Group study in 2009, and the impact of surgery extent was highlightly evaluated. This study enrolled patients with high-risk neuroblastoma between 2009 and 2014 in Department of Pediatric Oncology of Tianjin Medical University Cancer Institute and Hospital. The clinical characteristics of patients were illustrated and surgery extent was evaluated by the impact on survival rate. The 3-year overall survival (OS) and progression-free survival (PFS) were 56.2% and 50.5%, respectively. LDH (Pneuroblastoma patients in short time. This study showed no substantial survival benefit in patients with high-risk NB undergoing gross total tumor resection. Multidisciplinary intensive treatment was essential, especially for patients received subtotal tumor resection. Longer term follow-up is needed to survey complications in surviving patients who received intensive chemotherapy and radiotherapy.

  15. Incidence and Risk Factors of Parenteral Nutrition-Associated Cholestasis in Omani Neonates; Single centre experience

    Directory of Open Access Journals (Sweden)

    Sharef W. Sharef

    2015-05-01

    Full Text Available Objectives: Parenteral nutrition-associated cholestasis (PNAC is one of the most challenging complications of prolonged parenteral nutrition (PN in neonates. There is a lack of research investigating its incidence in newborn infants in Oman and the Arab region. Therefore, this study aimed to assess the incidence of PNAC and its risk factors in Omani neonates. Methods: This retrospective study took place between January and April 2014. All neonates who received PN for ≥14 days during a four-year period (June 2009 to May 2013 at the neonatal intensive care unit (NICU in Sultan Qaboos University Hospital, Muscat, Oman, were enrolled. Results: A total of 1,857 neonates were admitted to the NICU over the study period and 135 neonates (7.3% received PN for ≥14 days. Determining the incidence of PNAC was only possible in 97 neonates; of these, 38 (39% had PNAC. The main risk factors associated with PNAC were duration of PN, duration of enteral starvation, gastrointestinal surgeries, blood transfusions and sepsis. Neonates with PNAC had a slightly higher incidence of necrotising enterocolitis in comparison to those without PNAC. Conclusion: This study found a PNAC incidence of 39% in Omani neonates. There were several significant risk factors for PNAC in Omani neonates; however, after logistic regression analysis, only total PN duration remained statistically significant. Preventive strategies should be implemented in NICUs so as to avoid future chronic liver disease in this population.

  16. Open Single Item of Perceived Risk Factors (OSIPRF toward Cardiovascular Diseases Is an Appropriate Instrument for Evaluating Psychological Symptoms

    Directory of Open Access Journals (Sweden)

    Mozhgan Saeidi

    2016-12-01

    Full Text Available Psychological symptoms are considered as one of the aspects and consequences of cardiovascular diseases (CVDs, management of which can precipitate and facilitate the process of recovery. Evaluation of the psychological symptoms can increase awareness of treatment team regarding patients’ mental health, which can be beneficial for designing treatment programs (1. However, time-consuming process of interviews and assessment by questionnaires lead to fatigue and lack of patient cooperation, which may be problematic for healthcare evaluators. Therefore, the use of brief and suitable alternatives is always recommended.The use of practical and easy to implement instruments is constantly emphasized. A practical method for assessing patients' psychological status is examining causal beliefs and attitudes about the disease. The causal beliefs and perceived risk factors by patients, which are significantly related to the actual risk factors for CVDs (2, are not only related to psychological adjustment and mental health but also have an impact on patients’ compliance with treatment recommendations (3.It seems that several risk factors are at play regarding the perceived risk factors for CVDs such as gender (4, age (5, and most importantly, patients’ psychological status (3. Accordingly, evaluation of causal beliefs and perceived risk factors by patients could probably be a shortcut method for evaluation of patients’ psychological health. In recent years, Saeidi and Komasi (5 proposed a question and investigated the perceived risk factors with an open single item: “What do you think is the main cause of your illness?”. According to the authors, the perceived risk factors are recorded in five categories including biological (age, gender, and family history, environmental (dust, smoke, passive smoking, toxic substances, and effects of war, physiological (diabetes, hypertension, hyperlipidemia, and obesity, behavioral (lack of exercise, nutrition

  17. Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study.

    Science.gov (United States)

    Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A

    2016-01-01

    Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (purinary tract (CAKUT) (purinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  18. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    Science.gov (United States)

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-10-01

    Polypharmacy, and specifically the use of multiple fall-risk-increasing drugs (FRID), have been associated with increased risk of falling in older age. However, it is not yet clear whether the known set of FRIDs can be extrapolated to recurrent fallers, since they form a distinct group of more vulnerable older persons with different characteristics. We aim to investigate which classes of medications are associated with recurrent falls in elderly patients visiting the Emergency Department (ED) after a fall. This study had a cross-sectional design and was conducted in the ED of an academic medical center. Patients who sustained a fall, 65 years or older, and who visited the ED between 2004 and 2010 were invited to fill in a validated fall questionnaire designed to assess patient and fall characteristics (CAREFALL Triage Instrument [CTI]). We translated self-reported medications to anatomical therapeutic chemical (ATC) codes (at the second level). Univariate logistic regression analysis was performed to explore the association between medication classes and the outcome parameter (recurrent fall). Multivariate logistic regression was used to assess the associations after adjustment to potential confounders. In total 2,258 patients participated in our study, of whom 39 % (873) had sustained two or more falls within the previous year. After adjustment for the potential confounders, drugs for acid-related disorders (adjusted odds ratio [aOR] 1.29; 95 % CI 1.03–1.60), analgesics (aOR 1.22; 95 % CI 1.06–1.41), anti-Parkinson drugs (aOR 1.59; 95 % CI 1.02–2.46), nasal preparations (aOR 1.49; 95 % CI 1.07–2.08), ophthalmologicals (aOR 1.51; 95 % CI 1.10–2.09); antipsychotics (aOR 2.21; 95 % CI 1.08–4.52), and antidepressants (aOR 1.64; 95 % CI 1.13–2.37) remained statistically significantly associated with an ED visit due to a recurrent fall. Known FRIDs, such as psychotropic drugs, also increase the risk of recurrent falls. However, we found four relatively new

  20. Risk factors and microbiology of wound infections following cesarean delivery: Experience of a single institution.

    Science.gov (United States)

    Ilhan, Gülşah; Verit Atmaca, Fatma Ferda; Kaya, Abdurrahman; Ergin, Ahmet Hasan; Gökmen Karasu, Ayşe Filiz; Turfan, Mehtap

    2016-10-01

    To determine the prevalence of wound infection following cesarean delivery, risk factors, common bacterial pathogens and their antibiotic sensitivity. The study population consisted of 5787 cesarean deliveries. All of the patients received 2 g doses of cephazolin perioperatively for antibiotic prophylaxis. Patients with wound infection who had two doses of 1 g cephazolin postoperatively and who were continued on oral preparations of 500 mg of cephuroxime twice daily for 5 days after hospital discharge were included in Group A. Patients with wound infection whose postoperative antibiotics and antibiotics after discharge were omitted were included in Group B. Patient related variables, gestational age, co-morbidities, cesarean section indications, neonatal intensive care requirements were assessed. Risk factors were evaluated according to the type of the procedure (elective or emergent) and administered antibiotic protocol. The incidence of wound infection following cesarean section was 0,37% in elective operations and 5,4% in emergency cases. On the other hand, wound infection rate was found to be 1,35% in antibiotic receiving group (Group A) and 1,12% in the group not receiving antibiotics (Group B). Increased rate of wound infections were remarkable in emergency cases and postoperative antibiotics did not have a major impact in reducing the rate of wound infection following cesarean section. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  1. Optimal hypofractionated conformal radiotherapy for large brain metastases in patients with high risk factors: a single-institutional prospective study

    International Nuclear Information System (INIS)

    Inoue, Hiroshi K; Sato, Hiro; Suzuki, Yoshiyuki; Saitoh, Jun-ichi; Noda, Shin-ei; Seto, Ken-ichi; Torikai, Kota; Sakurai, Hideyuki; Nakano, Takashi

    2014-01-01

    A single-institutional prospective study of optimal hypofractionated conformal radiotherapy for large brain metastases with high risk factors was performed based on the risk prediction of radiation-related complications. Eighty-eight patients with large brain metastases ≥10 cm 3 in critical areas treated from January 2010 to February 2014 using the CyberKnife were evaluated. The optimal dose and number of fractions were determined based on the surrounding brain volume circumscribed with a single dose equivalent (SDE) of 14 Gy (V14) to be less than 7 cm 3 for individual lesions. Univariate and multivariate analyses were conducted. As a result of optimal treatment, 92 tumors ranging from 10 to 74.6 cm 3 (median, 16.2 cm 3 ) in volume were treated with a median prescribed isodose of 57% and a median fraction number of five. In order to compare the results according to the tumor volume, the tumors were divided into the following three groups: 1) 10–19.9 cm 3 , 2) 20–29.9 cm 3 and 3) ≥30 cm 3 . The lesions were treated with a median prescribed isodose of 57%, 56% and 55%, respectively, and the median fraction number was five in all three groups. However, all tumors ≥20 cm 3 were treated with ≥ five fractions. The median SDE of the maximum dose in the three groups was 47.2 Gy, 48.5 Gy and 46.5 Gy, respectively. Local tumor control was obtained in 90.2% of the patients, and the median survival was nine months, with a median follow-up period of seven months (range, 3-41 months). There were no significant differences in the survival rates among the three groups. Six tumors exhibited marginal recurrence 7-36 months after treatment. Ten patients developed symptomatic brain edema or recurrence of pre-existing edema, seven of whom required osmo-steroid therapy. No patients developed radiation necrosis requiring surgical resection. Our findings demonstrate that the administration of optimal hypofractionated conformal radiotherapy based on the dose-volume prediction

  2. p16 gene silencing along with p53 single-nucleotide polymorphism and risk of esophageal cancer in Northeast India.

    Science.gov (United States)

    Das, Mandakini; Sharma, Santanu Kumar; Sekhon, Gaganpreet Singh; Mahanta, Jagadish; Phukan, Rup Kumar; Jalan, Bimal Kumar

    2017-05-01

    The high incidence of esophageal cancer in Northeast India and the unique ethnic background and dietary habits provide a great opportunity to study the molecular genetics behind esophageal squamous cell carcinoma in this part of the region. We hypothesized that in addition to currently known environmental risk factors for esophageal cancer, genetic and epigenetic factors are also involved in esophageal carcinogenesis in Northeast India. Therefore, in this study, we explored the possible association between the two important G1 cell cycle regulatory genes p16 and p53 and environmental risk factors and risk of esophageal carcinogenesis. A total of 100 newly diagnosed esophageal cancer cases along with equal number of age-, sex-, and ethnicity-matched controls were included in this study. Methylation-specific polymerase chain reaction was used to determine the p16 promoter methylation status. Single-nucleotide polymorphism at codon 72 of p53 gene was assessed by the polymerase chain reaction-restriction fragment length polymorphism method. Aberrant methylation of p16 gene was seen in 81% of esophageal cancer cases. Hypermethylation of p16 gene was not found in healthy controls. p53 Pro/Pro genotype was found to be a risk genotype in Northeast India compared with Arg/Pro and Arg/Arg. p53 variant/polymorphism was significantly associated with esophageal cancer risk in the study population under all three genetic models, namely, dominant model (Arg/Pro + Pro/Pro vs Arg/Arg odds ratio = 2.25, confidence interval = 1.19-4.26; p = 0.012), recessive model (Arg/Arg + Arg/Pro vs Pro/Pro odds ratio = 2.35, confidence interval = 1.24-4.44; p = 0.008), and homozygous model (Pro/Pro vs Arg/Arg odds ratio = 3.33, confidence interval = 1.54-7.20; p = 0.002). However, p53 variant/polymorphism was not statistically associated with esophageal cancer risk under the heterozygous model (Pro/Pro vs Arg/Pro). In the case-only analysis based on p16

  3. Longevity in Calumma parsonii, the World's largest chameleon.

    Science.gov (United States)

    Tessa, Giulia; Glaw, Frank; Andreone, Franco

    2017-03-01

    Large body size of ectothermic species can be correlated with high life expectancy. We assessed the longevity of the World's largest chameleon, the Parson's chameleon Calumma parsonii from Madagascar by using skeletochronology of phalanges taken from preserved specimens held in European natural history museums. Due to the high bone resorption we can provide only the minimum age of each specimen. The highest minimum age detected was nine years for a male and eight years for a female, confirming that this species is considerably long living among chameleons. Our data also show a strong correlation between snout-vent length and estimated age. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Worlds Largest Wave Energy Project 2007 in Wales

    DEFF Research Database (Denmark)

    Christensen, Lars; Friis-Madsen, Erik; Kofoed, Jens Peter

    2006-01-01

    This paper introduces world largest wave energy project being developed in Wales and based on one of the leading wave energy technologies. The background for the development of wave energy, the total resource ands its distribution around the world is described. In contrast to wind energy turbines...... a large number of fundamentally different technologies are utilised to harvest wave energy. The Wave Dragon belongs to the wave overtopping class of converters and the paper describes the fundamentals and the technical solutions used in this wave energy converter. An offshore floating WEC like the Wave...

  5. Perpetual American vanilla option pricing under single regime change risk: an exhaustive study

    Science.gov (United States)

    Montero, Miquel

    2009-07-01

    Perpetual American options are financial instruments that can be readily exercised and do not mature. In this paper we study in detail the problem of pricing this kind of derivatives, for the most popular flavour, within a framework in which some of the properties—volatility and dividend policy—of the underlying stock can change at a random instant of time but in such a way that we can forecast their final values. Under this assumption we can model actual market conditions because most relevant facts usually entail sharp predictable consequences. The effect of this potential risk on perpetual American vanilla options is remarkable: the very equation that will determine the fair price depends on the solution to be found. Sound results are found under the optics both of finance and physics. In particular, a parallelism among the overall outcome of this problem and a phase transition is established.

  6. Prospective evaluation of risk factors for mortality in patients of Fournier's gangrene: A single center experience

    Science.gov (United States)

    Vyas, Hari Gopal; Kumar, Anup; Bhandari, Vimal; Kumar, Niraj; Jain, Abhinav; Kumar, Rohit

    2013-01-01

    Introduction: Fournier's gangrene is an aggressive disease with high morbidity and mortality. The aim of this study was to assess risk factors associated with mortality among patients of Fournier's gangrene. Materials and Methods: Between May 2011 and September 2012, all patients of Fournier's gangrene treated at our center were included in the study. All patients underwent emergency surgical debridement and received broad spectrum intravenous antibiotics. Their baseline characteristics, treatment, and follow-up data were recorded and analyzed. Results: A total of 30 patients were included in the study. Of these, six patients (20%) died during the treatment. Age Fournier gangrene severity index (FGSI) score Fournier's gangrene, increased age, total leukocyte count, extent of the area involved, septic shock at admission, VAS score, and FGSI score at admission have a significant association with mortality. PMID:24082432

  7. Risk factors for technical and biological complications with zirconia single crowns.

    Science.gov (United States)

    Rinke, Sven; Lange, Katharina; Roediger, Matthias; Gersdorff, Nikolaus

    2015-11-01

    This practice-based study evaluated the clinical performance and risk factors for biological and technical complications with conventionally luted zirconia crowns. Sixty-eight patients (39 female) with a total of 323 restorations placed on 219 vital teeth, 69 endodontically treated teeth (ETT), and 41 implants (incisors, 96; premolars, 89; molars, 138; observational period, 79.7 ± 14.2 months) underwent a clinical follow-up examination and were included in the study. Time-dependent survival (in situ), success (event free), and veneering ceramic fracture (VCF) rates were calculated and analyzed relative to the following risk factors: smoking status, location of the crown, and type of abutment. Fifty-three complete failures were recorded. A significant influence of the abutment type on survival could be detected (p = 0.033): ETT demonstrated a significantly (p = 0.029) lower 7-year survival rate (73.8%, 95% confidence interval [95% CI] 0.600-0.876) than crowns placed on implants (90.0%, 95% CI 0.814-0.990). The success rate of the crowns was significantly influenced by the location of the restoration (p = 0.0058). A total of 75.6% (95% CI 0.648-0.864) of the anterior crowns remained event free, compared to 50.4% (95% CI 0.388-0.621) of the molar crowns. Furthermore, the location of the crowns affected the VCF rate (p = 0.018, event-free anterior teeth 95.2% (95% CI 0.880-1), event-free molars 80.9% (95% CI 0.706-0.913)). Survival and success rates were significantly influenced by the type of abutment and the location of the restoration. More complete failures should be expected for crowns placed on ETT, while crowns on molars demonstrated more biological and technical complications than anterior zirconia crowns.

  8. Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction.

    Science.gov (United States)

    Teng, P S P; Kong, P W; Leong, K F

    2017-06-01

    Non-contact anterior cruciate ligament (ACL) injuries commonly occur when athletes land in high risk positions such as knee valgus. The position of the foot at landing may influence the transmission of forces from the ankle to the knee. Using an experimental approach to manipulate foot rotation positions, this study aimed to provide new insights on how knee valgus during single-leg landing may be influenced by foot positions. Eleven male recreational basketball players performed single-leg drop landings from a 30-cm high platform in three foot rotation positions (toe-in, toe-forward and toe-out) at initial contact. A motion capture system and a force plate were used to measure lower extremity kinematics and kinetics. Knee valgus angles at initial contact (KVA) and maximum knee valgus moments (KVM), which were known risk factors associated with ACL injury, were measured. A one-way repeated measures Analysis of Variance was conducted (α=0.05) to compare among the three foot positions. Foot rotation positions were found to have a significant effect on KVA (p<0.001, η 2 =0.66) but the difference between conditions (about 1°) was small and not clinically meaningful. There was a significant effect of foot position on KVM (p<0.001, η 2 =0.55), with increased moment observed in the toe-out position as compared to toe-forward (p=0.012) or toe-in positions (p=0.002). When landing with one leg, athletes should avoid extreme toe-out foot rotation positions to minimise undesirable knee valgus loading associated with non-contact ACL injury risks. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  10. Association between Single Nucleotide Polymorphism rs1044925 and the Risk of Coronary Artery Disease and Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Dong-Feng Wu

    2014-02-01

    Full Text Available The present study was performed to clarify the association between the acyl-CoA:cholesterol acyltransferase-1 (ACAT-1 single nucleotide polymorphism (SNP rs1044925 and the risk of coronary artery disease (CAD and ischemic stroke (IS in the Guangxi Han population. Polymerase chain reaction and restriction fragment length polymorphism was performed to determine the genotypes of the ACAT-1 SNP rs1044925 in 1730 unrelated subjects (CAD, 587; IS, 555; and healthy controls; 588. The genotypic and allelic frequencies of rs1044925 were significantly different between the CAD patients and controls (p = 0.015 and borderline different between the IS patients and controls (p = 0.05. The AC/CC genotypes and C allele were associated with a decreased risk of CAD and IS (CAD: p = 0.014 for AC/CC vs. AA, p = 0.022 for C vs. A; IS: p = 0.014 for AC/CC vs. AA; p = 0.017 for C vs. A. The AC/CC genotypes in the healthy controls, but not in CAD or IS patients, were associated with an increased serum high-density lipoprotein cholesterol (HDL-C concentration. The present study shows that the C allele carriers of ACAT-1 rs1044925 were associated with an increased serum HDL-C level in the healthy controls and decreased risk in CAD and IS patients.

  11. Fishing down the largest coral reef fish species.

    Science.gov (United States)

    Fenner, Douglas

    2014-07-15

    Studies on remote, uninhabited, near-pristine reefs have revealed surprisingly large populations of large reef fish. Locations such as the northwestern Hawaiian Islands, northern Marianas Islands, Line Islands, U.S. remote Pacific Islands, Cocos-Keeling Atoll and Chagos archipelago have much higher reef fish biomass than islands and reefs near people. Much of the high biomass of most remote reef fish communities lies in the largest species, such as sharks, bumphead parrots, giant trevally, and humphead wrasse. Some, such as sharks and giant trevally, are apex predators, but others such as bumphead parrots and humphead wrasse, are not. At many locations, decreases in large reef fish species have been attributed to fishing. Fishing is well known to remove the largest fish first, and a quantitative measure of vulnerability to fishing indicates that large reef fish species are much more vulnerable to fishing than small fish. The removal of large reef fish by fishing parallels the extinction of terrestrial megafauna by early humans. However large reef fish have great value for various ecological roles and for reef tourism. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Assessing single-stranded oligonucleotide drug-induced effects in vitro reveals key risk factors for thrombocytopenia.

    Directory of Open Access Journals (Sweden)

    Sabine Sewing

    Full Text Available Single-stranded oligonucleotides (ON comprise a promising therapeutic platform that enables selective modulation of currently undruggable targets. The development of novel ON drug candidates has demonstrated excellent efficacy, but in certain cases also some safety liabilities were reported. Among them are events of thrombocytopenia, which have recently been evident in late stage trials with ON drugs. The underlying mechanisms are poorly understood and the risk for ON candidates causing such events cannot be sufficiently assessed pre-clinically. We investigated potential thrombocytopenia risk factors of ONs and implemented a set of in vitro assays to assess these risks. Our findings support previous observations that phosphorothioate (PS-ONs can bind to platelet proteins such as platelet collagen receptor glycoprotein VI (GPVI and activate human platelets in vitro to various extents. We also show that these PS-ONs can bind to platelet factor 4 (PF4. Binding to platelet proteins and subsequent activation correlates with ON length and connected to this, the number of PS in the backbone of the molecule. Moreover, we demonstrate that locked nucleic acid (LNA ribosyl modifications in the wings of the PS-ONs strongly suppress binding to GPVI and PF4, paralleled by markedly reduced platelet activation. In addition, we provide evidence that PS-ONs do not directly affect hematopoietic cell differentiation in culture but at higher concentrations show a pro-inflammatory potential, which might contribute to platelet activation. Overall, our data confirm that certain molecular attributes of ONs are associated with a higher risk for thrombocytopenia. We propose that applying the in vitro assays discussed here during the lead optimization phase may aid in deprioritizing ONs with a potential to induce thrombocytopenia.

  13. The burden of overtreatment: comparison of toxicity between single and combined modality radiation therapy among low risk prostate cancer patients.

    Science.gov (United States)

    Jiang, Renjian; Tomaszewski, Jeffrey J; Ward, Kevin C; Uzzo, Robert G; Canter, Daniel J

    2015-02-01

    To compare radiation related toxicities among men with low risk prostate cancer treated with single or multimodal radiation therapy. The SEER-Medicare linked database was used to assess the relationship between treatment type and toxicity among men with low risk prostate cancer treated with brachytherapy (BT), external beam radiation therapy (EBRT), or combined therapy between 2004 and 2007. Inverse probability of treatment weighting was utilized to minimize selection bias and control for confounding. Multivariate logistic regression models were used to explore the relationship between treatment and outcomes. Overall 1915 (43.9%), 1893 (43.4%), and 555 (12.7%) patients were treated with EBRT, BT, and combined therapy, respectively. In univariate analyses, combined modality radiation was more toxic than BT alone for GU incontinence (56.76% versus 49.08%), GU obstruction (21.26% versus 19.70%), and erectile dysfunction (22.52% versus 22.24%) (p combined modality radiation was more toxic for GI bleeding (7.21% versus 6.21%), GU incontinence (56.76% versus 29.24%), GU obstruction (21.26% versus 14.15%), and erectile dysfunction (22.52% versus 15.35%) (p combined modality treatment and lowest for the group treated with EBRT. After multivariate adjustment, EBRT alone demonstrated protective effects against GU obstruction (OR 0.56 [CI 0.50-0.63]), GI bleeding (OR 0.57 [CI 0.48-0.67]), GU incontinence (OR 0.39 [CI 0.36-0.43]), and erectile dysfunction (OR 0.68 [CI 0.61-0.76]) when compared to combined therapy. The use of combined modality radiation therapy in low risk prostate cancer patients is discordant with clinical guidelines and associated with a significantly increased burden of associated toxicity when compared to EBRT monotherapy. Prudent patient selection and judicious use of combined therapy among men with low risk prostate cancer represents a targetable area to reduce the burden of overtreatment.

  14. Medical marijuana: largest provider closed, some alternatives available.

    Science.gov (United States)

    James, J S

    1998-06-05

    The Cannabis Healing Center, the largest of the medical marijuana buyers' clubs in San Francisco, was shut down on May 25 due to a court order obtained by State Attorney General Dan Lungren. The closure creates an emergency situation for thousands of persons who obtained the drug through the center. City officials are exploring ways to develop guidelines for the medical usage of marijuana that would be consistent with California Proposition 215. Proposition 215 does not nullify Federal laws against marijuana, however, Federal authorities usually allow State or local jurisdictions to handle marijuana enforcement. The three other buyers' clubs in the city are unable to meet the needs of everyone due to insufficient staffing. The closure also shut down the campaign office of Dennis Peron, who was the founder of the previous Cannabis Buyers' Club, and who was running for governor. Contact information and documentation requirements are included for the buyers' clubs.

  15. Collapse of the world’s largest herbivores

    Science.gov (United States)

    Ripple, William J.; Newsome, Thomas M.; Wolf, Christopher; Dirzo, Rodolfo; Everatt, Kristoffer T.; Galetti, Mauro; Hayward, Matt W.; Kerley, Graham I. H.; Levi, Taal; Lindsey, Peter A.; Macdonald, David W.; Malhi, Yadvinder; Painter, Luke E.; Sandom, Christopher J.; Terborgh, John; Van Valkenburgh, Blaire

    2015-01-01

    Large wild herbivores are crucial to ecosystems and human societies. We highlight the 74 largest terrestrial herbivore species on Earth (body mass ≥100 kg), the threats they face, their important and often overlooked ecosystem effects, and the conservation efforts needed to save them and their predators from extinction. Large herbivores are generally facing dramatic population declines and range contractions, such that ~60% are threatened with extinction. Nearly all threatened species are in developing countries, where major threats include hunting, land-use change, and resource depression by livestock. Loss of large herbivores can have cascading effects on other species including large carnivores, scavengers, mesoherbivores, small mammals, and ecological processes involving vegetation, hydrology, nutrient cycling, and fire regimes. The rate of large herbivore decline suggests that ever-larger swaths of the world will soon lack many of the vital ecological services these animals provide, resulting in enormous ecological and social costs. PMID:26601172

  16. Switzerland's largest wood-pellet factory in Balsthal

    International Nuclear Information System (INIS)

    Stohler, F.

    2004-01-01

    This article describes how a small Swiss electricity utility has broken out of its traditional role in power generation and the distribution of electricity and gone into the production of wood pellets. The pellets, which are made from waste wood (sawdust) available from wood processing companies, are produced on a large scale in one of Europe's largest pellets production facilities. The boom in the use of wood pellets for heating purposes is discussed. The article discusses this unusual approach for a Swiss power utility, which also operates a wood-fired power station and is even involved in an incineration plant for household wastes. The markets being aimed for in Switzerland and in Europe are described, including modern low-energy-consumption housing projects. A further project is described that is to use waste wood available from a large wood processing facility planned in the utility's own region

  17. Largest US oil and gas fields, August 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The Largest US Oil and Gas Fields is a technical report and part of an Energy Information Administration (EIA) series presenting distributions of US crude oil and natural gas resources, developed using field-level data collected by EIA's annual survey of oil and gas proved reserves. The series' objective is to provide useful information beyond that routinely presented in the EIA annual report on crude oil and natural gas reserves. These special reports also will provide oil and gas resource analysts with a fuller understanding of the nature of US crude oil and natural gas occurrence, both at the macro level and with respect to the specific subjects addressed. The series' approach is to integrate EIA's crude oil and natural gas survey data with related data obtained from other authoritative sources, and then to present illustrations and analyses of interest to a broad spectrum of energy information users ranging from the general public to oil and gas industry personnel

  18. BALU: Largest autoclave research facility in the world

    Directory of Open Access Journals (Sweden)

    Hakan Ucan

    2016-03-01

    Full Text Available Among the large-scale facilities operated at the Center for Lightweight-Production-Technology of the German Aerospace Center in Stade BALU is the world's largest research autoclave. With a loading length of 20m and a loading diameter of 5.8 m the main objective of the facility is the optimization of the curing process operated by components made of carbon fiber on an industrial scale. For this reason, a novel dynamic autoclaving control has been developed that is characterized by peripheral devices to expend the performance of the facility for differential applications, by sensing systems to detect the component state throughout the curing process and by a feedback system, which is capable to intervene into the running autoclave process.

  19. Fifteen Years of Operation at NASA's National Transonic Facility with the World's Largest Adjustable Speed Drive

    Science.gov (United States)

    Sydnor, George H.; Bhatia, Ram; Krattiger, Hansueli; Mylius, Justus; Schafer, D.

    2012-01-01

    In September 1995, a project was initiated to replace the existing drive line at NASA's most unique transonic wind tunnel, the National Transonic Facility (NTF), with a single 101 MW synchronous motor driven by a Load Commutated Inverter (LCI). This Adjustable Speed Drive (ASD) system also included a custom four-winding transformer, harmonic filter, exciter, switch gear, control system, and feeder cable. The complete system requirements and design details have previously been presented and published [1], as well as the commissioning and acceptance test results [2]. The NTF was returned to service in December 1997 with the new drive system powering the fan. Today, this installation still represents the world s largest horizontal single motor/drive combination. This paper describes some significant events that occurred with the drive system during the first 15 years of service. These noteworthy issues are analyzed and root causes presented. Improvements that have substantially increased the long term viability of the system are given.

  20. Single nucleotide polymorphisms in the PRDX3 and RPS19 and risk of HPV persistence and cervical precancer/cancer.

    Directory of Open Access Journals (Sweden)

    Mahboobeh Safaeian

    Full Text Available Host genetic factors might affect the risk of progression from infection with carcinogenic human papillomavirus (HPV, the etiologic agent for cervical cancer, to persistent HPV infection, and hence to cervical precancer and cancer.We assessed 18,310 tag single nucleotide polymorphisms (SNPs from 1113 genes in 416 cervical intraepithelial neoplasia 3 (CIN3/cancer cases, 356 women with persistent carcinogenic HPV infection (median persistence of 25 months and 425 randomly selected women (non-cases and non-HPV persistent from the 10,049 women from the Guanacaste, Costa Rica HPV natural history cohort. For gene and SNP associations, we computed age-adjusted odds ratio and p-trend. Three comparisons were made: 1 association with CIN3/cancer (compared CIN3/cancer cases to random controls, 2 association with persistence (compared HPV persistence to random controls, and 3 progression (compared CIN3/cancers with HPV-persistent group. Regions statistically significantly associated with CIN3/cancer included genes for peroxiredoxin 3 PRDX3, and ribosomal protein S19 RPS19. The single most significant SNPs from each gene associated with CIN3/cancer were PRDX3 rs7082598 (P(trend<0.0001, and RPS19 rs2305809 (P(trend=0.0007, respectively. Both SNPs were also associated with progression.These data suggest involvement of two genes, RSP19 and PRDX3, or other SNPs in linkage disequilibrium, with cervical cancer risk. Further investigation showed that they may be involved in both the persistence and progression transition stages. Our results require replication but, if true, suggest a role for ribosomal dysfunction, mitochondrial processes, and/or oxidative stress, or other unknown function of these genes in cervical carcinogenesis.

  1. Single and combined metal contamination in coastal environments in China: current status and potential ecological risk evaluation.

    Science.gov (United States)

    Manzoor, Romana; Zhang, Tingwan; Zhang, Xuejiao; Wang, Min; Pan, Jin-Fen; Wang, Zhumei; Zhang, Bo

    2018-01-01

    With the development of industrialization and urbanization, metal and metalloid pollution is one of the most serious environmental problems in China. Current contamination status of metals and metalloid and their potential ecological risks along China's coasts were reviewed in the present paper by a comprehensive study on metal contents in marine waters and sediments in the past few decades. The priority metals/metalloid cadmium (Cd), mercury (Hg), chromium (Cr), lead (Pb), and arsenic (As), which were the target elements of the designated project "Comprehensive Prevention and Control of Heavy Metal Pollution" issued by the Chinese government in 2011, were selected considering their high toxicity, persistence, and prevalent existence in coastal environment. Commonly used environmental quality evaluation methods for single and combined metals were compared, and we accordingly suggest the comprehensive approach of joint utilization of the Enrichment Factor and Effect Range Median combined with Pollution Load Index and Mean Effect Range Median Quotient (EEPME); this battery of guidelines may provide consistent, internationally comparable, and accurate understanding of the environment pollution status of combined metals/metalloid and their potential ecological risk.

  2. Value of a gene signature assay in patients with early breast cancer and intermediate risk: a single institution retrospective study.

    Science.gov (United States)

    Bonneterre, Jacques; Prat, Aleix; Galván, Patricia; Morel, Pascale; Giard, Sylvia

    2016-05-01

    Purpose In daily clinical practice, the indication for adjuvant chemotherapy (CT) is relatively easy to make in patients with early hormone-receptor-positive (HR+) breast cancer with either very poor or very good clinicopathological prognostic variables. However, this decision is much more difficult in patients with intermediate clinicopathological prognostic variables. Here, we evaluate the value of a gene-expression profile identified by the Prosigna gene signature assay in guiding treatment decision-making in patients with these intermediate features. Methods A consecutive cohort of 577 HR + breast cancer patients surgically treated in a single institution between January 2012 and December 2012 was evaluated. From this population, pre- and post-menopausal patients with intermediate prognosis clinicopathological variables were identified and indication of adjuvant CT in these patients was recorded. The gene signature assay was performed retrospectively in this intermediate risk group. Descriptive statistics are presented. Results Among 96 intermediate-risk patients, 64 postmenopausal patients underwent gene signature testing. Subtype distribution was as follows: Luminal A (N = 33; 51.6%), Luminal B (N = 31; 48.4%). Risk of recurrence (ROR) distribution was as follows: ROR-low (n = 16; 25%); ROR-intermediate (N = 26; 40.6%); and ROR-high (N = 22; 34.4%). CT was subsequently administered in 18.7%, 53.8% and 59.0% of the ROR-low, ROR-intermediate and ROR-high groups, respectively. With the use of the gene signature assay, 59.4% of the intermediate cases were re-classified to either ROR-low or ROR-high risk categories. In the ROR-intermediate group, 11/26 patients (42.3%) had Luminal A and 15/26 (57.7%) had Luminal B. Due to follow-up time constraints, no patient outcome results were evaluated. Conclusion The gene signature assay provides clinically useful information and improved treatment decision-making in patients with intermediate risk based on

  3. El Paso natural gas nearing completion of system's largest expansion

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    El Paso Natural Gas Co.'s largest expansion program in its 64-year history will be completed along its northern system this spring or early summer. According to the company, the three-tiered, $241.5 million expansion program will increase El Paso's gas-transport capacity by 835 MMcfd to 2.5 bcfd of conventional and coal-seam gas from the San Juan basin in northwestern New Mexico. That's enough natural gas, says the company, to supply the needs of a city of more than 800,000 residents. This paper reports that the expansion involves the San Juan Triangle system, the company's northern main line, and the Permian-San Juan crossover line. The company also filed with the Federal Energy Regulatory Commission (FERC) in October 1991 to construct a new $15.2 million compressor station, Rio Vista, south of Bloomfield, N.M. The station would be used to move additional gas to the main line

  4. Characterization of the largest effector gene cluster of Ustilago maydis.

    Directory of Open Access Journals (Sweden)

    Thomas Brefort

    2014-07-01

    Full Text Available In the genome of the biotrophic plant pathogen Ustilago maydis, many of the genes coding for secreted protein effectors modulating virulence are arranged in gene clusters. The vast majority of these genes encode novel proteins whose expression is coupled to plant colonization. The largest of these gene clusters, cluster 19A, encodes 24 secreted effectors. Deletion of the entire cluster results in severe attenuation of virulence. Here we present the functional analysis of this genomic region. We show that a 19A deletion mutant behaves like an endophyte, i.e. is still able to colonize plants and complete the infection cycle. However, tumors, the most conspicuous symptoms of maize smut disease, are only rarely formed and fungal biomass in infected tissue is significantly reduced. The generation and analysis of strains carrying sub-deletions identified several genes significantly contributing to tumor formation after seedling infection. Another of the effectors could be linked specifically to anthocyanin induction in the infected tissue. As the individual contributions of these genes to tumor formation were small, we studied the response of maize plants to the whole cluster mutant as well as to several individual mutants by array analysis. This revealed distinct plant responses, demonstrating that the respective effectors have discrete plant targets. We propose that the analysis of plant responses to effector mutant strains that lack a strong virulence phenotype may be a general way to visualize differences in effector function.

  5. LHC : The World's Largest Vacuum Systems being commissioned at CERN

    CERN Document Server

    Jiménez, J M

    2008-01-01

    When it switches on in 2008, the 26.7 km Large Hadron Collider (LHC) at CERN, will have the world's largest vacuum system operating over a wide range of pressures and employing an impressive array of vacuum technologies. This system is composed by 54 km of UHV vacuum for the circulating beams and 50 km of insulation vacuum around the cryogenic magnets and the liquid helium transfer lines. Over the 54 km of UHV beam vacuum, 48 km of this are at cryogenic temperature (1.9 K). The remaining 6 km of beam vacuum containing the insertions for "cleaning" the proton beams, radiofrequency cavities for accelerating the protons as well as beam-monitoring equipment is at ambient temperature and uses non-evaporable getter (NEG) coatings - a vacuum technology that was born and industrialized at CERN. The pumping scheme is completed using 780 ion pumps to remove noble gases and to provide pressure interlocks to the 303 vacuum safety valves. Pressure readings are provided by 170 Bayard-Alpert gauges and 1084 gauges (Pirani a...

  6. Largest US oil and gas fields, August 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-06

    The Largest US Oil and Gas Fields is a technical report and part of an Energy Information Administration (EIA) series presenting distributions of US crude oil and natural gas resources, developed using field-level data collected by EIA`s annual survey of oil and gas proved reserves. The series` objective is to provide useful information beyond that routinely presented in the EIA annual report on crude oil and natural gas reserves. These special reports also will provide oil and gas resource analysts with a fuller understanding of the nature of US crude oil and natural gas occurrence, both at the macro level and with respect to the specific subjects addressed. The series` approach is to integrate EIA`s crude oil and natural gas survey data with related data obtained from other authoritative sources, and then to present illustrations and analyses of interest to a broad spectrum of energy information users ranging from the general public to oil and gas industry personnel.

  7. Swarming behaviour and mass occurrences in the world's largest ...

    African Journals Online (AJOL)

    The first records of mass occurrences (swarming behaviour) in giant pill - millipedes, order Sphaerotheriida, are reported from Madagascar. Swarming behaviour in the order Sphaerotheriida seems to be restricted to a single of more than sixty described Malagasy species, Zoosphaerium neptunus (Butler, 1872), which is the ...

  8. Flow mixing at the World's largest river confluence

    Science.gov (United States)

    Best, Jim; Ianniruberto, Marco; Gualtieri, Carlo; Paes de Almeida, Renato; Freitas, Bernardo; Nogueira, Pedro; Cisneros, Julia

    2017-04-01

    River confluences form key nodes within all fluvial networks and points of significant, and non-linear, changes in flow discharge, sediment grain size and bed morphology. It is generally acknowledged that the hydrodynamics and morphodynamics within the confluence zone are influenced by the junction planform, the momentum flux ratio between the merging streams, and the level of concordance between channel beds at the confluence entrance. Recent work has also identified the role of density differences between the confluent flows as potentially exerting a significant influence on fluid mixing. Perhaps the most well-known example, which has attracted considerable recent study, is at the world's largest river confluence - the Rio Solimões and Rio Negro (the Encontro das Águas), near Manaus, in the Amazonian basin. This paper sheds new light on the patterns of mixing at the Encontro das Águas as revealed by combined multibeam echo sounder (MBES) and acoustic Doppler current profiling (aDcp) surveys. The MBES survey reveals that the scour and bed morphology at this confluence, that can be up to c. 80m deep, is dominated by the presence of Cretaceous bedrock and that the mobile bedload sediment from the Rio Solimões is confined to a narrow zone of transport. The suspended sediment plume from the Rio Solimões interacts with the bedrock, which can comprise subaqueous roughness up to 20m in height, and is consequently diverted both laterally and vertically by this topography. The aDcp surveys reveal the nature of this topographic interaction and suggest that the routing of sediment-laden fluid within the junction, and the patterns of upwelling on the flow surface, are significantly influenced by these flow-bedrock interactions. Details of the topography and these fluid dynamic interactions will be presented, together with an analysis of satellite imagery that links the longevity of the location of some of the upwellings to the presence of bedrock roughness.

  9. Reach and messages of the world's largest ivory burn.

    Science.gov (United States)

    Braczkowski, Alexander; Holden, Matthew H; O'Bryan, Christopher; Choi, Chi-Yeung; Gan, Xiaojing; Beesley, Nicholas; Gao, Yufang; Allan, James; Tyrrell, Peter; Stiles, Daniel; Brehony, Peadar; Meney, Revocatus; Brink, Henry; Takashina, Nao; Lin, Ming-Ching; Lin, Hsien-Yung; Rust, Niki; Salmo, Severino G; Watson, James Em; Kahumbu, Paula; Maron, Martine; Possingham, Hugh P; Biggs, Duan

    2018-03-01

    Recent increases in ivory poaching have depressed African elephant populations. Successful enforcement has led to ivory being stockpiled. Stockpile destruction is becoming increasingly popular, and most destruction has occurred in the last five years. Ivory destruction is intended to send a strong message against ivory consumption, both in promoting a taboo on ivory use and catalyzing policy change. However, there has been no effort to establish the distribution and extent of media reporting on ivory destruction events globally. We analyze media coverage across eleven important nation states of the largest ivory destruction event in history (Kenya, 30 April 2016). We used a well-accepted online media crawling tool and key language translations to search online and print newspapers. We found most online news on the ivory burn came from the US (81% of articles), while print news was dominated by Kenya (61% of articles). We subjected online articles from five key countries and territories to content analysis and found 86-97% of all online articles reported the burn as a positive conservation action, while between 4-50% discussed ivory burning as having a negative impact on elephant conservation. Most articles discussed law enforcement and trade bans as effective for elephant conservation. There was more relative search interest globally on the 2016 Kenyan ivory burn than any other in five years. Our study is the first attempt to track the spread of media around an ivory burn and is a case study in tracking the effects of a conservation-marketing event. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Safety and efficacy assessment of carotid artery stenting in a high-risk population in a single-centre registry.

    Science.gov (United States)

    Kosowski, Michał; Zimoch, Wojciech; Gwizdek, Tomasz; Konieczny, Radosław; Kübler, Piotr; Telichowski, Artur; Jankowska, Ewa A; Reczuch, Krzysztof

    2014-01-01

    Ischaemic stroke is the primary cause of long-term disability and the third most common cause of death. Internal carotid artery stenosis is an important risk factor for stroke and transient ischaemic attack (TIA). European Society of Cardiology (ESC) and American Heart Association (AHA) guidelines allow carotid artery stenting (CAS) as an alternative to endarterectomy in centres with low rates of death or stroke. To assess the safety and efficacy of CAS in a single-centre observation. We performed a retrospective analysis of all patients treated with CAS between March 2008 and July 2012. Clinical data and outcomes in both asymptomatic and symptomatic patients were analysed. A total of 214 consecutive patients were included in the registry. Symptomatic patients accounted for 57% of the study group and were more likely to have a history of stroke and/or TIA that occurred more than 6 months before the procedure (50% vs. 8%, p likely to have a history of coronary artery disease (88% vs. 61%, p < 0.001), and the rates of previous acute coronary syndrome and revascularisation were also higher in this group (58% vs. 41% and 71% vs. 52%, respectively, both p < 0.05). The symptomatic group had higher incidence of stroke in periprocedural and 30-day observation (4% vs. 0%, p < 0.05). There was no difference in incidence of adverse events in long-term observation. Carotid artery stenting is a safe and efficacious procedure. Every centre performing CAS should monitor the rate of periprocedural complications.

  11. Glu504Lys Single Nucleotide Polymorphism of Aldehyde Dehydrogenase 2 Gene and the Risk of Human Diseases

    Directory of Open Access Journals (Sweden)

    Yan Zhao

    2015-01-01

    Full Text Available Aldehyde dehydrogenase (ALDH 2 is a mitochondrial enzyme that is known for its important role in oxidation and detoxification of ethanol metabolite acetaldehyde. ALDH2 also metabolizes other reactive aldehydes such as 4-hydroxy-2-nonenal and acrolein. The Glu504Lys single nucleotide polymorphism (SNP of ALDH2 gene, which is found in approximately 40% of the East Asian populations, causes defect in the enzyme activity of ALDH2, leading to alterations in acetaldehyde metabolism and alcohol-induced “flushing” syndrome. Evidence suggests that ALDH2 Glu504Lys SNP is a potential candidate genetic risk factor for a variety of chronic diseases such as cardiovascular disease, cancer, and late-onset Alzheimer’s disease. In addition, the association between ALDH2 Glu504Lys SNP and the development of these chronic diseases appears to be affected by the interaction between the SNP and lifestyle factors such as alcohol consumption as well as by the presence of other genetic variations.

  12. A single nucleotide polymorphism in the dimethylarginine dimethylaminohydrolase gene is associated with lower risk of pulmonary hypertension in bronchopulmonary dysplasia

    Science.gov (United States)

    Trittmann, JK; Gastier-Foster, JM; Zmuda, EJ; Frick, J; Rogers, LK; Vieland, VJ; Chicoine, LG; Nelin, LD

    2016-01-01

    Aim Pulmonary hypertension (PH) develops in 25–40% of bronchopulmonary dysplasia (BPD) patients, substantially increasing mortality. We have previously found that asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide (NO) production, is elevated in patients with BPD-associated PH. ADMA is metabolized by NG,NG- dimethylarginine dimethylaminohydrolase (DDAH). Presently, we test the hypothesis that there are single nucleotide polymorphisms (SNPs) in DDAH1 and/or DDAH2 associated with the development of PH in BPD patients. Methods BPD patients were enrolled (n=98) at Nationwide Children’s Hospital. Clinical characteristics and 36 SNPs in DDAH1 and DDAH2 were compared between BPD-associated PH patients (cases) and BPD-alone patients (controls). Results In BPD patients, 25 (26%) had echocardiographic evidence of PH (cases). In this cohort, DDAH1 wildtype rs480414 was 92% sensitive and 53% specific for PH in BPD, and the DDAH1 SNP rs480414 decreased the risk of PH in an additive model of inheritance (OR=0.39; 95% CI [0.18–0.88], p=0.01). Conclusion The rs480414 SNP in DDAH1 may be protective against the development of PH in patients with BPD. Furthermore, the DDAH1 rs480414 may be a useful biomarker in developing predictive models for PH in patients with BPD. PMID:26663142

  13. GIS learning tool for world's largest earthquakes and their causes

    Science.gov (United States)

    Chatterjee, Moumita

    The objective of this thesis is to increase awareness about earthquakes among people, especially young students by showing the five largest and two most predictable earthquake locations in the world and their plate tectonic settings. This is a geographic based interactive tool which could be used for learning about the cause of great earthquakes in the past and the safest places on the earth in order to avoid direct effect of earthquakes. This approach provides an effective way of learning for the students as it is very user friendly and more aligned to the interests of the younger generation. In this tool the user can click on the various points located on the world map which will open a picture and link to the webpage for that point, showing detailed information of the earthquake history of that place including magnitude of quake, year of past quakes and the plate tectonic settings that made this place earthquake prone. Apart from knowing the earthquake related information students will also be able to customize the tool to suit their needs or interests. Students will be able to add/remove layers, measure distance between any two points on the map, select any place on the map and know more information for that place, create a layer from this set to do a detail analysis, run a query, change display settings, etc. At the end of this tool the user has to go through the earthquake safely guidelines in order to be safe during an earthquake. This tool uses Java as programming language and uses Map Objects Java Edition (MOJO) provided by ESRI. This tool is developed for educational purpose and hence its interface has been kept simple and easy to use so that students can gain maximum knowledge through it instead of having a hard time to install it. There are lots of details to explore which can help more about what a GIS based tool is capable of. Only thing needed to run this tool is latest JAVA edition installed in their machine. This approach makes study more fun and

  14. Landscapes of thermal inequity: disproportionate exposure to urban heat in the three largest US cities

    Science.gov (United States)

    Mitchell, Bruce C.; Chakraborty, Jayajit

    2015-11-01

    Heat waves are the most significant cause of mortality in the US compared to other natural hazards. Prior studies have found increased heat exposure for individuals of lower socioeconomic status in several US cities, but few comparative analyses of the social distribution of urban heat have been conducted. To address this gap, our paper examines and compares the environmental justice consequences of urban heat risk in the three largest US cities: New York City, Los Angeles, and Chicago. Risk to urban heat is estimated on the basis of three characteristics of the urban thermal landscape: land surface temperature, vegetation abundance, and structural density of the built urban environment. These variables are combined to develop an urban heat risk index, which is then statistically compared with social vulnerability indicators representing socioeconomic status, age, disability, race/ethnicity, and linguistic isolation. The results indicate a consistent and significant statistical association between lower socioeconomic and minority status and greater urban heat risk, in all three cities. Our findings support a growing body of environmental justice literature that indicates the presence of a landscape of thermal inequity in US cities and underscores the need to conduct comparative analyses of social inequities in exposure to urban heat.

  15. Mortgage loans: an analysis of the portfolios of the largest banks in Brazil

    Directory of Open Access Journals (Sweden)

    Bruno Vinícius Ramos Fernandes

    2013-05-01

    Full Text Available Given the current macroeconomic environment experienced in Brazil, where inflation has stabilized and the basic interest rate of the economy is in one of their historical lows, demand for mortgages is increasing. In this context, the mortgage is presented with great emphasis to meet the demand for purchasing housing in addition to being a catalyst for the reduction of the high housing deficit. From a descriptive and empirical-analytic was analyzed the mortgage loan portfolio of the largest banks of the country between the years 2001 and 2010 through Quarterly Financial Information (IFT available on the Central Bank website. It was settled a comparative relationship between the data in order to check the development of mortgage portfolios over the years and the factors that influenced this evolution, and evaluate the timeliness and quality of those loans. For the evolution of the portfolio there was an economic context in which Brazil was included in the period, and observed that for most of these operations are long term the banks are more exposed to market risk. With regard to credit risk parse that, over the years, Brazilian banks are presenting a mortgage loan portfolio with lower risk, and it is found that institutions with real estate credits with higher levels of portfolio risk are subject to have higher losses on such operations in the possibility of default.

  16. Single-port versus conventional multiport access prophylactic laparoscopic bilateral salpingo-oophorectomy in high-risk patients for ovarian cancer: a comparison of surgical outcomes

    Directory of Open Access Journals (Sweden)

    Angioni S

    2015-06-01

    Full Text Available Stefano Angioni,1 Alessandro Pontis,1 Federica Sedda,1 Theodoros Zampetoglou,2 Vito Cela,3 Liliana Mereu,4 Pietro Litta51Department of Surgical Sciences, University of Cagliari, Cagliari, Italy; 2Obstetrics and Gynecology, Iaso Thessalia Hospital, Larissa, Greece; 3Department of Obstetrics and Gynecology, University of Pisa, Pisa, 4Ospedale S Chiara, Trento, 5Department of Obstetrics and Gynecology, University of Padua, Padua, ItalyAbstract: Bilateral salpingo-oophorectomy (BSO in carriers of BRCA1 and BRCA2 mutations is widely recommended as part of a risk-reduction strategy for ovarian or breast cancer due to an underlying genetic predisposition. BSO is also performed as a therapeutic intervention for patients with hormone-positive premenopausal breast cancer. BSO may be performed via a minimally invasive approach with the use of three to four 5 mm and/or 12 mm ports inserted through a skin incision. To further reduce the morbidity associated with the placement of multiple port sites and to improve cosmetic outcomes, single-port laparoscopy has been developed with a single access point from the umbilicus. The purpose of this study was to evaluate the surgical outcomes associated with reducing the risks of salpingo-oophorectomy performed in a single port, while comparing multiport laparoscopy in women with a high risk for ovarian cancer. Single-port laparoscopy–BSO is feasible and safe, with favorable surgical and cosmetic outcomes when compared to conventional laparoscopy.Keywords: prophylactic salpingectomy, single-port access laparoscopy, BRCA carriers

  17. Single-Nucleotide Polymorphisms of Genes Involved in Repair of Oxidative DNA Damage and the Risk of Recurrent Depressive Disorder

    Science.gov (United States)

    Czarny, Piotr; Kwiatkowski, Dominik; Toma, Monika; Gałecki, Piotr; Orzechowska, Agata; Bobińska, Kinga; Bielecka-Kowalska, Anna; Szemraj, Janusz; Berk, Michael; Anderson, George; Śliwiński, Tomasz

    2016-01-01

    Background Depressive disorder, including recurrent type (rDD), is accompanied by increased oxidative stress and activation of inflammatory pathways, which may induce DNA damage. This thesis is supported by the presence of increased levels of DNA damage in depressed patients. Such DNA damage is repaired by the base excision repair (BER) pathway. BER efficiency may be influenced by polymorphisms in BER-related genes. Therefore, we genotyped nine single-nucleotide polymorphisms (SNPs) in six genes encoding BER proteins. Material/Methods Using TaqMan, we selected and genotyped the following SNPs: c.-441G>A (rs174538) of FEN1, c.2285T>C (rs1136410) of PARP1, c.580C>T (rs1799782) and c.1196A>G (rs25487) of XRCC1, c.*83A>C (rs4796030) and c.*50C>T (rs1052536) of LIG3, c.-7C>T (rs20579) of LIG1, and c.-468T>G (rs1760944) and c.444T>G (rs1130409) of APEX1 in 599 samples (288 rDD patients and 311 controls). Results We found a strong correlation between rDD and both SNPs of LIG3, their haplotypes, as well as a weaker association with the c.-468T>G of APEXI which diminished after Nyholt correction. Polymorphisms of LIG3 were also associated with early onset versus late onset depression, whereas the c.-468T>G polymorphism showed the opposite association. Conclusions The SNPs of genes involved in the repair of oxidative DNA damage may modulate rDD risk. Since this is an exploratory study, the results should to be treated with caution and further work needs to be done to elucidate the exact involvement of DNA damage and repair mechanisms in the development of this disease. PMID:27866211

  18. Psychiatric disorders and suicide in the nation's largest state prison system.

    Science.gov (United States)

    Baillargeon, Jacques; Penn, Joseph V; Thomas, Christopher R; Temple, Jeff R; Baillargeon, Gwen; Murray, Owen J

    2009-01-01

    This study examined the relationship between the overall rate of psychiatric disorders and suicides in the nation's largest state prison population. Data from 234,031 Texas Department of Criminal Justice inmates who were incarcerated for any duration between September 2006 and September 2007 were analyzed by Poisson regression, to assess the independent associations of major psychiatric disorders and demographic characteristics with suicide. Across the entire study cohort, 41 inmates (18 per 100,000) were reported to have committed suicide during the 12-month follow-up period; 21 of them had a diagnosis of a serious mental illness. An elevated risk of suicide was observed among inmates with major depressive disorder (relative risk [RR] = 5.1, 95% confidence interval [CI] = 1.9-13.8), bipolar disorder (RR = 4.6, CI = 1.3-15.9), and schizophrenia (RR = 7.3, CI = 1.7-15.9). The highest overall risk was present in those inmates with a nonschizophrenic psychotic disorder (RR = 13.8, CI = 5.8-32.9). These findings highlight the importance of maintaining suicide prevention programs in correctional settings, with particular emphasis on screening and monitoring of patients with severe psychiatric disorders.

  19. Risk evaluation of embedded, single-walled liquid low-level waste piping at Oak Ridge National Laboratory. ESD Publication 4315

    International Nuclear Information System (INIS)

    1994-10-01

    Four categories of liquid low-level radioactive waste (LLLW) systems are defined in the Federal Facility Agreement (FFA) for the Oak Ridge Reservation (ORR). Categories A and B are new and fully compliant existing systems, respectively: Category C is singly contained and must be removed from service, and Category D is inactive. The FFA requires that secondary containment and leak detection be provided for all Category A and B piping in the LLLW System at Oak Ridge National Laboratory (ORNL); however, as noted in the D2 revision of the secondary containment design demonstration report (DOE 1994), some sections of single-walled embedded piping in Category B underground vaults at three ORNL facilities do not meet this requirement. A risk evaluation was performed in order compare the potential radiation dose to a member of the public that could result from a postulated leak in the single-walled pipes with projected radiation exposure to the workers who would modify the piping to meet FFA requirements. The risk to human health from replacing segments of embedded, single-walled piping in the LLW system is higher than the risk of leaving the piping as it is

  20. Ownership, financing, and management strategies of the ten largest for-profit nursing home chains in the United States.

    Science.gov (United States)

    Harrington, Charlene; Hauser, Clarilee; Olney, Brian; Rosenau, Pauline Vaillancourt

    2011-01-01

    This study examined the ownership, financing, and management strategies of the 10 largest for-profit nursing home chains in the United States, including the four largest chains purchased by private equity corporations. Descriptive data were collected from Internet searches, company reports, and other sources for the decade 1998-2008. Since 1998, the largest chains have made many changes in their ownership and structure, and some have converted from publicly traded companies to private ownership. This study shows the increasing complexity of corporate nursing home ownership and the lack of public information about ownership and financial status. The chains have used strategies to maximize shareholder and investor value that include increasing Medicare revenues, occupancy rates, and company diversification, establishing multiple layers of corporate ownership, developing real estate investment trusts, and creating limited liability companies. These strategies enhance shareholder and investor profits, reduce corporate taxes, and reduce liability risk. There is a need for greater transparency in ownership and financial reporting and for more government oversight of the largest for-profit chains, including those owned by private equity companies.

  1. A single visit multidisciplinary model for managing patients with mutations in moderate and high-risk genes in a community practice setting.

    Science.gov (United States)

    O'Leary, Michael P; Goldner, Bryan S; Abboy, Sridevi; Mercado, Philip D; Plurad, Hong Yoon

    2018-01-01

    The introduction of screening for multiple high and moderate risk mutations in genes has resulted in a complex approach to patient care involving multiple disciplines. We sought to describe the feasibility of a single visit multidisciplinary approach to the management of patients with an identified high/moderate risk gene mutation. Patients who presented to our community hospital over a 1-year period who were found to have a high/moderate risk genetic mutation on a screening panel were referred to the High Risk Genetic Clinic. Thirty-five patients were included. The majority were female [34 (97.1%)], Hispanic [22 (62.9%)], with a family history of cancer [21 (60%)]. Mean age was 40.3 years. Most of the participants had a BRCA1 gene mutation [10 (28.6%)]. Patients were seen at the High Risk Genetic Clinic within a mean of 41.9 days from the day of genetic mutation diagnosis. Four patients did not show and were significantly younger (19.3 vs. 39.6 years, p = 0.014). In this community setting, we provided coordinated care within multiple disciplines related to a genetic mutation in a single clinic visit. Increased efforts at coordinating early care should be directed towards patients diagnosed at a younger age.

  2. Combined inflatable penile prosthesis-artificial urinary sphincter implantation: no increased risk of adverse events compared to single or staged device implantation.

    Science.gov (United States)

    Segal, Robert L; Cabrini, Mercelo R; Harris, Elaine D; Mostwin, Jacek L; Bivalacqua, Trinity J; Burnett, Arthur L

    2013-12-01

    Little data exist on the outcome of combined inflatable penile prosthesis and artificial urinary sphincter insertion for erectile dysfunction and stress urinary incontinence. We assessed patient outcomes for combined vs single device implantation at a single institution. We retrospectively reviewed the records of all patients who underwent inflatable penile prosthesis and artificial urinary sphincter insertion at our hospital from January 2000 to December 2011. A total of 55 combined procedures were performed compared to the single insertion of 336 inflatable penile prostheses and 279 artificial urinary sphincters. The surgical approach consisted of penoscrotal incisions for inflatable penile prostheses and transperineal incisions for artificial urinary sphincter cuff placement with a secondary lower abdominal incision for reservoir placement. Men treated with combined implantation had greater mean age and were at greater risk for prostate cancer diagnosis and treatment, and at lesser risk for Peyronie disease than men who received an inflatable penile prosthesis alone (each pprosthesis alone and the AUS alone (mean 218.1 vs 145.9 and 114.7 minutes, respectively, p0.05). Combined inflatable penile prosthesis-artificial urinary sphincter implantation and staged prosthesis implantation are feasible without an increased risk of adverse outcomes compared to implantation of a single prosthesis. Patients with concomitant erectile dysfunction and stress urinary incontinence should be counseled about the possible advantages of this surgical option, which include a single anesthesia event and faster resumption of sexual activity and urinary control. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Progesterone Therapy for the Prevention of Preterm Labor in Women with Single Risk-factor: A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Kefayat Chaman-Ara

    2016-04-01

    Full Text Available Background: Preterm labor is a common complication of pregnancy which has become a main health concern around the world due to its negative consequences. Objective: To investigate the efficacy of progesterone therapy in the prevention of preterm labor in women with single risk factor. Search strategy: A PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Science Direct, Scopus, OVID, EMBASE, SID, Magiran and Google Scholar search (date last searched April 2016 without any time, language and location restriction was done. Inclusion criteria: All randomized clinical trials of singleton pregnancies with single risk factor (prior preterm labor without short cervical length or short cervical length without prior preterm labor which were randomized to progesterone and control groups were included in our meta-analysis. Primary outcome: Our primary outcome was gestational age at delivery. Results: 13 studies (1259 subjects and 2653 control women were included in the meta-analysis. Using random effect model showed that mean gestational age at delivery of progesterone group is 0.74 (0.41-1.06 month longer than that of control group with CI=95% which is significant statically. Conclusions: Progesterone therapy is an effective intervention for the prevention of preterm labor in women with single risk factor. 

  4. The Role of the Risk-Neutral Jump Size Distribution in Single-Factor Interest Rate Models

    Directory of Open Access Journals (Sweden)

    L. Gómez-Valle

    2015-01-01

    Full Text Available We obtain a result that relates the risk-neutral jump size of interest rates with yield curve data. This function is unobservable; therefore, this result opens a way to estimate the jump size directly from data in the markets together with the risk-neutral drift and jump intensity estimations. Then, we investigate the finite sample performance of this approach with a test problem. Moreover, we analyze the effect of estimating the risk-neutral jump size instead of assuming that it is artificially absorbed by the jump intensity, as usual in the interest rate literature. Finally, an application to US Treasury Bill data is also illustrated.

  5. Housing as a Social Determinant of Health: Exploring the Relationship between Rent Burden and Risk Behaviors for Single Room Occupancy Building Residents.

    Science.gov (United States)

    Bowen, Elizabeth A; Mitchell, Christopher G

    2016-01-01

    A growing body of health determinants research recognizes that housing and health are intimately linked. This study explores the relationship between rent burden (the ratio of rent to income) and health risk behaviors among a sample of single room occupancy (SRO) building residents. Cross-sectional data were gathered from a sample of 162 residents living in privately owned, for-profit SROs in Chicago. Findings indicated that participants who had full rental subsidies and thus were designated in a no-rent-burden category were more likely to engage in risk behaviors including illicit drug use, having multiple sexual partners, and having sex without a condom, in comparison to participants with moderate or high-rent burdens. These findings suggest that interventions to increase housing stability and affordability and bolster reliable income sources (in addition to rental subsidies) may be key in reducing risk behaviors and improving health for vulnerably housed populations such as SRO residents.

  6. [Being raised by lesbian parents or in a single-parent family is no risk factor for problem behavior, however being raised as an adopted child is].

    Science.gov (United States)

    Verhulst, F C; Versluis-den Bieman, H O; Balmus, N C

    1997-03-01

    Modern reproductive techniques and alternative family structures (with single or homosexual parents and adoption situations) raise questions about the consequences for the growing children involved. Genetic links appear to be less important for the functioning of a family than a strong wish for parenthood; parents who have become parents only through great efforts display a better quality of parenthood than average natural parents. Characteristics of the parent/parents, such as paedagogic qualities, and the quality of the parent-child relationship appear more important than the type of family. Published results of research reveal no reason why lesbian families should be judged differently from heterosexual ones as family types for the raising of children. The main negative factor for the functioning of the child growing up in a single-parent family is the marriage conflicts that have led to the single-parent situation; being raised by a single parent in itself has no adverse effect. Raising adopted children from other countries makes far greater demands on the adoptive parents than parents of biological children have to meet. The raising of a foreign adopted child by a single parent entails additional risks for the child's development. Data on the development of children in alternative family structures frequently concern exceptionally competent parents, which may have biased the findings.

  7. Risk factors for poor outcome of a single Epley maneuver and residual positional vertigo in patients with benign paroxysmal positional vertigo.

    Science.gov (United States)

    Sato, Go; Sekine, Kazunori; Matsuda, Kazunori; Takeda, Noriaki

    2013-11-01

    The findings suggest that in patients with posterior semicircular canal (PSCC) benign paroxysmal positional vertigo (P-BPPV), head trauma and prolonged bedrest, but not inner ear disease, are risk factors for poor outcome of a single Epley maneuver and persistent residual positional vertigo. We first examined the efficacy of a single Epley maneuver and then assessed the time course in remission of residual positional vertigo in patients with idiopathic P-BPPV and secondary P-BPPV. A total of 157 patients with idiopathic P-BPPV and 40 patients with secondary P-BPPV (secondary to head trauma in 8 patients, to prolonged bedrest in 14 patients, and to inner ear disease in 18 patients) were treated with a single Epley maneuver. The negative rates of the Dix-Hallpike test on day 7 after a single Epley maneuver in both patients with P-BPPV secondary to head trauma (25%) and those with prolonged bedrest (36%) were significantly lower than that (73%) in patients with idiopathic P-BPPV. Additionally, the remission of residual positional vertigo in the former groups of patients was significantly delayed in comparison with that of the latter group. However, there were no significant differences in the efficacy of a single Epley maneuver and persistent residual positional vertigo between idiopathic P-BPPV and P-BPPV secondary to inner ear disease.

  8. Clinical features and risk assessment for cardiac surgery in adult congenital heart disease: Three years at a single Japanese center

    Directory of Open Access Journals (Sweden)

    Satoshi Kurokawa

    2014-04-01

    Conclusion: Cardiac surgery could be safely performed in most ACHD cases. Exercise tolerance testing can be useful in identifying patients at high risk of mortality or major complications. BNP can be valuable in predicting poor outcomes after cardiac surgery.

  9. Risk factors for early complications after laparoscopic total mesorectal excision for locally advanced rectal cancer: A single center experience

    Directory of Open Access Journals (Sweden)

    Liye Liu

    2016-01-01

    Conclusions: Aged patients, large tumor, lower tumor location and conversion were risk factors in performing laparoscopic TME for locally advanced rectal cancer. Patients with these characteristics should be carefully considered before undergoing laparoscopic total mesorectal excision.

  10. Analysis of risk factors of long-term complications in congenital diaphragmatic hernia: A single institution's experience

    Directory of Open Access Journals (Sweden)

    Hajime Takayasu

    2017-01-01

    Conclusion: Patients who developed short-term complications seemed to be at risk of long-term complications. Therefore, to minimize long-term morbidities in CDH survivors, the prevention of short-term complications might be important.

  11. Comparison of primary radiation versus robotic surgery plus adjuvant radiation in high-risk prostate cancer: A single center experience

    OpenAIRE

    Prabhsimranjot Singh; Prashant Desai; Shruthi Arora; Anthony H Pham; A Gabriella Wernicke; Michael Smith; Dattatreyudu Nori; K S Clifford Chao; Bhupesh Parashar

    2015-01-01

    Objective: The objective of this study was to compare robotic-prostatectomy plus adjuvant radiation therapy (RPRAT) versus primary RT for high-risk prostate cancer (HRPCa). Materials and Methods: A retrospective chart review was performed for the HRPCa patients treated in our institution between 2000 and 2010. One hundred and twenty-three patients with high-risk disease were identified. The Chi-square test and Fisher′s exact test were used to compare local control and distant failure rate...

  12. Setting Single or Multiple Goals for Diet and Physical Activity Behaviors Improves Cardiovascular Disease Risk Factors in Adults With Type 2 Diabetes: A Pragmatic Pilot Randomized Trial.

    Science.gov (United States)

    Swoboda, Christine M; Miller, Carla K; Wills, Celia E

    2016-08-01

    The purpose of this study was to evaluate a 4-month telephone-based goal-setting and decision support intervention among adults with type 2 diabetes mellitus (T2DM) and multiple risk factors for cardiovascular disease (CVD). A randomized pretest-posttest control group design was employed. Overweight or obese adults aged 40 to 75 years with T2DM and ≥1 additional CVD risk factor were provided with individualized CVD risk information. At baseline and each biweekly telephone call, the multiple-goal group self-selected both diet- and physical activity-related goals, the single goal group set a single goal, and the control group received information about community health resources. Dietary intake was assessed via a food frequency questionnaire, physical activity via questionnaire, and A1C and blood lipids via fasting fingerstick sample. Between-group differences for clinical (ie, A1C, blood pressure, and blood lipids), physical activity, and dietary variables were evaluated using Kruskal-Wallis, Mann-Whitney U, analysis of variance, and t tests. From pre- to postintervention, the single-goal group demonstrated significant improvement in systolic blood pressure and intake of servings of fruits, vegetables, and refined grains (all P < .05). The multiple-goal group reported significant reduction in percent energy from total, saturated, monounsaturated, and trans fat intake and significant increase in leisure time walking (all P < .05). A multiple-goal approach over 4 months can improve dietary and physical activity outcomes, while a single-goal approach may facilitate improvement in one behavioral domain. Additional research is needed to evaluate maintenance of the achieved changes. © 2016 The Author(s).

  13. Echinoderes rex n. sp. (Kinorhyncha: Cyclorhagida, the largest Echinoderes species found so far

    Directory of Open Access Journals (Sweden)

    Henriette Lundbye

    2010-11-01

    Full Text Available A new kinorhynch species, Echinoderes rex n. sp., is described from the Korea Strait. The new species is characterized by a pair of diminutive lateral terminal spines (19-23 μm and a trunk length of 482-528 μm, making it the largest Echinoderes described so far. Unique for the new species is also the presence of a type of putative glandular cell outlets that have not been described previously. This paper presents light and scanning electron micrographs of the new structure. In addition, E. rex n. sp. is characterized by having a single middorsal spine on segment 4, lateroventral tubules on segment 5 and 8 and lateroventral acicular spines on segments 6 and 7. A pair of distinct and conspicuously large sieve plates, only described from two other species of the genus, is present on segment 9 in E. rex n. sp. A comparison is made with other species of Echinoderes and the similarities are discussed.

  14. Invertebrate population genetics across Earth's largest habitat: The deep-sea floor.

    Science.gov (United States)

    Taylor, M L; Roterman, C N

    2017-10-01

    Despite the deep sea being the largest habitat on Earth, there are just 77 population genetic studies of invertebrates (115 species) inhabiting non-chemosynthetic ecosystems on the deep-sea floor (below 200 m depth). We review and synthesize the results of these papers. Studies reveal levels of genetic diversity comparable to shallow-water species. Generally, populations at similar depths were well connected over 100s-1,000s km, but studies that sampled across depth ranges reveal population structure at much smaller scales (100s-1,000s m) consistent with isolation by adaptation across environmental gradients, or the existence of physical barriers to connectivity with depth. Few studies were ocean-wide (under 4%), and 48% were Atlantic-focused. There is strong emphasis on megafauna and commercial species with research into meiofauna, "ecosystem engineers" and other ecologically important species lacking. Only nine papers account for ~50% of the planet's surface (depths below 3,500 m). Just two species were studied below 5,000 m, a quarter of Earth's seafloor. Most studies used single-locus mitochondrial genes revealing a common pattern of non-neutrality, consistent with demographic instability or selective sweeps; similar to deep-sea hydrothermal vent fauna. The absence of a clear difference between vent and non-vent could signify that demographic instability is common in the deep sea, or that selective sweeps render single-locus mitochondrial studies demographically uninformative. The number of population genetics studies to date is miniscule in relation to the size of the deep sea. The paucity of studies constrains meta-analyses where broad inferences about deep-sea ecology could be made. © 2017 The Authors. Molecular Ecology Published by John Wiley & Sons Ltd.

  15. Concentration risk

    Directory of Open Access Journals (Sweden)

    Matić Vesna

    2016-01-01

    Full Text Available Concentration risk has been gaining a special dimension in the contemporary financial and economic environment. Financial institutions are exposed to this risk mainly in the field of lending, mostly through their credit activities and concentration of credit portfolios. This refers to the concentration of different exposures within a single risk category (credit risk, market risk, operational risk, liquidity risk.

  16. Elevated gastrocnemius forces compensate for decreased hamstrings forces during the weight-acceptance phase of single-leg jump landing: implications for anterior cruciate ligament injury risk.

    Science.gov (United States)

    Morgan, Kristin D; Donnelly, Cyril J; Reinbolt, Jeffrey A

    2014-10-17

    Approximately 320,000 anterior cruciate ligament (ACL) injuries in the United States each year are non-contact injuries, with many occurring during a single-leg jump landing. To reduce ACL injury risk, one option is to improve muscle strength and/or the activation of muscles crossing the knee under elevated external loading. This study's purpose was to characterize the relative force production of the muscles supporting the knee during the weight-acceptance (WA) phase of single-leg jump landing and investigate the gastrocnemii forces compared to the hamstrings forces. Amateur male Western Australian Rules Football players completed a single-leg jump landing protocol and six participants were randomly chosen for further modeling and simulation. A three-dimensional, 14-segment, 37 degree-of-freedom, 92 muscle-tendon actuated model was created for each participant in OpenSim. Computed muscle control was used to generate 12 muscle-driven simulations, 2 trials per participant, of the WA phase of single-leg jump landing. A one-way ANOVA and Tukey post-hoc analysis showed both the quadriceps and gastrocnemii muscle force estimates were significantly greater than the hamstrings (p<0.001). Elevated gastrocnemii forces corresponded with increased joint compression and lower ACL forces. The elevated quadriceps and gastrocnemii forces during landing may represent a generalized muscle strategy to increase knee joint stiffness, protecting the knee and ACL from external knee loading and injury risk. These results contribute to our understanding of how muscle's function during single-leg jump landing and should serve as the foundation for novel muscle-targeted training intervention programs aimed to reduce ACL injuries in sport. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Intra-observer agreement in single and joint double readings of contrast-enhanced breast MRI screening for women with high genetic breast cancer risks

    Directory of Open Access Journals (Sweden)

    Hugo C

    2013-04-01

    Full Text Available Objectives: To examine intra-observer reliability (IR for lesion detection on contrast-enhanced breast magnetic resonance images (MRI for screening women at high risk of breast cancer in single and joint double readings, without case selection. Methods: Contrast-enhanced breast MRIs were interpreted twice by the same independent reader and twice in joint readings. IR was assessed for lesion detection, normal MRI identification, mass, non-mass like enhancements (NMLE and focus characterisation, and BI-RADS assessment. Results: MRI examinations for 124 breasts, 65 women (mean age 43.4y were retrospectively reviewed with 110 lesions identified. Abnormal BIRADS (3-5 classifications were found for 52.3% in single readings and 58.5% in joint readings. Seven biopsies were performed for 4 histologically confirmed cancers. IR for BI-RADS classifications was good for single (0.63, 95% CI: 0.49-0.77, and joint readings (0.77, 95% CI: 0.61-0.93. IR for background parenchymal enhancement (BPE was moderate across single (0.53, 95% CI: 0.40-0.65 and joint readings (0.44, 95% CI: 0.33-0.56. IR for BI-RADS category according to each enhancement was poor for single (0.27, 95% CI: 0.10-0.44, and higher for joint readings, (0.58, 95% CI: 0.43-0.72. Conclusions: IR in BI-RADS breast assessments or BI-RADS lesion assessments are better with joint reading in screening for women with high genetic risks, in particular for abnormal MRI (BI-RADS 3, 4 and 5.

  18. Functional single nucleotide polymorphisms within the cyclin-dependent kinase inhibitor 2A/2B region affect pancreatic cancer risk

    Czech Academy of Sciences Publication Activity Database

    Campa, D.; Pastore, M.; Gentiluomo, M.; Talar-Wojnarowska, R.; Kupcinskas, J.; Malecka-Panas, E.; Neoptolemos, J. P.; Niesen, W.; Vodička, Pavel; Delle Fave, G.; Bueno-de-Mesquita, H. B.; Gazouli, M.; Pacetti, P.; Di Leo, M.; Ito, H.; Klüter, H.; Souček, P.; Corbo, V.; Yamao, K.; Hosono, S.; Kaaks, R.; Vashist, Y.; Gioffreda, D.; Strobel, O.; Shimizu, Y.; Dijk, F.; Andriulli, A.; Ivanauskas, A.; Bugert, P.; Tavano, F.; Vodičková, L.; Zambon, C.F.; Lovecek, M.; Landi, S.; Key, T. J.; Boggi, U.; Pezzilli, R.; Jamroziak, K.; Mohelníková-Duchoňová, B.; Mambrini, A.; Bambi, F.; Busch, O.; Pazienza, V.; Valente, R.; Theodoropoulos, G.E.; Hackert, T.; Capurso, G.; Cavestro, G.M.; Pasquali, C.; Basso, D.; Sperti, C.; Matsuo, K.; Büchler, M.; Khaw, K. T.; Izbicki, J.; Costello, E.; Katzke, V.; Michalski, Ch.; Stepien, A.; Rizzato, C.; Canzian, F.

    2016-01-01

    Roč. 7, č. 35 (2016), s. 57011-57020 ISSN 1949-2553 R&D Projects: GA ČR GAP301/12/1734 Institutional support: RVO:68378041 Keywords : pancreatic cancer * CDKN2A * single nucleotide polymorphisms Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 5.168, year: 2016

  19. Risk of estrogen receptor-positive and -negative breast cancer and single-nucleotide polymorphism 2q35-rs13387042

    DEFF Research Database (Denmark)

    Milne, Roger L; Benítez, Javier; Nevanlinna, Heli

    2009-01-01

    BACKGROUND: A recent genome-wide association study identified single-nucleotide polymorphism (SNP) 2q35-rs13387042 as a marker of susceptibility to estrogen receptor (ER)-positive breast cancer. We attempted to confirm this association using the Breast Cancer Association Consortium. METHODS: 2q35...

  20. Prenatal diagnosis and risk factors for preoperative death in neonates with single right ventricle and systemic outflow obstruction: screening data from the Pediatric Heart Network Single Ventricle Reconstruction Trial(∗).

    Science.gov (United States)

    Atz, Andrew M; Travison, Thomas G; Williams, Ismee A; Pearson, Gail D; Laussen, Peter C; Mahle, William T; Cook, Amanda L; Kirsh, Joel A; Sklansky, Mark; Khaikin, Svetlana; Goldberg, Caren; Frommelt, Michele; Krawczeski, Catherine; Puchalski, Michael D; Jacobs, Jeffrey P; Baffa, Jeanne M; Rychik, Jack; Ohye, Richard G

    2010-12-01

    The purpose of this analysis was to assess preoperative risk factors before the first-stage Norwood procedure in infants with hypoplastic left heart syndrome and related single-ventricle lesions and to evaluate practice patterns in prenatal diagnosis, as well as the role of prenatal diagnosis in outcome. Data from all live births with morphologic single right ventricle and systemic outflow obstruction screened for the Pediatric Heart Network's Single Ventricle Reconstruction Trial were used to investigate prenatal diagnosis and preoperative risk factors. Demographics, gestational age, prenatal diagnosis status, presence of major extracardiac congenital abnormalities, and preoperative mortality rates were recorded. Of 906 infants, 677 (75%) had prenatal diagnosis, 15% were preterm (<37 weeks' gestation), and 16% were low birth weight (<2500 g). Rates of prenatal diagnosis varied by study site (59% to 85%, P < .0001). Major extracardiac congenital abnormalities were less prevalent in those born after prenatal diagnosis (6% vs 10%, P = .03). There were 26 (3%) deaths before Norwood palliation; preoperative mortality did not differ by prenatal diagnosis status (P = .49). In multiple logistic regression models, preterm birth (P = .02), major extracardiac congenital abnormalities (P < .0001), and obstructed pulmonary venous return (P = .02) were independently associated with preoperative mortality. Prenatal diagnosis occurred in 75%. Preoperative death was independently associated with preterm birth, obstructed pulmonary venous return, and major extracardiac congenital abnormalities. Adjusted for gestational age and the presence of obstructed pulmonary venous return, the estimated odds of preoperative mortality were 10 times greater for subjects with a major extracardiac congenital abnormality. Copyright © 2010 The American Association for Thoracic Surgery. All rights reserved.

  1. 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.

  2. Differences between serious and nonserious patient safety incidents in the largest hospital district in Finland.

    Science.gov (United States)

    Jämsä, Juho Olavi; Palojoki, Sari Hannele; Lehtonen, Lasse; Tapper, Anna-Maija

    2018-01-10

    To determine if and in what ways serious patient safety incidents differ from nonserious patient safety incidents. Statistical analysis was performed on patient safety incident reports that were reported in 2015 in Finland's largest hospital district (Helsinki and Uusimaa, HUS). Reports were divided into two groups: nonserious incidents and serious incidents. Differences between groups were studied from several types of categorically divided information. Of the total number of reports (15,863), 1% were serious incidents (175). Serious and nonserious incidents differed significantly from each other. Serious incidents concerning laboratory, imaging, or medical equipment were more common. On the other hand, incidents concerning medication, infusion, and blood transfusion were less frequent. In serious incidents, the proportion of doctors reporting was greater, and contributing factors were better recognized, the most common being working of procedures. In the future, special attention should be given to the particular aspects of serious patient safety incidents, such as safe use of medical equipment, training, and handling of procedures. Root cause analysis is an effective way to handle serious incidents and enables the prevention of their reoccurrence. However, a systematic follow-up of the root cause analysis should be developed. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

  3. Revisiting the phylogeny of Ocellularieae, the second largest tribe within Graphidaceae (lichenized Ascomycota: Ostropales)

    Science.gov (United States)

    Ekaphan Kraichak; Sittiporn Parnmen; Robert Lücking; Eimy Rivas Plata; Andre Aptroot; Marcela E.S. Caceres; Damien Ertz; Armin Mangold; Joel A. Mercado-Diaz; Khwanruan Papong; Dries Van der Broeck; Gothamie Weerakoon; H. Thorsten. Lumbsch; NO-VALUE

    2014-01-01

    We present an updated 3-locus molecular phylogeny of tribe Ocellularieae, the second largest tribe within subfamily Graphidoideae in the Graphidaceae. Adding 165 newly generated sequences from the mitochondrial small subunit rDNA (mtSSU), the nuclear large subunit rDNA (nuLSU), and the second largest subunit of the DNA-directed RNA polymerase II (RPB2), we currently...

  4. First Experience from the World Largest fully commercial Solar Heating Plant

    DEFF Research Database (Denmark)

    Heller, Alfred; Furbo, Simon

    1997-01-01

    The first experience from the largest solar heating plant in the world is given. The plant is situated in Marstal and is has a total area of 8000 square m.......The first experience from the largest solar heating plant in the world is given. The plant is situated in Marstal and is has a total area of 8000 square m....

  5. Functional single nucleotide polymorphisms within the cyclin-dependent kinase inhibitor 2A/2B region affect pancreatic cancer risk

    NARCIS (Netherlands)

    Campa, Daniele; Pastore, Manuela; Gentiluomo, Manuel; Talar-Wojnarowska, Renata; Kupcinskas, Juozas; Malecka-Panas, Ewa; Neoptolemos, John P.; Niesen, Willem; Vodicka, Pavel; Delle Fave, Gianfranco; Bueno-de-Mesquita, H. Bas; Gazouli, Maria; Pacetti, Paola; Di Leo, Milena; Ito, Hidemi; Klüter, Harald; Soucek, Pavel; Corbo, Vincenzo; Yamao, Kenji; Hosono, Satoyo; Kaaks, Rudolf; Vashist, Yogesh; Gioffreda, Domenica; Strobel, Oliver; Shimizu, Yasuhiro; Dijk, Frederike; Andriulli, Angelo; Ivanauskas, Audrius; Bugert, Peter; Tavano, Francesca; Vodickova, Ludmila; Zambon, Carlo Federico; Lovecek, Martin; Landi, Stefano; Key, Timothy J.; Boggi, Ugo; Pezzilli, Raffaele; Jamroziak, Krzysztof; Mohelnikova-Duchonova, Beatrice; Mambrini, Andrea; Bambi, Franco; Busch, Olivier; Pazienza, Valerio; Valente, Roberto; Theodoropoulos, George E.; Hackert, Thilo; Capurso, Gabriele; Cavestro, Giulia Martina; Pasquali, Claudio; Basso, Daniela; Sperti, Cosimo; Matsuo, Keitaro; Büchler, Markus; Khaw, Kay-Tee; Izbicki, Jakob; Costello, Eithne; Katzke, Verena; Michalski, Christoph; Stepien, Anna; Rizzato, Cosmeri; Canzian, Federico

    2016-01-01

    The CDKN2A (p16) gene plays a key role in pancreatic cancer etiology. It is one of the most commonly somatically mutated genes in pancreatic cancer, rare germline mutations have been found to be associated with increased risk of developing familiar pancreatic cancer and CDKN2A promoter

  6. Risk factors for developing cardiotoxicity of trastuzumab in breast cancer patients: An observational single-centre study.

    Science.gov (United States)

    Gunaldi, Meral; Duman, Berna Bozkurt; Afsar, Cigdem Usul; Paydas, Semra; Erkisi, Melek; Kara, I Oguz; Sahin, Berksoy

    2016-04-01

    Trastuzumab is a recombinant humanized monoclonal antibody used to treat human epidermal growth factor receptor 2 positive breast cancer, with recognized associated cardiotoxicity. In this retrospective observational study, we investigated associated cardiotoxicity on clinical outcomes using trastuzumab in women referred to our clinic. The study was made up of 111 women with human epidermal growth factor receptor 2-overexpressing breast cancer who received trastuzumab in the Medical Oncology Department, between 2010 and 2013. A > 10% reduction of the baseline fraction of the left ventricular ejection fraction was observed in 18 (16.21%) women. Two individuals (1.8%) suffered from symptomatic heart failure, seven women showed cardiac symptoms and nine women showed asymptomatic decline of left ventricular ejection fraction. Risk factors for cardiotoxicity in the group included: postmenopausal status (p = 0.01), hypertension (p = 0.002), obesity (p = 0.0001), previously diagnosed coronary artery disease (p = 0.0001) and smoking (p = 0.03). The aforementioned factors pose a risk for cardiotoxicity. We found postmenopausal status, hypertension, obesity, previous coronary artery disease and smoking to be associated with an increased risk of cardiac dysfunction in women using trastuzumab. While administering trastuzumab to women who have these conditions, one must be aware of the risk of cardiotoxicity of trastuzumab. © The Author(s) 2015.

  7. Identification of the timing-of-events model with multiple competing exit risks from single-spell data

    NARCIS (Netherlands)

    Drepper, Bettina; Effraimidis, Georgios

    2016-01-01

    The identification result of the timing-of-events model (Abbring and Van den Berg, 2003b) is extended to a model with several competing exit risk equations. This extension allows e.g. to simultaneously identify the different effects a benefit sanction has on the rate of finding work and leaving the

  8. Risk Factors Analyses for Seizure Recurrence in Different Periods After Refractory Epilepsy Surgery: A Prospective Single-Center Study.

    Science.gov (United States)

    Liu, Xueyou; Xu, Jianguo; Mao, Ke; Wang, Mengmeng; Ren, Peng; Lei, Ding; Fang, Yuan; Chen, Wenjing; Mao, Boyong; Zhou, Dong; Li, Jinmei; Hong, Zhen; Yan, Bo; An, Dongmei; Liu, Ling; Chen, Jiani; Luo, Rong; Zhou, Hui; Yu, Tao; Zhang, Heng

    2018-04-01

    To evaluate the potential risk factors associated with seizure recurrence in different periods after epilepsy surgery. A total of 303 patients with refractory epilepsy after epilepsy surgery were included. The Kaplan-Meier method with log-rank test and univariate and multivariate Cox proportional hazards model were performed to calculate the comparison of survival curves between groups and identify the risk factors associated with seizure recurrence in different periods after surgery. The significant predictors of seizure recurrence were determined, including duration of epilepsy (P = 0.018), seizure types (P = 0.009), magnetic resonance imaging findings (P = 0.007), intracranial electroencephalographic recordings (P = 0.002), sides of epileptogenic zone (P = 0.025), and types of surgery (P = 0.002). Moreover, the significant predictors of seizure recurrence within 12 months after surgery were also included, such as gender (P = 0.007), duration of epilepsy (P = 0.013), intracranial electroencephalographic recordings (P = 0.003), and types of surgery (P 36 months after surgery. We reconfirmed the well-known risk factors associated with seizure recurrence and also identified the controversial variables. In addition, we found that the risk factors associated with seizure recurrence were different in different periods after epilepsy surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Identification of the timing-of-events model with multiple competing exit risks from single-spell data

    DEFF Research Database (Denmark)

    Drepper, Bettina; Effraimidis, G.

    2016-01-01

    The identification result of the timing-of-events model (Abbring and Van den Berg, 2003b) is extended to a model with several competing exit risk equations. This extension allows e.g. to simultaneously identify the different effects a benefit sanction has on the rate of finding work and leaving...

  10. Efficiency of Visual Information Processing in Children at-Risk for Dyslexia: Habituation of Single-Trial ERPs

    Science.gov (United States)

    Regtvoort, Anne G. F. M.; van Leeuwen, Theo H.; Stoel, Reinoud D.; van der Leij, Aryan

    2006-01-01

    To investigate underlying learning mechanisms in relation to the development of dyslexia, event-related potentials to visual standards were recorded in five-year-old pre-reading children at-risk for familial dyslexia (n=24) and their controls (n=14). At the end of second grade the children aged 8 years were regrouped into three groups according to…

  11. Defining the risk of toxicity in phase I oncology trials of novel molecularly targeted agents: A single-center experience

    NARCIS (Netherlands)

    Fehrmann, Rudolf

    2010-01-01

    Background: Phase I oncology trials are designed to define the maximum tolerated dose and toxicity of new drugs. This study aims to define the risk of toxicity in phase I trials of novel molecularly targeted agents (MTA), as this therapeutic approach is becoming increasingly relevant. Methods: We

  12. Defining the risk of toxicity in phase I oncology trials of novel molecularly targeted agents : a single centre experience

    NARCIS (Netherlands)

    Molife, L R; Alam, S; Olmos, D; Puglisi, M; Shah, K; Fehrmann, Rudolf; Trani, L; Tjokrowidjaja, A; de Bono, J S; Banerji, U; Kaye, S B

    BACKGROUND: This study defined the risk of serious toxicity in phase I trials of molecularly targeted agents (MTA). PATIENTS AND METHODS: A retrospective analysis of toxicity data from patients treated in phase I trials of MTAs was carried out to define the rate of treatment-related grade 3/4 toxic

  13. Monitoring Risk Behaviors by Managing Social Support in the Network of a Forensic Psychiatric Patient : A Single-Case Analysis

    NARCIS (Netherlands)

    ter Haar-Pomp, Lydia; de Beer, Carlijn; van der Lem, Rosalind; Spreen, Marinus; Bogaerts, Stefan

    2015-01-01

    This prospective case study examines changes over time in the social support network of a forensic psychiatric patient diagnosed with attention deficit hyperactivity disorder (ADHD). The focus is on the functional and dysfunctional influences of the patient's social support dynamics on his risk

  14. Individual risk factors for deep infection and compromised fracture healing after intramedullary nailing of tibial shaft fractures: a single centre experience of 480 patients.

    Science.gov (United States)

    Metsemakers, W-J; Handojo, K; Reynders, P; Sermon, A; Vanderschot, P; Nijs, S

    2015-04-01

    Despite modern advances in the treatment of tibial shaft fractures, complications including nonunion, malunion, and infection remain relatively frequent. A better understanding of these injuries and its complications could lead to prevention rather than treatment strategies. A retrospective study was performed to identify risk factors for deep infection and compromised fracture healing after intramedullary nailing (IMN) of tibial shaft fractures. Between January 2000 and January 2012, 480 consecutive patients with 486 tibial shaft fractures were enrolled in the study. Statistical analysis was performed to determine predictors of deep infection and compromised fracture healing. Compromised fracture healing was subdivided in delayed union and nonunion. The following independent variables were selected for analysis: age, sex, smoking, obesity, diabetes, American Society of Anaesthesiologists (ASA) classification, polytrauma, fracture type, open fractures, Gustilo type, primary external fixation (EF), time to nailing (TTN) and reaming. As primary statistical evaluation we performed a univariate analysis, followed by a multiple logistic regression model. Univariate regression analysis revealed similar risk factors for delayed union and nonunion, including fracture type, open fractures and Gustilo type. Factors affecting the occurrence of deep infection in this model were primary EF, a prolonged TTN, open fractures and Gustilo type. Multiple logistic regression analysis revealed polytrauma as the single risk factor for nonunion. With respect to delayed union, no risk factors could be identified. In the same statistical model, deep infection was correlated with primary EF. The purpose of this study was to evaluate risk factors of poor outcome after IMN of tibial shaft fractures. The univariate regression analysis showed that the nature of complications after tibial shaft nailing could be multifactorial. This was not confirmed in a multiple logistic regression model, which

  15. Effects of menarcheal age on the anterior cruciate ligament injury risk factors during single-legged drop landing in female artistic elite gymnasts.

    Science.gov (United States)

    Kim, Kew-Wan; Lim, Bee-Oh

    2014-11-01

    Although numerous studies have demonstrated the relationship between maturation and lower extremity biomechanics during landing in team sport athletes, we are presently uninformed of any research that examined the single-legged drop landing biomechanics of gymnasts. The purpose of this study is to investigate the effects of the menarcheal age on the lower extremity biomechanics during a single-legged drop landing in female artistic elite gymnasts. Twenty-two female artistic elite gymnasts, between 9 and 36 years of age, participated in this study. The participants were divided into two groups pre- (n = 11) and post- (n = 11) menarche and asked to perform a single-legged drop landing on top of a 30 cm platform and land on a force plate. The statistical analysis consisted of the multivariate analysis with the level of significance set at p knee flexion angle and increase in their maximum knee abduction angle, maximum internal tibial rotation angle, maximum knee abduction moment, and hamstring-quadriceps muscle activity ratio compared with the pre-menarche group during the single-legged drop landing. The post-menarche group showed an increased noncontact anterior cruciate ligament injury risk, due to their greater knee loads, compared with the pre-menarche group.

  16. Association of single nucleotide polymorphisms in WNT genes with the risk of nonsyndromic cleft lip with or without cleft palate.

    Science.gov (United States)

    Rafighdoost, Houshang; Hashemi, Mohammad; Asadi, Hossein; Bahari, Gholamreza

    2018-01-22

    Nonsyndromic cleft lip with or without cleft palate is a common congenital deformity worldwide with multifaceted etiology. Interaction of genes and environmental factors has been indicated to be related with susceptibility to nonsyndromic cleft lip with or without cleft palate. Some WNT genes which are involved in craniofacial embryogenesis may play a key role in the pathogenesis of nonsyndromic cleft lip with or without cleft palate. In the present study, we aimed to inspect the relationship between WNT3 (rs3809857 and rs9890413), WNT3A (rs752107 and rs3121310), and WNT10a rs201002930 (c.392 C>T) polymorphisms and nonsyndromic cleft lip with or without cleft palate in an Iranian population. The present case-control study was carried out on 120 unrelated nonsyndromic cleft lip with or without cleft palate patients and 112 healthy subjects. The variants were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. The findings suggest that the rs3809857 polymorphism significantly decreased the risk of nonsyndromic cleft lip with or without cleft palate in codominant (odds ratio = 0.16, 95% confidence interval = 0.03-0.75, P = 0.020, TT vs GG), recessive (odds ratio = 0.16, 95% confidence interval = 0.03-0.72, P = 0.009, TT vs GG + GT) inheritance models. The rs9890413 variant marginally decreased the risk of nonsyndromic cleft lip with or without cleft palate in codominant (odds ratio = 0.41, 95% confidence interval = 0.17-0.99, P = 0.047, AG vs AA) model. Regarding C392T variant, the findings revealed that this variant significantly decreased the risk of nonsyndromic cleft lip with or without cleft palate in codominant (odds ratio = 0.24, 95% confidence interval = 0.10-0.58, P = 0.002, CT vs CC) and allele (odds ratio = 0.26, 95% confidence interval = 0.11-0.62, P = 0.002, T vs C) models. No significant association was observed between the rs752107 and rs3121310 variants

  17. Evaluation of the SIPAT instrument to assess psychosocial risk in heart transplant candidates: A retrospective single center study.

    Science.gov (United States)

    Vandenbogaart, Elizabeth; Doering, Lynn; Chen, Belinda; Saltzman, Ann; Chaker, Tamara; Creaser, Julie W; Rourke, Darlene; Cheng, Richard W; Fonarow, Gregg C; Deng, Mario

    We evaluated the reliability of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) in heart transplant (HT) recipients and explored its usefulness in predicting post-transplant outcomes. Pre-transplant psychosocial and behavioral risk is associated with post-transplant clinical outcomes. SIPAT is a risk assessment tool created for pre-transplant psychosocial evaluation. Via retrospective chart review, three examiners applied the SIPAT to 51 adult HT recipients. Examiners blinded to SIPAT scores extracted data and interviewed clinicians for one-year post-transplant outcomes. Analysis included Intra-class correlation coefficient (ICC), Pearson's correlation coefficient and Chi-square. SIPAT demonstrated strong inter-rater reliability (ICC = 0.89, 95% CI = 0.76-0.96). Compared to those with SIPAT ratings of "Excellent/Good", the "Minimally Acceptable Candidate/High Risk" group was more likely to miss clinic visits (p = 0.004). The SIPAT tool had strong IRR. Less favorable SIPAT ratings were associated with nonadherence to clinic visits. Further study is warranted to determine association of SIPAT ratings to clinical outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Risk factors for postoperative pancreatic fistula after laparoscopic distal pancreatectomy using stapler closure technique from one single surgeon.

    Directory of Open Access Journals (Sweden)

    Tao Xia

    Full Text Available Laparoscopic distal pancreatectomy (LDP is a safe and reliable treatment for tumors in the body and tail of the pancreas. Postoperative pancreatic fistula (POPF is a common complication of pancreatic surgery. Despite improvement in mortality, the rate of POPF still remains high and unsolved. To identify risk factors for POPF after laparoscopic distal pancreatectomy, clinicopathological variables on 120 patients who underwent LDP with stapler closure were retrospectively analyzed. Univariate and multivariate analyses were performed to identify risk factors for POPF. The rate of overall and clinically significant POPF was 30.8% and13.3%, respectively. Higher BMI (≥25kg/m2 (p-value = 0.025 and longer operative time (p-value = 0.021 were associated with overall POPF but not clinically significant POPF. Soft parenchymal texture was significantly associated with both overall (p-value = 0.012 and clinically significant POPF (p-value = 0.000. In multivariable analyses, parenchymal texture (OR, 2.933, P-value = 0.011 and operative time (OR, 1.008, P-value = 0.022 were risk factors for overall POPF. Parenchymal texture was an independent predictive factor for clinically significant POPF (OR, 7.400, P-value = 0.001.

  19. Risk factors for vertical transmission of hepatitis C virus: a single center experience with 710 HCV-infected mothers.

    Science.gov (United States)

    Garcia-Tejedor, Amparo; Maiques-Montesinos, Vicente; Diago-Almela, Vicente José; Pereda-Perez, Antonio; Alberola-Cuñat, Vicente; López-Hontangas, José Luís; Perales-Puchalt, Alfredo; Perales, Alfredo

    2015-11-01

    The aim of this study was to analyze the risk factors on the perinatal transmission of hepatitis C virus (HCV). A retrospective cohort study with 711 infants born to 710 HCV-infected mothers was conducted at the Hospital La Fe, in Valencia, Spain, from 1986 to 2011. As potential risk factors for transmission we analyzed: maternal age, mode of acquisition of HCV infection, HIV co-infection, antiretroviral treatment against HIV, CD4 cell count, HIV and HCV viral load, liver enzyme levels during pregnancy, smoking habit, gestational age, intrapartum invasive procedures, length of rupture of membranes, length of labor, mode of delivery, episiotomy, birth weight, newborn gender and type of feeding. Overall perinatal HCV transmission rate was 2.4%. The significant risk factors related with HCV transmission were maternal virus load >615copies/mL (OR 9.3 [95% CI 1.11-78.72]), intrapartum invasive procedures (OR 10.1 [95% CI 2.6-39.02]) and episiotomy (OR 4.2 [95% CI 1.2-14.16]). HIV co-infection and newborn female were near significance (p=0.081 and 0.075, respectively). Invasive procedures as fetal scalp blood sampling or internal electrode and episiotomy increase vertical transmission of HCV, especially in patients with positive HCV RNA virus load at delivery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The Risk of Radiation-Induced Tumors or Malignant Transformation After Single-Fraction Intracranial Radiosurgery: Results Based on a 25-Year Experience

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, Bruce E., E-mail: pollock.bruce@mayo.edu [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Link, Michael J. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Department of Otorhinolaryngology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Stafford, Scott L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Parney, Ian F. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Garces, Yolanda I.; Foote, Robert L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota (United States)

    2017-04-01

    Purpose: To determine the risk of radiation-induced tumors or malignant transformation after single-fraction intracranial stereotactic radiosurgery (SRS). Methods and Materials: We performed a retrospective review of 1837 patients who received single-fraction SRS for arteriovenous malformation or benign tumor (meningioma, vestibular schwannoma, pituitary adenoma, glomus tumor) at a single center between 1990 and 2009. Patients were excluded if they refused research authorization (n=31), had a genetic predisposition to tumor development (n=84), received prior or concurrent radiation therapy (n=79), or had less than 5 years of imaging follow-up after SRS (n=501). The median imaging follow-up period for the remaining 1142 patients was 9.0 years (range, 5-24.9 years). Results: No radiation-induced tumors were identified in 11,264 patient-years of follow-up after SRS. The risk of a radiation-induced tumor developing after SRS was 0.0% at 5 years (95% confidence interval [CI], 0.0%-0.4%), 0.0% at 10 years (95% CI, 0.0%-0.9%), and 0.0% at 15 years (95% CI, 0.0%-2.8%). Malignant transformation occurred in 7 of 316 meningioma patients (2.2%) and 1 of 358 vestibular schwannoma patients (0.3%) at a median of 4.9 years (range, 2.8-13.8 years) after SRS. No cases of malignant transformation were noted in patients with pituitary adenomas (n=188) or glomus tumors (n=47). The 5-, 10-, and 15-year risk of malignant transformation was 0.5% (95% CI, 0.0%-0.9%), 0.8% (95% CI, 0.0%-1.8%), and 2.4% (95% CI, 0.0%-5.5%), respectively. Patients who underwent prior resection (hazard ratio, 14.56; 95% CI, 1.79-118.33; P=.01) and who had meningioma pathology (hazard ratio, 11.72; 95% CI, 1.44-96.15; P=.02) were at increased risk of malignant transformation. Conclusions: The risk of radiation-induced tumors or malignant transformation after SRS is very low and should not be used as a justification for choosing alternative treatment approaches (surgical resection, observation) over SRS

  1. Understanding the risks associated with the use of new psychoactive substances (NPS): high variability of active ingredients concentration, mislabelled preparations, multiple psychoactive substances in single products.

    Science.gov (United States)

    Zamengo, Luca; Frison, Giampietro; Bettin, Chiara; Sciarrone, Rocco

    2014-08-17

    New psychoactive substances (NPS), are now a large group of substances of abuse not yet completely controlled by international drug conventions, which may pose a public health threat. Anxiety, paranoia, hallucinations, seizures, hyperthermia and cardiotoxicity are some of the common adverse effects associated with these compounds. In this paper, three case reports taken from the archive of processed cases of the authors' laboratory are presented and discussed to stress the risks of possible adverse consequences for NPS users: in particular, (i) the risk deriving from the difficulty of predicting the actual consumed dose, due to variability of active ingredients concentration in consumed products, (ii) the risk deriving from the difficulty of predicting the actual active ingredients present in consumed products, as opposed to those claimed by the manufacturer, and (iii) the risk deriving from the difficulty of predicting the actual pharmacological and toxicological effects related to the simultaneous consumption of different psychoactive ingredients contained in single products, whose interactions are mostly unknown. Each of them individually provide a source of concern for possible serious health related consequences. However, they should be considered in conjunction with each others, with the worldwide availability of NPS through the web and also with the incessantly growing business derived from the manipulation and synthesis of new substances. The resulting scenario is that of a cultural challenge which demands a global approach from different fields of knowledge. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Association between single nucleotide polymorphisms of sterol regulatory element binding protein-2 gene and risk of knee osteoarthritis in a Chinese Han population.

    Science.gov (United States)

    Qiu, Xiao-Ming; Jin, Cheng-Tao; Wang, Wei

    2014-04-01

    To investigate associations between single nucleotide polymorphisms (SNPs) rs2228314 and rs2267443 in the sterol regulatory element binding protein-2 gene (SREBP-2) and knee osteoarthritis (OA) susceptibility in a Chinese Han population. SREBP-2 rs2228314 and rs2267443 polymorphisms were genotyped in patients with knee OA and age- and sex-matched OA-free controls from a Chinese Han population. A total of 402 patients with knee OA and 410 controls were enrolled in the study. GC and CC genotypes of rs2228314, and variant C, were associated with a significantly increased risk of knee OA. On stratification analysis, the association between the risk of OA and rs2228314 GC heterozygotes compared with GG homozygotes was stronger in females and those aged >65 years. In contrast, the GA and AA genotypes of rs2267443 were not significantly associated with the risk of knee OA, even after further stratification analysis according to age or sex. SREBP-2 rs2228314 G to C change and variant C genotype may contribute to knee OA risk in a Chinese Han population.

  3. ESR1 single nucleotide polymorphism rs1062577 (c.*3804T>A) alters the susceptibility of breast cancer risk in Iranian population.

    Science.gov (United States)

    Dehghan, Zahra; Sadeghi, Samira; Tabatabaeian, Hossein; Ghaedi, Kamran; Azadeh, Mansoureh; Fazilati, Mohammad; Bagheri, Fatemeh

    2017-05-05

    Albeit single nucleotide polymorphisms related to ESR1 gene have been studied, only a number of them have been reported to be associated with breast cancer risk. rs1062577 is one of the most recent microRNA-related ESR1 SNPs; however, no study has been conducted to investigate the significance this polymorphism in Iranian population. In this study, we aimed to investigate the frequency and also the association between rs1062577 and breast cancer. rs1062577 position was genotyped by Tetra-primer ARMS-PCR in totally 182 blood specimens obtained from breast cancer patients (n=86), and healthy blood donors (n=96). The distribution of different genotypes was statistically analyzed in terms of the potential association between rs1062577 different alleles, breast cancer risk and clinicopathological criteria of breast cancer patients. The statistical analyses confidently indicated that rs1062577 A allele is associated with the increased breast cancer risk in both univariate and multivariate regression models (Odds Ratio=8.403 and 32.602 respectively). rs1062577 T allele was statistically associated with stage I of breast cancer patients (p-value=0.025). In silico studies implied that rs1062577 A allele can alter the binding capacity of ESR1 mRNA and miRNAs via either breakage or formation of hydrogen bonds. rs1062577 A allele is significantly and dramatically associated with the elevated risk and greater stages of breast cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Square-stepping exercise and fall risk factors in older adults: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Shigematsu, Ryosuke; Okura, Tomohiro; Nakagaichi, Masaki; Tanaka, Kiyoji; Sakai, Tomoaki; Kitazumi, Suguru; Rantanen, Taina

    2008-01-01

    Decreased fitness of the lower extremities is a potentially modifiable fall risk factor. This study aimed to compare two exercise programs--square-stepping exercise (SSE), which is a low-cost indoor program, and walking--for improving the fitness of the lower extremities. We randomly allocated 68 community-dwelling older adults (age 65-74 years) to either the SSE or walking group (W group). During the 12-week regimen, the SSE group participated in 70-minute exercise sessions conducted twice a week at a local health center, and the W group participated in outdoor supervised walking sessions conducted weekly. The W group was instructed to increase the number of daily steps. Prior to and after the program, we obtained information on 11 physical performance tests for known fall risk factors and 3 self-reported scales. The fall incidence was followed-up for 8 months. At 12 weeks postregimen, significant differences were observed between the two exercise groups with respect to leg power (1 item), balance (2 items), agility (2 items), reaction time (2 items), and a self-reported scale (1 item); the SSE group demonstrated a marked improvement in the above-mentioned items with Group x Time interactions. Significant time effects were observed in the tests involving chair stands, functional reach, and standing up from a lying-down position without Group x Time interactions. During the follow-up period, the fall rates per person-year in the SSE and W groups were 23.4% and 33.3%, respectively (p =.31). Although further studies are required, SSE is apparently more effective than walking in reducing fall risk factors, and it appears that it may be recommended as a health promotion exercise in older adults.

  5. Serial prostate biopsy and risk of lower urinary tract symptoms: results from a large, single-institution active surveillance cohort.

    Science.gov (United States)

    Glass, Allison S; Hilton, Joan F; Cowan, Janet E; Washington, Samuel L; Carroll, Peter R

    2014-01-01

    To describe the effect of serial prostate biopsy on lower urinary tract symptoms (LUTS) in men who undergo active surveillance (AS) at a large academic institution. This is a retrospective study of men enrolled in AS for ≥6 months who underwent ≥1 biopsy and completed ≥1 International Prostate Symptom Score (IPSS) questionnaire. In additional to total IPSS, we report the mean difference between the first and last questionnaires for patients who completed ≥2 questionnaires. Multivariate models, adjusting for disease features, age, race, prostate volume and baseline, or incident benign prostatic hypertrophy (BPH), were used to assess relationships between IPSS and total biopsy exposure. Four hundred eighty-two men were eligible, and 291 completed ≥2 IPSS questionnaires. Overall, mean (standard deviation) age was 61.7 (7.8) years, and median prostate volume (interquartile range) was 42 (34-61) mL. At baseline, 11% provided history of BPH. Among men who completed multiple questionnaires, 25% experienced clinically significant worsening (IPSS increase ≥4 points). In regression model, total IPSS was not significantly associated with greater biopsy exposure (P = .25). IPSS change from initial and the latest questionnaire was not significantly associated with initial or interval biopsy exposure in an adjusted longitudinal model (P = .64 and .50, respectively), but a trend was observed with greater age decade (+4.07 points, 95% CI -0.30 to 8.4; P = .07). Repeated prostate biopsy does not appear to independently pose additional risk of LUTS in an AS population. In unadjusted analyses, greater biopsy exposure is a surrogate for increasing follow-up time, age, and BPH risk, and thus, risk of LUTS onset and progression. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults.

    Science.gov (United States)

    Caton, Carol L M; Dominguez, Boanerges; Schanzer, Bella; Hasin, Deborah S; Shrout, Patrick E; Felix, Alan; McQuistion, Hunter; Opler, Lewis A; Hsu, Eustace

    2005-10-01

    We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, symptoms, and coping skills; social and family history; and service use were analyzed. Kaplan-Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness. Eighty-one percent of participants returned to community housing during the follow-up period; the median duration of homelessness was 190 days. Kaplan-Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group Phomelessness. Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventions.

  7. Epidemiology, risk factor, species distribution, antifungal resistance and outcome of Candidemia at a single French hospital: a 7-year study.

    Science.gov (United States)

    Tadec, Laurent; Talarmin, Jean-Philippe; Gastinne, Thomas; Bretonnière, Cédric; Miegeville, Michel; Le Pape, Patrice; Morio, Florent

    2016-05-01

    Candidemia remains a major cause of disease worldwide and is associated with a high mortality rate. We conducted a retrospective study of candidemia at Nantes Hospital, France, between 2004 and 2010. A total of 191 episodes (n = 188 patients) were reviewed. Incidence, demographics, risk factors, antifungal management, species identification, in vitro susceptibility and 12 weeks survival were analysed. Global incidence of candidemia was 0.37‰ admissions. Higher incidences were observed in haematology (6.65‰) and intensive care units (2‰). Central venous catheter and antibiotic exposure were the most frequent risk factors (77% and 76% respectively). Candida albicans was the predominant species (51.8%) followed by C. parapsilosis (14.5%), C. glabrata (9.8%), C. tropicalis (9.8%) and C. krusei (4.1%). However, species distribution differed significantly between medical units with frequency of C. tropicalis being higher in haematology compared to other medical units. Fluconazole and caspofungin were the main antifungals given as first-line therapy. Although not significant, 12 weeks mortality rate was 30.9%, being higher for C. tropicalis (44.4%) than for C. parapsilosis (16%). Acquired azole or echinocandin resistance was noted in some isolates, underlining the need for systematic antifungal susceptibility testing in patients with candidemia. These epidemiological findings will be of interest for antifungal stewardship at our hospital. © 2016 Blackwell Verlag GmbH.

  8. Single and joint ecotoxicity data estimation of organic UV filters and nanomaterials toward selected aquatic organisms. Urban groundwater risk assessment.

    Science.gov (United States)

    Molins-Delgado, Daniel; Gago-Ferrero, Pablo; Díaz-Cruz, M Silvia; Barceló, Damià

    2016-02-01

    The hazardous potential of organic UV filters (UV-Fs) is becoming an issue of great concern due to the widespread application of these compounds in most daily-use goods, such as hygiene and beauty products. Nanomaterials (NMs) have also been used in personal care products (PCPs) for many years. Nowadays, both classes of chemicals are considered environmental emerging contaminants. Despite some studies performed in vitro and in vivo reported adverse effects of many UV-Fs on the normal development of organisms, there is scarce data regarding acute and chronic toxicity. The aim of the present study was to determine the EC50 values of selected UV-Fs using standardised toxicity assays on three aquatic species i.e. Daphnia magna, Raphidocelis subcapitata and Vibrio fischeri. EC50 values obtained were in the mgl(-1) range for all the species. The estimated toxicity data allowed us to assess the environmental risk posed by selected UV-Fs in urban groundwater from Barcelona (Spain). The calculated ecological risk indicated a negligible impact on the aquifer. Giving the increasing importance of studying mixtures of pollutants and due to the widespread presence of nanomaterials (NMs) in the aquatic environment, other objective of this work was to explore the response on D. magna after exposure to both binary combinations of UV-Fs among them and UV-F with NMs. In all cases but the nano-silver mixtures, joint toxicity was mitigated or even eradicated. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Comparison of primary radiation versus robotic surgery plus adjuvant radiation in high-risk prostate cancer: A single center experience

    Directory of Open Access Journals (Sweden)

    Prabhsimranjot Singh

    2015-01-01

    Full Text Available Objective: The objective of this study was to compare robotic-prostatectomy plus adjuvant radiation therapy (RPRAT versus primary RT for high-risk prostate cancer (HRPCa. Materials and Methods: A retrospective chart review was performed for the HRPCa patients treated in our institution between 2000 and 2010. One hundred and twenty-three patients with high-risk disease were identified. The Chi-square test and Fisher′s exact test were used to compare local control and distant failure rates between the two treatment modalities. For prostate-specific antigen comparisons between groups, Wilcoxon rank-sum test was used. Results: The median follow-up was 49 months (range: 3-138 months. Local control, biochemical recurrence rate, distant metastasis, toxicity, and disease-free survival were similar in the two groups. Conclusions: Primary RT is an excellent treatment option in patients with HRPCa, is equally effective and less expensive treatment compared with RPRAT. A prospective randomized study is required to guide treatment for patients with HRPCa.

  10. Quantification of myocardial area at risk in the absence of collateral flow: the validation of angiographic scores by myocardial perfusion single-photon emission computed tomography.

    Science.gov (United States)

    Rodríguez-Palomares, José F; Alonso, Albert; Martí, Gerard; Aguadé-Bruix, Santiago; González-Alujas, M T; Romero-Farina, Guillermo; Candell-Riera, Jaume; García del Blanco, Bruno; Evangelista, Artur; García-Dorado, David

    2013-02-01

    Our study aimed to compare the area at risk (AAR) determined by single-photon emission computed tomography (SPECT) with the Bypass Angioplasty Revascularization Investigation (BARI) and modified Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) angiographic scores in the setting of patients undergoing coronary angioplasty for either unstable angina or an STEMI. Radionuclide myocardial perfusion imaging prior to reperfusion has classically been the most widely practised technique for assessing the AAR and has been successfully used to compare the efficacy of various reperfusion strategies in patients with an ST-segment elevation myocardial infarction (STEMI). The BARI and modified APPROACH scores are angiographic methods widely used to provide a rapid estimation of the AAR; however, they have not been directly validated with myocardial perfusion single-photon emission computed tomography (SPECT). Fifty-five patients with no previous myocardial infarction who underwent coronary angioplasty for single-vessel disease (unstable angina: n = 25 or an STEMI: n = 30) with no evidence of collaterals (Rentrop Collateral Score collateral flow, BARI and APPROACH scores constitute valid methods for AAR estimation in current clinical practice, with more accurate results when used for the LAD territory; both are useful not only in STEMI patients but also in patients with unstable angina.

  11. Can two-dimensional video analysis during single-leg drop vertical jumps help identify non-contact knee injury risk? A one-year prospective study.

    Science.gov (United States)

    Dingenen, Bart; Malfait, Bart; Nijs, Stefaan; Peers, Koen H E; Vereecken, Styn; Verschueren, Sabine M P; Staes, Filip F

    2015-10-01

    Previous studies showed that the amount of hip flexion and the combination of knee valgus and lateral trunk motion, measured with two-dimensional video analysis, were related to three-dimensional measured knee joint moments during single-leg drop vertical jumps, but it remains unclear whether these measurements can be used to identify non-contact knee injury risk. Fifty injury-free female athletes participated in the study. Two-dimensional video analysis was used to measure hip flexion, knee valgus and lateral trunk motion angles during single-leg drop vertical jumps. Time loss non-contact knee injuries were registered during a one-year follow-up. Independent t-tests and receiver operating characteristic analysis were used to analyze the predictive ability of the two-dimensional angles. Seven participants sustained a time loss non-contact knee injury. Hip flexion was not significantly different between groups (P>.05). The combination of knee valgus and lateral trunk motion was significantly smaller in the injured (P=.036) and non-injured legs (P=.009) of the future injured group compared with the respective matched leg of the non-injured group. The receiver operating characteristic analysis showed a significant discriminative accuracy between groups for the combination of knee valgus and lateral trunk motion of the uninjured leg of the future injured group with the matched leg of the non-injured group (area under curve=0.803; P=.012). The measurement of a combination of increased knee valgus and ipsilateral trunk motion during the single-leg drop vertical jump with two-dimensional video analysis can be used to help identify female athletes with increased non-contact knee injury risk. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. NEGOTIATING PLACE AND GENDERED VIOLENCE IN CANADA’S LARGEST OPEN DRUG SCENE

    Science.gov (United States)

    McNeil, Ryan; Shannon, Kate; Shaver, Laura; Kerr, Thomas; Small, Will

    2014-01-01

    Background Vancouver’s Downtown Eastside is home to Canada’s largest street-based drug scene and only supervised injection facility (Insite). High levels of violence among men and women have been documented in this neighbourhood. This study was undertaken to explore the role of violence in shaping the socio-spatial relations of women and ‘marginal men’ (i.e., those occupying subordinate positions within the drug scene) in the Downtown Eastside, including access to Insite. Methods Semi-structured qualitative interviews were conducted with 23 people who inject drugs (PWID) recruited through the Vancouver Area Network of Drug Users, a local drug user organization. Interviews included a mapping exercise. Interview transcripts and maps were analyzed thematically, with an emphasis on how gendered violence shaped participants’ spatial practices. Results Hegemonic forms of masculinity operating within the Downtown Eastside framed the everyday violence experienced by women and marginal men. This violence shaped the spatial practices of women and marginal men, in that they avoided drug scene milieus where they had experienced violence or that they perceived to be dangerous. Some men linked their spatial restrictions to the perceived 'dope quality' of neighbourhood drug dealers to maintain claims to dominant masculinities while enacting spatial strategies to promote safety. Environmental supports provided by health and social care agencies were critical in enabling women and marginal men to negotiate place and survival within the context of drug scene violence. Access to Insite did not motivate participants to enter into “dangerous” drug scene milieus but they did venture into these areas if necessary to obtain drugs or generate income. Conclusion Gendered violence is critical in restricting the geographies of men and marginal men within the street-based drug scene. There is a need to scale up existing environmental interventions, including supervised injection

  13. Negotiating place and gendered violence in Canada's largest open drug scene.

    Science.gov (United States)

    McNeil, Ryan; Shannon, Kate; Shaver, Laura; Kerr, Thomas; Small, Will

    2014-05-01

    Vancouver's Downtown Eastside is home to Canada's largest street-based drug scene and only supervised injection facility (Insite). High levels of violence among men and women have been documented in this neighbourhood. This study was undertaken to explore the role of violence in shaping the socio-spatial relations of women and 'marginal men' (i.e., those occupying subordinate positions within the drug scene) in the Downtown Eastside, including access to Insite. Semi-structured qualitative interviews were conducted with 23 people who inject drugs (PWID) recruited through the Vancouver Area Network of Drug Users, a local drug user organization. Interviews included a mapping exercise. Interview transcripts and maps were analyzed thematically, with an emphasis on how gendered violence shaped participants' spatial practices. Hegemonic forms of masculinity operating within the Downtown Eastside framed the everyday violence experienced by women and marginal men. This violence shaped the spatial practices of women and marginal men, in that they avoided drug scene milieus where they had experienced violence or that they perceived to be dangerous. Some men linked their spatial restrictions to the perceived 'dope quality' of neighbourhood drug dealers to maintain claims to dominant masculinities while enacting spatial strategies to promote safety. Environmental supports provided by health and social care agencies were critical in enabling women and marginal men to negotiate place and survival within the context of drug scene violence. Access to Insite did not motivate participants to enter into "dangerous" drug scene milieus but they did venture into these areas if necessary to obtain drugs or generate income. Gendered violence is critical in restricting the geographies of men and marginal men within the street-based drug scene. There is a need to scale up existing environmental interventions, including supervised injection services, to minimize violence and potential drug

  14. New Chicago-Indiana computer network will handle dataflow from world's largest scientific experiment

    CERN Multimedia

    2006-01-01

    "Massive quantities of data will soon begin flowing from the largest scientific instrument ever built into an international netword of computer centers, including one operated jointly by the University of Chicago and Indiana University." (1,5 page)

  15. Analytic approximation to the largest eigenvalue distribution of a white Wishart matrix

    CSIR Research Space (South Africa)

    Vlok, JD

    2012-08-14

    Full Text Available offers largely simplified computation and provides statistics such as the mean value and region of support of the largest eigenvalue distribution. Numeric results from the literature are compared with the approximation and Monte Carlo simulation results...

  16. [Percutaneous rheolytic thrombectomy in the treatment of high-risk acute pulmonary embolism: Initial experience of a single center].

    Science.gov (United States)

    Faria, Rita; Oliveira, Márcia; Ponte, Marta; Pires-Morais, Gustavo; Sousa, Marta; Fernandes, Paula; Rodrigues, Alberto; Braga, Pedro; Gonçalves, Manuel; Gama, Vasco

    2014-06-01

    For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strategies: thrombolysis, whose benefits have been documented in randomized trials, and surgical embolectomy. However, mechanical reperfusion by percutaneous techniques is used in an increasing number of patients, and is a valid therapeutic option when there is a formal contraindication to thrombolysis, as rescue therapy when thrombolysis fails to improve hemodynamics, and/or when emergency surgical thrombectomy is unavailable or contraindicated. This article discusses the indications for the use of percutaneous techniques in PE, reports the initial experience of our center with the AngioJet® thrombectomy device (Possis Medical Inc, Minneapolis, MN, USA) and reviews the available evidence, the most recent recommendations and the main complications associated with this procedure. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  17. Fecal carriage of carbapenem-resistant Enterobacteriaceae and risk factor analysis in hospitalised patients: A single centre study from India

    Directory of Open Access Journals (Sweden)

    Balvinder Mohan

    2017-01-01

    Full Text Available Purpose: Carbapenem-resistant Enterobacteriaceae (CRE have emerged and disseminated widely causing a variety of infections. In India, the carriage of CRE in hospitalised patients has not been well-studied. Therefore, we conducted the present study to observe gut carriage rate of CRE in patients admitted to our tertiary care hospital. Methods: A total of 232 faecal swabs collected from consecutive stool samples from admitted patients were inoculated on ChromID extended spectrum β-lactamase plates and members of Enterobacteriaceae family were subjected to antibiotic susceptibility as per the Clinical Laboratory Standards Institute guidelines. Polymerase chain reaction for blaVIM, blaKPC, blaIMPand blaNDM-1 genes was performed. CRE was identified if the isolates showed resistance to either imipenem or meropenem or showed the presence of resistant genes. Risk factors of patients with or without CRE colonisation were also analysed. Results: A total of 232 faecal swabs yielded 252 Enterobacteriaceae isolates, of which 49 isolates from 42 patients showed the presence of CRE (occurrence 42/232; 18.1%; 27 isolates from 22 patients carried blaNDM-1, whereas 20 isolates from 17 patients possessed blaVIMgene. No isolate was positive for blaKPCand blaIMPgenes. The CRE was common in both intensive care units (38.4% and wards (46% which may reflect the excessive use of broad-spectrum antibiotics in both these settings. The CRE was also found to have a significantly higher antimicrobial resistance as compared to non-CRE isolates. The logistic regression analysis of significance showed the presence of any indwelling device (P = 0.049 and nasogastric tube (P = 0.043 as independent risk factors for acquiring gut colonisation. Conclusions: The study is the first from India to show high CRE carriage in patients admitted to a tertiary care centre and emphasises the need of strict antimicrobial stewardship implementation in hospitals to prevent dissemination of

  18. The effect of single nucleotide polymorphisms in G-rich regions of high-risk human papillomaviruses on structural diversity of DNA.

    Science.gov (United States)

    Marušič, Maja; Hošnjak, Lea; Krafčikova, Petra; Poljak, Mario; Viglasky, Viktor; Plavec, Janez

    2017-05-01

    Infection with high-risk human papillomaviruses (HPVs) can lead to development of cancer of the head and neck and anogenital regions. G-rich sequences found in genomes of high-risk HPVs can fold into non-canonical secondary structures that could serve as 3D motifs distinct from double-stranded DNA and present recognition sites for ligands and opportunity for gene expression modulation. Combination of UV, CD and NMR spectroscopy and PAGE electrophoresis were used as they offer complementary insights into structural changes of G-rich oligonucleotides. G-rich region of HPV16 is shown to preferentially form hairpin structures, while regions of HPV18, HPV52 and HPV58 fold into four-stranded DNA structures called G-quadruplexes. Single nucleotide polymorphisms found in G-rich sequences have been found to promote formation of hairpin structures of HPV16 and have affected number of species formed in G-rich region of HPV52, whereas they have exhibited minimal effect on the formation of HPV18 and HPV58 G-quadruplex structures. These structural changes were reflected in differences in apparent thermal stabilities. Potential of G-rich sequences as drug targets was evaluated based on the results of the current study. HPV16 and HPV18 are considered less appropriate targets due to several single nucleotide polymorphisms and low stability, respectively. On the other hand, HPV52 and HPV58 could be used for small-molecule mediated stabilization. G-rich sequences occurring in high-risk HPVs can fold into hairpin and G-quadruplex structures that could be potentially utilized as drug targets. This article is part of a Special Issue entitled "G-quadruplex" Guest Editor: Dr. Concetta Giancola and Dr. Daniela Montesarchio. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Perception and Interpretation of Sustainability Among the Largest Corporations Established in the Czech Republic

    OpenAIRE

    Petr Petera; Jaroslav Wagner; Kateřina Knorová

    2016-01-01

    The paper addresses perception and interpretation of sustainability among the largest corporations established in the Czech Republic. Despite the fact that the amount of literature on sustainability is substantial, there is lack of empirical investigation into understanding sustainability among corporations established in the Czech Republic. We used qualitative methodology (semi-structured interviews) to investigate how the largest corporations established in the Czech Republic understand and...

  20. Favorable Preliminary Outcomes for Men With Low- and Intermediate-risk Prostate Cancer Treated With 19-Gy Single-fraction High-dose-rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Krauss, Daniel J., E-mail: dkrauss@beaumont.edu [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Ye, Hong [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro A. [21st Century Oncology, Farmington Hills, Michigan (United States); Mitchell, Beth; Sebastian, Evelyn; Limbacher, Amy; Gustafson, Gary S. [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2017-01-01

    Purpose: To report the toxicity and preliminary clinical outcomes of a prospective trial evaluating 19-Gy, single-fraction high-dose-rate (HDR) brachytherapy for men with low- and intermediate-risk prostate cancer. Methods and Materials: A total of 63 patients were treated according to an institutional review board-approved prospective study of single-fraction HDR brachytherapy. Eligible patients had tumor stage ≤T2a, prostate-specific antigen level ≤15 ng/mL, and Gleason score ≤7. Patients with a prostate gland volume >50 cm{sup 3} and baseline American Urologic Association symptom score >12 were ineligible. Patients underwent transrectal ultrasound-guided transperineal implantation of the prostate, followed by single-fraction HDR brachytherapy. Treatment was delivered using {sup 192}Ir to a dose of 19 Gy prescribed to the prostate, with no additional margin applied. Results: Of the 63 patients, 58 had data available for analysis. Five patients had withdrawn consent during the follow-up period. The median follow-up period was 2.9 years (range 0.3-5.2). The median age was 61.4 years. The median gland volume at treatment was 34.8 cm{sup 3}. Of the 58 patients, 91% had T1 disease, 71% had Gleason score ≤6 (29% with Gleason score 7), and the median pretreatment prostate-specific antigen level was 5.1 ng/mL. The acute and chronic grade 2 genitourinary toxicity incidence was 12.1% and 10.3%, respectively. No grade 3 urinary toxicity occurred. No patients experienced acute rectal toxicity grade ≥2, and 2 experienced grade ≥2 chronic gastrointestinal toxicity. Three patients experienced biochemical failure, yielding a 3-year cumulative incidence estimate of 6.8%. Conclusions: Single-fraction HDR brachytherapy is well-tolerated, with favorable preliminary biochemical and clinical disease control rates.

  1. Estimating central tendency from a single spot measure: A closed-form solution for lognormally distributed biomarker data for risk assessment at the individual level.

    Science.gov (United States)

    Pleil, Joachim D; Sobus, Jon R

    2016-01-01

    Exposure-based risk assessment employs large cross-sectional data sets of environmental and biomarker measurements to predict population statistics for adverse health outcomes. The underlying assumption is that long-term (many years) latency health problems including cancer, autoimmune and cardiovascular disease, diabetes, and asthma are triggered by lifetime exposures to environmental stressors that interact with the genome. The aim of this study was to develop a specific predictive method that provides the statistical parameters for chronic exposure at the individual level based upon a single spot measurement and knowledge of global summary statistics as derived from large data sets. This is a profound shift in exposure and health statistics in that it begins to answer the question "How large is my personal risk?" rather than just providing an overall population-based estimate. This approach also holds value for interpreting exposure-based risks for small groups of individuals within a community in comparison to random individuals from the general population.

  2. Risk factors for postoperative subsidence of single-level anterior cervical discectomy and fusion: the significance of the preoperative cervical alignment.

    Science.gov (United States)

    Lee, Young-Seok; Kim, Young-Baeg; Park, Seung-Won

    2014-07-15

    Retrospective cohort study. To investigate and analyze the preoperative risk factors affecting subsidence after anterior cervical discectomy and fusion (ACDF) to reduce subsidence. Subsidence after ACDF may be caused by various risk factors, although the related information is scarce. Seventy-eight patients who underwent single-level ACDF between 2005 and 2011 were included. Patients were categorized into the subsidence (n = 26) and nonsubsidence groups (n = 52). Preoperative factors such as age, sex, operative level, bone mineral density, cervical alignment, segmental sagittal angle, and anterior/posterior disc height were assessed. The use of plates and the anterior/posterior disc height gap were examined as perioperative factors. The clinical outcome was assessed using a visual analogue scale for neck and arm pain. Subsidence occurred in 26 (33.3%) of 78 patients. A significant difference was found in clinical outcomes between the subsidence and nonsubsidence groups (P subsidence group. The mean time to subsidence was 4.8 months. Logistic regression analysis revealed that cervical alignment (P = 0.017), age (P = 0.022), and use of plates (P = 0.041) affected subsidence. In patients who received a stand-alone cage, the risk of subsidence was significantly greater in the kyphotic angle group than in the lordotic angle group (odds ratio = 13.56; P subsidence are cervical alignment, age, and use of plates. Our data suggest that surgeons should consider the kyphotic curvature and/or age when deciding on the use of plates.

  3. Can Asperger syndrome be diagnosed at 26 months old? A genetic high-risk single-case study.

    Science.gov (United States)

    Baron-Cohen, Simon; Scott, Fiona; Wheelwright, Sally; Johnson, Mark; Bisarya, Dheraj; Desai, Atman; Ahluwalia, Jag

    2006-04-01

    Asperger syndrome, a heritable condition entailing empathy deficits together with unusually narrow interests in individuals of normal or even above-average intelligence, was recognized only recently. Here we report the first-ever prospective study of a child born to two adults with a formal diagnosis of Asperger syndrome. The child's parents are both scientists (a mathematician and a chemist). The aim of study 1 was to test if the child also developed Asperger syndrome, given the heritability of the condition, and if Asperger syndrome can be detected at 26 months. At 18 months, the child was given the Checklist for Autism in Toddlers, and at 26 months, she was assessed diagnostically for autism spectrum conditions using the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observational Scale. The child failed the Checklist for Autism in Toddlers at 18 months and met the criteria for Asperger syndrome at 26 months. This single case is consistent with the hypersystemizing, assortative mating theory of autism. This theory requires further testing with large samples. This study also demonstrates that Asperger syndrome can be diagnosed by age 26 months. The aim of study 2 was to test if dyadic eye contact in infancy is intact in a child later diagnosed with Asperger syndrome. The same child's eye contact was measured at three time points (3, 6, and 9 months) over her first year of life and compared with that of age-matched controls. Although the child had low rates of eye contact at 6 months, it was within the normal range at all three points in the first year of life. We conclude that low levels of eye contact are not predictive of later development of Asperger syndrome.

  4. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  5. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-28

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  6. Risk factors for single crowns supported by short (6-mm) implants in the posterior region: A prospective clinical and radiographic study.

    Science.gov (United States)

    Villarinho, Eduardo Aydos; Triches, Diego Fernandes; Alonso, Fernando Rizzo; Mezzomo, Luis André Mendonça; Teixeira, Eduardo Rolim; Shinkai, Rosemary Sadami Arai

    2017-08-01

    The use of short implants is still not a consensus for challenging clinical situations, such as unfavorable crown-to-implant (C/I) ratio. This prospective study evaluated the rates of prosthetic complications and implant failure, the mean marginal bone loss of 6-mm dental implants with single crowns in posterior regions and the potential risk factors. Forty-six dental implants, 6-mm long and 4.1-mm wide, were placed in the posterior region in 20 patients. Patients were clinically and radiographically examined after the restoration with single crowns and on a yearly basis. Potential risk factors (arch, bruxism, maximum bite force, anatomical and clinical C/I ratios, and occlusal table area) were analyzed according to the following outcomes: implant survival, bone loss, and prosthetic complications. The mean follow-up time was 45 ± 9 (16-57) months. There was no early loss of implants. After prosthetic loading, 4 implants were lost (2 in the mandible and 2 in the maxilla; 91.3% survival), and there were 13 prosthetic complications (28.3%), yielding a 65.2% success rate. The frailty term showed a 95% greater chance of loss in the mandible than the maxilla. Mean peri-implant bone loss was of 0.2 ± 0.4 mm, 0.1 ± 0.2 mm, 0.1 ± 0.3 mm, and 0.2 ± 0.4 mm in the first, second, third, and fourth years, respectively, with a mean cumulative loss of 0.3 ± 0.5 mm at 48 months. In the multilevel model, the effects of the clinical C/I ratio and time were significant for bone loss (P implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss. © 2017 Wiley Periodicals, Inc.

  7. LDL cholesterolemia as a novel risk factor for radiographic progression of rheumatoid arthritis: a single-center prospective study.

    Directory of Open Access Journals (Sweden)

    Yune-Jung Park

    Full Text Available Dyslipidemia has been implicated in various musculoskeletal diseases, including rheumatoid arthritis (RA. Evidence is emerging that there might be a pathogenic interaction among inflammation, dyslipidemia, and adipokines. We prospectively investigated the association of cumulative lipid levels with radiographic progression of RA. RA patients (n=242 underwent plasma cholesterol assessment at four visits. Disease activity parameters and X-rays of the hands and feet were also serially monitored in these patients. The cumulative inflammatory burden and lipid levels were estimated by time-integrated values. Serum leptin and adiponectin concentrations were determined by ELISA. When patients were divided into three groups according to time-integrated lipid levels, as expected, patients with LDL cholesterol and/or triglyceride levels in the third tertile had persistently higher ESR and CRP levels. In parallel, a more rapid radiographic progression over two years was observed in patients with higher LDL cholesterol and/or triglyceride levels. In multivariate analysis, time-integrated LDL cholesterol was independently associated with radiographic progression. Particularly, the risk of radiographic progression was 5.6-fold in a subgroup with both LDL cholesterol and triglyceride levels in the third tertile. Moreover, LDL cholesterol synergistically increased the adjusted probability of radiographic progression in patients with high serum leptin levels but not in those without. These results demonstrate that LDL cholesterolemia is a novel serum marker that can be used to predict radiographic progression of RA, which seems to be related to circulatory leptin levels. We suggest that personalized and more aggressive anti-rheumatic therapy is required for dyslipidemic subgroups in RA patients.

  8. Risk factors and outcomes for catastrophic failures at the top of long pedicle screw constructs: a matched cohort analysis performed at a single center.

    Science.gov (United States)

    O'Leary, Patrick T; Bridwell, Keith H; Lenke, Lawrence G; Good, Christopher R; Pichelmann, Mark A; Buchowski, Jacob M; Kim, Yongjung J; Flynn, Jennifer

    2009-09-15

    Retrospective review with matched-cohort analysis performed at a single institution. To determine risk factors and outcomes for acute fractures at the proximal aspect of long pedicle screw constructs. Acute fractures at the top of long segmental pedicle screw constructs (FPSC) can be catastrophic. Substantial surgical increase in lordosis may precipitate this problem. In relation to a matched cohort, we postulated that age, body mass index (BMI), and significant correction of lumbar lordosis would increase risk of FPSC and patients with FPSC would have lesser improvements in outcomes. Thirteen patients who sustained FPSC between 2000 and 2007 were evaluated. During this time, 264 patients aged 40 or older had a spinal fusion from the thoracic spine to the sacrum using an all-pedicle screw construct. A cohort of 31 of these patients without FPSC but with all pedicle screw constructs was matched for diagnosis of positive sagittal imbalance, gender, preoperative C7 sagittal plumb, and number of levels fused. There was a significant difference in age (P = 0.02) and BMI (P = 0.006) between the matched groups. There was no significant difference in preoperative/postoperative C7 plumb or change in lumbar lordosis between groups. Acute neurological deficit developed in 2 patients; both patients improved substantially after revision surgery. Nine patients underwent proximal extension of the fusion. For 7 of the 13 FPSC patients with bone mineral density data (BMD) available, average T score was-1.73; -0.58 for the matched group (10/31 with bone mineral density data) (P = 0.02). Factors that increased the risk of FPSC included obesity and older age. Osteopenia increased the risk as evidenced by BMD (based on 17 patients) and the older age of these patients. There was no statistical difference in clinical improvement between groups based on ODI, but the FPSC group did demonstrate a smaller improvement in ODI score than the matched cohort.

  9. Single Particle Entropy in Heated Nuclei

    International Nuclear Information System (INIS)

    Guttormsen, M.; Chankova, R.; Hjorth-Jensen, M.; Rekstad, J.; Siem, S.; Sunde, A. C.; Syed, N. U. H.; Agvaanluvsan, U.; Schiller, A.; Voinov, A.

    2006-01-01

    The thermal motion of single particles represents the largest contribution to level density (or entropy) in atomic nuclei. The concept of single particle entropy is presented and shown to be an approximate extensive (additive) quantity for mid-shell nuclei. A few applications of single particle entropy are demonstrated

  10. Distribution and Modeled Transport of Plastic Pollution in the Great Lakes, the World's Largest Freshwater Resource

    Directory of Open Access Journals (Sweden)

    Rachel N. Cable

    2017-07-01

    Full Text Available Most plastic pollution originates on land. As such, freshwater bodies serve as conduits for the transport of plastic litter to the ocean. Understanding the concentrations and fluxes of plastic litter in freshwater ecosystems is critical to our understanding of the global plastic litter budget and underpins the success of future management strategies. We conducted a replicated field survey of surface plastic concentrations in four lakes in the North American Great Lakes system, the largest contiguous freshwater system on the planet. We then modeled plastic transport to resolve spatial and temporal variability of plastic distribution in one of the Great Lakes, Lake Erie. Triplicate surface samples were collected at 38 stations in mid-summer of 2014. Plastic particles >106 μm in size were quantified. Concentrations were highest near populated urban areas and their water infrastructure. In the highest concentration trawl, nearly 2 million fragments km−2 were found in the Detroit River—dwarfing previous reports of Great Lakes plastic abundances by over 4-fold. Yet, the accuracy of single trawl counts was challenged: within-station plastic abundances varied 0- to 3-fold between replicate trawls. In the smallest size class (106–1,000 μm, false positive rates of 12–24% were determined analytically for plastic vs. non-plastic, while false negative rates averaged ~18%. Though predicted to form in summer by the existing Lake Erie circulation model, our transport model did not predict a permanent surface “Lake Erie Garbage Patch” in its central basin—a trend supported by field survey data. Rather, general eastward transport with recirculation in the major basins was predicted. Further, modeled plastic residence times were drastically influenced by plastic buoyancy. Neutrally buoyant plastics—those with the same density as the ambient water—were flushed several times slower than plastics floating at the water's surface and exceeded the

  11. Transcriptome Sequencing and Analysis for Culm Elongation of the World's Largest Bamboo (Dendrocalamus sinicus.

    Directory of Open Access Journals (Sweden)

    Kai Cui

    Full Text Available Dendrocalamus sinicus is the world's largest bamboo species with strong woody culms, and known for its fast-growing culms. As an economic bamboo species, it was popularized for multi-functional applications including furniture, construction, and industrial paper pulp. To comprehensively elucidate the molecular processes involved in its culm elongation, Illumina paired-end sequencing was conducted. About 65.08 million high-quality reads were produced, and assembled into 81,744 unigenes with an average length of 723 bp. A total of 64,338 (79% unigenes were annotated for their functions, of which, 56,587 were annotated in the NCBI non-redundant protein database and 35,262 were annotated in the Swiss-Prot database. Also, 42,508 and 21,009 annotated unigenes were allocated to gene ontology (GO categories and clusters of orthologous groups (COG, respectively. By searching against the Kyoto Encyclopedia of Genes and Genomes Pathway database (KEGG, 33,920 unigenes were assigned to 128 KEGG pathways. Meanwhile, 8,553 simple sequence repeats (SSRs and 81,534 single-nucleotide polymorphism (SNPs were identified, respectively. Additionally, 388 transcripts encoding lignin biosynthesis were detected, among which, 27 transcripts encoding Shikimate O-hydroxycinnamoyltransferase (HCT specifically expressed in D. sinicus when compared to other bamboo species and rice. The phylogenetic relationship between D. sinicus and other plants was analyzed, suggesting functional diversity of HCT unigenes in D. sinicus. We conjectured that HCT might lead to the high lignin content and giant culm. Given that the leaves are not yet formed and culm is covered with sheaths during culm elongation, the existence of photosynthesis of bamboo culm is usually neglected. Surprisedly, 109 transcripts encoding photosynthesis were identified, including photosystem I and II, cytochrome b6/f complex, photosynthetic electron transport and F-type ATPase, and 24 transcripts were characterized

  12. Evaluation of world's largest social welfare scheme: An assessment using non-parametric approach.

    Science.gov (United States)

    Singh, Sanjeet

    2016-08-01

    Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) is the world's largest social welfare scheme in India for the poverty alleviation through rural employment generation. This paper aims to evaluate and rank the performance of the states in India under MGNREGA scheme. A non-parametric approach, Data Envelopment Analysis (DEA) is used to calculate the overall technical, pure technical, and scale efficiencies of states in India. The sample data is drawn from the annual official reports published by the Ministry of Rural Development, Government of India. Based on three selected input parameters (expenditure indicators) and five output parameters (employment generation indicators), I apply both input and output oriented DEA models to estimate how well the states utilize their resources and generate outputs during the financial year 2013-14. The relative performance evaluation has been made under the assumption of constant returns and also under variable returns to scale to assess the impact of scale on performance. The results indicate that the main source of inefficiency is both technical and managerial practices adopted. 11 states are overall technically efficient and operate at the optimum scale whereas 18 states are pure technical or managerially efficient. It has been found that for some states it necessary to alter scheme size to perform at par with the best performing states. For inefficient states optimal input and output targets along with the resource savings and output gains are calculated. Analysis shows that if all inefficient states operate at optimal input and output levels, on an average 17.89% of total expenditure and a total amount of $780million could have been saved in a single year. Most of the inefficient states perform poorly when it comes to the participation of women and disadvantaged sections (SC&ST) in the scheme. In order to catch up with the performance of best performing states, inefficient states on an average need to enhance

  13. The Multivariate Largest Lyapunov Exponent as an Age-Related Metric of Quiet Standing Balance

    Directory of Open Access Journals (Sweden)

    Kun Liu

    2015-01-01

    Full Text Available The largest Lyapunov exponent has been researched as a metric of the balance ability during human quiet standing. However, the sensitivity and accuracy of this measurement method are not good enough for clinical use. The present research proposes a metric of the human body’s standing balance ability based on the multivariate largest Lyapunov exponent which can quantify the human standing balance. The dynamic multivariate time series of ankle, knee, and hip were measured by multiple electrical goniometers. Thirty-six normal people of different ages participated in the test. With acquired data, the multivariate largest Lyapunov exponent was calculated. Finally, the results of the proposed approach were analysed and compared with the traditional method, for which the largest Lyapunov exponent and power spectral density from the centre of pressure were also calculated. The following conclusions can be obtained. The multivariate largest Lyapunov exponent has a higher degree of differentiation in differentiating balance in eyes-closed conditions. The MLLE value reflects the overall coordination between multisegment movements. Individuals of different ages can be distinguished by their MLLE values. The standing stability of human is reduced with the increment of age.

  14. Risk stratifying chest pain patients in the emergency department using HEART, GRACE and TIMI scores, with a single contemporary troponin result, to predict major adverse cardiac events.

    Science.gov (United States)

    Reaney, Peter D W; Elliot, Hamish I; Noman, Awsan; Cooper, Jamie G

    2018-04-05

    The majority of patients presenting to the ED with cardiac sounding chest pain have a non-diagnostic ECG and the problem of differentiating those suffering an acute coronary syndrome from those without is familiar to all ED clinical staff. To stratify risk in these patients, specific scores have been developed. Recent work has focused on incorporating newer high-sensitivity cardiac troponin (hs-cTn) assays; however, issues regarding performance and availability of these assays remain. Prospectively compare HEART, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores, using a single contemporary cTn at admission, to predict a major adverse cardiac event (MACE) at 30 days. Prospective observational cohort study performed in a UK tertiary hospital in patients with suspected cardiac chest pain and no significant ST elevation on initial ECG. Data collection took place 2 December 2014 to 8 February 2016. The treating clinician recorded risk score data real time and a single contemporary cTn taken at presentation was used in score calculation. The primary endpoint was 30-day MACE. C-statistic was determined for each score and diagnostic characteristics of high-risk and low-risk cut-offs were calculated. 189/1000 patients in the study developed a 30-day MACE. The c-statistic of HEART for 30-day MACE (0.87 (95% CI 0.84 to 0.90)) was higher than TIMI (0.78 (95% CI 0.74 to 0.81)) and GRACE (0.74 (95% CI 0.70 to 0.78)).HEART score ≤3 identified low-risk patients with sensitivity 99.5% (95% CI 97.1% to 99.9%) and negative predictive value (NPV) 99.6% (95% CI 97.3% to 99.9%) exceeding TIMI 0 (sensitivity 97.4% (95% CI 93.9% to 99.1%) and NPV 97.8% (95% CI 94.8% to 99.1%)) and GRACE score 0-55 (sensitivity 95.2% (95% CI 91.1% to 97.8%) and NPV 95.8% (95% CI 92.2% to 97.7%)). HEART outperformed both TIMI and GRACE in overall discriminative capacity for 30-day MACE. Using a single contemporary cTn at presentation, a HEART score

  15. No evidence for mitochondrial genetic variability in the largest population of critically endangered Tonkin snub-nosed monkeys in Vietnam.

    Science.gov (United States)

    Ang, Andie; Srivathsan, Amrita; Meier, Rudolf; Luu, Tuong Bach; Le, Quyet Khac; Covert, Herbert

    2016-10-01

    The Tonkin snub-nosed monkey (Rhinopithecus avunculus) with a global population of Vietnam and was feared extinct until its rediscovery in 1989. The largest single population of R. avunculus consists of 125-130 individuals in an area of forest called Khau Ca in Ha Giang Province. We used non-invasively collected fecal samples to establish the amount of genetic diversity in this population based on mitochondrial information. We amplified and sequenced a 467- to 650-bp section of the hypervariable region I (HVI) of the mitochondrial D-loop for 201 samples and reconstructed the full mitochondrial genomes for five samples based on metagenomic data. All 201 HVI sequences were identical and no variability was found in the five mitochondrial genomes. Our results highlight the immediate need for a comprehensive assessment of the genetic diversity of all populations of R. avunculus based on mitochondrial and nuclear markers. The latter need to be developed for this species.

  16. Xanthine Oxidase Activity Is Associated with Risk Factors for Cardiovascular Disease and Inflammatory and Oxidative Status Markers in Metabolic Syndrome: Effects of a Single Exercise Session

    Directory of Open Access Journals (Sweden)

    Ana Maria Pandolfo Feoli

    2014-01-01

    Full Text Available Objective. The main goal of the present study was to investigate the xanthine oxidase (XO activity in metabolic syndrome in subjects submitted to a single exercise session. We also investigated parameters of oxidative and inflammatory status. Materials/Methods. A case-control study (9 healthy and 8 MS volunteers was performed to measure XO, superoxide dismutase (SOD, glutathione peroxidase activities, lipid peroxidation, high-sensitivity C-reactive protein (hsCRP content, glucose levels, and lipid profile. Body mass indices, abdominal circumference, systolic and diastolic blood pressure, and TG levels were also determined. The exercise session consisted of 3 minutes of stretching, 3 minutes of warm-up, 30 minutes at a constant dynamic workload at a moderate intensity, and 3 minutes at a low speed. The blood samples were collected before and 15 minutes after the exercise session. Results. Serum XO activity was higher in MS group compared to control group. SOD activity was lower in MS subjects. XO activity was correlated with SOD, abdominal circumference, body mass indices, and hsCRP. The single exercise session reduced the SOD activity in the control group. Conclusions. Our data support the association between oxidative stress and risk factors for cardiovascular diseases and suggest XO is present in the pathogenesis of metabolic syndrome.

  17. Prophylactic adjacent-segment vertebroplasty following kyphoplasty for a single osteoporotic vertebral fracture and the risk of adjacent fractures: a retrospective study and clinical experience.

    Science.gov (United States)

    Eichler, Martin C; Spross, Christian; Ewers, Alexander; Mayer, Ryan; Külling, Fabrice A

    2016-10-01

    OBJECTIVE This study investigated the benefit of prophylactic vertebroplasty of the adjacent vertebrae in single-segment osteoporotic vertebral body fractures treated with kyphoplasty. METHODS All patients treated with kyphoplasty for osteoporotic single-segment fractures between January 2007 and August 2012 were included in this retrospective study. The patients received either kyphoplasty alone (kyphoplasty group) or kyphoplasty with additional vertebroplasty of the adjacent segment (vertebroplasty group). The segmental kyphosis with the rate of adjacent-segment fractures (ASFs) and remote fractures were studied on plain lateral radiographs preoperatively, postoperatively, at 3 months, and at final follow-up. RESULTS Thirty-seven (82%) of a possible 45 patients were included for the analysis, with a mean follow-up of 16 months (range 3-54 months). The study population included 31 women, and the mean age of the total patient population was 72 years old (range 53-86 years). In 21 patients (57%), the fracture was in the thoracolumbar junction. Eighteen patients were treated with additional vertebroplasty and 19 with kyphoplasty only. The segmental kyphosis increased in both groups at final follow-up. A fracture through the primary treated vertebra (kyphoplasty) was found in 4 (22%) of the vertebroplasty group and in 3 (16%) of the kyphoplasty group (p = 0.6). An ASF was found in 50% (n = 9) of the vertebroplasty group and in 16% (n = 3) of the kyphoplasty group (p = 0.03). Remote fractures occurred in 1 patient in each group (p = 1.0). CONCLUSIONS Prophylactic vertebroplasty of the adjacent vertebra in patients with single-segment osteoporotic fractures as performed in this study did not decrease the rate of adjacent fractures. Based on these retrospective data, the possible benefits of prophylactic vertebroplasty do not compensate for the possible risks of an additional cement augmentation.

  18. HOW THE WORLD’S LARGEST CORPORATIONS EVOLVED IN THE PERIOD 2012-2013

    Directory of Open Access Journals (Sweden)

    Sorin-George TOMA

    2014-11-01

    Full Text Available The largest multinational and transnational corporations are key actors in the world economy. Their number has significantly increased in the last decades both in the developed and the developing countries. Consequently, they are more dispersed globally than in the past. As the world’s largest corporations have become more powerful over time, they represent not only an economic force, but also a political and cultural force in today’s highly globalized world. They have a huge impact on the lives of billions of people every day. The aim of our paper is to analyse the evolution of the first ten world’s largest corporations by their revenues and profits in the period 2012-2013. The research type is literature review.

  19. Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms.

    Science.gov (United States)

    Semb, Olof; Strömsten, Lotta M J; Sundbom, Elisabet; Fransson, Per; Henningsson, Mikael

    2011-08-01

    To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.

  20. Incidence and relative risk of cutaneous squamous cell carcinoma with single-agent BRAF inhibitor and dual BRAF/MEK inhibitors in cancer patients: a meta-analysis.

    Science.gov (United States)

    Peng, Ling; Wang, Yina; Hong, Yun; Ye, Xianghua; Shi, Peng; Zhang, Junyan; Zhao, Qiong

    2017-10-10

    BRAF inhibitor and dual BRAF/MEK inhibitors have been approved for the treatment of BRAF-mutated melanoma. Cutaneous squamous cell carcinoma (cuSCC) is an adverse event associated with these drugs. The contribution of BRAF inhibitor and dual BRAF/MEK inhibitors to cuSCC are still unknown. We performed this meta-analysis to determine the overall incidence and relative risk of cuSCC in cancer patients treated with these drugs. A total of 7,442 patients from 24 primary studies were included. The incidences of all-grade and high-grade cuSCC in cancer patients treated with BRAF inhibitor were 12.5% (95% CI: 10.8-14.6%) and 11.6% (95% CI: 9.8-13.8%), and dual BRAF/MEK inhibitors were 3.0% (95% CI: 2.0-4.5%) and 2.8% (95% CI: 1.9-4.0%), respectively. On subgroup analysis and meta-regression, the incidence of cuSCC did not vary with tumor type, study design and specific drug used. The use of single agent BRAF inhibitor significantly increased the risk of developing cuSCC comparing with dual BRAF/MEK inhibitors for all-grade (RR 4.72, 95% CI: 2.42-9.20) and high-grade (RR 4.92, 95% CI: 2.64-9.16) in cancer patients. The databases of PubMed, Embase and abstracts published in ASCO proceedings were searched for relevant studies from January 2000 to June 2017. Summary incidences, relative risks (RRs) and 95% confidence intervals (CIs) were calculated by using either random effects or fixed effect models according to the heterogeneity of included studies. BRAF inhibitor significantly increases the risk of developing cuSCC compared with dual BRAF/MEK inhibitors in cancer patients. Clinicians should be aware of the risks of cuSCC with the administration of these drugs in cancer patients.

  1. Sex Steroid Hormone Single-Nucleotide Polymorphisms, Pesticide Use, and the Risk of Prostate Cancer: A Nested Case–Control Study within the Agricultural Health Study

    Science.gov (United States)

    Christensen, Carol H.; Barry, Kathryn Hughes; Andreotti, Gabriella; Alavanja, Michael C. R.; Cook, Michael B.; Kelly, Scott P.; Burdett, Laurie A.; Yeager, Meredith; Beane Freeman, Laura E.; Berndt, Sonja I.; Koutros, Stella

    2016-01-01

    Experimental and epidemiologic investigations suggest that certain pesticides may alter sex steroid hormone synthesis, metabolism or regulation, and the risk of hormone-related cancers. Here, we evaluated whether single-nucleotide polymorphisms (SNPs) involved in hormone homeostasis alter the effect of pesticide exposure on prostate cancer risk. We evaluated pesticide–SNP interactions between 39 pesticides and SNPs with respect to prostate cancer among 776 cases and 1,444 controls nested in the Agricultural Health Study cohort. In these interactions, we included candidate SNPs involved in hormone synthesis, metabolism or regulation (N = 1,100), as well as SNPs associated with circulating sex steroid concentrations, as identified by genome-wide association studies (N = 17). Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Multiplicative SNP–pesticide interactions were calculated using a likelihood ratio test. We translated p-values for interaction into q-values, which reflected the false discovery rate, to account for multiple comparisons. We observed a significant interaction, which was robust to multiple comparison testing, between the herbicide dicamba and rs8192166 in the testosterone metabolizing gene SRD5A1 (p-interaction = 4.0 × 10−5; q-value = 0.03), such that men with two copies of the wild-type genotype CC had a reduced risk of prostate cancer associated with low use of dicamba (OR = 0.62 95% CI: 0.41, 0.93) and high use of dicamba (OR = 0.44, 95% CI: 0.29, 0.68), compared to those who reported no use of dicamba; in contrast, there was no significant association between dicamba and prostate cancer among those carrying one or two copies of the variant T allele at rs8192166. In addition, interactions between two organophosphate insecticides and SNPs related to estradiol metabolism were observed to result in an increased risk of prostate cancer. While replication is

  2. A NEIL1 single nucleotide polymorphism (rs4462560) predicts the risk of radiation-induced toxicities in esophageal cancer patients treated with definitive radiotherapy.

    Science.gov (United States)

    Chen, Yun; Zhu, Meiling; Zhang, Zhen; Jiang, Guoliang; Fu, Xiaolong; Fan, Min; Sun, Menghong; Wei, Qingyi; Zhao, Kuaile

    2013-12-01

    To assess the association between single nucleotide polymorphisms (SNPs) of base-excision repair genes and clinical outcomes, the roles of genetic variants of 3 selected genes-flap structure-specific endonuclease 1 (FEN1), 8-hydroxyguanine DNA glycosylase (hOGG1), and nei endonuclease VIII-like 1 (NEIL1)--were investigated in radiation-induced esophageal toxicity (RIET), radiation pneumonitis (RP), and overall survival (OS) after radio(chemo)therapy in patients with esophageal squamous cell carcinoma (ESCC). NEIL1 reference SNP 4462560 (rs4462560) and rs7402844, hOGG1 rs1052133 and rs293795, and FEN1 rs4246215 and rs174538 were genotyped in 187 patients with ESCC who received definitive radiotherapy with or without chemotherapy. Kaplan-Meier cumulative probabilities and Cox proportional hazards regression models were used to assess the effect of the genotypes on the risk of RIET, RP, and OS. The authors observed that patients who had the NEIL1 rs4462560 GC/CC genotype had a statistically significantly lower risk of both grade ≥ 2 acute radiation-induced esophageal toxicity (RIET) (adjusted hazard ratio [HR], 0.421; 95% confidence interval [CI], 0.207-0.856; P = .017) and grade ≥ 2 acute radiation pneumonitis (RP) (adjusted HR, 0.392; 95% CI, 0.163-0.946; P = .037) compared with patients who had the GG genotype, but the genotype did not affect OS (adjusted HR, 0.778; 95% CI, 0.471-1.284; P = .326). There were no significant findings for other the SNPs under investigation. The NEIL1 rs4462560 SNP may serve as a predictor of acute RIET and RP risk but not of OS. Larger prospective studies are needed to validate these findings. © 2013 American Cancer Society.

  3. A functional single nucleotide polymorphism at the promoter region of cyclin A2 is associated with increased risk of colon, liver, and lung cancers.

    Science.gov (United States)

    Kim, Duk-Hwan; Park, Seong-Eun; Kim, Minseung; Ji, Yong Ick; Kang, Mi Yeon; Jung, Eun Hyun; Ko, Eunkyung; Kim, Yujin; Kim, Sung; Shim, Young Mog; Park, Joobae

    2011-09-01

    The objective of this was to identify functional single nucleotide polymorphisms (SNPs) in cyclin-dependent kinases (CDKs) and cyclins that are associated with risk of human cancer. First, 45 SNPs in CDKs and cyclins were analyzed in 106 lung cancers and 108 controls for a pilot study. One SNP (reference SNP [rs] 769236, +1 guanine to adenine [G→A]) at the promoter region of cyclin A2 (CCNA2) also was analyzed in 1989 cancers (300 breast cancers, 450 colorectal cancers, 450 gastric cancers, 367 hepatocellular carcinomas, and 422 lung cancers) and in 1096 controls. Genotyping was performed using matrix-assisted laser desorption-ionization/time-of-flight mass spectrometry. Transcriptional activity of the SNP according to the cell cycle was analyzed by using a luciferase reporter assay and fluorescence-activated cell sorting analysis in NIH3T3 cells. In the pilot study, the SNP (rs769236) was associated significantly with the risk of lung cancer. In the expanded study, multivariate logistic regression indicated that the AA homozygous variant of the SNP was associated significantly with the development of lung cancer (P hepatocellular carcinoma (P = .02) but not with breast cancer or gastric cancer. The luciferase activity of a 300-base pair construct that contained the A allele was 1.5-fold greater than the activity of a construct with the G allele in NIH3T3 cells. The high luciferase activity of constructs that contained the A allele did not change with cell cycle progression. The current results suggested that an SNP (rs769236) at the promoter of CCNA2 may be associated significantly with increased risk of colon, liver, and lung cancers. Cancer 2011 © 2011 American Cancer Society.

  4. Largest Serous Cystadenoma in the first Trimester treated Laparoscopically: A Case Report

    Science.gov (United States)

    Dhuliya, Dolly Jaykant; Rahana, Farah; Al Wahibi, Ayman; Al Mamari, Muna Salim; Al Mamari, Altaf Mubarak; Devi, Nirmala; Jahan, Arif; Dar, Manzoor A.; Al Madhani, Ali; Al Kindi, Salam

    2012-01-01

    We report the first case of a giant serous cystadenoma approximately 7.5kg in weight in a 28-year old primigravida at 8 weeks of gestation which was successfully excised laparoscopically. Postoperatively, she had a quick recovery and she was discharged on post op day 3 with an intact pregnancy and no complications. This is the largest ovarian cyst in early pregnancy that has been ever reported from our hospital. We also believe this cyst to be the largest cyst in early pregnancy ever reported in the literature that has been managed by Laparoscopy. PMID:28861184

  5. World's third-largest producer of nuclear power. Japan in need of energy

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2008-04-07

    Japan is the third largest oil consumer in the world behind the United States and China, and the second largest net importer of oil. Japan boasts one of the largest economies in the world. The country continues to experience a moderate economic recovery that began in 2003, following a decade of economic stagnation. Japan's real gross domestic product (GDP) grew by 2.5% in 2005 and 2.3% in 2004. The modest upturn over the last few years reflects higher business confidence in Japan, a surge in export demand led by exports to China, and robust consumer spending. Unemployment in Japan fell to 4.4% in 2005, down from an early 2003 peak of 5.5%. Japan has virtually no domestic oil or natural gas reserves, and in 2005 was the second largest net importer of crude oil in the world. Despite the country's dearth of hydrocarbon resources, Japanese companies have actively pursued upstream oil and natural gas projects overseas. Japan remains one of the major exporters of energy-sector capital equipment, and Japanese companies provide engineering, construction, and project management services for energy projects. (orig.)

  6. Preserving the world second largest hypersaline lake under future irrigation and climate change

    NARCIS (Netherlands)

    Shadkam, Somayeh; Ludwig, Fulco; Vliet, van Michelle T.H.; Pastor, Amandine; Kabat, Pavel

    2016-01-01

    Iran Urmia Lake, the world second largest hypersaline lake, has been largely desiccated over the last two decades resulting in socio-environmental consequences similar or even larger than the Aral Sea disaster. To rescue the lake a new water management plan has been proposed, a rapid 40% decline

  7. Predicting Traffic Flow in Local Area Networks by the Largest Lyapunov Exponent

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2016-01-01

    Full Text Available The dynamics of network traffic are complex and nonlinear, and chaotic behaviors and their prediction, which play an important role in local area networks (LANs, are studied in detail, using the largest Lyapunov exponent. With the introduction of phase space reconstruction based on the time sequence, the high-dimensional traffic is projected onto the low dimension reconstructed phase space, and a reduced dynamic system is obtained from the dynamic system viewpoint. Then, a numerical method for computing the largest Lyapunov exponent of the low-dimensional dynamic system is presented. Further, the longest predictable time, which is related to chaotic behaviors in the system, is studied using the largest Lyapunov exponent, and the Wolf method is used to predict the evolution of the traffic in a local area network by both Dot and Interval predictions, and a reliable result is obtained by the presented method. As the conclusion, the results show that the largest Lyapunov exponent can be used to describe the sensitivity of the trajectory in the reconstructed phase space to the initial values. Moreover, Dot Prediction can effectively predict the flow burst. The numerical simulation also shows that the presented method is feasible and efficient for predicting the complex dynamic behaviors in LAN traffic, especially for congestion and attack in networks, which are the main two complex phenomena behaving as chaos in networks.

  8. Phase space reconstruction and estimation of the largest Lyapunov exponent for gait kinematic data

    Energy Technology Data Exchange (ETDEWEB)

    Josiński, Henryk [Silesian University of Technology, Akademicka 16, 44-100 Gliwice (Poland); Świtoński, Adam [Polish-Japanese Institute of Information Technology, Aleja Legionów 2, 41-902 Bytom (Poland); Silesian University of Technology, Akademicka 16, 44-100 Gliwice (Poland); Michalczuk, Agnieszka; Wojciechowski, Konrad [Polish-Japanese Institute of Information Technology, Aleja Legionów 2, 41-902 Bytom (Poland)

    2015-03-10

    The authors describe an example of application of nonlinear time series analysis directed at identifying the presence of deterministic chaos in human motion data by means of the largest Lyapunov exponent. The method was previously verified on the basis of a time series constructed from the numerical solutions of both the Lorenz and the Rössler nonlinear dynamical systems.

  9. Discovery of the largest orbweaving spider species: the evolution of gigantism in Nephila.

    Directory of Open Access Journals (Sweden)

    Matjaz Kuntner

    2009-10-01

    Full Text Available More than 41,000 spider species are known with about 400-500 added each year, but for some well-known groups, such as the giant golden orbweavers, Nephila, the last valid described species dates from the 19(th century. Nephila are renowned for being the largest web-spinning spiders, making the largest orb webs, and are model organisms for the study of extreme sexual size dimorphism (SSD and sexual biology. Here, we report on the discovery of a new, giant Nephila species from Africa and Madagascar, and review size evolution and SSD in Nephilidae.We formally describe N. komaci sp. nov., the largest web spinning species known, and place the species in phylogenetic context to reconstruct the evolution of mean size (via squared change parsimony. We then test female and male mean size correlation using phylogenetically independent contrasts, and simulate nephilid body size evolution using Monte Carlo statistics.Nephila females increased in size almost monotonically to establish a mostly African clade of true giants. In contrast, Nephila male size is effectively decoupled and hovers around values roughly one fifth of female size. Although N. komaci females are the largest Nephila yet discovered, the males are also large and thus their SSD is not exceptional.

  10. Distribution of the Largest Eigenvalues of the Levi-Smirnov Ensemble

    International Nuclear Information System (INIS)

    Wieczorek, W.

    2004-01-01

    We calculate the distribution of the k-th largest eigenvalue in the random matrix Levi - Smirnov Ensemble (LSE), using the spectral dualism between LSE and chiral Gaussian Unitary Ensemble (GUE). Then we reconstruct universal spectral oscillations and we investigate an asymptotic behavior of the spectral distribution. (author)

  11. CERN: Digital image analysis in the world's largest research center for particle physics

    CERN Multimedia

    2005-01-01

    Those interested in researching into the smallest building blocks that matter is made up of need the largest instruments. CERN, near Geneva, Switzerland is where the most powerful circular accelerator in the world is being built: the Large Hadron Collider (LHC) for proton collisions. It has a circumference of 26.7 km (4 pages)

  12. Phase space reconstruction and estimation of the largest Lyapunov exponent for gait kinematic data

    International Nuclear Information System (INIS)

    Josiński, Henryk; Świtoński, Adam; Michalczuk, Agnieszka; Wojciechowski, Konrad

    2015-01-01

    The authors describe an example of application of nonlinear time series analysis directed at identifying the presence of deterministic chaos in human motion data by means of the largest Lyapunov exponent. The method was previously verified on the basis of a time series constructed from the numerical solutions of both the Lorenz and the Rössler nonlinear dynamical systems

  13. CERN, World's largest particle physics lab, selects Progress SonicMQ

    CERN Multimedia

    2007-01-01

    "Progress Software Corporation (NADAQ: PRGS), a global supplier of application insfrastructure software used to develop, deploy, integrate and manage business applications, today announced that CERN the world's largest physis laboratory and particle accelerator, has chosen Progress® SonicMQ® for mission-critical message delivery." (1 page)

  14. A 10-year retrospective cohort study on the risk factors for peritoneal dialysis-related peritonitis: a single-center study at Tokai University Hospital.

    Science.gov (United States)

    Nishina, Makoto; Yanagi, Hidetaka; Kakuta, Takatoshi; Endoh, Masayuki; Fukagawa, Masafumi; Takagi, Atsushi

    2014-08-01

    Common outcomes of peritoneal dialysis (PD)-related peritonitis include catheter removal and transition to hemodialysis (HD). According to recent data, the incidence of PD-related peritonitis in Japan is not low, and peritonitis is the most common cause of withdrawal from PD. Against this backdrop, the purpose of this study is to determine the incidence of PD-related peritonitis at the Outpatient Nephrology Clinic of Tokai University Hospital (hereafter "the Clinic") and to examine causative bacteria and the risk factors related to the development of peritonitis. We investigated all PD-related peritonitis episodes of 192 PD patients who visited the Clinic during the period from April 1, 2001 to March 31, 2011 and established the incidence of PD-related peritonitis, along with culture-negative peritonitis rates. Regarding the risk factors that are associated with the development of peritonitis, we examined patient backgrounds, whether an automated peritoneal dialysis (APD) device was used, and which type of connection system was employed. The incidence of peritonitis was one episode per 64.5 patient-months, and the culture-negative peritonitis rate was 16.4 %. Of the cultured bacterial isolates 71.3 % were Gram-positive cocci, including 25.0 % of coagulase-negative staphylococci, 13.2 % of methicillin-susceptible Staphylococcus aureus (MSSA), and 6.6 % of methicillin-resistant Staphylococcus aureus (MRSA). Gram-negative rods were 19.1 %. Risk factors associated with the development of peritonitis included age at the start of PD [odds ratio 1.042, 95 % confidence interval (CI) 1.016-1.069, p value = 0.001], diabetes mellitus nephropathy (DMN) (odds ratio 22.003, 95 % CI 2.101-230.452, p value = 0.010), and the use of a sterile tubing welder device (STWD) (odds ratio 2.399, 95 % CI 1.043-5.521, p value = 0.040). Regarding the situation of peritonitis at a single center during the 10-year period of this study, risk factors associated with the development of peritonitis

  15. SLC2A3 single-nucleotide polymorphism and duplication influence cognitive processing and population-specific risk for attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Merker, Sören; Reif, Andreas; Ziegler, Georg C; Weber, Heike; Mayer, Ute; Ehlis, Ann-Christine; Conzelmann, Annette; Johansson, Stefan; Müller-Reible, Clemens; Nanda, Indrajit; Haaf, Thomas; Ullmann, Reinhard; Romanos, Marcel; Fallgatter, Andreas J; Pauli, Paul; Strekalova, Tatyana; Jansch, Charline; Vasquez, Alejandro Arias; Haavik, Jan; Ribasés, Marta; Ramos-Quiroga, Josep Antoni; Buitelaar, Jan K; Franke, Barbara; Lesch, Klaus-Peter

    2017-07-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common, highly heritable neurodevelopmental disorder with profound cognitive, behavioral, and psychosocial impairments with persistence across the life cycle. Our initial genome-wide screening approach for copy number variants (CNVs) in ADHD implicated a duplication of SLC2A3, encoding glucose transporter-3 (GLUT3). GLUT3 plays a critical role in cerebral glucose metabolism, providing energy for the activity of neurons, which, in turn, moderates the excitatory-inhibitory balance impacting both brain development and activity-dependent neural plasticity. We therefore aimed to provide additional genetic and functional evidence for GLUT3 dysfunction in ADHD. Case-control association analyses of SLC2A3 single-nucleotide polymorphisms (SNPs) and CNVs were conducted in several European cohorts of patients with childhood and adult ADHD (SNP, n = 1,886 vs. 1,988; CNV, n = 1,692 vs. 1,721). These studies were complemented by SLC2A3 expression analyses in peripheral cells, functional EEG recordings during neurocognitive tasks, and ratings of food energy content. Meta-analysis of all cohorts detected an association of SNP rs12842 with ADHD. While CNV analysis detected a population-specific enrichment of SLC2A3 duplications only in German ADHD patients, the CNV + rs12842 haplotype influenced ADHD risk in both the German and Spanish cohorts. Duplication carriers displayed elevated SLC2A3 mRNA expression in peripheral blood cells and altered event-related potentials reflecting deficits in working memory and cognitive response control, both endophenotypic traits of ADHD, and an underestimation of energy units of high-caloric food. Taken together, our results indicate that both common and rare SLC2A3 variation impacting regulation of neuronal glucose utilization and energy homeostasis may result in neurocognitive deficits known to contribute to ADHD risk. © 2017 Association for Child and Adolescent Mental Health.

  16. Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiation Therapy in the Treatment of Intermediate-Risk Prostate Cancer - Long Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Cury, Fabio L., E-mail: fabio.cury@muhc.mcgill.ca [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); Duclos, Marie [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); Aprikian, Armen [Department of Urology, McGill University Health Centre, Montreal, QC (Canada); Patrocinio, Horacio [Department of Medical Physics, McGill University Health Centre, Montreal, QC (Canada); Kassouf, Wassim [Department of Urology, McGill University Health Centre, Montreal, QC (Canada); Shenouda, George; Faria, Sergio; David, Marc; Souhami, Luis [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada)

    2012-03-15

    Purpose: We present the long-term results of a cohort of patients with intermediate-risk prostate cancer (PC) treated with single-fraction high-dose-rate brachytherapy (HDRB) combined with hypofractionated external beam radiation therapy (HypoRT). Methods and Materials: Patients were treated exclusively with HDRB and HypoRT. HDRB delivered a dose of 10 Gy to the prostate surface and HypoRT consisted of 50 Gy delivered in 20 daily fractions. The first 121 consecutive patients with a minimum of 2 years posttreatment follow-up were assessed for toxicity and disease control. Results: The median follow-up was 65.2 months. No acute Grade III or higher toxicity was seen. Late Grade II gastrointestinal toxicity was seen in 9 patients (7.4%) and Grade III in 2 (1.6%). Late Grade III genitourinary toxicity was seen in 2 patients (1.6%). After a 24-month follow-up, a rebiopsy was offered to the first 58 consecutively treated patients, and 44 patients agreed with the procedure. Negative biopsies were found in 40 patients (91%). The 5-year biochemical relapse-free survival rate was 90.7% (95% CI, 84.5-96.9%), with 13 patients presenting biochemical failure. Among them, 9 were diagnosed with distant metastasis. Prostate cancer-specific and overall survival rates at 5 years were 100% and 98.8% (95% CI, 96.4-100%), respectively. Conclusion: The combination of HDRB and HypoRT is well tolerated, with acceptable toxicity rates. Furthermore, results from rebiopsies revealed an encouraging rate of local control. These results confirm that the use of conformal RT techniques, adapted to specific biological tumor characteristics, have the potential to improve the therapeutic ratio in intermediate-risk PC patients.

  17. Combination Testing Using a Single MSH5 Variant alongside HLA Haplotypes Improves the Sensitivity of Predicting Coeliac Disease Risk in the Polish Population.

    Directory of Open Access Journals (Sweden)

    Agnieszka Paziewska

    Full Text Available Assessment of non-HLA variants alongside standard HLA testing was previously shown to improve the identification of potential coeliac disease (CD patients. We intended to identify new genetic variants associated with CD in the Polish population that would improve CD risk prediction when used alongside HLA haplotype analysis. DNA samples of 336 CD and 264 unrelated healthy controls were used to create DNA pools for a genome wide association study (GWAS. GWAS findings were validated with individual HLA tag single nucleotide polymorphism (SNP typing of 473 patients and 714 healthy controls. Association analysis using four HLA-tagging SNPs showed that, as was found in other populations, positive predicting genotypes (HLA-DQ2.5/DQ2.5, HLA-DQ2.5/DQ2.2, and HLA-DQ2.5/DQ8 were found at higher frequencies in CD patients than in healthy control individuals in the Polish population. Both CD-associated SNPs discovered by GWAS were found in the CD susceptibility region, confirming the previously-determined association of the major histocompatibility (MHC region with CD pathogenesis. The two most significant SNPs from the GWAS were rs9272346 (HLA-dependent; localized within 1 Kb of DQA1 and rs3130484 (HLA-independent; mapped to MSH5. Specificity of CD prediction using the four HLA-tagging SNPs achieved 92.9%, but sensitivity was only 45.5%. However, when a testing combination of the HLA-tagging SNPs and the MSH5 SNP was used, specificity decreased to 80%, and sensitivity increased to 74%. This study confirmed that improvement of CD risk prediction sensitivity could be achieved by including non-HLA SNPs alongside HLA SNPs in genetic testing.

  18. Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: A single center retrospective study.

    Science.gov (United States)

    Corcione, Silvia; Angilletta, Roberto; Raviolo, Stefania; Filippini, Claudia; Fossati, Lucina; Di Perri, Giovanni; Cavallo, Rossana; De Rosa, Francesco Giuseppe

    2018-02-01

    The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected. Aims of this study were to describe epidemiology and to evaluate risk factors for in-hospital mortality in this group of patients. Seven hundred-eighty six cases were analyzed: 398 CDI, 137 candidemia, 125 ESBL-E BSI and 126 CP-Kp BSI. CDI, candidemia and ESBL-E BSI were more frequently reported in internal medicine wards (IMW), whilst CP-Kp were more described in intensive care unit (ICU). Sixty-six percent of patients had a previous hospitalization and the majority of patients had several medical comorbidities. In-hospital death occurred in 23.4%. Independent risk factors for mortality were antibiotic therapy before hospital admission, cardiovascular diseases, neutropenia, urinary catheter, total parenteral nutrition, SIRS and higher creatinine levels at diagnosis. Previous abdominal surgery, inflammatory bowel disease, higher serum albumin levels at the admission and fever at diagnosis were significantly associated with survival. Our data showed that CDI, ESBL-E BSI and candidemia are more frequent in frail patients, admitted to IMW, with chronic comorbidities and broad exposure to antibiotic therapies, with the exception for CP-Kp BSI, still more common in the ICU. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  19. Alcohol consumption among students - a cross-sectional study at three largest universities in Serbia

    Directory of Open Access Journals (Sweden)

    Višnjić Aleksandar

    2015-01-01

    Full Text Available Introduction. The prevalence of unhealthy alcohol use among university students is increasing in many countries. Objective. The aim of the study was to investigate alcohol consumption and alcohol-related knowledge, attitudes and risky behaviors among Serbian university students. Methods. The cross-sectional study was carried out at the three state universities from January to June in the academic year 2009/2010 and included 2,285 students of both genders. The students filled out a questionnaire consisting of 70 questions with respect to demographic and socioeconomic characteristics, their lifestyle habits, styles and attitudes, health assessment, as well as exposure to different risk factors. Results. It was found that 77.7% of students drank alcohol occasionally, 4.6% of them consumed it on a daily basis. Friedman’s test (p<0.001 showed that students prefer drinking beer to all other alcoholic beverages. Students in Belgrade and students of Technical faculties are undisputed champions when it comes to how often they drink six or more drinks on a single occasion. Older students in Serbia drink more and get drunk more frequently. Conclusion. A high percentage of Serbian students consume alcohol, and even though they have their first drink at an early age, they generally drink less than students in many other countries.

  20. Cardiovascular Risk Factors After Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): a New Effective Therapeutic Approach?

    Science.gov (United States)

    Torres, Antonio; Rubio, Miguel A; Ramos-Leví, Ana M; Sánchez-Pernaute, Andrés

    2017-11-07

    Obesity and its associated comorbidities entail a significantly increased cardiovascular mortality. Therefore, approaching obesity control must include among its aims the reduction of the associated comorbidities and the higher cardiovascular mortality risk and not only weight loss. Many observational studies indicate that bariatric surgery (BS) is associated with a better long-term survival than standard care. Furthermore, in general, these epidemiological studies included patients who underwent gastric bypass (GB), not biliopancreatic diversion/duodenal switch (BPD/DS), so the potential additional benefit of this latter technique remains unknown. In this regard, in theory, derivative techniques are usually associated to a higher rate of long-term improvement of metabolic comorbidities, so their potential impact on cardiovascular morbidity and mortality could be even greater than what has been published up to date. In 2007, our group proposed a simplification of the bariatric technique based on the duodenal switch, which we termed "single anastomosis duodeno-ileal bypass with sleeve gastrectomy" or SADI-S. In this review, and 10 years later, we describe some of the main results of those patients who underwent this procedure, specifically regarding their outcome on metabolic comorbidities and cardiovascular risk. Considering the findings presented in this review, in which a significant improvement of all metabolic comorbidities was observed, we may confidently suggest that SADI-S seems comparable to a BPD/DS procedure in the mid-term outcome. After all, the SADI-S procedure was conceived as a simplified version of the BPD/DS technique and not necessarily intended to maximize the improvement of cardiovascular and metabolic comorbidities, which is already sufficiently optimal. In this regard, in our experience, we have encountered a new satisfactory result, which combines more pros than cons. In fact, as we have seen, after a follow-up of 3 years, the outcomes of

  1. To what extent do single symptoms from a depression rating scale predict risk of long-term sickness absence among employees who are free of clinical depression?

    DEFF Research Database (Denmark)

    Rugulies, R; Hjarsbech, PU; Aust, B

    2013-01-01

    PURPOSE: Depression rating scales have predicted long-term sickness absence (LTSA) in previous studies. With this study, we investigated to what extent single symptoms from a depression rating scale predicted LTSA among employees who were free of clinical depression. METHODS: We studied 6...... symptoms, three predicted LTSA after adjustment for covariates: "felt low in spirits and sad" (HR = 1.41, 95 % CI = 1.05-1.89), "felt lacking in energy and strength" (HR = 1.33, 95 % CI = 1.08-1.64), and "had trouble sleeping at night" (HR = 1.38, 95 % CI = 1.09-1.74). CONCLUSION: Among female eldercare...... workers free of clinical depression, feelings of low spirits and sadness, feelings of lack of energy and strength, and sleep disturbances predict risk of LTSA. Interventions that decrease the prevalence of these symptoms might contribute to a reduction in LTSA in this population....

  2. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience

    Science.gov (United States)

    Sherrod, Brandon A.; Arynchyna, Anastasia A.; Johnston, James M.; Rozzelle, Curtis J.; Blount, Jeffrey P.; Oakes, W. Jerry; Rocque, Brandon G.

    2017-01-01

    operation (OR 1.843, 95% CI 1.011–3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036–2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085–2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062–2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354–11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957–4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955–4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7. Conclusions NSQIP-P SSI rates, but not risk factors, were similar to data from a single center. PMID:28186476

  3. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience.

    Science.gov (United States)

    Sherrod, Brandon A; Arynchyna, Anastasia A; Johnston, James M; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry; Rocque, Brandon G

    2017-04-01

    .843, 95% CI 1.011-3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036-2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085-2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062-2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354-11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957-4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955-4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7. CONCLUSIONS The NSQIP-P SSI rates, but not risk factors, were similar to data from a single center.

  4. Public health aspects of the world's largest mass gathering: The 2013 Kumbh Mela in Allahabad, India.

    Science.gov (United States)

    Balsari, Satchit; Greenough, P Gregg; Kazi, Dhruv; Heerboth, Aaron; Dwivedi, Shraddha; Leaning, Jennifer

    2016-12-01

    India's Kumbh Mela remains the world's largest and longest mass gathering. The 2013 event, where participants undertook a ritual bath, hosted over 70 million Hindu pilgrims during 55 days on a 1936 hectare flood plain at the confluence of the Yamuna and Ganga Rivers. On the holiest bathing days, the population surged. Unlike other religious, cultural, and sports mass gatherings, the Kumbh Mela's administration cannot estimate or limit the participant number. The event created serious and uncommon public health challenges: initiating crowd safety measures where population density and mobility directly contact flowing bodies of water; providing water, sanitation, and hygiene to a population that frequently defecates in the open; and establishing disease surveillance and resource use measures within a temporary health delivery system. We review the world's largest gathering by observing first-hand the public health challenges, plus the preparations for and responses to them. We recommend ways to improve preparedness.

  5. Overview of pharmacovigilance practices at the largest academic healthcare system in the State of Qatar.

    Science.gov (United States)

    Al Hail, Moza; Elkassem, Wessam; Hamad, Anas; Abdulrouf, Pallivalappila; Thomas, Binny; Stewart, Derek

    2018-04-03

    Adverse Drug Reactions (ADRs) are major global concern, adversely impacting patient safety and health outcomes. ADRs cause significant morbidity and mortality among hospitalised patients, causing greater length of hospital stay, increased healthcare costs and patient dissatisfaction to the treatments. Pharmacovigilance (PV), a process of detecting, monitoring and preventing drug-related harm, plays a vital role to ensure patient safety. ADR reporting is the cornerstone of PV. PV practices in Qatar are relatively new and are evolving rapidly. The purpose of this article is to explore the medication safety practices (notably ADR reporting) at the largest academic healthcare center in Qatar. The article further provides evidence on how information related to ADRs are generated and interpreted. Furthermore, it describes how a designated center for monitoring medication safety activities was established at the largest healthcare provider in Qatar.

  6. Constraining the magnitude of the largest event in a foreshock-main shock-aftershock sequence

    Science.gov (United States)

    Shcherbakov, Robert; Zhuang, Jiancang; Ogata, Yosihiko

    2018-01-01

    Extreme value statistics and Bayesian methods are used to constrain the magnitudes of the largest expected earthquakes in a sequence governed by the parametric time-dependent occurrence rate and frequency-magnitude statistics. The Bayesian predictive distribution for the magnitude of the largest event in a sequence is derived. Two types of sequences are considered, that is, the classical aftershock sequences generated by large main shocks and the aftershocks generated by large foreshocks preceding a main shock. For the former sequences, the early aftershocks during a training time interval are used to constrain the magnitude of the future extreme event during the forecasting time interval. For the latter sequences, the earthquakes preceding the main shock are used to constrain the magnitudes of the subsequent extreme events including the main shock. The analysis is applied retrospectively to past prominent earthquake sequences.

  7. THE BRIGHTEST CLUSTER GALAXY IN A85: THE LARGEST CORE KNOWN SO FAR

    International Nuclear Information System (INIS)

    López-Cruz, O.; Añorve, C.; Ibarra-Medel, H. J.; Birkinshaw, M.; Worrall, D. M.; Barkhouse, W. A.; Torres-Papaqui, J. P.; Motta, V.

    2014-01-01

    We have found that the brightest cluster galaxy (BCG) in A85, Holm 15A, displays the largest core known so far. Its cusp radius, r γ = 4.57 ± 0.06 kpc (4.''26 ± 0.''06), is more than 18 times larger than the mean for BCGs and ≳ 1 kpc larger than A2261-BCG, hitherto the largest-cored BCG. Holm 15A hosts the luminous amorphous radio source 0039-095B and has the optical signature of a LINER. Scaling laws indicate that this core could host a supermassive black hole (SMBH) of mass M • ∼ (10 9 -10 11 ) M ☉ . We suggest that cores this large represent a relatively short phase in the evolution of BCGs, whereas the masses of their associated SBMH might be set by initial conditions

  8. THE BRIGHTEST CLUSTER GALAXY IN A85: THE LARGEST CORE KNOWN SO FAR

    Energy Technology Data Exchange (ETDEWEB)

    López-Cruz, O.; Añorve, C.; Ibarra-Medel, H. J. [Instituto Nacional de Astrofísica, Óptica y Electrónica (INAOE), Astrofísica, Luis Enrique Erro No.1, Tonantzintla, Pue., C.P. 72840 (Mexico); Birkinshaw, M.; Worrall, D. M. [HH Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol, BS8 1TL (United Kingdom); Barkhouse, W. A. [Department of Physics and Astrophysics, University of North Dakota, Grand Forks, ND 58202 (United States); Torres-Papaqui, J. P. [Departamento de Astronomía, Universidad de Guanajuato (DAUG), Callejón Jalisco S/N Col. Valenciana, C.P. 36240 Guanajuato, Gto. (Mexico); Motta, V., E-mail: omarlx@inaoep.mx [Instituto de Física y Astronomía, Universidad de Valparaíso, Avda. Gran Bretaña 1111 Varaíso (Chile)

    2014-11-10

    We have found that the brightest cluster galaxy (BCG) in A85, Holm 15A, displays the largest core known so far. Its cusp radius, r {sub γ} = 4.57 ± 0.06 kpc (4.''26 ± 0.''06), is more than 18 times larger than the mean for BCGs and ≳ 1 kpc larger than A2261-BCG, hitherto the largest-cored BCG. Holm 15A hosts the luminous amorphous radio source 0039-095B and has the optical signature of a LINER. Scaling laws indicate that this core could host a supermassive black hole (SMBH) of mass M {sub •} ∼ (10{sup 9}-10{sup 11}) M {sub ☉}. We suggest that cores this large represent a relatively short phase in the evolution of BCGs, whereas the masses of their associated SBMH might be set by initial conditions.

  9. Sustainability reporting within the shipping industry - An exploratory study of the ten largest container shipping companies

    OpenAIRE

    Olsen, Christian

    2015-01-01

    The shipping industry is one of the driving forces of the global economy, and sustainability issues are of key importance to the future of our world. Therefore, this thesis will combine them and look at sustainability within the shipping sector by doing an exploratory study of the ten largest container sh ipping companies . Sustainability reporting is becoming commonplace among larger companies, and therefore this thesis sets out to look at what i...

  10. Wet scavenging of SO2 emissions around India's largest lignite based power plant

    OpenAIRE

    A. Rai; S. Ghosh; S. Chakraborty

    2010-01-01

    The Neyveli Lignite Corporation (NLC) is among the largest lignite based power plants in South East Asia. The four elevated stacks from this power plant emanate a substantial amount of sulphur dioxide into a tropical boundary layer. Sulphur dioxide being a soluble pollutant gas is absorbed by falling raindrops. This is a first study that quantifies the scavenging action of the North Eastern monsoonal rains from a lignite based power plant. We find that although the North Eas...

  11. Approaching the largest ‘API’: extracting information from the Internet with Python

    OpenAIRE

    Jonathan E. Germann

    2018-01-01

    This article explores the need for libraries to algorithmically access and manipulate the world’s largest API: the Internet. The billions of pages on the ‘Internet API’ (HTTP, HTML, CSS, XPath, DOM, etc.) are easily accessible and manipulable. Libraries can assist in creating meaning through the datafication of information on the world wide web. Because most information is created for human consumption, some programming is required for automated extraction. Python is an easy-to-learn progra...

  12. Statistics of the largest sunspot and facular areas per solar cycle

    International Nuclear Information System (INIS)

    Willis, D.M.; Kabasakal Tulunay, Y.

    1979-01-01

    The statistics of extreme values is used to investigate the statistical properties of the largest areas sunspots and photospheric faculae per solar cycle. The largest values of the synodic-solar-rotation mean areas of umbrae, whole spots and faculae, which have been recorded for nine solar cycles, are each shown to comply with the general form of the extreme value probability function. Empirical expressions are derived for the three extreme value populations from which the characteristic statistical parameters, namely the mode, median, mean and standard deviation, can be calculated for each population. These three extreme value populations are also used to find the expected ranges of the extreme areas in a group of solar cycles as a function of the number of cycles in the group. The extreme areas of umbrae and whole spots have a dispersion comparable to that found by Siscoe for the extreme values of sunspot number, whereas the extreme areas of faculae have a smaller dispersion which is comparable to that found by Siscoe for the largest geomagnetic storm per solar cycle. The expected range of the largest sunspot area per solar cycle for a group of one hundred cycles appears to be inconsistent with the existence of the prolonged periods of sunspot minima that have been inferred from the historical information on solar variability. This inconsistency supports the contention that there are temporal changes of solar-cycle statistics during protracted periods of sunspot minima (or maxima). Indeed, without such temporal changes, photospheric faculae should have been continually observable throughout the lifetime of the Sun. (orig.)

  13. The global diversion of pharmaceutical drugs. India: the third largest illicit opium producer?

    Science.gov (United States)

    Paoli, Letizia; Greenfield, Victoria A; Charles, Molly; Reuter, Peter

    2009-03-01

    This paper explores India's role in the world illicit opiate market, particularly its role as a producer. India, a major illicit opiate consumer, is also the sole licensed exporter of raw opium: this unique status may be enabling substantial diversion to the illicit market. Participant observation and interviews were carried out at eight different sites. Information was also drawn from all standard secondary sources and the analysis of about 180 drug-related criminal proceedings reviewed by Indian High Courts and the Supreme Court from 1985 to 2001. Diversion from licit opium production takes place on such a large scale that India may be the third largest illicit opium producer after Afghanistan and Burma. With the possible exceptions of 2005 and 2006, 200-300 tons of India's opium may be diverted yearly. After estimating India's opiate consumption on the basis of UN-reported prevalence estimates, we find that diversion from licit production might have satisfied a quarter to more than a third of India's illicit opiate demand to 2004. India is not only among the world's largest consumer of illicit opiates but also one of the largest illicit opium producers. In contrast to all other illicit producers, India owes the latter distinction not to blatantly illicit cultivation but to diversion from licit cultivation. India's experience suggests the difficulty of preventing substantial leakage, even in a relatively well-governed nation.

  14. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  15. Collaborative spectrum sensing based on the ratio between largest eigenvalue and Geometric mean of eigenvalues

    KAUST Repository

    Shakir, Muhammad

    2011-12-01

    In this paper, we introduce a new detector referred to as Geometric mean detector (GEMD) which is based on the ratio of the largest eigenvalue to the Geometric mean of the eigenvalues for collaborative spectrum sensing. The decision threshold has been derived by employing Gaussian approximation approach. In this approach, the two random variables, i.e. The largest eigenvalue and the Geometric mean of the eigenvalues are considered as independent Gaussian random variables such that their cumulative distribution functions (CDFs) are approximated by a univariate Gaussian distribution function for any number of cooperating secondary users and received samples. The approximation approach is based on the calculation of exact analytical moments of the largest eigenvalue and the Geometric mean of the eigenvalues of the received covariance matrix. The decision threshold has been calculated by exploiting the CDF of the ratio of two Gaussian distributed random variables. In this context, we exchange the analytical moments of the two random variables with the moments of the Gaussian distribution function. The performance of the detector is compared with the performance of the energy detector and eigenvalue ratio detector. Analytical and simulation results show that our newly proposed detector yields considerable performance advantage in realistic spectrum sensing scenarios. Moreover, our results based on proposed approximation approach are in perfect agreement with the empirical results. © 2011 IEEE.

  16. Physical performance and quality of life in single and recurrent fallers: Data from the improving medication prescribing to reduce risk of falls study

    NARCIS (Netherlands)

    N.D.A. Boyé (Nicole); F.U.S. Mattace Raso (Francesco); E.M.M. van Lieshout (Esther); K.A. Hartholt (Klaas); E.F. van Beeck (Ed); T.J.M. van der Cammen (Tischa)

    2014-01-01

    textabstractAim: Although guidelines regarding falls prevention make a clear distinction between single and recurrent fallers, differences in functional status, physical performance, and quality of life in single and recurrent fallers have not been thoroughly investigated. Therefore, we investigated

  17. Astronomers Break Ground on Atacama Large Millimeter Array (ALMA) - World's Largest Millimeter Wavelength Telescope

    Science.gov (United States)

    2003-11-01

    Scientists and dignitaries from Europe, North America and Chile are breaking ground today (Thursday, November 6, 2003) on what will be the world's largest, most sensitive radio telescope operating at millimeter wavelengths . ALMA - the "Atacama Large Millimeter Array" - will be a single instrument composed of 64 high-precision antennas located in the II Region of Chile, in the District of San Pedro de Atacama, at the Chajnantor altiplano, 5,000 metres above sea level. ALMA 's primary function will be to observe and image with unprecedented clarity the enigmatic cold regions of the Universe, which are optically dark, yet shine brightly in the millimetre portion of the electromagnetic spectrum. The Atacama Large Millimeter Array (ALMA) is an international astronomy facility. ALMA is an equal partnership between Europe and North America, in cooperation with the Republic of Chile, and is funded in North America by the U.S. National Science Foundation (NSF) in cooperation with the National Research Council of Canada (NRC), and in Europe by the European Southern Observatory (ESO) and Spain. ALMA construction and operations are led on behalf of North America by the National Radio Astronomy Observatory (NRAO), which is managed by Associated Universities, Inc. (AUI), and on behalf of Europe by ESO. " ALMA will be a giant leap forward for our studies of this relatively little explored spectral window towards the Universe" , said Dr. Catherine Cesarsky , Director General of ESO. "With ESO leading the European part of this ambitious and forward-looking project, the impact of ALMA will be felt in wide circles on our continent. Together with our partners in North America and Chile, we are all looking forward to the truly outstanding opportunities that will be offered by ALMA , also to young scientists and engineers" . " The U.S. National Science Foundation joins today with our North American partner, Canada, and with the European Southern Observatory, Spain, and Chile to prepare

  18. Food web de-synchronization in England's largest lake: an assessment based on multiple phenological metrics.

    Science.gov (United States)

    Thackeray, Stephen J; Henrys, Peter A; Feuchtmayr, Heidrun; Jones, Ian D; Maberly, Stephen C; Winfield, Ian J

    2013-12-01

    Phenological changes have been observed globally for marine, freshwater and terrestrial species, and are an important element of the global biological 'fingerprint' of climate change. Differences in rates of change could desynchronize seasonal species interactions within a food web, threatening ecosystem functioning. Quantification of this risk is hampered by the rarity of long-term data for multiple interacting species from the same ecosystem and by the diversity of possible phenological metrics, which vary in their ecological relevance to food web interactions. We compare phenological change for phytoplankton (chlorophyll a), zooplankton (Daphnia) and fish (perch, Perca fluviatilis) in two basins of Windermere over 40 years and determine whether change has differed among trophic levels, while explicitly accounting for among-metric differences in rates of change. Though rates of change differed markedly among the nine metrics used, seasonal events shifted earlier for all metrics and trophic levels: zooplankton advanced most, and fish least, rapidly. Evidence of altered synchrony was found in both lake basins, when combining information from all phenological metrics. However, comparisons based on single metrics did not consistently detect this signal. A multimetric approach showed that across trophic levels, earlier phenological events have been associated with increasing water temperature. However, for phytoplankton and zooplankton, phenological change was also associated with changes in resource availability. Lower silicate, and higher phosphorus, concentrations were associated with earlier phytoplankton growth, and earlier phytoplankton growth was associated with earlier zooplankton growth. The developing trophic mismatch detected between the dominant fish species in Windermere and important zooplankton food resources may ultimately affect fish survival and portend significant impacts upon ecosystem functioning. We advocate that future studies on phenological

  19. Association of single nucleotide polymorphisms of IL23R and IL17 with ulcerative colitis risk in a Chinese Han population.

    Directory of Open Access Journals (Sweden)

    Pengli Yu

    Full Text Available BACKGROUND: Previous studies implicated that IL23R and IL17 genes play an important role in autoimmune inflammation. Genome-wide association studies have also identified multiple single nucleotide polymorphisms (SNPs in the IL23R gene region associated with inflammatory bowel diseases. This study examined the association of IL23R and IL17A gene SNPs with ulcerative colitis susceptibility in a population in China. METHODOLOGY: A total of 270 ulcerative colitis and 268 healthy controls were recruited for the analyses of 23 SNPs in the IL23R and IL17A regions. Genomic DNA was extracted and analysis of these 23 SNPs using ligase detection reaction allelic (LDR technology. Genotype and allele associations were calculated using SPSS 13.0 software package. PRINCIPAL FINDINGS: Compared to the healthy controls, the variant alleles IL23R rs7530511, and rs11805303 showed a statistically significant difference for ulcerative colitis susceptibility (0.7% vs 3.3%, P = 0.002; 60.4% vs 53.2%, P = 0.0017, respectively. The linkage disequilibrium (LD patterns of these SNPs were measured and three LD blocks from the SNPs of IL23R and one block from those of IL17A were identified. A novel association with ulcerative colitis susceptibility occurred in haplotypes of IL23R (Block1 H3 P = 0.02; Block2 H2 P = 0.019; Block3 H4 P = 0.029 and IL17A (H4 P = 0.034. Pair-wise analyses showed an interaction between the risk haplotypes in IL23R and IL17A (P = 0.014. CONCLUSIONS: Our study demonstrated that rs7530511, and rs11805303 of IL23R were significantly associated with ulcerative colitis susceptibility in the Chinese population. The most noticeable finding was the linkage of IL23R and IL17A gene region to ulcerative colitis risk due to the gene-gene interaction.

  20. Does a single session of high-intensity interval training provoke a transient elevated risk of falling in seniors and adults?

    Science.gov (United States)

    Donath, Lars; Kurz, Eduard; Roth, Ralf; Hanssen, Henner; Schmidt-Trucksäss, Arno; Zahner, Lukas; Faude, Oliver

    2015-01-01

    Balance and strength training can reduce seniors' fall risk up to 50%. Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control. High-intensity endurance training has been successfully applied in different populations. Thus, it seemed valuable to examine the acute effects of high-intensity interval training (HIIT) on neuromuscular performance in seniors and young adults. The acute impact of a HIIT session on balance performance and muscle activity after exercise cessation and during post-exercise recovery was examined in young and old adults. We intended to investigate whether a transient exercise-induced fall-risk may occur in both groups. 20 healthy seniors (age 70 (SD 4) years) and young adults (age 27 (SD 3) years) were examined on 3 days. After exhaustive ramp-like treadmill testing in order to determine maximal heart rate (HRmax) on the first day, either a 4 × 4 min HIIT at 90% of HRmax or a control condition (CON) was randomly performed on the second and third day, respectively. Balance performance (postural sway) was assessed during single limb stance with open eyes (SLEO) and double limb stance with closed eyes (DLEC). EMG was recorded for the soleus (SOL), anterior tibialis (TIB), gastrocnemius (GM) and peroneus longus (PL) muscles at the dominant leg. All measures were collected before, immediately as well as 10, 30 and 45 min after HIIT and CON, respectively. Compared to CON, HIIT induced significant increases of postural sway immediately after exercise cessation during SLEO in both groups (adults: p HIIT (post: p = 0.003, Δ = +14% sway, 10 min post: p = 0.004, Δ = +18% sway). Muscle activity was increased during SLEO for TIB until 10 min post in seniors (0.008 HIIT in adults (p HIIT training may cause an acute 'open-fall-window' with a transient impairment of balance performance for at least 10 min after exercise cessation in both groups. Occluded vision in seniors seems to prolong this period

  1. Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: methods of reducing patient risk.

    Science.gov (United States)

    Pidcoke, Heather F; Wade, Charles E; Mann, Elizabeth A; Salinas, Jose; Cohee, Brian M; Holcomb, John B; Wolf, Steven E

    2010-02-01

    Intensive insulin therapy in the critically ill reduces mortality but carries the risk of increased hypoglycemia. Point-of-care blood glucose analysis is standard; however, anemia causes falsely high values and potentially masks hypoglycemia. Permissive anemia is practiced routinely in most intensive care units. We hypothesized that point-of-care glucometer error due to anemia is prevalent, can be corrected mathematically, and correction uncovers occult hypoglycemia during intensive insulin therapy. The study has both retrospective and prospective phases. We reviewed data to verify the presence of systematic error, determine the source of error, and establish the prevalence of anemia. We confirmed our findings by reproducing the error in an in vitro model. Prospective data were used to develop a correction formula validated by the Monte Carlo method. Correction was implemented in a burn intensive care unit and results were evaluated after 9 mos. Burn and trauma intensive care units at a single research institution. Samples for in vitro studies were taken from healthy volunteers. Samples for formula development were from critically ill patients who received intensive insulin therapy. Insulin doses were calculated based on predicted serum glucose values from corrected point-of-care glucometer measurements. Time-matched point-of-care glucose, laboratory glucose, and hematocrit values. We previously found that anemia (hematocrit error in glucometer measurements. The error was correctible with a mathematical formula developed and validated, using prospectively collected data. Error of uncorrected point-of-care glucose ranged from 19% to 29% (p < .001), improving to < or = 5% after mathematical correction of prospective data. Comparison of data pairs before and after correction formula implementation demonstrated a 78% decrease in the prevalence of hypoglycemia in critically ill and anemic patients treated with insulin and tight glucose control (p < .001). A mathematical

  2. Single Nucleotide Polymorphisms in IL17A and IL6 Are Associated with Decreased Risk for Pulmonary Tuberculosis in Southern Brazilian Population.

    Directory of Open Access Journals (Sweden)

    Mariana Milano

    Full Text Available In Mycobacterium tuberculosis (MTB infection, the complex interaction of host immune system and the mycobacteria is associated with levels of cytokines production that play a major role in determining the outcome of the disease. Several single-nucleotide polymorphisms (SNPs in cytokine genes have been associated with tuberculosis (TB outcome. The aim of this study was to evaluate the association between previously reported SNPs IL2-330 T>G (rs2069762; IL4-590 C>T (rs2243250; IL6-174 G>C (rs1800795; IL10-592 A>C (rs1800872; IL10-1082 G>A (rs1800896; IL17A -692 C>T (rs8193036; IL17A -197 G>A (rs2275913; TNF -238 G>A (rs361525; TNF -308 G>A (rs1800629 and IFNG +874 T>A (rs2430561 and pulmonary TB (PTB susceptibility. We conducted a case-control study in individuals from Southern Brazil who were recruited between February 2012 and October 2013 in a high incidence TB city. We performed a multiplex genotyping assay in 191 patients with PTB and 175 healthy subjects. Our results suggest a decreased risk for PTB development associated with the IL17A -197A allele (OR = 0.29; p = 0.04, AA genotype (OR = 0.12; p = 0.04 and A carrier (AG/AA (OR = 0.29; p = 0.004 and IL6 -174C carrier (CC/CG (OR = 0.46; p = 0.04. We could not properly analyze IL17A -692 C>T (rs8193036 and IFNG +874T>A due to genotypic inconsistencies and found no evidence of association for the IL2, IL4, IL10 and TNF polymorphisms and PTB. In conclusion, our results show a protective effect of IL17 and IL6 polymorphisms on PTB outcome in Southern Brazilian population.

  3. Risk assessment

    International Nuclear Information System (INIS)

    1983-01-01

    The report is in sections, entitled: preface; summary and conclusions; introduction (historical and organizational); estimating engineering risks (techniques of risk estimation and forms of expression of risk); laboratory experiments for estimation of biological risks; estimation of risk from observations on man (travel, medical procedures; occupations; sport); the perception of risks; (as an example of attitudes towards a single hazard, studies of nuclear power are considered among other topics in this section); risk management (estimation; perception; acceptability, analysis of risk, costs and benefits; safety standards; decision-making process; possible guidelines). (U.K.)

  4. Comprehensive smoke-free laws--50 largest U.S. cities, 2000 and 2012.

    Science.gov (United States)

    2012-11-16

    Secondhand smoke (SHS) exposure causes heart disease and lung cancer in nonsmoking adults and several health conditions in children. Only completely eliminating smoking in indoor spaces fully protects nonsmokers from SHS. State and local laws can provide this protection in enclosed workplaces and public places by completely eliminating smoking in these settings. CDC considers a smoke-free law to be comprehensive if it prohibits smoking in all indoor areas of private workplaces, restaurants, and bars, with no exceptions. In response to growing evidence on the health effects of SHS, communities and states have increasingly adopted comprehensive smoke-free (CSF) laws in recent years. To assess trends in protecting the population from SHS exposure, CDC and the American Nonsmokers' Rights Foundation (ANRF) compared coverage by local or state CSF laws in the 50 largest U.S. cities as of December 31, 2000, and October 5, 2012. The analysis focused on smoking restrictions in the 50 largest cities because these cities represent an important indicator of nationwide trends in local and state policy and because they are home to an estimated 47 million persons, or nearly 15% of the U.S. population. The analysis found that the number of these cities covered by local and/or state CSF laws increased from one city (2%) in 2000 to 30 cities (60%) in 2012. A total of 20 cities (40%) were not covered by a CSF law at either the local or state level in 2012, although 14 of these cities had 100% smoke-free provisions in place at the local or state level in at least one of the three settings considered. The results of this analysis indicate that substantial progress has been achieved during 2000-2012 in implementing CSF laws in the 50 largest U.S. cities. However, gaps in coverage, especially in the southern United States and in states with laws that preempt local smoking restrictions, are contributing to disparities in SHS protections.

  5. Risk-adapted single or fractionated stereotactic high-precision radiotherapy in a pooled series of nonfunctioning pituitary adenomas. High local control and low toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, Jan Patrick [MediClin Robert Janker Clinic and MediClin MVZ Bonn, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); University Hospital of Bonn, Department of Neurosurgery, Bonn (Germany); Meyer, Almuth [HELIOS Klinikum Erfurt, Department of Endocrinology, Erfurt (Germany); Pintea, Bogdan [University Hospital of Bonn, Department of Neurosurgery, Bonn (Germany); Gerlach, Ruediger [HELIOS Klinikum Erfurt, Department of Neurosurgery, Erfurt (Germany); Surber, Gunnar; Hamm, Klaus [HELIOS Klinikum Erfurt, Department of Radiosurgery, Erfurt (Germany); Lammering, Guido [MediClin Robert Janker Clinic and MediClin MVZ Bonn, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); Heinrich-Heine-University of Duesseldorf, Department of Radiotherapy and Radiation Oncology, Duesseldorf (Germany)

    2014-12-15

    The purpose of this work was to evaluate a prospectively initiated two-center protocol of risk-adapted single-fraction (SRS) or fractionated radiotherapy (SRT) in patients with nonsecretory pituitary adenomas (NSA). A total of 73 NSA patients (39 men/34 women) with a median age of 62 years were prospectively included in a treatment protocol of SRS [planning target volume (PTV) < 4 ccm, > 2 mm to optic pathways = low risk] or SRT (PTV ≥ 4 ccm, ≤ 2 mm to optic pathways = high risk) in two Novalis registered centers. Mean tumor volume was 7.02 ccm (range 0.58-57.29 ccm). Based on the protocol guidelines, 5 patients were treated with SRS and 68 patients with SRT. Median follow-up (FU) reached 5 years with 5-year overall survival (OS) of 90.4 % (CI 80.2-95 %) and 5-year local control and progression-free survival rates of 100 % (CI 93.3-100 %) and 90.4 % (CI 80.2-95 %), respectively. A post-SRS/SRT new visual disorder occurred in 2 patients (2.7 %), a new oculomotor nerve palsy in one pre-irradiated patient, in 3 patients (4.1 %) a pre-existing visual disorder improved. New complete hypopituitarism occurred in 4 patients (13.8 %) and in 3 patients (25 %) with pre-existing partial hypopituitarism. Pituitary function in 26 % of patients retained normal. Patients with tumor shrinkage (65.75 %) had a significantly longer FU (p = 0.0093). Multivariate analysis confirmed correlation of new hypopituitarism with duration of FU (p = 0.008) and correlation of new hypopituitarism and tumor volume (p = 0.023). No significant influence factors for occurrence of visual disorders were found. Our SRS/SRT protocol proved to be safe and successful in terms of tumor control and protection of the visual system, especially for large tumors located close to optic pathways. (orig.) [German] Evaluation eines prospektiv angelegten Behandlungsprotokolls einer risikoadaptierten Radiochirurgie (SRS) oder stereotaktischen Radiotherapie (SRT) von Patienten mit hormoninaktiven Hypophysenadenomen

  6. Line Balancing Using Largest Candidate Rule Algorithm In A Garment Industry: A Case Study

    Directory of Open Access Journals (Sweden)

    V. P.Jaganathan

    2014-12-01

    Full Text Available The emergence of fast changes in fashion has given rise to the need to shorten production cycle times in the garment industry. As effective usage of resources has a significant effect on the productivity and efficiency of production operations, garment manufacturers are urged to utilize their resources effectively in order to meet dynamic customer demand. This paper focuses specifically on line balancing and layout modification. The aim of assembly line balance in sewing lines is to assign tasks to the workstations, so that the machines of the workstation can perform the assigned tasks with a balanced loading. Largest Candidate Rule Algorithm (LCR has been deployed in this paper.

  7. Female urethral diverticulum presenting with acute urinary retention: Reporting the largest diverticulum with review of literature

    Directory of Open Access Journals (Sweden)

    Manas Ranjan Pradhan

    2012-01-01

    Full Text Available Female urethral diverticulum is a rare entity with diverse spectrum of clinical manifestations. It is a very rare cause of bladder outlet obstruction and should be considered as a differential diagnosis in females presenting with acute urinary retention associated with a vaginal mass. Strong clinical suspicion combined with thorough physical examination and focused radiological investigations are vital for its diagnosis. Herein we report a case of giant urethral diverticulum presenting with acute urinary retention in a young female. It was managed by excision and urethral closure, and is the largest urethral diverticulum reported till date in the literature.

  8. OBJECT TRACKING WITH ROTATION-INVARIANT LARGEST DIFFERENCE INDEXED LOCAL TERNARY PATTERN

    Directory of Open Access Journals (Sweden)

    J Shajeena

    2017-02-01

    Full Text Available This paper presents an ideal method for object tracking directly in the compressed domain in video sequences. An enhanced rotation-invariant image operator called Largest Difference Indexed Local Ternary Pattern (LDILTP has been proposed. The Local Ternary Pattern which worked very well in texture classification and face recognition is now extended for rotation invariant object tracking. Histogramming the LTP code makes the descriptor resistant to translation. The histogram intersection is used to find the similarity measure. This method is robust to noise and retain contrast details. The proposed scheme has been verified on various datasets and shows a commendable performance.

  9. THE EVOLUTION OF THE WORLD’S LARGEST AUTOMAKERS IN THE PERIOD 2013-2014

    Directory of Open Access Journals (Sweden)

    Sorin-George TOMA

    2015-04-01

    Full Text Available The automotive industry has always represented an economic engine for many countries. It is dealing with the design, development, manufacture, marketing, and sale of the motor vehicles. Nowadays, this industry is full of intense competition between big auto groups fighting for higher profits and larger market shares. The key players in the automotive market are operating at a global scale in a highly competitive environment. In the last years, Toyota Motor and Volkswagen Group have proved to be the main competitors. The aim of our paper is to analyze the evolution of the world’s largest automakers in the period 2013-2014. The research type is literature review.

  10. Wet scavenging of SO2 emissions around India's largest lignite based power plant

    Science.gov (United States)

    Rai, A.; Ghosh, S.; Chakraborty, S.

    2010-03-01

    The Neyveli Lignite Corporation (NLC) is among the largest lignite based power plants in South East Asia. The four elevated stacks from this power plant emanate a substantial amount of sulphur dioxide into a tropical boundary layer. Sulphur dioxide being a soluble pollutant gas is absorbed by falling raindrops. This is a first study that quantifies the scavenging action of the North Eastern monsoonal rains from a lignite based power plant. We find that although the North Eastern monsoonal rains have a preponderance of very large droplets, the contribution of the small droplets cannot be neglected. We expect that the estimated scavenging coefficients can be used by large eddy and climate models.

  11. The Genome Russia project: closing the largest remaining omission on the world Genome map.

    Science.gov (United States)

    Oleksyk, Taras K; Brukhin, Vladimir; O'Brien, Stephen J

    2015-01-01

    We are witnessing the great era of genome exploration of the world, as genetic variation in people is being detailed across multiple varied world populations in an effort unprecedented since the first human genome sequence appeared in 2001. However, these efforts have yet to produce a comprehensive mapping of humankind, because important regions of modern human civilization remain unexplored. The Genome Russia Project promises to fill one of the largest gaps, the expansive regions across the Russian Federation, informing not just medical genomics of the territories, but also the migration settlements  of historic and pre-historic Eurasian peoples.

  12. How the largest electric and gas utility companies administer public relations

    Energy Technology Data Exchange (ETDEWEB)

    Bogart, J.D.

    1979-04-12

    This article describes the findings of a survey conducted by the author in the second half of 1978 to determine the sizes of the public relations staffs of the nation's largest operating electric and gas utilities, their budgets, organizational differences, and specific functions. Common public relations issues and major public relations problems of the utilities are identified, as well as recent trends or changes in budgeting and organization. Some functional variations of public relations departments among utility companies were detected and described.

  13. Revisiting the impacts of oil price increases on monetary policy implementation in the largest oil importers

    Directory of Open Access Journals (Sweden)

    Nurtac Yildirim

    2015-06-01

    Full Text Available The aim of this paper is to test the impacts of oil price increases on monetary policy implementation in the largest oil importers. For that purpose, we estimate structural vector error correction (SVEC models to show the impacts of oil price increases on industrial production, consumer prices and immediate interest rates which are the elements of Taylor rule for the four largest oil importers (the USA, the EU, China and Japan. Our results indicate that oil price increases transmit to output and inflation and lead to fluctuations in industrial production, consumer prices and immediate interest rates which in turn influence the monetary policy stance in the following periods. The basic conclusion of research is that the channels through which oil prices affect output, inflation and interest rates should be identified by the monetary policy authorities of the USA, the EU, China and Japan. We also emphasize the importance of the determination of the optimal monetary policy framework to eliminate the negative consequences of oil price increases.

  14. Largest vertebrate vomeronasal type 1 receptor gene repertoire in the semiaquatic platypus.

    Science.gov (United States)

    Grus, Wendy E; Shi, Peng; Zhang, Jianzhi

    2007-10-01

    Vertebrate vomeronasal chemoreception plays important roles in many aspects of an organism's daily life, such as mating, territoriality, and foraging. Vomeronasal type 1 receptors (V1Rs) and vomeronasal type 2 receptors (V2Rs), 2 large families of G protein-coupled receptors, serve as vomeronasal receptors to bind to various pheromones and odorants. Contrary to the previous observations of reduced olfaction in aquatic and semiaquatic mammals, we here report the surprising finding that the platypus, a semiaquatic monotreme, has the largest V1R repertoire and nearly largest combined repertoire of V1Rs and V2Rs of all vertebrates surveyed, with 270 intact genes and 579 pseudogenes in the V1R family and 15 intact genes, 55 potentially intact genes, and 57 pseudogenes in the V2R family. Phylogenetic analysis shows a remarkable expansion of the V1R repertoire and a moderate expansion of the V2R repertoire in platypus since the separation of monotremes from placentals and marsupials. Our results challenge the view that olfaction is unimportant to aquatic mammals and call for further study into the role of vomeronasal reception in platypus physiology and behavior.

  15. SUPERGRANULATION AS THE LARGEST BUOYANTLY DRIVEN CONVECTIVE SCALE OF THE SUN

    Energy Technology Data Exchange (ETDEWEB)

    Cossette, Jean-Francois [Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO (United States); Rast, Mark P. [Department of Astrophysical and Planetary Sciences, Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO (United States)

    2016-09-20

    The origin of solar supergranulation remains a mystery. Unlike granulation, the size of which is comparable to both the thickness of the radiative boundary layer and local scale-height in the photosphere, supergranulation does not reflect any obvious length scale of the solar convection zone. Moreover, recent observations of flows in the photosphere using Doppler imaging or correlation or feature tracking show a monotonic decrease in horizontal flow power at scales larger than supergranulation. Both local area and global spherical shell simulations of solar convection by contrast show the opposite, an increase in horizontal flow amplitudes to a low wavenumber. We examine these disparities and investigate how the solar supergranulation may arise as a consequence of nonlocal heat transport by cool diving plumes. Using three-dimensional anelastic simulations with surface driving, we show that the kinetic energy of the largest convective scales in the upper layers of a stratified domain reflects the depth of transition from strong buoyant driving to adiabatic stratification below caused by the dilution of the granular downflows. This depth is quite shallow because of the rapid increase of the mean density below the photosphere. We interpret the observed monotonic decrease in solar convective power at scales larger than supergranulation to be a consequence of this rapid transition, with the supergranular scale the largest buoyantly driven mode of convection in the Sun.

  16. New Closed-Form of the Largest Eigenvalue PDF for Max-SNR MIMO System Performances

    Science.gov (United States)

    Letessier, Jonathan; Vrigneau, Baptiste; Rostaing, Philippe; Burel, Gilles

    Multiple-input multiple-output (MIMO) maximum-SNR (max-SNR) system employs the maximum ratio combiner (MRC) at the receiver side and the maximum ratio transmitter (MRT) at the transmitter side. Its performances highly depend on MIMO channel characteristics, which vary according to both the number of antennas and their distribution between the transmitter and receiver sides. By using the decomposition of the ordered Wishart distribution in the uncorrelated Rayleigh case, we derived a closed-form expression of the largest eigenvalue probability density function (PDF). The final result yields to an expression form of the PDF where polynomials are multiplied by exponentials; it is worth underlining that, though this form had been previously observed for given couples of antennas, to date no formally-written closed-form was available in the literature for an arbitrary couple. Then, this new expression permits one to quickly and easily get the well known largest eigenvalue PDF and use it to determine the binary error probability (BEP) of the max-SNR.

  17. Evaluation of nonlinear properties of epileptic activity using largest Lyapunov exponent

    Science.gov (United States)

    Medvedeva, Tatiana M.; Lüttjohann, Annika; van Luijtelaar, Gilles; Sysoev, Ilya V.

    2016-04-01

    Absence seizures are known to be highly non-linear large amplitude oscillations with a well pronounced main time scale. Whilst the appearance of the main frequency is usually considered as a transition from noisy complex dynamics of baseline EEG to more regular absence activity, the dynamical properties of this type of epileptiformic activity in genetic absence models was not studied precisely. Here, the estimation of the largest Lyapunov exponent from intracranial EEGs of 10 WAG/Rij rats (genetic model of absence epilepsy) was performed. Fragments of 10 seizures and 10 episodes of on-going EEG each of 4 s length were used for each animal, 3 cortical and 2 thalamic channels were analysed. The method adapted for short noisy data was implemented. The positive values of the largest Lyapunov exponent were found as for baseline as for spike wave discharges (SWDs), with values for SWDs being significantly less than for on-going activity. Current findings may indicate that SWD is a chaotic process with a well pronounced main timescale rather than a periodic regime. Also, the absence activity was shown to be less chaotic than the baseline one.

  18. Perception and Interpretation of Sustainability Among the Largest Corporations Established in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Petr Petera

    2016-01-01

    Full Text Available The paper addresses perception and interpretation of sustainability among the largest corporations established in the Czech Republic. Despite the fact that the amount of literature on sustainability is substantial, there is lack of empirical investigation into understanding sustainability among corporations established in the Czech Republic. We used qualitative methodology (semi-structured interviews to investigate how the largest corporations established in the Czech Republic understand and deal with sustainability-related issues. Key sustainability-related themes are identified and discussed in the paper. On the basis of comparison of our results with the prior literature it is possible to sum up that our findings are mostly in accordance with previous research. Majority of our respondents perceive sustainability as containing economic, environmental and social dimension and their sustainability-related initiatives are both internally and externally oriented. Reporting on sustainability is relatively new topic for respondents, but its importance is growing. The key future challenges include better integration of sustainability-related initiatives into the core business activities, implementation of sustainability accounting and standardization of sustainability reporting (probably on the basis of the Global Reporting Initiative guidelines.

  19. Constraining gravity at the largest scales through CMB lensing and galaxy velocities

    Science.gov (United States)

    Pullen, Anthony R.; Alam, Shadab; He, Siyu; Ho, Shirley

    2016-08-01

    We demonstrate a new method to constrain gravity on the largest cosmological scales by combining measurements of cosmic microwave background (CMB) lensing and the galaxy velocity field. EG is a statistic, constructed from a gravitational lensing tracer and a measure of velocities such as redshift-space distortions (RSD), that can discriminate between gravity models while being independent of clustering bias and σ8. While traditionally, the lensing field for EG has been probed through galaxy lensing, CMB lensing has been proposed as a more robust tracer of the lensing field for EG at higher redshifts while avoiding intrinsic alignments. We perform the largest-scale measurement of EG ever, up to 150 Mpc h-1, by cross-correlating the Planck CMB lensing map with the Sloan Digital Sky Survey III (SDSS-III) CMASS galaxy sample and combining this with our measurement of the CMASS auto-power spectrum and the RSD parameter β. We report EG(z = 0.57) = 0.243 ± 0.060 (stat) ± 0.013 (sys), a measurement in tension with the general relativity (GR) prediction at a level of 2.6σ. Note that our EG measurement deviates from GR only at scales greater than 80 Mpc h-1, scales which have not been probed by previous EG tests. Upcoming surveys, which will provide an order-of-magnitude reduction in statistical errors, can significantly constrain alternative gravity models when combined with better control of systematics.

  20. The largest magnitudes of earthquakes associated with some historical volcanic eruptions and their volcanological significance

    Directory of Open Access Journals (Sweden)

    I. Yokoyama

    2001-06-01

    Full Text Available We know several reports of earthquake swarms associated with volcanic eruptions in the 19th century or older periods when seismographs were not yet available. Even if we have no seismographs, the largest magnitudes of earthquakes can be estimated by the maximum distances of perceptibility which are determined by reports of felt shocks or by records of earthquake movements at various distances from the origins. For example, the largest magnitudes of the earthquake swarms associated with the 1815 eruption of Tambora is estimated at 7 by the reports of felt shocks from three sites and that of the 1883 eruption of Krakatau is estimated at 5 by examination of magnetograms in place of seismograms. The magnitude of the 7 class is exceptionally large as volcanic origin, but we know a few examples besides Tambora. The magnitude 5 of the Krakatau eruption is rather small contrary to our expectation, and implies that crustal stresses had not accumulated much at the Krakatau area to cause larger earthquakes. The earthquake magnitudes associated with volcanic eruptions are not necessarily proportional to explosion magnitudes or volume of volcanic ejecta, and may have a volcanological significance. Such volcanic earthquakes may be closely related to readjustments of tectonic stresses caused by magma movements or phase transitions of magmatic material beneath and around volcanoes, and may be called magmatotectonic earthquakes.

  1. Ownership structure and economic and socio-environmental disclosure in the largest Brazilian companies

    Directory of Open Access Journals (Sweden)

    Tatiana Aquino Almeida

    2016-01-01

    Full Text Available The disclosure of sustainable practices has become important in the search for competitive advantage, so as to meet the expectations of the various stakeholders. Thus, the study aims to investigate the relationship between the ownership structure and the economic and environmental voluntary disclosure in the largest Brazilian companies, analyzing ownership concentration and the identity of the controlling shareholder. For the analysis, we considered the economic, social and environmental perspectives, addressed both individually and jointly. The sample consists of 47 companies from the 100 largest public companies listed on BM&FBOVESPA, according to the magazine Exame Biggest and Best, edition 2013. The research is descriptive and quantitative, using Multiple Linear Regression for statistical analysis. The descriptive analysis of the prospects of (economic, social, environmental and sustainability disclosure showed lower average disclosure for the environmental aspect. The state control organizations stood out with the highest average in three of the four levels of disclosure: economic, social and sustainability. As regards the application of statistical analysis, the regression models were not statistically significant, indicating that, for the companies in the sample, the ownership structure does not influence the economic and socio-environmental disclosure.

  2. Risk strata-based therapy and outcome in stage Ib-IIa carcinoma cervix: single-centre ten-year experience.

    Science.gov (United States)

    Kundargi, Rajshekar S; Guruprasad, B; Rathod, Praveen Shankar; Shakuntala, Pn; Shobha, K; Pallavi, Vr; Uma Devi, K; Bafna, Ud

    2013-01-01

    To review the outcome of stage (Ib, IIa), cervical cancer patients were primarily treated with radical hysterectomy and risk-based postoperative therapy. Between January 2001 and December 2011, 601 cases underwent surgery followed by tailored therapy. Patients were classified into low risk (pelvic lymph node negative, tumour less than 4 cm, no evidence of lympho-vascular invasion, less than one-third of thickness of surgical stoma involved), intermediate risk (positive lympho-vascular space invasion, tumour size more than 4 cm, and deep invasion of cervical stroma), and high risk (pelvic lymph node involved, positive parametrial, or vaginal margins) groups. Postoperative adju-vant therapy in the form of radiotherapy alone to those with intermediate risk and chemo-radiotherapy to those with high risk was given to patients. The median follow-up was 60 months. The majority of patients had intermediate risk. The overall event-free survival (EFS) at five years was 74.37%, with EFS of 86.5% in those from the low-risk group, 73% in those from the intermediate-risk group, and 64% in those from the high-risk group. In conclusion, risk strata-based adjuvant postoperative therapy is able to provide a favourable outcome in patients with stage Ib-IIa cervical cancer with a nearly 11% improvement in survival compared with historical control.

  3. One last boom : Alberta's rapidly expanding oil mines may be the largest and messiest industrial projects in Canadian history

    International Nuclear Information System (INIS)

    Laird, G.

    2001-01-01

    The bitumen deposits of Alberta, 2.5 trillion barrels of oil, of which 300 billion are considered recoverable, represent the greatest single petroleum resources of the world, based on surface and subsurface calculations. Four deposits, covering an area the size of New Brunswick, are located in the area stretching from Cold Lake to Lloydminster (east of Edmonton), the upper reaches of the Athabasca River east to the Peace River. The largest by far is the Athabasca deposit in the vicinity of Fort McMurray, spread over 4.3 million hectares. The deposit is at the centre of the biggest industrial expansion witnessed by the province. Since 1996, 38 billion dollars worth of new projects have been announced. It is estimated that by 2025, the bulk of the national oil production will originate from open-pit mines and underground wells around Fort McMurray. This oil boom has economic benefits for the population, from welders to real estate agents to stakeholders. The environmental effects are not as beneficial. Huge strip mines are being carved next to the Athabasca River, with great amounts of greenhouse gases emissions. The Suncor and Syncrude oil-sands plants combined represent the fourth largest carbon dioxide emission source in Canada. The development of these projects dramatically affects global warming. The nitrogen and sulphur emissions could also acidify lakes and soil in the region. The Suncor mine resulted from the first boom to hit Fort McMurray in 1964. The Syncrude mine is the result of the second boom which took place in 1973. In 1996, Suncor installed a sulphur scrubber system that removes 95 per cent of sulphur dioxide from the electricity and steam-generation plant. Suncor also invested in various projects, such as wind-power, rainforest cultivation and biomass generation. The volume of pollution increases as the operations expand, even if operations are cleaner. If no new gains in pollution control are achieved, it is expected that by 2015, the total

  4. Assessment of microcystins in lake water and fish (Mugilidae, Liza sp.) in the largest Spanish coastal lake.

    Science.gov (United States)

    Romo, Susana; Fernández, Francisca; Ouahid, Youness; Barón-Sola, Ángel

    2012-01-01

    Cyanobacteria dominance and cyanotoxin production can become major threats to humans and aquatic life, especially in warm shallow lakes, which are often dominated by cyanobacteria. This study investigates the occurrence and distribution of microcystins (MCYST) in water, cell-bound and in the tissues of the commercial mugilid Liza sp. in the largest, coastal, Spanish Mediterranean lake (Albufera of Valencia). This is the first report concerning microcystin accumulation in tissues of mugilid fish species. Considerable amounts of microcystins were found in the water and seston, which correlated with development of Microcystis aeruginosa populations in the lake. The MCYST concentrations found in Lake Albufera (mean 1.7 and 17 μg/L and maximum 16 and 120 μg/L in water and seston, respectively) exceeded by one to two orders of magnitude the guideline levels proposed by the World Health Organization and were higher than that reported in other lakes of the Mediterranean zone. The presence of MCYST was found in all the fishes studied and accumulated differently among tissues of the commercial species Liza sp. Toxin accumulation in fish tissues showed that although the target organ for MCYST was the liver, high concentrations of microcystins were also found in other analysed tissues (liver>intestine>gills>muscle). Human tolerable daily intake for microcystins is assessed relative to the WHO guidelines, and potential toxicological risks for humans, wildlife and related ecosystems of the lake are discussed.

  5. Efficacy of ultra-short single agent regimen antibiotic chemo-prophylaxis in reducing the risk of meningitis in patients undergoing endoscopic endonasal transsphenoidal surgery.

    Science.gov (United States)

    Somma, Teresa; Maraolo, Alberto Enrico; Esposito, Felice; Cavallo, Luigi Maria; Tosone, Grazia; Orlando, Raffaele; Cappabianca, Paolo

    2015-12-01

    The study aims to evaluate the incidence of infectious complications (namely meningitis) within 30 days after endoscopic endonasal transspheinodal neurosurgery (EETS) in patients receiving an ultra-short peri-operative chemo-prophylaxis regimen with 2 doses of 1st generation cephalosporin or macrolide. We retrospectively analyzed the clinical records of 145 patients who received an ultra-short chemoprophylaxis with two doses of an antibiotic, given 30 min before and 8h after EETS, over a 30-month time-frame. Ninety-seven patients (66.89%) received endovenous cefazolin, a 1st generation cephalosporin, administered at a dosage of 1000 mg, and 48 patients (33.10%) with an history of allergy to various agents, received endovenous clarithromycin at a dosage of 500 mg. No case of peri- and post-operative meningitis occurred in patients receiving the 2 doses of antibiotic. Only one patient (0.68%) developed cerebral fluid leakage on the 7th postoperative day, which required the switching to a broad-spectrum antibiotic prophylaxis for one week; this patient received the ultrashort prophylaxis with a macrolide. In addition, 7 patients (4.82%) developed minor infectious complications such as low-grade fever (3 cases, all of them receiving cefazolin), enlarged submandibular and cervical lymphnodes (3 cases, all of them receiving cefazolin), and upper and lower respiratory tract infection (1 case receiving clarithromycin). The cost of this prophylaxis regimen ranged from 7.76 Euro (cefazolin) to 39.54 Euro (clarithromycin). This study suggested that an ultra-short single-antibiotic prophylaxis is a safe, cheap and effective regimen to prevent post-operative meningitis in patients undergoing EETS and who do not require lumbar drainage after surgery. In these patients also the rate of minor infective complications was acceptable when compared with the previous more expensive regimen based on 3rd generation cephalosporin plus aminoglycoside or alone, that could be suitable only

  6. Predicting mortality after congenital heart surgeries: evaluation of the Aristotle and Risk Adjustement in Congenital Heart Surgery-1 risk prediction scoring systems: a retrospective single center analysis of 1150 patients.

    Science.gov (United States)

    Joshi, Shreedhar S; Anthony, G; Manasa, D; Ashwini, T; Jagadeesh, A M; Borde, Deepak P; Bhat, Seetharam; Manjunath, C N

    2014-01-01

    To validate Aristotle basic complexity and Aristotle comprehensive complexity (ABC and ACC) and risk adjustment in congenital heart surgery-1 (RACHS-1) prediction models for in hospital mortality after surgery for congenital heart disease in a single surgical unit. Patients younger than 18 years, who had undergone surgery for congenital heart diseases from July 2007 to July 2013 were enrolled. Scoring for ABC and ACC scoring and assigning to RACHS-1 categories were done retrospectively from retrieved case files. Discriminative power of scoring systems was assessed with area under curve (AUC) of receiver operating curves (ROC). Calibration (test for goodness of fit of the model) was measured with Hosmer-Lemeshow modification of χ2 test. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were applied to assess reclassification. A total of 1150 cases were assessed with an all-cause in-hospital mortality rate of 7.91%. When modeled for multivariate regression analysis, the ABC (χ2 = 8.24, P = 0.08), ACC (χ2 = 4.17 , P = 0.57) and RACHS-1 (χ2 = 2.13 , P = 0.14) scores showed good overall performance. The AUC was 0.677 with 95% confidence interval (CI) of 0.61-0.73 for ABC score, 0.704 (95% CI: 0.64-0.76) for ACC score and for RACHS-1 it was 0.607 (95%CI: 0.55-0.66). ACC had an improved predictability in comparison to RACHS-1 and ABC on analysis with NRI and IDI. ACC predicted mortality better than ABC and RCAHS-1 models. A national database will help in developing predictive models unique to our populations, till then, ACC scoring model can be used to analyze individual performances and compare with other institutes.

  7. Statistics of the largest geomagnetic storms per solar cycle (1844-1993

    Directory of Open Access Journals (Sweden)

    D. M. Willis

    1997-06-01

    Full Text Available A previous application of extreme-value statistics to the first, second and third largest geomagnetic storms per solar cycle for nine solar cycles is extended to fourteen solar cycles (1844–1993. The intensity of a geomagnetic storm is measured by the magnitude of the daily aa index, rather than the half-daily aa index used previously. Values of the conventional aa index (1868–1993, supplemented by the Helsinki Ak index (1844–1880, provide an almost continuous, and largely homogeneous, daily measure of geomagnetic activity over an interval of 150 years. As in the earlier investigation, analytic expressions giving the probabilities of the three greatest storms (extreme values per solar cycle, as continuous functions of storm magnitude (aa, are obtained by least-squares fitting of the observations to the appropriate theoretical extreme-value probability functions. These expressions are used to obtain the statistical characteristics of the extreme values; namely, the mode, median, mean, standard deviation and relative dispersion. Since the Ak index may not provide an entirely homogeneous extension of the aa index, the statistical analysis is performed separately for twelve solar cycles (1868–1993, as well as nine solar cycles (1868–1967. The results are utilized to determine the expected ranges of the extreme values as a function of the number of solar cycles. For fourteen solar cycles, the expected ranges of the daily aa index for the first, second and third largest geomagnetic storms per solar cycle decrease monotonically in magnitude, contrary to the situation for the half-daily aa index over nine solar cycles. The observed range of the first extreme daily aa index for fourteen solar cycles is 159–352 nT and for twelve solar cycles is 215–352 nT. In a group of 100 solar cycles the expected ranges are expanded to 137–539 and 177–511 nT, which represent increases of 108% and 144% in the respective ranges. Thus there is at least a

  8. Out of sight, but in their minds: Brazil and its neighbours work together to protect one of the world’s largest groundwater reservoirs

    International Nuclear Information System (INIS)

    Jawerth, Nicole

    2015-01-01

    Shrouded in mystery, the future of the largest groundwater reservoir in Latin America once left scientists, academics and politicians in Brazil, Argentina, Paraguay and Uruguay concerned about the fate of their major freshwater resource. Uncovering clues using nuclear techniques, Brazil and its neighbours are now well-acquainted with the Guarani Aquifer and can confidently expect that, with their new protection and sustainable use framework, water from the aquifer will continue to flow for at least another 200 years. Using isotope hydrology, a nuclear technique, the four countries analysed and assessed the aquifer to evaluate the age, origin and evolution of the groundwater, as well as its quality and the risk of contamination.

  9. Single and Cumulative Relations of Social Risk Factors with Children's Dental Health and Care-Utilization Within Regions of the United States.

    Science.gov (United States)

    Yang, Alyssa J; Gromoske, Andrea N; Olson, Melissa A; Chaffin, Jeffrey G

    2016-03-01

    The purpose is to examine the relation of social risk factors, and the cumulative burden of social risk factors, on parent-reported dental health and dental care-seeking behavior. National Survey of Children's Health data (2011-2012) were analyzed for US children by Title V Block Grant regions. Multivariate logistic regressions were estimated for ten social risk factors, as well as a cumulative risk index, to find any associations with poor condition of teeth, presence of dental caries, and no dental care visits. Almost all of the risk factors were significantly associated with poor condition of teeth and presence of dental caries for the US. Models associating no dental care visits suggested that low family income (OR 1.58), poor maternal mental health (OR 1.54), high school education or less (OR 1.34), and multi-racial/other race (OR 1.18) were significant factors for the US. Regional variation existed for those risk factors and their association with the outcomes, but income, education, and poor maternal mental health consistently played a significant role in adverse outcomes. The cumulative risk index was strongly related to poor oral health outcomes, with a weaker relationship to dental care utilization. US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.

  10. Microbial life in the Lake Medee, the largest deep-sea salt-saturated formation.

    Science.gov (United States)

    Yakimov, Michail M; La Cono, Violetta; Slepak, Vladlen Z; La Spada, Gina; Arcadi, Erika; Messina, Enzo; Borghini, Mireno; Monticelli, Luis S; Rojo, David; Barbas, Coral; Golyshina, Olga V; Ferrer, Manuel; Golyshin, Peter N; Giuliano, Laura

    2013-12-19

    Deep-sea hypersaline anoxic lakes (DHALs) of the Eastern Mediterranean represent some of the most hostile environments on our planet. We investigated microbial life in the recently discovered Lake Medee, the largest DHAL found to-date. Medee has two unique features: a complex geobiochemical stratification and an absence of chemolithoautotrophic Epsilonproteobacteria, which usually play the primary role in dark bicarbonate assimilation in DHALs interfaces. Presumably because of these features, Medee is less productive and exhibits reduced diversity of autochthonous prokaryotes in its interior. Indeed, the brine community almost exclusively consists of the members of euryarchaeal MSBL1 and bacterial KB1 candidate divisions. Our experiments utilizing cultivation and [(14)C]-assimilation, showed that these organisms at least partially rely on reductive cleavage of osmoprotectant glycine betaine and are engaged in trophic cooperation. These findings provide novel insights into how prokaryotic communities can adapt to salt-saturated conditions and sustain active metabolism at the thermodynamic edge of life.

  11. What could we learn about high energy particle physics from cosmological observations at largest spatial scales ?

    Directory of Open Access Journals (Sweden)

    Gorbunov Dmitry

    2017-01-01

    Full Text Available The very well known example of cosmology testing particle physics is the number of relativistic particles (photons and three active neutrinos within the Standard Model at primordial nucleosynthesis. These days the earliest moment we can hope to probe with present cosmological data is the early time inflation. The particle physics conditions there and now are different because of different energy scales and different values of the scalar fields, that usually prohibits a reliable connection between the particle physics parameters at the two interesting epochs. The physics at the highest energy scales may be probed with observations at the largest spatial scales (just somewhat smaller than the size of the visible Universe. However, we are not (yet ready to make the tests realistic, because of lack of a self-consistent theoretical description of the presently favorite cosmological models to be valid right after inflation.

  12. EVALUATION OF E-RECRUITMENT LEVEL AMONG THE LARGEST COMPANIES IN POLAND - PROJECT OF RESEARCH

    Directory of Open Access Journals (Sweden)

    Dorota Buchnowska

    2015-12-01

    Full Text Available The changes taking place in the labor market cause that it is increasingly difficult to recruit employees with the right skills and competencies to companies. To reach the right candidates, they use modern IT solutions, such as ATS (Applicant Tracking System, which are supporting the processes of recruitment. Among others, they enable the publication of job offers on the Internet - on corporate websites, job portals and business social networking services - and apply for jobs online through these channels. This article pre-sents the evolution of the use of the Internet, and particularly the social media, in the recruitment process and presents a projekt of comprehensive research, which aims is to analyze and evaluate of the level of development of e-recruitment in Poland among largest companies.

  13. The Large Hadron Collider and the Role of Superconductivity in One of the Largest Scientific Enterprises

    CERN Document Server

    Rossi, Lucio

    2007-01-01

    After ten years of R&D and industrialization and seven years of construction, the LHC is near completion. The manufacture of the 1750 main superconducting magnets and of the 8000 superconducting correctors for the accelerator, as well as their cold test at CERN, is approaching the end, while their commissioning in the 27 km-long tunnel has started. The very large superconducting magnets for the main detectors, ATLAS and CMS, are installed and their commissioning is under way. Superconductivity is the key technology for the largest scientific enterprise of this decade: it accounts for half of the total cost and has proved to be affordable and reliable. Thanks to superconductivity we can probe new states of matters and reproduce conditions of 1 ps after the big bang. The paper will give the link between the Physics requirements and the answers that applied superconductivity has offered in this project.

  14. Analysis of the Emergence in Swarm Model Based on Largest Lyapunov Exponent

    Directory of Open Access Journals (Sweden)

    Yu Wu

    2011-01-01

    Full Text Available Emergent behaviors of collective intelligence systems, exemplified by swarm model, have attracted broad interests in recent years. However, current research mostly stops at observational interpretations and qualitative descriptions of emergent phenomena and is essentially short of quantitative analysis and evaluation. In this paper, we conduct a quantitative study on the emergence of swarm model by using chaos analysis of complex dynamic systems. This helps to achieve a more exact understanding of emergent phenomena. In particular, we evaluate the emergent behaviors of swarm model quantitatively by using the chaos and stability analysis of swarm model based on largest Lyapunov exponent. It is concluded that swarm model is at the edge of chaos when emergence occurs, and whether chaotic or stable at the beginning, swarm model will converge to stability with the elapse of time along with interactions among agents.

  15. A general scaling law reveals why the largest animals are not the fastest.

    Science.gov (United States)

    Hirt, Myriam R; Jetz, Walter; Rall, Björn C; Brose, Ulrich

    2017-08-01

    Speed is the fundamental constraint on animal movement, yet there is no general consensus on the determinants of maximum speed itself. Here, we provide a general scaling model of maximum speed with body mass, which holds across locomotion modes, ecosystem types and taxonomic groups. In contrast to traditional power-law scaling, we predict a hump-shaped relationship resulting from a finite acceleration time for animals, which explains why the largest animals are not the fastest. This model is strongly supported by extensive empirical data (474 species, with body masses ranging from 30 μg to 100 tonnes) from terrestrial as well as aquatic ecosystems. Our approach unravels a fundamental constraint on the upper limit of animal movement, thus enabling a better understanding of realized movement patterns in nature and their multifold ecological consequences.

  16. Contamination Control Assessment of the World's Largest Space Environment Simulation Chamber

    Science.gov (United States)

    Snyder, Aaron; Henry, Michael W.; Grisnik, Stanley P.; Sinclair, Stephen M.

    2012-01-01

    The Space Power Facility s thermal vacuum test chamber is the largest chamber in the world capable of providing an environment for space simulation. To improve performance and meet stringent requirements of a wide customer base, significant modifications were made to the vacuum chamber. These include major changes to the vacuum system and numerous enhancements to the chamber s unique polar crane, with a goal of providing high cleanliness levels. The significance of these changes and modifications are discussed in this paper. In addition, the composition and arrangement of the pumping system and its impact on molecular back-streaming are discussed in detail. Molecular contamination measurements obtained with a TQCM and witness wafers during two recent integrated system tests of the chamber are presented and discussed. Finally, a concluding remarks section is presented.

  17. Approaching the largest ‘API’: extracting information from the Internet with Python

    Directory of Open Access Journals (Sweden)

    Jonathan E. Germann

    2018-02-01

    Full Text Available This article explores the need for libraries to algorithmically access and manipulate the world’s largest API: the Internet. The billions of pages on the ‘Internet API’ (HTTP, HTML, CSS, XPath, DOM, etc. are easily accessible and manipulable. Libraries can assist in creating meaning through the datafication of information on the world wide web. Because most information is created for human consumption, some programming is required for automated extraction. Python is an easy-to-learn programming language with extensive packages and community support for web page automation. Four packages (Urllib, Selenium, BeautifulSoup, Scrapy in Python can automate almost any web page for all sized projects. An example warrant data project is explained to illustrate how well Python packages can manipulate web pages to create meaning through assembling custom datasets.

  18. Enhanced natural radiation exposure enhanced by human activity: the largest contributor to the Chinese population dose

    International Nuclear Information System (INIS)

    Pan Ziqiang; Liu Yanyang

    2011-01-01

    For the radiation exposure caused by human activities, the enhanced natural radiation exposure is the largest contributor to Chinese population dose. This problem has attracted social attention in recent years. Efforts have been made in several fields, such as radon indoors and in workplace, environmental problems associated with NORMs, occupational radiation hazards of non-uranium mine, and radiation dose evaluation for energy chain, but there are still many problems to be solved. In order to protect the health of workers and the public, while ensuring industrial production and economic development, it is also necessary to continue to strengthen research in all aspects above mentioned, and gradually promote the control of natural radiation exposure enhanced by human activities. (authors)

  19. Field Note: Threatening Tonle Sap: Challenges for Southeast-Asia’s largest Freshwater Lake

    Directory of Open Access Journals (Sweden)

    Kuenzer, Claudia

    2013-09-01

    Full Text Available The Tonle Sap ecosystem in Cambodia is Southeast Asia’s largest freshwater lake; strongly impacted by the Mekong river flood pulse. The lake is home to exceptional biodiversity, and rural communities living in free floating villages on the lake and on its shores. The fragile niche ecosystems as well as the rural livelihoods of Tonle Sap are under severe threat. Overfishing, illegal wood harvesting, further resource exploitation, and water quality deterioration all impact the stability of the socio-ecological system of Tonle Sap. At the same time, expected flood pulse changes due to regulatory measures in the context of hydropower development upstream on the Mekong are a severe threat for Tonle Sap’s ecosystem stability. The area needs to shift into the focus of attention of national and international re-searchers, stakeholders, and decision makers, to find suitable pathways for a future sustainable development of this unique and pristine region.

  20. A marine heatwave drives massive losses from the world’s largest seagrass carbon stocks

    KAUST Repository

    Arias-Ortiz, A.

    2018-03-29

    Seagrass ecosystems contain globally significant organic carbon (C) stocks. However, climate change and increasing frequency of extreme events threaten their preservation. Shark Bay, Western Australia, has the largest C stock reported for a seagrass ecosystem, containing up to 1.3% of the total C stored within the top metre of seagrass sediments worldwide. On the basis of field studies and satellite imagery, we estimate that 36% of Shark Bay’s seagrass meadows were damaged following a marine heatwave in 2010/2011. Assuming that 10 to 50% of the seagrass sediment C stock was exposed to oxic conditions after disturbance, between 2 and 9 Tg CO could have been released to the atmosphere during the following three years, increasing emissions from land-use change in Australia by 4–21% per annum. With heatwaves predicted to increase with further climate warming, conservation of seagrass ecosystems is essential to avoid adverse feedbacks on the climate system.

  1. The largest deep-ocean silicic volcanic eruption of the past century.

    Science.gov (United States)

    Carey, Rebecca; Soule, S Adam; Manga, Michael; White, James; McPhie, Jocelyn; Wysoczanski, Richard; Jutzeler, Martin; Tani, Kenichiro; Yoerger, Dana; Fornari, Daniel; Caratori-Tontini, Fabio; Houghton, Bruce; Mitchell, Samuel; Ikegami, Fumihiko; Conway, Chris; Murch, Arran; Fauria, Kristen; Jones, Meghan; Cahalan, Ryan; McKenzie, Warren

    2018-01-01

    The 2012 submarine eruption of Havre volcano in the Kermadec arc, New Zealand, is the largest deep-ocean eruption in history and one of very few recorded submarine eruptions involving rhyolite magma. It was recognized from a gigantic 400-km 2 pumice raft seen in satellite imagery, but the complexity of this event was concealed beneath the sea surface. Mapping, observations, and sampling by submersibles have provided an exceptionally high fidelity record of the seafloor products, which included lava sourced from 14 vents at water depths of 900 to 1220 m, and fragmental deposits including giant pumice clasts up to 9 m in diameter. Most (>75%) of the total erupted volume was partitioned into the pumice raft and transported far from the volcano. The geological record on submarine volcanic edifices in volcanic arcs does not faithfully archive eruption size or magma production.

  2. Quicksort, largest bucket, and min-wise hashing with limited independence

    DEFF Research Database (Denmark)

    Knudsen, Mathias Bæk Tejs; Stöckel, Morten

    2015-01-01

    Randomized algorithms and data structures are often analyzed under the assumption of access to a perfect source of randomness. The most fundamental metric used to measure how “random” a hash function or a random number generator is, is its independence: a sequence of random variables is said...... to be k-independent if every variable is uniform and every size k subset is independent. In this paper we consider three classic algorithms under limited independence. Besides the theoretical interest in removing the unrealistic assumption of full independence, the work is motivated by lower independence...... being more practical. We provide new bounds for randomized quicksort, min-wise hashing and largest bucket size under limited independence. Our results can be summarized as follows. Randomized Quicksort. When pivot elements are computed using a 5-independent hash function, Karloff and Raghavan, J.ACM’93...

  3. On a thin set of integers involving the largest prime factor function

    Directory of Open Access Journals (Sweden)

    Jean-Marie De Koninck

    2003-01-01

    Full Text Available For each integer n≥2, let P(n denote its largest prime factor. Let S:={n≥2:n does not divide P(n!} and S(x:=#{n≤x:n∈S}. Erdős (1991 conjectured that S is a set of zero density. This was proved by Kastanas (1994 who established that S(x=O(x/logx. Recently, Akbik (1999 proved that S(x=O(x exp{−(1/4logx}. In this paper, we show that S(x=x exp{−(2+o(1×log x log log x}. We also investigate small and large gaps among the elements of S and state some conjectures.

  4. The chance of transport behavior paradigm in the largest cities of Russian Federation

    Science.gov (United States)

    Vlasov, Denis

    2017-06-01

    This article discusses the issue of transit scenarios (or paradigm) changes in the largest Russian cities. Carrying out research and evaluation studies the authors surveyed the passengers of the new rapid off-street transit system, the Moscow Central Circle (MCC). The survey was prepared using the MCC reports data on passengers landing measured in the morning peak hours. Analysis of the survey results obtained by the authors, reveals shifts in pedestrian traffic and permits to estimate its size and main directions. It was noted a significant change in common behaviour regarding the increased length of the walking distance to the stations of rapid off-street transport. In view of the fact that the issue of the walking distance standard governs a huge range of further decisions, the research results can be used in sustainable transit travel planning and urban territorial development as well as in preparation of the regulatory documentation.

  5. Dissolved Oxygen Dynamics in Backwaters of North America's Largest River Swamp

    Science.gov (United States)

    Bueche, S. M.; Xu, Y. J.; Reiman, J. H.

    2017-12-01

    The Atchafalaya River (AR) is the largest distributary of the Mississippi River flowing through south-central Louisiana, creating North America's largest river swamp basin - the Atchafalaya River Basin (ARB). Prior to human settlement, the AR's main channel was highly connected to this large wetland ecosystem. However, due to constructed levee systems and other human modifications, much of the ARB is now hydrologically disconnected from the AR's main channel except during high flow events. This lack of regular inputs of fresh, oxygenated water to these wetlands, paired with high levels of organic matter decomposition in wetlands, has caused low oxygen-deprived hypoxic conditions in the ARB's back waters. In addition, due to the incredibly nutrient-rich and warm nature of the ARB, microbial decomposition in backwater areas with limited flow often results in potentially stressful, if not lethal, levels of DO for organisms during and after flood pulses. This study aims to investigate dynamics of dissolved oxygen in backwaters of the Atchafalaya River Basin, intending to answer a crucial question about hydrological and water quality connectivity between the river's mainstem and its floodplain. Specifically, the study will 1) conduct field water quality measurements, 2) collect composite water samples for chemical analysis of nutrients and carbon, 3) investigate DO dynamics over different seasons for one year, and 4) determine the major factors that affect DO dynamics in this unique swamp ecosystem. The study is currently underway; therefore, in this presentation we will share the major findings gained in the past several months and discuss backwater effects on river chemistry.

  6. Is Kasei Valles (Mars) the largest volcanic channel in the solar system?

    Science.gov (United States)

    Leverington, David W.

    2018-02-01

    With a length of more than 2000 km and widths of up to several hundred kilometers, Kasei Valles is the largest outflow system on Mars. Superficially, the scabland-like character of Kasei Valles is evocative of terrestrial systems carved by catastrophic aqueous floods, and the system is widely interpreted as a product of outbursts from aquifers. However, as at other Martian outflow channels, clear examples of fluvial sedimentary deposits have proven difficult to identify here. Though Kasei Valles lacks several key properties expected of aqueous systems, its basic morphological and contextual properties are aligned with those of ancient volcanic channels on Venus, the Moon, Mercury, and Earth. There is abundant evidence that voluminous effusions of low-viscosity magmas occurred at the head of Kasei Valles, the channel system acted as a conduit for associated flows, and mare-style volcanic plains developed within its terminal basin. Combined mechanical and thermal incision rates of at least several meters per day are estimated to have been readily achieved at Kasei Valles by 20-m-deep magmas flowing with viscosities of 1 Pa s across low topographic slopes underlain by bedrock. If Kasei Valles formed through incision by magma, it would be the largest known volcanic channel in the solar system. The total volume of magma erupted at Kasei Valles is estimated here to have possibly reached or exceeded ∼5 × 106 km3, a volume comparable in magnitude to those that characterize individual Large Igneous Provinces on Earth. Development of other large outflow systems on Mars is expected to have similarly involved eruption of up to millions of cubic kilometers of magma.

  7. Spatial and temporal activity patterns of the free-living giant mole-rat (Fukomys mechowii, the largest social bathyergid.

    Directory of Open Access Journals (Sweden)

    Matěj Lövy

    Full Text Available Despite the considerable attention devoted to the biology of social species of African mole-rats (Bathyergidae, Rodentia, knowledge is lacking about their behaviour under natural conditions. We studied activity of the largest social bathyergid, the giant mole-rat Fukomys mechowii, in its natural habitat in Zambia using radio-telemetry. We radio-tracked six individuals during three continuous 72-h sessions. Five of these individuals, including a breeding male, belonged to a single family group; the remaining female was probably a solitary disperser. The non-breeders of the family were active (i.e. outside the nest 5.8 hours per 24h-day with the activity split into 6.5 short bouts. The activity was more concentrated in the night hours, when the animals also travelled longer distances from the nest. The breeding male spent only 3.2 hours per day outside the nest, utilizing less than 20% of the whole family home range. The dispersing female displayed a much different activity pattern than the family members. Her 8.0 hours of outside-nest activity per day were split into 4.6 bouts which were twice as long as in the family non-breeders. Her activity peak in the late afternoon coincided with the temperature maximum in the depth of 10 cm (roughly the depth of the foraging tunnels. Our results suggest that the breeding individuals (at least males contribute very little to the work of the family group. Nevertheless, the amount of an individual's activity and its daily pattern are probably flexible in this species and can be modified in response to actual environmental and social conditions.

  8. Multivariate logistic regression analysis of postoperative complications and risk model establishment of gastrectomy for gastric cancer: A single-center cohort report.

    Science.gov (United States)

    Zhou, Jinzhe; Zhou, Yanbing; Cao, Shougen; Li, Shikuan; Wang, Hao; Niu, Zhaojian; Chen, Dong; Wang, Dongsheng; Lv, Liang; Zhang, Jian; Li, Yu; Jiao, Xuelong; Tan, Xiaojie; Zhang, Jianli; Wang, Haibo; Zhang, Bingyuan; Lu, Yun; Sun, Zhenqing

    2016-01-01

    Reporting of surgical complications is common, but few provide information about the severity and estimate risk factors of complications. If have, but lack of specificity. We retrospectively analyzed data on 2795 gastric cancer patients underwent surgical procedure at the Affiliated Hospital of Qingdao University between June 2007 and June 2012, established multivariate logistic regression model to predictive risk factors related to the postoperative complications according to the Clavien-Dindo classification system. Twenty-four out of 86 variables were identified statistically significant in univariate logistic regression analysis, 11 significant variables entered multivariate analysis were employed to produce the risk model. Liver cirrhosis, diabetes mellitus, Child classification, invasion of neighboring organs, combined resection, introperative transfusion, Billroth II anastomosis of reconstruction, malnutrition, surgical volume of surgeons, operating time and age were independent risk factors for postoperative complications after gastrectomy. Based on logistic regression equation, p=Exp∑BiXi / (1+Exp∑BiXi), multivariate logistic regression predictive model that calculated the risk of postoperative morbidity was developed, p = 1/(1 + e((4.810-1.287X1-0.504X2-0.500X3-0.474X4-0.405X5-0.318X6-0.316X7-0.305X8-0.278X9-0.255X10-0.138X11))). The accuracy, sensitivity and specificity of the model to predict the postoperative complications were 86.7%, 76.2% and 88.6%, respectively. This risk model based on Clavien-Dindo grading severity of complications system and logistic regression analysis can predict severe morbidity specific to an individual patient's risk factors, estimate patients' risks and benefits of gastric surgery as an accurate decision-making tool and may serve as a template for the development of risk models for other surgical groups.

  9. [Steroid dominance, enzyme activity and morphological appearance of granulosa cells in the largest follicles in cows].

    Science.gov (United States)

    Lazár, L; Kolodzieyski, L

    1993-01-01

    The cyclic nature of the female reproduction process depends to a considerable degree on the unique capacity of ovarial follicles to change their structure and function. The differentiation process during folliculogenesis takes place in all parts of the follicle. Granulosa cells reflect a high degree of structural changes and play an important role in functional maturation of the inert follicle. Changes in the reaction to endocrine and paracrine effects from a unique environment that is inevitably necessary for oocyte growth and ovulation were reached by changes in the biochemical activity and the internal anatomic mutual relation of the follicle (Linder et al., 1976; Hsueh, 1976). This growth process and differentiation depend on gonadotropic stimulation of the follicles and the quantity of receptor sites able to bind them. The aim of this work was compare estradiol 17-beta and progesterone levels in the follicular fluid of the largest follicles with the morphological structure and enzymatic activity of membrana granulosa cells. Ovaries were obtained from 34 SS x LBS randomly chosen cows at the slaughter-house. Follicular fluid to estradiol 17-beta and progesterone level determination was obtained by aspiration of the largest follicles. Estradiol 17-beta and progesterone levels were determined by RIA sets from the URVJT (Institute of Radioecology and Use of Nuclear Techniques) in Kosice, type RIA-test-ESTRA (SI-125-129) and RIAA-test-Prog (SI-125-6), respectively. With the methods used the variation coefficient of intra- and interassay for the estradiol 17-beta of the RIA set were 10.1 and 13.3%, for progesterone of the RIA set these values were 11.4 and 13.7% respectively. Steroid dominance of follicles was determined by the method described by Căllesen et al. (1986), based on the expression of the index of the mutual relation between progesterone levels and estradiol 17-beta was levels. Excisions from the follicular wall were examined under the scanning

  10. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    OpenAIRE

    Aki Kiuchi; Yasushi Ohashi; Reibin Tai; Toshiyuki Aoki; Sonoo Mizuiri; Toyoko Ogura; Atsushi Aikawa; Ken Sakai

    2016-01-01

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were ...

  11. Bioremediation efficiency of the largest scale artificial Porphyra yezoensis cultivation in the open sea in China.

    Science.gov (United States)

    Wu, Hailong; Huo, Yuanzi; Zhang, Jianheng; Liu, Yuanyuan; Zhao, Yating; He, Peimin

    2015-06-15

    The bioremediation efficiency of China's largest scale Porphyra yezoensis cultivation for removing dissolved nutrients and controlling harmful algae was studied in the radial sandbanks waters of Jiangsu Province in the year 2012-2013. Mean nutrient concentration values in the P. yezoensis cultivation area were significantly lower than those in the non-cultivation area, especially during the cultivation season (p<0.05). Tissue nitrogen and phosphorus contents of seaweeds were 5.99-0.80% (dry weight (DW)) and 0.16-0.19% (DW), respectively. Production of P. yezoensis was 58950.87tons DW. Based on these values, 3688.15tons of tissue nitrogen and 105.61tons of tissue phosphorus were removed by harvesting P. yezoensis. The richness index of the red tide species Skeleton emacostatum declined from 0.32 to 0.05 during the P. yezoensis cultivation season. These results indicate that large-scale cultivation of P. yezoensis can be used to efficiently alleviate eutrophication and control harmful algae blooms in open sea. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Characterization of the largest relic Eurasian wild grapevine reservoir in Southern Iberian Peninsula

    Energy Technology Data Exchange (ETDEWEB)

    Arroyo-García, R.; Cantos, M.; Lara, M.; López, M.A.; Gallardo, A.; Ocete, C.A.; Pérez, A.; Bánáti, B.; García, J.L.; Ocete, R.

    2016-11-01

    Wild grapevine is becoming a threatened species in the Iberian Peninsula due to human impacts. The aim of this work was to carry out a holistic study for six years of the largest wild grapevine population found up to date in SW Iberian Peninsula. This population has 115 vines. Ampelographic and soil characteristics have been studied. Evaluation of its environment has also been studied by describing the main parasitic species and natural enemies of pests. The ability of this plant material for its micropropagation and storage in slow-growth conditions has been tested. Microvinification resulted in a wine with good acidity and medium color intensity, two interesting characteristics under a warm climatology. Finally, the identification of private alleles in this wild population, absent in other locations from the Northern and Southern Iberian territories, is a very valuable feature and confirms the importance of establishing conservation programs. The population here studied is genetically unique and potentially useful for commercial rootstocks and cultivars breeding that would improve viticulture and enology. (Author)

  13. Dragon bridge - the world largest dragon-shaped (ARCH steel bridge as element of smart city

    Directory of Open Access Journals (Sweden)

    Chinh Luong Minh

    2016-01-01

    Full Text Available Dragon Bridge - The world’s largest dragon-shaped steel bridge, with an installation cost of $85 million USD, features 6 lanes for two separate directions, 666 meters of undulating steel in the shape of a dragon in the Ly Dynasty, the symbol of prosperity in Vietnamese culture. This unique and beautifully lit bridge, which also breathes fire and sprays water. It’s the purposeful integration of the lighting hardware articulates the dragon’s form, and the fire-breathing dragon head. This project transcends the notion of monumental bridge with dynamic colour-changing lighting, creating an iconic sculpture in the skyline that is both reverent and whimsical. The signature feature of the bridge was the massive undulating support structure resembling a dragon flying over the river. The dragon is prominent in Vietnamese culture as a symbol of power and nobility. Dragon Bridge stands out as a model of innovation. It has received worldwide attention in the design community and from the global media for its unique arch support system. Dragon Bridge serves as an example of how aesthetic quality of a design can serve cultural, economic and functional purposes. The article presents design solutions of the object and the evaluation of the technical condition before putting the facility into service.

  14. Dynamics of sediment disturbance by periodic artificial discharges from the world's largest tidal power plant

    Science.gov (United States)

    Kim, J. W.; Ha, H. K.; Woo, S. B.

    2017-05-01

    To investigate the dynamics of sediment disturbance near the world's largest Sihwa tidal power plant (TPP), two mooring observations have been conducted. The mooring results show that current velocity and suspended sediment concentration (SSC) were significantly disturbed over various time scales. On the short-term (flood-ebb) time scale, resuspension of bottom sediment is mainly controlled by the strong jet-flow (>2 m s-1) and resulting anticlockwise rotating vortex associated with the artificial discharge. During ebb phase, the strong flow resulted in suspension of high-concentration near-bed sediment and seaward transport of the suspended sediment. After turning to flood phase, the vortex produced secondary SSC peaks, transporting the suspended sediment toward the Sihwa TPP. The most active suspension of bed sediment predominantly occurred during 1-2 h immediately after the start of artificial discharge. For the fortnightly (spring-neap) time scale, SSC during spring tide was approximately 2-5 times higher than that during neap tide. During the combined period of ebb and spring tides, in particular, the periodic artificial discharge can enhance the responses of SSC in the vicinity of Sihwa TPP.

  15. Sistema Faro, Isla de Mona, Puerto Rico: speleogenesis of the worlds largest flank margin cave

    International Nuclear Information System (INIS)

    Lace, M. J.; Kambesis, P. N.; Mylroie, J. E.

    2016-01-01

    Isla de Mona, a small, uplifted carbonate plateau jutting out of the waters of the Mona Passage, is an incredibly fragile and densely karstic environment. Expedition work was conducted by the Isla de Mona Project in cooperation with the Departamento Recursos Naturales y Ambientales de Puerto Rico (DRNA), including contributions from many researchers and cavers volunteering from across the U.S and Puerto Rico in the course of 12 separate expeditions, spanning a 14 year period (1998 to 2013). Over 200 caves have been documented on the island to date, the majority of this inventory is composed of flank margin caves but also includes sea caves, pit caves and talus caves. The most extensive example of cave development on the island is Sistema Faro - a sprawling maze-like series of chambers formed within the eastern point of the island with over 40 cliffside entrances overlooking the Caribbean Sea. Detailed cartography and analysis of the geomorphology and development of the Sistema Faro has helped form a complex model of carbonate island cave development as a function of tectonic uplift, lithology, sea level changes, karst hydrogeology and cliff retreat. This communication examines the roles these controls have played in the genesis of the world's largest flank margin cave. (Author)

  16. The largest human cognitive performance dataset reveals insights into the effects of lifestyle factors and aging

    Directory of Open Access Journals (Sweden)

    Daniel A Sternberg

    2013-06-01

    Full Text Available Making new breakthroughs in understanding the processes underlying human cognition may depend on the availability of very large datasets that have not historically existed in psychology and neuroscience. Lumosity is a web-based cognitive training platform that has grown to include over 600 million cognitive training task results from over 35 million individuals, comprising the largest existing dataset of human cognitive performance. As part of the Human Cognition Project, Lumosity’s collaborative research program to understand the human mind, Lumos Labs researchers and external research collaborators have begun to explore this dataset in order uncover novel insights about the correlates of cognitive performance. This paper presents two preliminary demonstrations of some of the kinds of questions that can be examined with the dataset. The first example focuses on replicating known findings relating lifestyle factors to baseline cognitive performance in a demographically diverse, healthy population at a much larger scale than has previously been available. The second example examines a question that would likely be very difficult to study in laboratory-based and existing online experimental research approaches: specifically, how learning ability for different types of cognitive tasks changes with age. We hope that these examples will provoke the imagination of researchers who are interested in collaborating to answer fundamental questions about human cognitive performance.

  17. Characteristics and Trends in Hypnotics Consumption in the Largest Health Care System in Israel

    Directory of Open Access Journals (Sweden)

    O. Marom

    2016-01-01

    Full Text Available Objectives. To quantify and characterize hypnotics consumption habits among adult patients insured by Clalit Health Services (CHS, the largest health care provider in Israel, in 2000 and 2010. Methods. A retrospective analysis of CHS computerized pharmacy records. Data were collected for all patients over the age of 18 years who were prescribed hypnotics in 2000 and in 2010. Results. Sleep medications were consumed by 8.7% of the adult CHS population in 2000 and by 9.6% in 2010. About one-quarter of consumers were treated for more than 6 months in both years. Multiple sleeping drugs were consumed more often in 2010 (45.2% than a decade before (22%. While in 2000 benzodiazepines accounted for 84.5% of hypnotics, in 2010 this was reduced to 73.7% (p<0.05. Of all patients treated for longer than 6 months only 11% in 2000 and 9% in 2010 required a dose escalation suggesting the absence of tolerance. Conclusions. Nine percent of the Israeli population consumes hypnotics. There is a major increase in prescription of combination of medications between 2000 and 2010, with an increase in Z class medications use and reduction in benzodiazepines. Most patients chronically treated did not escalate dosage, suggesting the absence of tolerance.

  18. Racial Disparities in Heart Disease Mortality in the 50 Largest U.S. Cities.

    Science.gov (United States)

    Benjamins, Maureen R; Hirschtick, Jana L; Hunt, Bijou R; Hughes, Michelle M; Hunter, Brittany

    2016-12-06

    Heart disease is not only the leading cause of death in the U.S. but also the main contributor to racial disparities in life expectancy. Despite this, heart disease mortality rates and racial disparities in these rates are not readily available at the city level where they can be the most quickly and effectively addressed. We calculated age-adjusted heart disease mortality rates and corresponding racial rate ratios (RRs) and rate differences (RDs) for the non-Hispanic Black (Black) and non-Hispanic White (White) populations for the years 1990-1994 and 2005-2009 for the U.S. and the 50 largest cities therein. We then examined relationships between the disparities and city-level population indicators. Nationally, mortality rates were significantly higher among Blacks than Whites at both time periods. Larger improvements in rates for Whites compared to Blacks resulted in a significant increase in disparities over the 20-year period for 11 cities. There were 19,448 excess Black deaths in the U.S. annually. City-level income inequality, as well as the overall city and White median household income, contributed to these disparities. By identifying city-specific disparities and trends, health care providers, public health agencies, and researchers can target the areas with the most need and can look at cities without disparities for clues on how to best advance health equity in heart disease morbidity and mortality.

  19. Stand Up for the Burrup: Saving the Largest Aboriginal Rock Art Precinct in Australia

    Directory of Open Access Journals (Sweden)

    Jenny Gregory

    2009-12-01

    Full Text Available The Dampier Rock Art Precinct contains the largest and most ancient collection of Aboriginal rock art in Australia. The cultural landscape created by generations of Aboriginal people includes images of long-extinct fauna and demonstrates the response of peoples to a changing climate over thousands of years as well as the continuity of lived experience. Despite Australian national heritage listing in 2007, this cultural landscape continues to be threatened by industrial development. Rock art on the eastern side of the archipelago, on the Burrup Peninsula, was relocated following the discovery of adjacent off-shore gas reserves so that a major gas plant could be constructed. Work has now begun on the construction of a second major gas plant nearby. This article describes the rock art of the Dampier Archipelago and the troubled history of European-Aboriginal contact history, before examining the impact of industry on the region and its environment. The destruction of Aboriginal rock art to meet the needs of industry is an example of continuing indifference to Aboriginal culture. While the complex struggle to protect the cultural landscape of the Burrup, in particular, involving Indigenous people, archaeologists, historians, state and federal politicians, government bureaucrats and multi-national companies, eventually led to national heritage listing, it is not clear that the battle to save the Burrup has been won.

  20. Reconstructing the population history of the largest tribe of India: the Dravidian speaking Gond.

    Science.gov (United States)

    Chaubey, Gyaneshwer; Tamang, Rakesh; Pennarun, Erwan; Dubey, Pavan; Rai, Niraj; Upadhyay, Rakesh Kumar; Meena, Rajendra Prasad; Patel, Jayanti R; van Driem, George; Thangaraj, Kumarasamy; Metspalu, Mait; Villems, Richard

    2017-04-01

    The Gond comprise the largest tribal group of India with a population exceeding 12 million. Linguistically, the Gond belong to the Gondi-Manda subgroup of the South Central branch of the Dravidian language family. Ethnographers, anthropologists and linguists entertain mutually incompatible hypotheses on their origin. Genetic studies of these people have thus far suffered from the low resolution of the genetic data or the limited number of samples. Therefore, to gain a more comprehensive view on ancient ancestry and genetic affinities of the Gond with the neighbouring populations speaking Indo-European, Dravidian and Austroasiatic languages, we have studied four geographically distinct groups of Gond using high-resolution data. All the Gond groups share a common ancestry with a certain degree of isolation and differentiation. Our allele frequency and haplotype-based analyses reveal that the Gond share substantial genetic ancestry with the Indian Austroasiatic (ie, Munda) groups, rather than with the other Dravidian groups to whom they are most closely related linguistically.

  1. Inequalities in noncommunicable disease mortality in the ten largest Japanese cities.

    Science.gov (United States)

    Kano, Megumi; Hotta, Miyuki; Prasad, Amit

    2013-12-01

    The burden of noncommunicable diseases and social inequalities in health among urban populations is becoming a common problem around the world. This phenomenon is further compounded by population aging. Japan faces the task of maintaining its high level of population health while dealing with these challenges. This study focused on the ten largest cities in Japan and, using publicly available administrative data, analyzed standardized mortality ratios to examine inequalities in relative mortality levels due to major noncommunicable disease at both city and subcity levels. On average, the ten major cities had excess mortality due to cancer and lower mortality due to heart disease and cerebrovascular disease compared to the country as a whole. Substantial inequalities in relative mortality were observed both between and within cities, especially for heart disease and cerebrovascular disease among men. Inequalities in relative mortality levels within cities appear to be increasing over time even while relative mortality levels are decreasing overall. The widely observed health inequalities signal the need for actions to ensure health equity while addressing the burden of noncommunicable diseases. Increasingly, more countries will have to deal with these challenges of inequity, urbanization, aging, and noncommunicable diseases. Local health governance informed by locally specific data on health determinants and outcomes is essential for developing contextualized interventions to improve health and health equity in major urban areas.

  2. UV-B-induced forest sterility: Implications of ozone shield failure in Earth's largest extinction.

    Science.gov (United States)

    Benca, Jeffrey P; Duijnstee, Ivo A P; Looy, Cindy V

    2018-02-01

    Although Siberian Trap volcanism is considered a primary driver of the largest extinction in Earth history, the end-Permian crisis, the relationship between these events remains unclear. However, malformations in fossilized gymnosperm pollen from the extinction interval suggest biological stress coinciding with pulsed forest decline. These grains are hypothesized to have been caused by enhanced ultraviolet-B (UV-B) irradiation from volcanism-induced ozone shield deterioration. We tested this proposed mechanism by observing the effects of inferred end-Permian UV-B regimes on pollen development and reproductive success in living conifers. We find that pollen malformation frequencies increase fivefold under high UV-B intensities. Surprisingly, all trees survived but were sterilized under enhanced UV-B. These results support the hypothesis that heightened UV-B stress could have contributed not only to pollen malformation production but also to deforestation during Permian-Triassic crisis intervals. By reducing the fertility of several widespread gymnosperm lineages, pulsed ozone shield weakening could have induced repeated terrestrial biosphere destabilization and food web collapse without exerting a direct "kill" mechanism on land plants or animals. These findings challenge the paradigm that mass extinctions require kill mechanisms and suggest that modern conifer forests may be considerably more vulnerable to anthropogenic ozone layer depletion than expected.

  3. Characterization of the largest relic Eurasian wild grapevine reservoir in Southern Iberian Peninsula

    Directory of Open Access Journals (Sweden)

    Rosa Arroyo-García

    2016-08-01

    Full Text Available Wild grapevine is becoming a threatened species in the Iberian Peninsula due to human impacts. The aim of this work was to carry out a holistic study for six years of the largest wild grapevine population found up to date in SW Iberian Peninsula. This population has 115 vines. Ampelographic and soil characteristics have been studied. Evaluation of its environment has also been studied by describing the main parasitic species and natural enemies of pests. The ability of this plant material for its micropropagation and storage in slow-growth conditions has been tested. Microvinification resulted in a wine with good acidity and medium color intensity, two interesting characteristics under a warm climatology. Finally, the identification of private alleles in this wild population, absent in other locations from the Northern and Southern Iberian territories, is a very valuable feature and confirms the importance of establishing conservation programs. The population here studied is genetically unique and potentially useful for commercial rootstocks and cultivars breeding that would improve viticulture and enology.

  4. Monitoring coastal pollution associated with the largest oil refinery complex of Venezuela

    Directory of Open Access Journals (Sweden)

    Aldo Croquer

    2016-06-01

    Full Text Available This study evaluated pollution levels in water and sediments of Península de Paraguaná and related these levels with benthic macrofauna along a coastal area where the largest Venezuelan oil refineries have operated over the past 60 years. For this, the concentration of heavy metals, of hydrocarbon compounds and the community structure of the macrobenthos were examined at 20 sites distributed along 40 km of coastline for six consecutive years, which included windy and calm seasons. The spatial variability of organic and inorganic compounds showed considerably high coastal pollution along the study area, across both years and seasons. The southern sites, closest to the refineries, had consistently higher concentrations of heavy metals and organic compounds in water and sediments when compared to those in the north. The benthic community was dominated by polychaetes at all sites, seasons and years, and their abundance and distribution were significantly correlated with physical and chemical characteristics of the sediments. Sites close to the oil refineries were consistently dominated by families known to tolerate xenobiotics, such as Capitellidae and Spionidae. The results from this study highlight the importance of continuing long-term environmental monitoring programs to assess the impact of effluent discharge and spill events from the oil refineries that operate in the western coast of Paraguaná, Venezuela.

  5. KEPLER-1647B: THE LARGEST AND LONGEST-PERIOD KEPLER TRANSITING CIRCUMBINARY PLANET

    Energy Technology Data Exchange (ETDEWEB)

    Kostov, Veselin B. [NASA Goddard Space Flight Center, Mail Code 665, Greenbelt, MD 20771 (United States); Orosz, Jerome A.; Welsh, William F.; Short, Donald R. [Department of Astronomy, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182 (United States); Doyle, Laurance R. [SETI Institute, 189 Bernardo Avenue, Mountain View, CA 94043 (United States); Principia College, IMoP, One Maybeck Place, Elsah, IL 62028 (United States); Fabrycky, Daniel C. [Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637 (United States); Haghighipour, Nader [Institute for Astronomy, University of Hawaii-Manoa, Honolulu, HI 96822 (United States); Quarles, Billy [Department of Physics and Physical Science, The University of Nebraska at Kearney, Kearney, NE 68849 (United States); Cochran, William D.; Endl, Michael [McDonald Observatory, The University of Texas as Austin, Austin, TX 78712-0259 (United States); Ford, Eric B. [Department of Astronomy and Astrophysics, The Pennsylvania State University, 428A Davey Lab, University Park, PA 16802 (United States); Gregorio, Joao [Atalaia Group and Crow-Observatory, Portalegre (Portugal); Hinse, Tobias C. [Korea Astronomy and Space Science Institute (KASI), Advanced Astronomy and Space Science Division, Daejeon 305-348 (Korea, Republic of); Isaacson, Howard [Department of Astronomy, University of California Berkeley, 501 Campbell Hall, Berkeley, CA 94720 (United States); Jenkins, Jon M. [NASA Ames Research Center, Moffett Field, CA 94035 (United States); Jensen, Eric L. N. [Department of Physics and Astronomy, Swarthmore College, Swarthmore, PA 19081 (United States); Kane, Stephen [Department of Physics and Astronomy, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132 (United States); Kull, Ilya, E-mail: veselin.b.kostov@nasa.gov [Department of Astronomy and Astrophysics, Tel Aviv University, 69978 Tel Aviv (Israel); and others

    2016-08-10

    We report the discovery of a new Kepler transiting circumbinary planet (CBP). This latest addition to the still-small family of CBPs defies the current trend of known short-period planets orbiting near the stability limit of binary stars. Unlike the previous discoveries, the planet revolving around the eclipsing binary system Kepler-1647 has a very long orbital period (∼1100 days) and was at conjunction only twice during the Kepler mission lifetime. Due to the singular configuration of the system, Kepler-1647b is not only the longest-period transiting CBP at the time of writing, but also one of the longest-period transiting planets. With a radius of 1.06 ± 0.01 R {sub Jup}, it is also the largest CBP to date. The planet produced three transits in the light curve of Kepler-1647 (one of them during an eclipse, creating a syzygy) and measurably perturbed the times of the stellar eclipses, allowing us to measure its mass, 1.52 ± 0.65 M {sub Jup}. The planet revolves around an 11-day period eclipsing binary consisting of two solar-mass stars on a slightly inclined, mildly eccentric ( e {sub bin} = 0.16), spin-synchronized orbit. Despite having an orbital period three times longer than Earth’s, Kepler-1647b is in the conservative habitable zone of the binary star throughout its orbit.

  6. KEPLER-1647B: THE LARGEST AND LONGEST-PERIOD KEPLER TRANSITING CIRCUMBINARY PLANET

    International Nuclear Information System (INIS)

    Kostov, Veselin B.; Orosz, Jerome A.; Welsh, William F.; Short, Donald R.; Doyle, Laurance R.; Fabrycky, Daniel C.; Haghighipour, Nader; Quarles, Billy; Cochran, William D.; Endl, Michael; Ford, Eric B.; Gregorio, Joao; Hinse, Tobias C.; Isaacson, Howard; Jenkins, Jon M.; Jensen, Eric L. N.; Kane, Stephen; Kull, Ilya

    2016-01-01

    We report the discovery of a new Kepler transiting circumbinary planet (CBP). This latest addition to the still-small family of CBPs defies the current trend of known short-period planets orbiting near the stability limit of binary stars. Unlike the previous discoveries, the planet revolving around the eclipsing binary system Kepler-1647 has a very long orbital period (∼1100 days) and was at conjunction only twice during the Kepler mission lifetime. Due to the singular configuration of the system, Kepler-1647b is not only the longest-period transiting CBP at the time of writing, but also one of the longest-period transiting planets. With a radius of 1.06 ± 0.01 R Jup , it is also the largest CBP to date. The planet produced three transits in the light curve of Kepler-1647 (one of them during an eclipse, creating a syzygy) and measurably perturbed the times of the stellar eclipses, allowing us to measure its mass, 1.52 ± 0.65 M Jup . The planet revolves around an 11-day period eclipsing binary consisting of two solar-mass stars on a slightly inclined, mildly eccentric ( e bin = 0.16), spin-synchronized orbit. Despite having an orbital period three times longer than Earth’s, Kepler-1647b is in the conservative habitable zone of the binary star throughout its orbit.

  7. Percolation under noise: Detecting explosive percolation using the second-largest component

    Science.gov (United States)

    Viles, Wes; Ginestet, Cedric E.; Tang, Ariana; Kramer, Mark A.; Kolaczyk, Eric D.

    2016-05-01

    We consider the problem of distinguishing between different rates of percolation under noise. A statistical model of percolation is constructed allowing for the birth and death of edges as well as the presence of noise in the observations. This graph-valued stochastic process is composed of a latent and an observed nonstationary process, where the observed graph process is corrupted by type-I and type-II errors. This produces a hidden Markov graph model. We show that for certain choices of parameters controlling the noise, the classical (Erdős-Rényi) percolation is visually indistinguishable from a more rapid form of percolation. In this setting, we compare two different criteria for discriminating between these two percolation models, based on the interquartile range (IQR) of the first component's size, and on the maximal size of the second-largest component. We show through data simulations that this second criterion outperforms the IQR of the first component's size, in terms of discriminatory power. The maximal size of the second component therefore provides a useful statistic for distinguishing between different rates of percolation, under physically motivated conditions for the birth and death of edges, and under noise. The potential application of the proposed criteria for the detection of clinically relevant percolation in the context of applied neuroscience is also discussed.

  8. Multisensor Parallel Largest Ellipsoid Distributed Data Fusion with Unknown Cross-Covariances.

    Science.gov (United States)

    Liu, Baoyu; Zhan, Xingqun; Zhu, Zheng H

    2017-06-29

    As the largest ellipsoid (LE) data fusion algorithm can only be applied to two-sensor system, in this contribution, parallel fusion structure is proposed to introduce the LE algorithm into a multisensor system with unknown cross-covariances, and three parallel fusion structures based on different estimate pairing methods are presented and analyzed. In order to assess the influence of fusion structure on fusion performance, two fusion performance assessment parameters are defined as Fusion Distance and Fusion Index. Moreover, the formula for calculating the upper bounds of actual fused error covariances of the presented multisensor LE fusers is also provided. Demonstrated with simulation examples, the Fusion Index indicates fuser's actual fused accuracy and its sensitivity to the sensor orders, as well as its robustness to the accuracy of newly added sensors. Compared to the LE fuser with sequential structure, the LE fusers with proposed parallel structures not only significantly improve their properties in these aspects, but also embrace better performances in consistency and computation efficiency. The presented multisensor LE fusers generally have better accuracies than that of covariance intersection (CI) fusion algorithm and are consistent when the local estimates are weakly correlated.

  9. Hydrodynamic and Inundation Modeling of China’s Largest Freshwater Lake Aided by Remote Sensing Data

    Directory of Open Access Journals (Sweden)

    Peng Zhang

    2015-04-01

    Full Text Available China’s largest freshwater lake, Poyang Lake, is characterized by rapid changes in its inundation area and hydrodynamics, so in this study, a hydrodynamic model of Poyang Lake was established to simulate these long-term changes. Inundation information was extracted from Moderate Resolution Imaging Spectroradiometer (MODIS remote sensing data and used to calibrate the wetting and drying parameter by assessing the accuracy of the simulated inundation area and its boundary. The bottom friction parameter was calibrated using current velocity measurements from Acoustic Doppler Current Profilers (ADCP. The results show the model is capable of predicting the inundation area dynamic through cross-validation with remotely sensed inundation data, and can reproduce the seasonal dynamics of the water level, and water discharge through a comparison with hydrological data. Based on the model results, the characteristics of the current velocities of the lake in the wet season and the dry season of the lake were explored, and the potential effect of the current dynamic on water quality patterns was discussed. The model is a promising basic tool for prediction and management of the water resource and water quality of Poyang Lake.

  10. Epidemiological study of hepatitis A, B and C in the largest Afro-Brazilian isolated community.

    Science.gov (United States)

    Matos, Márcia A D; Reis, Nádia Rúbia S; Kozlowski, Aline G; Teles, Sheila A; Motta-Castro, Ana Rita C; Mello, Francisco C A; Gomes, Selma A; Martins, Regina M B

    2009-09-01

    This study was conducted to estimate the prevalence and molecular epidemiological features of viral hepatitis A, B and C in the Kalunga population, which represents the largest Afro-Brazilian isolated community. Among 878 individuals studied, the overall prevalence of anti-hepatitis A virus antibodies was 80.9%, with a significant rise from 44.8% to near 100% between the first and fourth decade of life. Rates for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc) of 1.8% and 35.4%, respectively, were found. Increasing age, male gender, illiteracy and history of multiple sexual partners were associated with hepatitis B virus (HBV) infection. An occult HBV infection rate of 1.7% (5/295) was found among anti-HBc-positive individuals. HBV genotype A (subtype Aa) was dominant in this community. Only 5/878 individuals (0.6%) were positive for anti-hepatitis C virus (HCV). HCV RNA was detected in three of them, who were infected with genotype 1 (subtype 1a). These findings point out high, intermediate and low endemicity for hepatitis A, B and C, respectively, in the Kalunga community in Brazil. Circulation of HBV genotype A (subtype Aa) in this Afro-Brazilian isolated community indicates the introduction of this virus during the slave trade from Africa to Brazil.

  11. Carbon footprint of premium quality export bananas: case study in Ecuador, the world's largest exporter.

    Science.gov (United States)

    Iriarte, Alfredo; Almeida, Maria Gabriela; Villalobos, Pablo

    2014-02-15

    Nowadays, the new international market demands challenge the food producing countries to include the measurement of the environmental impact generated along the production process for their products. In order to comply with the environmentally responsible market requests the measurement of the greenhouse gas emissions of Ecuadorian agricultural goods has been promoted employing the carbon footprint concept. Ecuador is the largest exporter of bananas in the world. Within this context, this study is a first assessment of the carbon footprint of the Ecuadorian premium export banana (Musa AAA) using a considerable amount of field data. The system boundaries considered from agricultural production to delivery in a European destination port. The data collected over three years permitted identifying the hot spot stages. For the calculation, the CCaLC V3.0 software developed by the University of Manchester is used. The carbon footprint of the Ecuadorian export banana ranged from 0.45 to 1.04 kg CO2-equivalent/kg banana depending on the international overseas transport employed. The principal contributors to the carbon footprint are the on farm production and overseas transport stages. Mitigation and reduction strategies were suggested for the main emission sources in order to achieve sustainable banana production. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Sources and distribution of microplastics in China's largest inland lake - Qinghai Lake.

    Science.gov (United States)

    Xiong, Xiong; Zhang, Kai; Chen, Xianchuan; Shi, Huahong; Luo, Ze; Wu, Chenxi

    2018-04-01

    Microplastic pollution was studied in China's largest inland lake - Qinghai Lake in this work. Microplastics were detected with abundance varies from 0.05 × 10 5 to 7.58 × 10 5 items km -2 in the lake surface water, 0.03 × 10 5 to 0.31 × 10 5 items km -2 in the inflowing rivers, 50 to 1292 items m -2 in the lakeshore sediment, and 2 to 15 items per individual in the fish samples, respectively. Small microplastics (0.1-0.5 mm) dominated in the lake surface water while large microplastics (1-5 mm) are more abundant in the river samples. Microplastics were predominantly in sheet and fiber shapes in the lake and river water samples but were more diverse in the lakeshore sediment samples. Polymer types of microplastics were mainly polyethylene (PE) and polypropylene (PP) as identified using Raman Spectroscopy. Spatially, microplastic abundance was the highest in the central part of the lake, likely due to the transport of lake current. Based on the higher abundance of microplastics near the tourist access points, plastic wastes from tourism are considered as an important source of microplastics in Qinghai Lake. As an important area for wildlife conservation, better waste management practice should be implemented, and waste disposal and recycling infrastructures should be improved for the protection of Qinghai Lake. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Bedrock Canyons Carved by the Largest Known Floods on Earth and Mars

    Science.gov (United States)

    Lamb, M. P.; Lapôtre, M. G. A.; Larsen, I. J.; Williams, R. M. E.

    2017-12-01

    The surface of Earth is a dynamic and permeable interface where the rocky crust is sculpted by ice, wind and water resulting in spectacular mountain ranges, vast depositional basins and environments that support life. These landforms and deposits contain a rich, yet incomplete, record of Earth history that we are just beginning to understand. Some of the most dramatic landforms are the huge bedrock canyons carved by catastrophic floods. On Mars, similar bedrock canyons, known as Outflow Channels, are the most important indicators of large volumes of surface water in the past. Despite their importance and now decades of observations of canyon morphology, we lack a basic understanding of how the canyons formed, which limits our ability to reconstruct flood discharge, duration and water volume. In this presentation I will summarize recent work - using mechanistic numerical models and field observations - that suggests that bedrock canyons carved by megafloods rapidly evolve to a size and shape such that boundary shear stresses just exceed that required to entrain fractured blocks of rock. The threshold shear stress constraint allows for quantitative reconstruction of the largest known floods on Earth and Mars, and implies far smaller discharges than previous methods that assume flood waters fully filled the canyons to high water marks.

  14. Corporate social responsibility of the 100 largest Indian companies – an analysis of website communication

    Directory of Open Access Journals (Sweden)

    Avinash Mulky

    2013-01-01

    Full Text Available Corporate social responsibility has become an important concept in the business world in recent decades. CSR is important in all countries but is particularly relevant in emerging markets where the levels of human development are not high. The United Nations Development Programme has created the Human Development Index (HDI to measure the human development in countries. The present study analyzes the CSR communication on the websites of the 100 largest Indian companies. The objective was to examine the reported CSR activities and determine whether the activities address the dimensions and indicators of the HDI. The study uses content analysis to classify the CSR activities into categories corresponding to HDI parameters. The findings indicate that about two thirds of the companies are using their websites to communicate CSR. Of the companies which reported CSR, about eighty percent report support for primary education and about seventy percent undertake livelihood support activities. The level of corporate involvement in the health dimension of human development is quite low. Reduction of infant and maternal mortality does not get much corporate attention. This study will add to the literature on CSR in emerging markets and will be useful for firms in India and other emerging markets that are planning CSR activities aimed at human development parameters.

  15. Evaluation of several priority pollutants in zebra mussels (Dreissena polymorpha) in the largest Italian subalpine lakes

    International Nuclear Information System (INIS)

    Riva, Consuelo; Binelli, Andrea; Provini, Alfredo

    2008-01-01

    Zebra mussel (Dreissena polymorpha) has been used for the biomonitoring of several POPs (PCBs, DDTs, HCB and HCHs) in the largest Italian subalpine great lakes (Lake Maggiore, Garda, Como, Iseo and Lugano). Samplings were carried out in April 2003 at 15 locations selected according to industrial and anthropic levels of lakes. Results have pointed out high DDT levels in D. polymorpha specimens from Lake Maggiore (700-1400 ng/g lipids, 5-9 times higher than those measured in mussels of other Italian lakes), due to a contamination from a chemical plant located on one of the main lake inlet that occurred in 1996. On the contrary, PCB levels (400-2509 ng/g lipids) highlighted an overall pollution, with some sporadic peaks of contamination. Data showed a moderate increase trend compared to those found in a previous monitoring campaign carried out in 1996. Future monitoring is needed in order to confirm this tendency. - Significant levels of DDTs and PCBs are still present in the Italian subalpine great lakes

  16. Evaluation of several priority pollutants in zebra mussels (Dreissena polymorpha) in the largest Italian subalpine lakes

    Energy Technology Data Exchange (ETDEWEB)

    Riva, Consuelo [Department of Biology, Ecology Section, University of Milan, Via Celoria 26, 20133 Milan (Italy)], E-mail: consuelo.riva@unimi.it; Binelli, Andrea; Provini, Alfredo [Department of Biology, Ecology Section, University of Milan, Via Celoria 26, 20133 Milan (Italy)

    2008-02-15

    Zebra mussel (Dreissena polymorpha) has been used for the biomonitoring of several POPs (PCBs, DDTs, HCB and HCHs) in the largest Italian subalpine great lakes (Lake Maggiore, Garda, Como, Iseo and Lugano). Samplings were carried out in April 2003 at 15 locations selected according to industrial and anthropic levels of lakes. Results have pointed out high DDT levels in D. polymorpha specimens from Lake Maggiore (700-1400 ng/g lipids, 5-9 times higher than those measured in mussels of other Italian lakes), due to a contamination from a chemical plant located on one of the main lake inlet that occurred in 1996. On the contrary, PCB levels (400-2509 ng/g lipids) highlighted an overall pollution, with some sporadic peaks of contamination. Data showed a moderate increase trend compared to those found in a previous monitoring campaign carried out in 1996. Future monitoring is needed in order to confirm this tendency. - Significant levels of DDTs and PCBs are still present in the Italian subalpine great lakes.

  17. Monitoring carbon monoxide pollution over the largest ten cities in the US using satellite observations

    Science.gov (United States)

    Zheng, B.; de Beurs, K.; Owsley, B.; Krehbiel, C. P.; Henebry, G. M.

    2015-12-01

    Carbon monoxide (CO) is one of the several air pollutants that are largely produced by anthropogenic activities in urban areas as a result of incomplete combustion of carbon-containing fuels. Long-term satellite data can monitor spatial and temporal changes in CO globally. Here we investigated spatial, vertical, and temporal changes in CO concentrations over the largest ten US metropolitan statistical areas (MSAs) using Version 6 MOPITT TIR-only CO retrievals. The 15-year average of MOPITT Surface CO concentrations over urban areas were highest (388 ppbv) over New York City and lowest (151 ppbv) over Miami. The influence of cities on elevated CO levels extends well beyond the immediate urban area. The CO seasonal profiles above the surface show distinct seasonality with peaks March-April and troughs September-October. However, larger cities show a lack of CO seasonality near the surface. We applied the nonparametric Seasonal Kendall (SK) trend test to the CO time series. Results revealed significant decreasing trends in CO concentration, with stronger trends in the lower atmosphere (>700 hPa) than in the mid-troposphere (500-700 hPa). Our results demonstrate the strong influence of local urban emissions on (near-) surface CO concentrations. Decreasing urban CO over the past 15 years reflects improved urban metabolism through improved energy efficiency, and increasing use of alternative transportation and zero-emission vehicles.

  18. Fire carbon emissions over maritime southeast Asia in 2015 largest since 1997

    Science.gov (United States)

    Huijnen, V.; Wooster, M. J.; Kaiser, J. W.; Gaveau, D. L. A.; Flemming, J.; Parrington, M.; Inness, A.; Murdiyarso, D.; Main, B.; van Weele, M.

    2016-05-01

    In September and October 2015 widespread forest and peatland fires burned over large parts of maritime southeast Asia, most notably Indonesia, releasing large amounts of terrestrially-stored carbon into the atmosphere, primarily in the form of CO2, CO and CH4. With a mean emission rate of 11.3 Tg CO2 per day during Sept-Oct 2015, emissions from these fires exceeded the fossil fuel CO2 release rate of the European Union (EU28) (8.9 Tg CO2 per day). Although seasonal fires are a frequent occurrence in the human modified landscapes found in Indonesia, the extent of the 2015 fires was greatly inflated by an extended drought period associated with a strong El Niño. We estimate carbon emissions from the 2015 fires to be the largest seen in maritime southeast Asia since those associated with the record breaking El Niño of 1997. Compared to that event, a much better constrained regional total carbon emission estimate can be made for the 2015 fires through the use of present-day satellite observations of the fire’s radiative power output and atmospheric CO concentrations, processed using the modelling and assimilation framework of the Copernicus Atmosphere Monitoring Service (CAMS) and combined with unique in situ smoke measurements made on Kalimantan.

  19. Rise and Fall of one of World's largest deltas; the Mekong delta in Vietnam

    Science.gov (United States)

    Minderhoud, P. S. J.; Eslami Arab, S.; Pham, H. V.; Erkens, G.; van der Vegt, M.; Oude Essink, G.; Stouthamer, E.; Hoekstra, P.

    2017-12-01

    The Mekong delta is the third's largest delta in the world. It is home to almost 20 million people and an important region for the food security in South East Asia. As most deltas, the Mekong delta is the dynamic result of a balance of sediment supply, sea level rise and subsidence, hosting a system of fresh and salt water dynamics. Ongoing urbanization, industrialization and intensification of agricultural practices in the delta, during the past decades, resulted in growing domestic, agricultural and industrial demands, and have led to a dramatic increase of fresh water use. Since the year 2000, the amount of fresh groundwater extracted from the subsurface increased by 500%. This accelerated delta subsidence as the groundwater system compacts, with current sinking rates exceeding global sea level rise up to an order of magnitude. These high sinking rates have greatly altered the sediment budget of the delta and, with over 50% of the Mekong delta surface elevated less than 1 meter above sea level, greatly increase vulnerability to flooding and storm surges and ultimately, permanent inundation. Furthermore, as the increasingly larger extractions rapidly reduce the fresh groundwater reserves, groundwater salinization subsequently increases. On top of that, dry season low-flows by the Mekong river cause record salt water intrusion in the delta's estuarine system, creating major problems for rice irrigation. We present the work of three years research by the Dutch-Vietnamese `Rise and Fall' project on land subsidence and salinization in both groundwater and surface water in the Vietnamese Mekong delta.

  20. The Largest Paracentric Inversion, The Highest Rate Of Recombinant Spermatozoa. Case Report: 46,Xy, Inv(2(Q21.2Q37.3 And Literature Review

    Directory of Open Access Journals (Sweden)

    C.C. Yapan

    2014-06-01

    Full Text Available Carriers of inversions involving euchromatic regions are at risk of having unbalanced offspring due to meiotic crossover. In carriers, recombination can occur during gametogenesis and cause genetically unbalanced sperm and subsequently unbalanced embryos. Here we present segregation analysis results of an infertile male with 46,XY,inv(2 (q21.2q37.3 using fluorescent in situ hybridization (FISH on sperm cells. This is the largest paracentric inversion (PAI reported so far in a meiotic segregation analysis study. Sperm FISH revealed 28.0% recombinant spermatozoa rate for chromosome 2, which was the highest rate in PAI carriers in the literature. Our results indicate a clear correlation between the size of the inverted segment and the frequency of the recombinant spermatozoa. The results of the FISH analysis with the information of unbalanced spermatozoa rate can provide accurate counseling on the genetic risk of infertility.

  1. [Tuberculosis among asylum-seekers in the Netherlands: a descriptive study among the two largest groups of asylum-seekers].

    Science.gov (United States)

    de Vries, Gerard; Gerritsen, Roald F; van Burg, Jan L; Erkens, Connie G M; van Hest, N A H Rob; Schimmel, Henrieke J; van Dissel, Jaap T

    2016-01-01

    To investigate the prevalence and incidence of tuberculosis (TB) among the two largest groups of asylum-seekers in the Netherlands, i.e. Syrians and Eritreans/Ethiopians. Descriptive study. We collected data from the screening of Syrian and Eritrean/Ethiopian asylum-seekers for the period January 2013 - September 2015 and linked these to notifications in the Netherlands Tuberculosis Register. Asylum-seekers from Syria and Eritrea/Ethiopia represented 65% and 72% of all asylum applications in 2014 and in the first nine months of 2015 respectively. Fourteen Syrian asylum-seekers applying during the study period were diagnosed with tuberculosis. The prevalence was 22 cases per 100,000 persons screened upon arrival (95% CI: 10-44), while the incidence within the first year after arrival was 19 per 100,000 persons (95% CI: 3-62). Tuberculosis was diagnosed in 133 Eritrean/Ethiopian asylum-seekers applying during the study period. The prevalence was 283 cases per 100,000 persons screened upon arrival (95% CI: 198-393) and the incidence in the first year after arrival was 1394 per 100,000 persons (95% CI: 1095-1751). In the last two years, most asylum-seekers have originated from Syria and among them tuberculosis is relatively uncommon. However, among Eritrean/Ethiopian asylum-seekers, prevalence and incidence in the first year in the Netherlands are high. This suggests that many of them have been recently infected, in their country of origin or during the journey. Other interventions are required, such as screening for latent infection, to prevent tuberculosis among high-risk asylum-seekers and further reduce the incidence of this disease in the Netherlands.

  2. Dioxins and Nonortho PCBs in Breast Milk of Vietnamese Mothers Living in the Largest Hot Spot of Dioxin Contamination.

    Science.gov (United States)

    Nghi, Tran Ngoc; Nishijo, Muneko; Manh, Ho Dung; Tai, Pham The; Van Luong, Hoang; Anh, Tran Hai; Thao, Pham Ngoc; Trung, Nguyen Viet; Waseda, Tomoo; Nakagawa, Hideaki; Kido, Teruhiko; Nishijo, Hisao

    2015-05-05

    Bien Hoa Air Base is the largest dioxin contamination hot spot in Vietnam. In 2012, we recruited 216 mothers who were living in 10 communities around Bien Hoa Air Base and had delivered newborns at a prefecture hospital, and we investigated recent exposure levels of dioxins and nonortho PCBs in their breast milk. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (2,3,7,8-tetraCDD) was present at 2.6 pg/g lipid in primiparae and 2.2 pg/g lipid in multiparae. Among multiparae and total subjects, significant high prevalence of 2,3,7,8-tetraCDD≥5 pg/g lipid and 2,3,7,8-tetraCDD contribution≥40% were observed in mothers living in the five communities closest to Bien Hoa Air Base. The TEQ for nonortho PCBs was 1.6 pg-TEQ/g lipid for primiparae, and this was even lower than that in the unsprayed area. The length of residency was a strong factor to increase dioxins, including 2,3,7,8-tetraCDD. Residency in the five communities with the highest exposure was a specific risk factor for increased 2,3,7,8-tetraCDD in breast milk. Food intake might contribute partly to the increased levels of dioxin congeners other than 2,3,7,8-tetraCDD in breast milk. These results suggest that Bien Hoa Air Base has led to elevated 2,3,7,8-tetraCDD levels in breast milk of mothers in nearby areas even in the recent years.

  3. Survey of 218 organic contaminants in groundwater derived from the world's largest untreated wastewater irrigation system: Mezquital Valley, Mexico.

    Science.gov (United States)

    Lesser, Luis E; Mora, Abrahan; Moreau, Cristina; Mahlknecht, Jürgen; Hernández-Antonio, Arturo; Ramírez, Aldo I; Barrios-Piña, Héctor

    2018-05-01

    The Mezquital Valley system is the world's oldest and largest example with regard to use of untreated wastewater for agricultural irrigation. Because of the artificial high recharge associated with the Mezquital Valley aquifers, groundwater is extracted for human consumption, and there are plans to use this groundwater as a water resource for Mexico City. Thus, this study analyzed 218 organic micro-contaminants in wastewater, springs, and groundwater from Mezquital Valley. Five volatile organic compounds (VOCs) and nine semi-volatile organic compounds (SVOCs) were detected in the wastewater used for irrigation. Only two SVOCs [bis-2-(ethylhexyl) phthalate and dibutyl phthalate] were detected in all the wastewater canals and groundwater sources, whereas no VOCs were detected in groundwater and springs. Of the 118 pharmaceutically active compounds (PhACs) and 7 reproductive hormones measured, 65 PhACs and 3 hormones were detected in the wastewater. Of these, metformin, caffeine, and acetaminophen account for almost sixty percent of the total PhACs in wastewater. Nevertheless, 23 PhACs were detected in groundwater sources, where the majority of these compounds have low detection frequencies. The PhACs sulfamethoxazole, N,N-diethyl-meta-toluamide, carbamazepine, and benzoylecgonine (primary cocaine metabolite) were frequently detected in groundwater, suggesting that although the soils act as a filter adsorbing and degrading the majority of the organic pollutant content in wastewater, these PhACs still reach the aquifer. Therefore, the presence of these PhACs, together with the high levels of the endocrine disruptor bis-2-(ethylhexyl) phthalate, indicate that water sources derived from the recharge of the studied aquifers may pose a risk to consumer health. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Astronomer's new guide to the galaxy: largest map of cold dust revealed

    Science.gov (United States)

    2009-07-01

    Astronomers have unveiled an unprecedented new atlas of the inner regions of the Milky Way, our home galaxy, peppered with thousands of previously undiscovered dense knots of cold cosmic dust -- the potential birthplaces of new stars. Made using observations from the APEX telescope in Chile, this survey is the largest map of cold dust so far, and will prove an invaluable map for observations made with the forthcoming ALMA telescope, as well as the recently launched ESA Herschel space telescope. ESO PR Photo 24a/09 View of the Galactic Plane from the ATLASGAL survey (annotated and in five sections) ESO PR Photo 24b/09 View of the Galactic Plane from the ATLASGAL survey (annotated) ESO PR Photo 24c/09 View of the Galactic Plane from the ATLASGAL survey (in five sections) ESO PR Photo 24d/09 View of the Galactic Plane from the ATLASGAL survey ESO PR Photo 24e/09 The Galactic Centre and Sagittarius B2 ESO PR Photo 24f/09 The NGC 6357 and NGC 6334 nebulae ESO PR Photo 24g/09 The RCW120 nebula ESO PR Video 24a/09 Annotated pan as seen by the ATLASGAL survey This new guide for astronomers, known as the APEX Telescope Large Area Survey of the Galaxy (ATLASGAL) shows the Milky Way in submillimetre-wavelength light (between infrared light and radio waves [1]). Images of the cosmos at these wavelengths are vital for studying the birthplaces of new stars and the structure of the crowded galactic core. "ATLASGAL gives us a new look at the Milky Way. Not only will it help us investigate how massive stars form, but it will also give us an overview of the larger-scale structure of our galaxy", said Frederic Schuller from the Max Planck Institute for Radio Astronomy, leader of the ATLASGAL team. The area of the new submillimetre map is approximately 95 square degrees, covering a very long and narrow strip along the galactic plane two degrees wide (four times the width of the full Moon) and over 40 degrees long. The 16 000 pixel-long map was made with the LABOCA submillimetre

  5. Critical Gaps in the World’s Largest Electronic Medical Record: Ad Hoc Nursing Narratives and Invisible Adverse Drug Events

    OpenAIRE

    Hurdle, John F.; Weir, Charlene R.; Roth, Beverly; Hoffman, Jennifer; Nebeker, Jonathan R.

    2003-01-01

    The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs, operates one of the largest healthcare networks in the world. Its electronic medical record (EMR) is fully integrated into clinical practice, having evolved over several decades of design, testing, trial, and error. It is unarguably the world’s largest EMR, and as such it makes an important case study for a host of timely informatics issues. The VHA consistently has been at the vanguard of patient safety, esp...

  6. LACK OF REPRODUCIBILITY OF A SINGLE NEGATIVE STING CHALLENGE RESPONSE IN THE ASSESSMENT OF ANAPHYLACTIC RISK IN PATIENTS WITH SUSPECTED YELLOW JACKET HYPERSENSITIVITY

    NARCIS (Netherlands)

    FRANKEN, HH; DUBOIS, AEJ; MINKEMA, HJ; VANDERHEIDE, S; DEMONCHY, JGR

    To investigate the reproducibility of a single negative response to sting challenge with a living insect, we rechallenged a group of 61 patients who showed no clinical response to a first sting challenge. All patients had previously had symptoms suggestive of anaphylaxis after a yellow jacket field

  7. Exploratory pilot study assessing the risk of cognitive impairment or sedation in the elderly following single doses of solifenacin 10 mg.

    Science.gov (United States)

    Wesnes, Keith A; Edgar, Chris; Tretter, Reiner N; Bolodeoku, John

    2009-11-01

    To assess the cognitive effects of single doses of solifenacin 10 mg compared with placebo (primary objective) and oxybutynin immediate release (IR) 10 mg (secondary objective) in elderly subjects. Single-centre, randomised, double-blind, placebo-controlled study in 12 healthy elderly volunteers, with three crossover periods separated by two 14-day washout periods. Each sequence consisted of a single dose of solifenacin 10 mg in one period, oxybutynin IR 10 mg in another and placebo in another. Aspects of attention, information processing, working memory, episodic memory and self-rated mood and alertness were tested using the validated Cognitive Drug Research computerised assessment system. There was no evidence from absolute mean values or changes from baseline to suggest that solifenacin 10 mg impaired cognition or self-ratings of mood and alertness versus placebo. Post-hoc ANCOVA showed no statistically significant cognitive deterioration with solifenacin versus placebo, when measured at a time point closest to the probable C(max) of solifenacin. Oxybutynin was associated with statistically significant impairments in several measures of cognitive function at a time point corresponding with its probable C(max). In this pilot study, single 10 mg doses of solifenacin did not show any clear propensity to impair cognitive function in a healthy elderly population.

  8. Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Lyman, J.T.

    1982-02-01

    The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained

  9. Risk of malignancy in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis under immunosuppressive therapy: a single-center experience.

    Science.gov (United States)

    Fantò, Marta; Peragallo, Mario Stefano; Pietrosanti, Mario; Di Rosa, Roberta; Picchianti Diamanti, Andrea; Salemi, Simonetta; D'Amelio, Raffaele

    2016-02-01

    Systemic inflammatory rheumatic diseases are associated with an increased risk of malignancy, in particular of lymphoproliferative disorders. Chronic inflammation, due to the disease itself, generates a microenvironment able to promote cancer development, but it is still controversial whether immunosuppressive therapy may contribute to carcinogenesis. The aim of the study was to evaluate the risk of malignancy in 399 patients affected by rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis, all treated with either tumor necrosis factor α-inhibitors plus disease-modifying anti-rheumatic drugs (DMARDs) or DMARDs alone. The risk of malignancy in this cohort of patients, observed in the period between 2005 and 2011 at S. Andrea Hospital-Sapienza University of Rome, was compared with that of the general Italian population, matched for age, sex, and area of residence. Fourteen (3.5%) malignancies, five of which were hematologic, have been observed. The overall cancer risk was not significantly increased in comparison to the general population, whereas the risk of hematologic malignancies appeared significantly higher in RA patients (SIR 4.94, 95% CI 1.35-12.64), particularly in female gender (SIR 6.9, 0.95% CI 1.88-17.66). No significant association between therapy and malignancy was demonstrated in RA patients.

  10. Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I.; Lyman, J.T.

    1982-02-01

    The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained.

  11. Rewriting the Landform History of One of Africa's Three Largest Basins

    Science.gov (United States)

    Wilkinson, Justin

    2014-01-01

    The Kalahari Basin in southern Africa - one of the largest basins in Africa, along with the Congo and Chad basins - has attracted attention since David Livingstone traveled through the area in the 1840s. It is a semiarid desert with a large freshwater swampland known as the Okavango Swamp (150 km radius). This prominent megafan (a fan with radii >100 km), with its fingers of dark green forests projecting into the dun colors of the dunes of the Kalahari semi-desert, has been well photographed by astronauts over the years. The study area in the northern Kalahari basin is centered on the Okavango megafan of northwest Botswana, whose swampland has become well known as an African wildlife preserve of importance to biology and tourism alike. The Okavango River is unusual because it has deposited not one but two megafans along its course: the Okavango megafan and the Cubango megafan. The Okavango megafan is one of only three well-known megafans in Africa. Megafans on Earth were once thought to be rare, but recent research has documented 68 in Africa alone. Eleven megafans, plus three more candidates, have been documented in the area immediately surrounding the Okavango feature. These 11 megafans occupy the flattest and smoothest terrains adjacent to the neighboring upland and stand out as the darkest areas in the roughness map of the area. Megafan terrains occupy at least 200,000 sq km of the study area. The roughness map shown is based on an algorithm used first on Mars to quantify topographic roughness. Research of Earth's flattest terrains is just beginning with the aid of such maps, and it appears that these terrains are analogous to the flattest regions of Mars. Implications: 1. The variability in depositional style in each subbasin may apply Africa-wide: rift megafan length is dominated by rift width, whereas Owambo subbasin megafans are probably controlled by upland basin size; Zambezi subbasin megafans appear more like foreland basin types, with the position of

  12. Indication and implementation of lipidapheresis, rheopheresis, or immunoadsorption (lessons learnt from Germany's largest apheresis center).

    Science.gov (United States)

    Heigl, Franz; Hettich, Reinhard; Lotz, Norbert; Reeg, Harduin; Eder, Bernadette; Steckholzer-Kroth, Karin; Browatzki, Michael; Harre, Kerstin; Arendt, Rainer

    2009-12-29

    Efficient modes of extracorporeal blood purification are available today for apheresis treatment of progressive atherosclerosis, autoimmune disease, or for improving hemorheology. Advanced technology and sophisticated care render apheresis treatment selective, safe and tolerable. Our task is to constantly update indications for apheresis based on best evidence available and good clinical practice, as well as, to determine how apheresis therapy can be made available to those in need or with otherwise refractory disease. Presenting examples of lipid apheresis, rheopheresis, or immunoadsorption for treatment of hypercholesterolemia, hyperlipoproteinemia (a), acute hearing loss, refractory or exacerbating multiple sclerosis, we highlight real world obstacles for implementation of treatment, resulting in still too many patients with proven or recommended indication left untreated. Based on the experience of the largest apheresis center in Germany, with more than 3,300 treatments per year, we depict the necessary structure for identification of patients, defining indication, referral, implementation of therapy, and reimbursement. Apheresis is unfamiliar to most patients and many practitioners or consultants. Nephrologists, performing >90% of apheresis treatments in Germany, have to form a network for referral comprising all regional care-givers, general practitioners as well as the respective specialists (mainly, cardiologists, endocrinologists, diabetologists, ORL specialists, neurologists, ophthalmologists, or rheumatologists), and insurances or other cost-bearing parties for offering a scientifically approved therapeutic regimen and comprehensive care. We have realized this concept in a high volume apheresis center acting in a closely knit network characterized by an unrelenting effort at ongoing medical education. As a consequence, we include approximately 10 times more patients with appropriate diagnoses in our apheresis program as compared to the national average

  13. Preserving the world second largest hypersaline lake under future irrigation and climate change.

    Science.gov (United States)

    Shadkam, Somayeh; Ludwig, Fulco; van Vliet, Michelle T H; Pastor, Amandine; Kabat, Pavel

    2016-07-15

    Iran Urmia Lake, the world second largest hypersaline lake, has been largely desiccated over the last two decades resulting in socio-environmental consequences similar or even larger than the Aral Sea disaster. To rescue the lake a new water management plan has been proposed, a rapid 40% decline in irrigation water use replacing a former plan which intended to develop reservoirs and irrigation. However, none of these water management plans, which have large socio-economic impacts, have been assessed under future changes in climate and water availability. By adapting a method of environmental flow requirements (EFRs) for hypersaline lakes, we estimated annually 3.7·10(9)m(3) water is needed to preserve Urmia Lake. Then, the Variable Infiltration Capacity (VIC) hydrological model was forced with bias-corrected climate model outputs for both the lowest (RCP2.6) and highest (RCP8.5) greenhouse-gas concentration scenarios to estimate future water availability and impacts of water management strategies. Results showed a 10% decline in future water availability in the basin under RCP2.6 and 27% under RCP8.5. Our results showed that if future climate change is highly limited (RCP2.6) inflow can be just enough to meet the EFRs by implementing the reduction irrigation plan. However, under more rapid climate change scenario (RCP8.5) reducing irrigation water use will not be enough to save the lake and more drastic measures are needed. Our results showed that future water management plans are not robust under climate change in this region. Therefore, an integrated approach of future land-water use planning and climate change adaptation is therefore needed to improve future water security and to reduce the desiccating of this hypersaline lake. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Nature appropriation and associations with population health in Canada's largest cities.

    Science.gov (United States)

    Rainham, Daniel; Cantwell, Rory; Jason, Timothy

    2013-03-26

    Earth is a finite system with a limited supply of resources. As the human population grows, so does the appropriation of Earth's natural capital, thereby exacerbating environmental concerns such as biodiversity loss, increased pollution, deforestation and global warming. Such concerns will negatively impact human health although it is widely believed that improving socio-economic circumstances will help to ameliorate environmental impacts and improve health outcomes. However, this belief does not explicitly acknowledge the fact that improvements in socio-economic position are reliant on increased inputs from nature. Gains in population health, particularly through economic means, are disconnected from the appropriation of nature to create wealth so that health gains become unsustainable. The current study investigated the sustainability of human population health in Canada with regard to resource consumption or "ecological footprints" (i.e., the resources required to sustain a given population). Ecological footprints of the 20 largest Canadian cities, along with several important determinants of health such as income and education, were statistically compared with corresponding indicators of human population health outcomes. A significant positive relationship was found between ecological footprints and life expectancy, as well as a significant negative relationship between ecological footprints and the prevalence of high blood pressure. Results suggest that increased appropriation of nature is linked to improved health outcomes. To prevent environmental degradation from excessive appropriation of natural resources will require the development of health promotion strategies that are de-coupled from ever-increasing and unsustainable resource use. Efforts to promote population health should focus on health benefits achieved from a lifestyle based on significantly reduced consumption of natural resources.

  15. Iceland as the largest source of natural air pollution in the Arctic

    Science.gov (United States)

    Dagsson Waldhauserova, Pavla; Meinander, Outi; Olafsson, Haraldur; Arnalds, Olafur

    2017-04-01

    Arctic aerosols are often attributed to the Arctic Haze and long-range transport tracers. There is, however, an important dust source in the Arctic/Sub-arctic region which should receive more attention. The largest desert in the Arctic as well as in the Europe is Iceland with > 40,000 km2 of desert areas. The mean dust suspension frequency was 135 dust days annually in 1949-2012 with decreasing numbers in 2013-2015. The annual dust deposition was calculated as 31-40 million tons yr-1 affecting the area of > 500,000 km2. Satelite MODIS pictures have revealed dust plumes traveling > 1000 km at times. The physical properties of Icelandic dust showed differences in mineralogy, geochemical compositions, shapes, sizes, and colour, compared to the crustal mineral dust. Icelandic dust is of volcanic origin, dark in colour with sharp-tipped shards and large bubbles. About 80% of the particulate matter is volcanic glass rich in heavy metals, such as iron and titanium. Suspended dust measured at the glacial dust source consisted of such high number of close-to-ultrafine particles as concentrations during active eruptions. Generally, about 50% of the suspended PM10 are submicron particles in Iceland. Contrarily, suspended grains > 2 mm were captured during severe dust storm after the 2010 Eyjafjallajokull eruption when the aeolian transport exceeded 11 t m-1 of materials and placed this storms among the most extreme wind erosion events recorded on Earth. Our reflectance measurements showed that Icelandic dust deposited on snow lowers the snow albedo and reduces the snow density as much as Black Carbon. Icelandic volcanic dust tends to act as a positive climate forcing agent, both directly and indirectly, which is different to what generally concluded for crustal dust in the 2013 IPCC report. The high frequency, severity and year-round activity of volcanic dust emissions suggest that Icelandic dust may contribute to Arctic warming.

  16. Surface Water Quality Monitoring Site Optimization for Poyang Lake, the Largest Freshwater Lake in China

    Directory of Open Access Journals (Sweden)

    Hua Wang

    2014-11-01

    Full Text Available In this paper, we propose a coupled method to optimize the surface water quality monitoring sites for a huge freshwater lake based on field investigations, mathematical analysis, and numerical simulation tests. Poyang Lake, the largest freshwater lake in China, was selected as the research area. Based on the field investigated water quality data in the 5 years from 2008 to 2012, the water quality inter-annual variation coefficients at all the present sites and the water quality correlation coefficients between adjacent sites were calculated and analyzed to present an optimization scheme. A 2-D unsteady water quality model was established to get the corresponding water quality data at the optimized monitoring sites, which were needed for the rationality test on the optimized monitoring network. We found that: (1 the water quality of Piaoshan (No. 10 fluctuated most distinguishably and the inter-annual variation coefficient of NH3-N and TP could reach 99.77% and 73.92%, respectively. The four studied indexes were all closely related at Piaoshan (No. 10 and Tangyin (No. 11, and the correlation coefficients of COD and NH3-N could reach 0.91 and 0.94 separately. (2 It was suggested that the present site No. 10 be removed to avoid repeatability, and it was suggested that the three sites of Changling, Huzhong, and Nanjiang be added to improve the representativeness of the monitoring sites. (3 According to the rationality analysis, the 21 optimized water quality monitoring sites could scientifically replace the primary network, and the new monitoring network could better reflect the water quality of the whole lake.

  17. Geochemical characterization of the largest upland lake of the Brazilian Amazonia: Impact of provenance and processes

    Science.gov (United States)

    Sahoo, Prafulla Kumar; Guimarães, José Tasso Felix; Souza-Filho, Pedro Walfir Martins; da Silva, Marcio Sousa; Nascimento, Wilson, Júnior; Powell, Mike A.; Reis, Luiza Santos; Pessenda, Luiz Carlos Ruiz; Rodrigues, Tarcísio Magevski; da Silva, Delmo Fonseca; Costa, Vladimir Eliodoro

    2017-12-01

    Lake Três Irmãs (LTI), the largest upland lake in the Brazilian Amazonia, located in Serra dos Carajás, was characterized using multi-elemental and isotope geochemistry (δ13C and δ15N) to understand the significance of organic and inorganic sources, weathering and sedimentary processes on the distribution of elements in lake bottom (surficial) sediments. Carbon and nitrogen isotopes from sedimentary organic matter suggest C3 terrestrial plants (forests > canga vegetation), macrophytes and freshwater DOC as the main sources. Sediments are depleted in most of the major oxides (except Fe2O3 and P2O5) when compared to upper continental crust (UCC) and their spatial distribution is highly influenced by catchment lithology. Principal Component Analysis revealed that most of the trace elements (Ba, Sr, Rb, Sc, Th, U, Zr, Hf, Nb, Y, V, Cr, Ga, Co, Ni) and REEs are closely correlated with Al and Ti (PC1; Group-1), so their redistribution is less influenced by post-depositional process. This is due to their relative immobility and being hosted by Al-bearing minerals during laterization. High Chemical Index of Alteration (CIA), Mafic Index of Alteration (MIA) and Index of Laterization (IOL) values indicate intense chemical weathering at source areas, but the weathering transformation was better quantified by IOL. A-CN-K plot along with elemental ratios (Al/K, Ti/K, Ti/Zr, La/Al, Cr/Th, Co/Th, La/Sm, La/Gd, Zr/Y, and Eu/Eu*) as well as chondrite-normalized REE patterns show that the detritic sediments are mainly sourced from ferruginous laterites and soils in the catchment, which may have characteristics similar to mafic rocks.

  18. Solomon Islands largest hawksbill turtle rookery shows signs of recovery after 150 years of excessive exploitation.

    Directory of Open Access Journals (Sweden)

    Richard J Hamilton

    Full Text Available The largest rookery for hawksbill turtles in the oceanic South Pacific is the Arnavon Islands, which are located in the Manning Strait between Isabel and Choiseul Province, Solomon Islands. The history of this rookery is one of overexploitation, conflict and violence. Throughout the 1800s Roviana headhunters from New Georgia repeatedly raided the Manning Strait to collect hawksbill shell which they traded with European whalers. By the 1970s the Arnavons hawksbill population was in severe decline and the national government intervened, declaring the Arnavons a sanctuary in 1976. But this government led initiative was short lived, with traditional owners burning down the government infrastructure and resuming intensive harvesting in 1982. In 1991 routine beach monitoring and turtle tagging commenced at the Arnavons along with extensive community consultations regarding the islands' future, and in 1995 the Arnavon Community Marine Conservation Area (ACMCA was established. Around the same time national legislation banning the sale of all turtle products was passed. This paper represents the first analysis of data from 4536 beach surveys and 845 individual turtle tagging histories obtained from the Arnavons between 1991-2012. Our results and the results of others, reveal that many of the hawksbill turtles that nest at the ACMCA forage in distant Australian waters, and that nesting on the Arnavons occurs throughout the year with peak nesting activity coinciding with the austral winter. Our results also provide the first known evidence of recovery for a western pacific hawksbill rookery, with the number of nests laid at the ACMCA and the remigration rates of turtles doubling since the establishment of the ACMCA in 1995. The Arnavons case study provides an example of how changes in policy, inclusive community-based management and long term commitment can turn the tide for one of the most charismatic and endangered species on our planet.

  19. Solar energy potential of the largest buildings in the United States

    Science.gov (United States)

    Wence, E. R.; Grodsky, S.; Hernandez, R. R.

    2017-12-01

    Sustainable pathways of land use for energy are necessary to mitigate climate change and limit conversion of finite land resources needed for conservation and food production. Large, commercial buildings (LCBs) are increasing in size and number throughout the United States (US) and may serve as suitable recipient environments for photovoltaic (PV) solar energy infrastructure that may support a low carbon, low land footprint energy transition. In this study, we identified, characterized, and evaluated the technical potential of the largest, commercial building rooftops (i.e., exceeding 110,000 m2) and their associated parking lots in the US for PV solar energy systems using Aurora, a cloud-based solar optimization platform. We also performed a case study of building-specific electricity generation: electricity consumption balance. Further, we quantified the environmental co-benefit of land sparing and associated avoided emissions (t-CO2-eq) conferred under the counterfactual scenario that solar development would otherwise proceed as a ground-mounted, utility-scale PV installation of equal nominal capacity. We identified and mapped 37 LCBs (by rooftop area) across 18 states in the US, spanning from as far north as the state of Minnesota to as far south as Florida. Rooftop footprints range from 427,297 to 113,689 m2 and have a cumulative surface area of 99.8 million ft2. We characterize the LCBs as either: distribution/warehouse, factory, shopping center, or administrative office/facility. Three of the 37 LCBs currently support rooftop PV and the numbers of associated, detached buildings number up to 38. This study elucidates the extent to which LCBs and their respective parking lots can serve as suitable sites for PV solar energy generation. Lastly, this study demonstrates research-based applications of the Aurora energy modeling platform and informs decision-making focused on redirecting energy development towards human-modified landscapes to prioritize land use for

  20. The world's largest macroalgal bloom in the Yellow Sea, China: Formation and implications

    Science.gov (United States)

    Liu, Dongyan; Keesing, John K.; He, Peimin; Wang, Zongling; Shi, Yajun; Wang, Yujue

    2013-09-01

    The world's largest trans-regional macroalgal blooms during 2008-2012 occurred in the Yellow Sea, China. This review addresses the causes, development and future challenges in this unique case. Satellite imagery and field observations showed that the macroalgal blooms in the Yellow Sea originated from the coast of Jiangsu province and that favorable geographic and oceanographic conditions brought the green macroalgae from the coast offshore. Optimal temperature, light, nutrients and wind contributed to the formation and transport of the massive bloom north into the Yellow Sea and its deposition onshore along the coast of Shandong province. Morphological and genetic evidence demonstrated that the species involved was Ulva prolifera, a fouling green commonly found growing on structures provided by facilities of Porphyra aquaculture. Large scale Porphyra aquaculture (covering >20,000 ha) along the Jiangsu coast thus hypothetically provided a nursery bed for the original biomass of U. prolifera. Porphyra growers remove U. prolifera from the mariculture rafts, and the cleaning releases about 5000 wet weight tonnes of green algae into the water column along the coast of Jiangsu province; the biomass then is dispersed by hydrographic forcing, and takes advantage of rather high nutrient supply and suitable temperatures to grow to impressive levels. Certain biological traits of U. prolifera —efficient photosynthesis, rapid growth rates, high capacity for nutrient uptake, and diverse reproductive systems— allowed growth of the original 5000 tonnes of U. prolifera biomass into more than one million tonnes of biomass in just two months. The proliferation of U. prolifera in the Yellow Sea resulted from a complex contingency of circumstances, including human activity (eutrophication by release of nutrients from wastewater, agriculture, and aquaculture), natural geographic and hydrodynamic conditions (current, wind) and the key organism's biological attributes. Better

  1. Dragon's paradise lost: palaeobiogeography, evolution and extinction of the largest-ever terrestrial lizards (Varanidae.

    Directory of Open Access Journals (Sweden)

    Scott A Hocknull

    Full Text Available BACKGROUND: The largest living lizard species, Varanus komodoensis Ouwens 1912, is vulnerable to extinction, being restricted to a few isolated islands in eastern Indonesia, between Java and Australia, where it is the dominant terrestrial carnivore. Understanding how large-bodied varanids responded to past environmental change underpins long-term management of V. komodoensis populations. METHODOLOGY/PRINCIPAL FINDINGS: We reconstruct the palaeobiogeography of Neogene giant varanids and identify a new (unnamed species from the island of Timor. Our data reject the long-held perception that V. komodoensis became a giant because of insular evolution or as a specialist hunter of pygmy Stegodon. Phyletic giantism, coupled with a westward dispersal from mainland Australia, provides the most parsimonious explanation for the palaeodistribution of V. komodoensis and the newly identified species of giant varanid from Timor. Pliocene giant varanid fossils from Australia are morphologically referable to V. komodoensis suggesting an ultimate origin for V. komodoensis on mainland Australia (>3.8 million years ago. Varanus komodoensis body size has remained stable over the last 900,000 years (ka on Flores, a time marked by major faunal turnovers, extinction of the island's megafauna, the arrival of early hominids by 880 ka, co-existence with Homo floresiensis, and the arrival of modern humans by 10 ka. Within the last 2000 years their populations have contracted severely. CONCLUSIONS/SIGNIFICANCE: Giant varanids were once a ubiquitous part of Subcontinental Eurasian and Australasian faunas during the Neogene. Extinction played a pivotal role in the reduction of their ranges and diversity throughout the late Quaternary, leaving only V. komodoensis as an isolated long-term survivor. The events over the last two millennia now threaten its future survival.

  2. Smart phone Acceptance among physicians: Application of structural equation modeling in Iranian largest university

    Directory of Open Access Journals (Sweden)

    Nematollahi M.

    2017-03-01

    Full Text Available Background: The present study aimed to determine attitudes and effective factors in the acceptance of smart phones by physicians of the largest University of Medical Sciences in the south of Iran. Methods: This cross-sectional study was performed using Structural Equation Modelling (SEM in 2014. Study participants included 200 physicians working in the hospitals of Shiraz University of Medical Sciences selected through two-stage stratified sampling, but 185 participants completed the study. The study data were collected using a researcher-made questionnaire completed through a 5-point Likert scale. The content validity of the questionnaire was confirmed by a panel of experts, its construct validity by confirmatory factor analysis, and its reliability by Cronbach’s alpha of 0.802. All data analyses were performed using SPSS (version 22 and LISREL (version 8.8. Results: Results showed that most physicians had a desirable attitude towards using smart phones. Besides, the results of SEM indicated a significant relationship between attitude and compatibility, observability, personal experience, voluntariness of use and perceived usefulness. Moreover, some important fitness indices revealed appropriate fitness of the study model (p=0.26, X2 /df=1.35, RMR=0.070, GFI=0.77, AGFI=0.71, NNFI=0.93, CFI=0.94. Conclusion: The results revealed that compatibility, observability, personal experience, voluntariness of use and perceived usefulness were effective in the physicians’ attitude towards using smart phones. Thus, by preparation of the required infrastructures, policymakers in the field of health technology can enhance the utilization of smart phones in hospitals.

  3. Lessons Learned in Deploying the World s Largest Scale Lustre File System

    Energy Technology Data Exchange (ETDEWEB)

    Dillow, David A [ORNL; Fuller, Douglas [ORNL; Wang, Feiyi [ORNL; Oral, H Sarp [ORNL; Zhang, Zhe [ORNL; Hill, Jason J [ORNL; Shipman, Galen M [ORNL

    2010-01-01

    The Spider system at the Oak Ridge National Laboratory's Leadership Computing Facility (OLCF) is the world's largest scale Lustre parallel file system. Envisioned as a shared parallel file system capable of delivering both the bandwidth and capacity requirements of the OLCF's diverse computational environment, the project had a number of ambitious goals. To support the workloads of the OLCF's diverse computational platforms, the aggregate performance and storage capacity of Spider exceed that of our previously deployed systems by a factor of 6x - 240 GB/sec, and 17x - 10 Petabytes, respectively. Furthermore, Spider supports over 26,000 clients concurrently accessing the file system, which exceeds our previously deployed systems by nearly 4x. In addition to these scalability challenges, moving to a center-wide shared file system required dramatically improved resiliency and fault-tolerance mechanisms. This paper details our efforts in designing, deploying, and operating Spider. Through a phased approach of research and development, prototyping, deployment, and transition to operations, this work has resulted in a number of insights into large-scale parallel file system architectures, from both the design and the operational perspectives. We present in this paper our solutions to issues such as network congestion, performance baselining and evaluation, file system journaling overheads, and high availability in a system with tens of thousands of components. We also discuss areas of continued challenges, such as stressed metadata performance and the need for file system quality of service alongside with our efforts to address them. Finally, operational aspects of managing a system of this scale are discussed along with real-world data and observations.

  4. Forest biomonitoring of the largest Slovene thermal power plant with respect to reduction of air pollution.

    Science.gov (United States)

    Al Sayegh Petkovšek, Samar

    2013-02-01

    The condition of the forest ecosystem in the vicinity of the largest Slovene power plant [the Šoštanj Thermal Power Plant (ŠTPP)] was monitored during the period 1991-2008 by determining the total concentration of sulphur, ascorbic acid and chlorophyll in Norway spruce needles. After 1995, the introduction of cleaning devices at the ŠTPP dramatically reduced the former extremely high SO(2) and dust emissions. The most significant findings of this comprehensive, long-duration survey are as follows: (1) the chosen parameters are suitable bioindicators of stress caused by air pollution in Norway spruce needles; they reflect both spatial and temporal variations in air pollution as well as the degree of efficiency of the cleaning devices; (2) observations show that the physiological condition of Norway spruce in northern Slovenia has significantly improved since 1995, when the first desulphurization device at ŠTPP was built, together with a reduction in the area influenced by pollution from ŠTPP; (3) metabolic processes in spruce needles react to air pollution according to the severity of the pollution and the length of exposure; exposure to high SO(2) ambient levels and/or spread over a long duration can damage the antioxidant defence mechanisms of spruce trees as well as diminishing the concentration of ascorbic acid; (4) a reduction in the exposure to air pollution improves the vitality of the trees (e.g. higher concentrations of total (a + b) chlorophyll), as well as restoring their defence capabilities as shown by higher concentrations of ascorbic acid; and (5) forest monitoring should be continued and focused on integrating the effects of multiple stressors, which can additionally affect a forest ecosystem.

  5. Solomon Islands largest hawksbill turtle rookery shows signs of recovery after 150 years of excessive exploitation.

    Science.gov (United States)

    Hamilton, Richard J; Bird, Tomas; Gereniu, Collin; Pita, John; Ramohia, Peter C; Walter, Richard; Goerlich, Clara; Limpus, Colin

    2015-01-01

    The largest rookery for hawksbill turtles in the oceanic South Pacific is the Arnavon Islands, which are located in the Manning Strait between Isabel and Choiseul Province, Solomon Islands. The history of this rookery is one of overexploitation, conflict and violence. Throughout the 1800s Roviana headhunters from New Georgia repeatedly raided the Manning Strait to collect hawksbill shell which they traded with European whalers. By the 1970s the Arnavons hawksbill population was in severe decline and the national government intervened, declaring the Arnavons a sanctuary in 1976. But this government led initiative was short lived, with traditional owners burning down the government infrastructure and resuming intensive harvesting in 1982. In 1991 routine beach monitoring and turtle tagging commenced at the Arnavons along with extensive community consultations regarding the islands' future, and in 1995 the Arnavon Community Marine Conservation Area (ACMCA) was established. Around the same time national legislation banning the sale of all turtle products was passed. This paper represents the first analysis of data from 4536 beach surveys and 845 individual turtle tagging histories obtained from the Arnavons between 1991-2012. Our results and the results of others, reveal that many of the hawksbill turtles that nest at the ACMCA forage in distant Australian waters, and that nesting on the Arnavons occurs throughout the year with peak nesting activity coinciding with the austral winter. Our results also provide the first known evidence of recovery for a western pacific hawksbill rookery, with the number of nests laid at the ACMCA and the remigration rates of turtles doubling since the establishment of the ACMCA in 1995. The Arnavons case study provides an example of how changes in policy, inclusive community-based management and long term commitment can turn the tide for one of the most charismatic and endangered species on our planet.

  6. The 100-C-7 Remediation Project. An Overview of One of DOE's Largest Remediation Projects - 13260

    International Nuclear Information System (INIS)

    Post, Thomas C.; Strom, Dean; Beulow, Laura

    2013-01-01

    The U.S. Department of Energy Richland Operations Office (RL), U.S. Environmental Protection Agency (EPA) and Washington Closure Hanford LLC (WCH) completed remediation of one of the largest waste sites in the U.S. Department of Energy complex. The waste site, 100-C-7, covers approximately 15 football fields and was excavated to a depth of 85 feet (groundwater). The project team removed a total of 2.3 million tons of clean and contaminated soil, concrete debris, and scrap metal. 100-C-7 lies in Hanford's 100 B/C Area, home to historic B and C Reactors. The waste site was excavated in two parts as 100-C-7 and 100-C-7:1. The pair of excavations appear like pit mines. Mining engineers were hired to design their tiered sides, with safety benches every 17 feet and service ramps which allowed equipment access to the bottom of the excavations. The overall cleanup project was conducted over a span of almost 10 years. A variety of site characterization, excavation, load-out and sampling methodologies were employed at various stages of remediation. Alternative technologies were screened and evaluated during the project. A new method for cost effectively treating soils was implemented - resulting in significant cost savings. Additional opportunities for minimizing waste streams and recycling were identified and effectively implemented by the project team. During the final phase of cleanup the project team applied lessons learned throughout the entire project to address the final, remaining source of chromium contamination. The C-7 cleanup now serves as a model for remediating extensive deep zone contamination sites at Hanford. (authors)

  7. Nature Appropriation and Associations with Population Health in Canada’s Largest Cities

    Directory of Open Access Journals (Sweden)

    Timothy Jason

    2013-03-01

    Full Text Available Earth is a finite system with a limited supply of resources. As the human population grows, so does the appropriation of Earth’s natural capital, thereby exacerbating environmental concerns such as biodiversity loss, increased pollution, deforestation and global warming. Such concerns will negatively impact human health although it is widely believed that improving socio-economic circumstances will help to ameliorate environmental impacts and improve health outcomes. However, this belief does not explicitly acknowledge the fact that improvements in socio-economic position are reliant on increased inputs from nature. Gains in population health, particularly through economic means, are disconnected from the appropriation of nature to create wealth so that health gains become unsustainable. The current study investigated the sustainability of human population health in Canada with regard to resource consumption or “ecological footprints” (i.e., the resources required to sustain a given population. Ecological footprints of the 20 largest Canadian cities, along with several important determinants of health such as income and education, were statistically compared with corresponding indicators of human population health outcomes. A significant positive relationship was found between ecological footprints and life expectancy, as well as a significant negative relationship between ecological footprints and the prevalence of high blood pressure. Results suggest that increased appropriation of nature is linked to improved health outcomes. To prevent environmental degradation from excessive appropriation of natural resources will require the development of health promotion strategies that are de-coupled from ever-increasing and unsustainable resource use. Efforts to promote population health should focus on health benefits achieved from a lifestyle based on significantly reduced consumption of natural resources.

  8. Risk factors for adjacent segment pathology requiring additional surgery after single-level spinal fusion: impact of pre-existing spinal stenosis demonstrated by preoperative myelography.

    Science.gov (United States)

    Yugué, Itaru; Okada, Seiji; Masuda, Muneaki; Ueta, Takayoshi; Maeda, Takeshi; Shiba, Keiichiro

    2016-05-01

    We determined the incidence of and risk factors for clinical adjacent segment pathology (C-ASP) requiring additional surgeries among patients previously treated with one-segment lumbar decompression and fusion surgery. We retrospectively analysed 161 consecutive patients who underwent one-segment lumbar decompression and fusion surgery for L4 degenerative spondylolisthesis. Patient age, sex, body mass index (BMI), facet orientation and tropism, laminar inclination angle, spinal canal stenosis ratio [on myelography and magnetic resonance imaging (MRI)], preoperative adjacent segment instability, arthrodesis type, pseudarthrosis, segmental lordosis at L4-5, and the present L4 slip were evaluated by a log-rank test using the Kaplan-Meier method. A multivariate Cox proportional-hazards model was used to analyse all factors found significant by the log-rank test. Of 161 patients, 22 patients (13.7 %) had additional surgeries at cranial segments located adjacent to the index surgery's location. Pre-existing canal stenosis ≥47 % at the adjacent segment on myelography, greater facet tropism, and high BMI were significant risk factors for C-ASP. The estimated incidences at 10 years postoperatively for each of these factors were 51.3, 39.6, and 32.5 %, and the risks for C-ASP were 4.9, 3.7, and, 3.1 times higher than their counterparts, respectively. Notably, spinal canal stenosis on myelography, but not on MRI, was found to be a significant risk factor for C-ASP (log-rank test P < 0.0001 and 0.299, respectively). Pre-existing spinal stenosis, greater facet tropism, and higher BMI significantly increased C-ASP risk. Myelography is a more accurate method for detecting latent spinal canal stenosis as a risk factor for C-ASP.

  9. A single-center experience and review of the literature: 64 cases of phyllodes tumors to better understand risk factors and disease management.

    Science.gov (United States)

    Lightner, Amy L; Shurell, Elizabeth; Dawson, Nicole; Omidvar, Yasaman; Foster, Nova

    2015-03-01

    Phyllodes tumors of the breast are rare fibroepithelial tumors that are characterized as benign, borderline, or malignant based on cellular characteristics such as stromal overgrowth and number of mitoses. Currently, there is a lack of consensus on risk factors and management of patients with phyllodes tumors, which has led to variation in treatment patterns as well as patient outcomes across many institutions. This study seeks to understand the clinicopathologic features, risk factors for local and metastatic recurrence, and clinical outcomes of patients with phyllodes tumors to better define optimal treatment patterns.

  10. The incidence and risk factors of resistant E. coli infections after prostate biopsy under fluoroquinolone prophylaxis: a single-centre experience with 2215 patients.

    Science.gov (United States)

    Kandemir, Özlem; Bozlu, Murat; Efesoy, Ozan; Güntekin, Onur; Tek, Mesut; Akbay, Erdem

    2016-08-01

    We evaluated the incidence and risk factors of resistant Escherichia coli infections after the prostate biopsy under flouroquinolone prophylaxis. From January 2003 to December 2012, we retrospectively evaluated the records of 2215 patients. The risk factors were described for infective complications and resistant E. coli in positive cultures was calculated. Of 2215 patients, 153 had positive urine cultures, such as 129 (84·3%) E. coli, 8 (5·2%) Enterococcus spp., 6 (3·9%) Enterobacter spp., 5 (3·2%) Pseudomonas spp., 3 (1·9%) MRCNS, and 2 (1·3%) Klebsiella spp. Of the positive urine cultures which yielded E. coli, 99 (76·7%) were evaluated for fluoroquinolone resistance. Of those, 83 (83·8%) were fluoroquinolone-resistant and composed of 51 (61·4%) extended-spectrum beta-lactamase (ESBL)-positive. Fluoroquinolone-resistant E. coli ratios were 73·4 and 95·9% before 2008 and after 2008, respectively (P = 0·002). The most sensitive antibiotics for fluoroquinolone-resistant E. coli strains were imipenem (100%), amikacin (84%) and cefoperazone (83%). The use of quinolones in the last 6 months and a history of hospitalization in the last 30 days were found to be significant risk factors. We found that resistant E. coli strains might be a common microorganism in patients with this kind of complication. The risk factors for development of infection with these resistant strains were history of the use of fluoroquinolones and hospitalization.

  11. Low bone mineral density may be associated with long-term risk of cancer in the middle-aged population: A retrospective observational study from a single center

    Directory of Open Access Journals (Sweden)

    Hsin-Fu Lee

    2018-04-01

    Full Text Available Background: It is generally understood that cancer patients are at an increased risk for osteoporosis. Additionally, recent studies have suggested a shared pathophysiological mechanism between the development of cancer and osteoporosis. The purpose of this investigation was to investigate whether low bone mineral density is associated with cancer risk. Methods: We enrolled 8780 subjects who underwent dual-energy X-ray absorptiometry (DXA and cancer screening from January 1, 2008–December 31, 2012 from a cohort selected from Chang Gung Health Care Center in Taiwan. The study end point was a definite pathological diagnosis of cancer or admission for cancer treatment. Results: During a mean follow-up of 6.6 ± 1.5 years, 110 incident cases of cancer occurred. The overall incidence of cancer was significantly higher in those patients with a low BMD (1.3% than in those with a normal BMD (1.0%. Multivariate Cox regression analysis showed that older age, smoking, and low BMD (hazard ratio: 1.5; 95% confidence interval: 1.0–2.3 were significant independent risk factors for cancer. Conclusion: Our investigation suggested that subjects with a low BMD may have a higher long-term risk of cancer compared with subjects with a normal BMD. Keywords: Bone mineral density, Cancer

  12. Risk factors and prognosis of intravesical recurrence after surgical management of upper tract urothelial carcinoma: A 30-year single centre experience

    Directory of Open Access Journals (Sweden)

    Mohamed Mohamed Elawdy

    2017-09-01

    Conclusions: In our present series, bladder cancer recurrence of urothelial malignancy occurred in nearly half of the patients after surgical management of UTUC. Ureteric tumour was the only identifiable risk factor, thus patients with ureteric tumours may benefit from prophylactic intravesical chemoimmunotherapy. Bladder recurrence does not appear to affect the cancer-specific survival after surgical management of UTUC.

  13. Relationship between single and multiple perpetrator rape perpetration in South Africa: A comparison of risk factors in a population-based sample.

    Science.gov (United States)

    R, Jewkes; Y, Sikweyiya; K, Dunkle; R, Morrell

    2015-07-07

    Studies of rape of women seldom distinguish between men's participation in acts of single and multiple perpetrator rape. Multiple perpetrator rape (MPR) occurs globally with serious consequences for women. In South Africa it is a cultural practice with defined circumstances in which it commonly occurs. Prevention requires an understanding of whether it is a context specific intensification of single perpetrator rape, or a distinctly different practice of different men. This paper aims to address this question. We conducted a cross-sectional household study with a multi-stage, randomly selected sample of 1686 men aged 18-49 who completed a questionnaire administered using an Audio-enhanced Personal Digital Assistant. We attempted to fit an ordered logistic regression model for factors associated with rape perpetration. 27.6 % of men had raped and 8.8 % had perpetrated multiple perpetrator rape (MPR). Thus 31.9 % of men who had ever raped had done so with other perpetrators. An ordered regression model was fitted, showing that the same associated factors, albeit at higher prevalence, are associated with SPR and MPR. Multiple perpetrator rape appears as an intensified form of single perpetrator rape, rather than a different form of rape. Prevention approaches need to be mainstreamed among young men.

  14. Use of a Single CPT Code for Risk Adjustment in American College of Surgeons NSQIP Database: Is There Potential Bias with Practice-Pattern Differences in Multiple Procedures under the Same Anesthetic?

    Science.gov (United States)

    Cohen, Mark E; Liu, Yaoming; Liu, Jason B; Ko, Clifford Y; Hall, Bruce L

    2018-03-01

    American College of Surgeons NSQIP risk-adjustment models rely on the designated "principal" CPT code to account for procedure-related risk. However, if hospitals differ in their propensity to undertake multiple major operations under the same anesthetic, then risk adjustment using only a single code could bias hospital quality estimates. This study investigated this possibility for bias. We examined hospital odds ratios (ORs) when either the principal CPT code was used for risk adjustment (along with other standard NSQIP predictor variables) or when this code was used in addition to the remaining reported CPT code with the highest associated risk. We examined models for general surgery mortality and morbidity and morbidity in datasets that included mastectomy and/or breast reconstruction, or hysterectomy and/or gynecologic reconstruction as areas known to likely involve more than 1 procedure. Hospital ORs based on 1 vs 2 CPT codes for risk adjustment were essentially the same for mortality and morbidity general surgery models and for the mastectomy and/or breast reconstruction model. For hysterectomy and/or gynecologic reconstruction, the 1 CPT code model tended to slightly overestimate ORs compared with the 2 CPT codes model, when the hospital's OR and the proportion of combined operations were large. Conditions under which practice-pattern-associated modeling bias might exist appear to be uncommon and to have a small impact on quality assessments for the areas examined. The evidence suggests that, within the American College of Surgeons NSQIP modeling paradigm, the principal CPT code adequately risk adjusts for operative procedure in performance assessments. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. High HIV Burden in Men Who Have Sex with Men across Colombia's Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study.

    Science.gov (United States)

    Rubio Mendoza, Martha Lucía; Jacobson, Jerry Owen; Morales-Miranda, Sonia; Sierra Alarcón, Clara Ángela; Luque Núñez, Ricardo

    2015-01-01

    Among Latin America's concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region's third largest country. To date, surveillance studies have been limited to Bogota, while 80% of HIV cases and deaths originate from Colombia's other cities and departments. The extent to which interventions should prioritize MSM outside of Bogota is unknown. We recruited 2603 MSM using respondent-driven sampling from seven of Colombia's largest cities. HIV prevalence was estimated by site from dried blood spot samples. Behavioral data were collected through face-to-face interviews and risk factors for HIV infection analyzed using weighted, multi-level logistical regression models accounting for recruitment patterns. Across cities, HIV prevalence averaged 15%, varied from 6% to 24% and was highest in Cali, Bogota, and Barranquilla. In the past 12 months, 65% of MSM had ≥ 5 casual male partners and 23% had a female partner. Across partnerships (i.e., casual, stable, and commercial), the proportion of MSM engaging in unprotected sex was ≥ 52% with male partners and ≥ 66% with female partners. Self-reported history of STI (24%) and past-year illicit drug use (38%) were also common. In multivariate analysis, age ≥ 35 (adjusted odds ratio [AOR], 19.2) and 25-39 (AOR, 5.6) relative to ≤ 18-24 years, identifying as homosexual relative to heterosexual (AOR 0.1), meeting casual partners on the Internet (adjusted odds ratio [AOR], 3.1) and age of sexual debut of ≤ 13 years (AOR, 3.1) predicted HIV infection. HIV testing and prevention messaging reached just 24% of MSM in the past year. Findings support consistently elevated HIV burden among MSM throughout Colombia's largest cities and a need for enhanced behavioral prevention and HIV testing, emphasizing men who use the Internet as well as physical venues to meet sex partners.

  16. Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles

    Directory of Open Access Journals (Sweden)

    Daar Abdallah S

    2010-12-01

    Full Text Available Abstract Background Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? Discussion A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews. This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z’s ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. Summary With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to

  17. Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles.

    Science.gov (United States)

    Masum, Hassan; Shah, Ronak; Schroeder, Karl; Daar, Abdallah S; Singer, Peter A

    2010-12-13

    Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs) due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews.This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z's ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme) certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to readers in the malaria community, especially in developing

  18. Oak habitat recovery on California's largest islands: Scenarios for the role of corvid seed dispersal

    Science.gov (United States)

    Pesendorfer, Mario B.; Baker, Christopher M.; Stringer, Martin; McDonald-Madden, Eve; Bode, Michael; McEachern, A. Kathryn; Morrison, Scott A.; Sillett, T. Scott

    2018-01-01

    California's second-largest island. The simulation model, extensively parameterized with field data, suggests that re-establishing the mutualism with seed-hoarding jays would accelerate the expansion of island scrub oak, which could benefit myriad species of conservation concern.

  19. What caused the UK's largest common dolphin (Delphinus delphis mass stranding event?

    Directory of Open Access Journals (Sweden)

    Paul D Jepson

    Full Text Available On 9 June 2008, the UK's largest mass stranding event (MSE of short-beaked common dolphins (Delphinus delphis occurred in Falmouth Bay, Cornwall. At least 26 dolphins died, and a similar number was refloated/herded back to sea. On necropsy, all dolphins were in good nutritive status with empty stomachs and no evidence of known infectious disease or acute physical injury. Auditory tissues were grossly normal (26/26 but had microscopic haemorrhages (5/5 and mild otitis media (1/5 in the freshest cases. Five lactating adult dolphins, one immature male, and one immature female tested were free of harmful algal toxins and had low chemical pollutant levels. Pathological evidence of mud/seawater inhalation (11/26, local tide cycle, and the relative lack of renal myoglobinuria (26/26 suggested MSE onset on a rising tide between 06:30 and 08∶21 hrs (9 June. Potential causes excluded or considered highly unlikely included infectious disease, gas/fat embolism, boat strike, by-catch, predator attack, foraging unusually close to shore, chemical or algal toxin exposure, abnormal weather/climatic conditions, and high-intensity acoustic inputs from seismic airgun arrays or natural sources (e.g., earthquakes. International naval exercises did occur in close proximity to the MSE with the most intense part of the exercises (including mid-frequency sonars occurring four days before the MSE and resuming with helicopter exercises on the morning of the MSE. The MSE may therefore have been a "two-stage process" where a group of normally pelagic dolphins entered Falmouth Bay and, after 3-4 days in/around the Bay, a second acoustic/disturbance event occurred causing them to strand en masse. This spatial and temporal association with the MSE, previous associations between naval activities and cetacean MSEs, and an absence of other identifiable factors known to cause cetacean MSEs, indicates naval activity to be the most probable cause of the Falmouth Bay MSE.

  20. What Caused the UK's Largest Common Dolphin (Delphinus delphis) Mass Stranding Event?

    Science.gov (United States)

    Jepson, Paul D.; Deaville, Robert; Acevedo-Whitehouse, Karina; Barnett, James; Brownlow, Andrew; Brownell Jr., Robert L.; Clare, Frances C.; Davison, Nick; Law, Robin J.; Loveridge, Jan; Macgregor, Shaheed K.; Morris, Steven; Murphy, Sinéad; Penrose, Rod; Perkins, Matthew W.; Pinn, Eunice; Seibel, Henrike; Siebert, Ursula; Sierra, Eva; Simpson, Victor; Tasker, Mark L.; Tregenza, Nick; Cunningham, Andrew A.; Fernández, Antonio

    2013-01-01

    On 9 June 2008, the UK's largest mass stranding event (MSE) of short-beaked common dolphins (Delphinus delphis) occurred in Falmouth Bay, Cornwall. At least 26 dolphins died, and a similar number was refloated/herded back to sea. On necropsy, all dolphins were in good nutritive status with empty stomachs and no evidence of known infectious disease or acute physical injury. Auditory tissues were grossly normal (26/26) but had microscopic haemorrhages (5/5) and mild otitis media (1/5) in the freshest cases. Five lactating adult dolphins, one immature male, and one immature female tested were free of harmful algal toxins and had low chemical pollutant levels. Pathological evidence of mud/seawater inhalation (11/26), local tide cycle, and the relative lack of renal myoglobinuria (26/26) suggested MSE onset on a rising tide between 06∶30 and 08∶21 hrs (9 June). Potential causes excluded or considered highly unlikely included infectious disease, gas/fat embolism, boat strike, by-catch, predator attack, foraging unusually close to shore, chemical or algal toxin exposure, abnormal weather/climatic conditions, and high-intensity acoustic inputs from seismic airgun arrays or natural sources (e.g., earthquakes). International naval exercises did occur in close proximity to the MSE with the most intense part of the exercises (including mid-frequency sonars) occurring four days before the MSE and resuming with helicopter exercises on the morning of the MSE. The MSE may therefore have been a “two-stage process” where a group of normally pelagic dolphins entered Falmouth Bay and, after 3–4 days in/around the Bay, a second acoustic/disturbance event occurred causing them to strand en masse. This spatial and temporal association with the MSE, previous associations between naval activities and cetacean MSEs, and an absence of other identifiable factors known to cause cetacean MSEs, indicates naval activity to be the most probable cause of the Falmouth Bay MSE. PMID

  1. SEQUENCING of TSUNAMI WAVES: Why the first wave is not always the largest?

    Science.gov (United States)

    Synolakis, C.; Okal, E.

    2016-12-01

    We discuss what contributes to the `sequencing' of tsunami waves in the far field, that is, to the distribution of the maximum sea surface amplitude inside the dominant wave packet constituting the primary arrival at a distant harbour. Based on simple models of sources for which analytical solutions are available, we show that, as range is increased, the wave pattern evolves from a regime of maximum amplitude in the first oscillation to one of delayed maximum, where the largest amplitude takes place during a subsequent oscillation. In the case of the simple, instantaneous uplift of a circular disk at the surface of an ocean of constant depth, the critical distance for transition between those patterns scales as r 30 /h2 where r0 is the radius of the disk and h the depth of the ocean. This behaviour is explained from simple arguments based on a model where sequencing results from frequency dispersion in the primary wave packet, as the width of its spectrum around its dominant period T0 becomes dispersed in time in an amount comparable to T0 , the latter being controlled by a combination of source size and ocean depth. The general concepts in this model are confirmed in the case of more realistic sources for tsunami excitation by a finite-time deformation of the ocean floor, as well as in real-life simulations of tsunamis excited by large subduction events, for which we find that the influence of fault width on the distribution of sequencing is more important than that of fault length. Finally, simulation of the major events of Chile (2010) and Japan (2011) at large arrays of virtual gauges in the Pacific Basin correctly predicts the majority of the sequencing patterns observed on DART buoys during these events. By providing insight into the evolution with time of wave amplitudes inside primary wave packets for far field tsunamis generated by large earthquakes, our results stress the importance, for civil defense authorities, of issuing warning and evacuation orders

  2. Sequencing of tsunami waves: why the first wave is not always the largest

    Science.gov (United States)

    Okal, Emile A.; Synolakis, Costas E.

    2016-02-01

    This paper examines the factors contributing to the `sequencing' of tsunami waves in the far field, that is, to the distribution of the maximum sea surface amplitude inside the dominant wave packet constituting the primary arrival at a distant harbour. Based on simple models of sources for which analytical solutions are available, we show that, as range is increased, the wave pattern evolves from a regime of maximum amplitude in the first oscillation to one of delayed maximum, where the largest amplitude takes place during a subsequent oscillation. In the case of the simple, instantaneous uplift of a circular disk at the surface of an ocean of constant depth, the critical distance for transition between those patterns scales as r_0^3 / h^2 where r0 is the radius of the disk and h the depth of the ocean. This behaviour is explained from simple arguments based on a model where sequencing results from frequency dispersion in the primary wave packet, as the width of its spectrum around its dominant period T0 becomes dispersed in time in an amount comparable to T0, the latter being controlled by a combination of source size and ocean depth. The general concepts in this model are confirmed in the case of more realistic sources for tsunami excitation by a finite-time deformation of the ocean floor, as well as in real-life simulations of tsunamis excited by large subduction events, for which we find that the influence of fault width on the distribution of sequencing is more important than that of fault length. Finally, simulation of the major events of Chile (2010) and Japan (2011) at large arrays of virtual gauges in the Pacific Basin correctly predicts the majority of the sequencing patterns observed on DART buoys during these events. By providing insight into the evolution with time of wave amplitudes inside primary wave packets for far field tsunamis generated by large earthquakes, our results stress the importance, for civil defense authorities, of issuing warning and

  3. Earth's Largest Terrestrial Landslide (The Markagunt Gravity Slide of Southwest Utah): Insights from the Catastrophic Collapse of a Volcanic Field

    Science.gov (United States)

    Hacker, D. B.; Biek, R. F.; Rowley, P. D.

    2015-12-01

    The newly discovered Miocene Markagunt gravity slide (MGS; Utah, USA) represents the largest volcanic landslide structure on Earth. Recent geologic mapping of the MGS indicates that it was a large contiguous volcanic sheet of allochthonous andesitic mudflow breccias and lava flows, volcaniclastic rocks, and intertonguing regional ash-flow tuffs that blanketed an area of at least 5000 km2 with an estimated volume of ~3000 km3. From its breakaway zone in the Tushar and Mineral Mountains to its southern limits, the MGS is over 95 km long and at least 65 km wide. The MGS consists of four distinct structural segments: 1) a high-angle breakaway segment, 2) a bedding-plane segment, ~60 km long and ~65 km wide, typically located within the volcaniclastic Eocene-Oligocene Brian Head Formation, 3) a ramp segment ~1-2 km wide where the slide cuts upsection, and 4) a former land surface segment where the upper-plate moved at least 35 km over the Miocene landscape. The presence of basal and lateral cataclastic breccias, clastic dikes, jigsaw puzzle fracturing, internal shears, pseudotachylytes, and the overall geometry of the MGS show that it represents a single catastrophic emplacement event. The MGS represents gravitationally induced collapse of the southwest sector of the Oligocene to Miocene Marysvale volcanic field. We suggest that continuous growth of the Marysvale volcanic field, loading more volcanic rocks on a structurally weak Brian Head basement, created conditions necessary for gravity sliding. In addition, inflation of the volcanic pile due to multiple magmatic intrusions tilted the strata gently southward, inducing lateral spreading of the sub-volcanic rocks prior to failure. Although similar smaller-scale failures have been recognized from individual volcanoes, the MGS represents a new class of low frequency but high impact hazards associated with catastrophic sector collapse of large volcanic fields containing multiple volcanoes. The relationship of the MGS to

  4. Reproduction in a gecko assemblage (Squamata: Phyllodactylidae in the Marañon Region (Peru and comments on the largest gecko in the New World

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    Janina Aurich

    2015-06-01

    Full Text Available Reproduction is described for four phyllodactylid geckos, Phyllopezus maranjonensis, Phyllodactylus delsolari, P. thompsoni and P. reissii from the upper Marañon Valley, Peru. Observations were made between March and May 2010 and voucher specimens, already housed in the Zoologisches Forschungsmuseum Alexander Koenig (ZFMK, were X-rayed to check for gravid females. Gravid female P. maranjonensis, P. delsolari and P. reissii contain two eggs, whereas P. thompsoni produces a single egg that is deposited in leaf litter or crevices of stone walls. It is likely that females of all of these species produce multiple clutches in one year; the reproductive period seems to be extended in at least two species. Furthermore, measurements of numerous specimens of all four species are presented herein, revealing that Phyllopezus maranjonensis is the largest species of New World geckos.

  5. Profitability as a business goal: the multicriteria approach to the ranking of the five largest Croatian banks

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    Višnja Vojvodić Rosenzweig

    2012-01-01

    Full Text Available Background: The ranking of commercial banks is usually based on using a single criterion, the size of assets or income. A multicriteria approach allows a more complex analysis of their business efficiency. Objectives: This paper proposes the ranking of banks based on six financial criteria using a multicriteria approach implementing a goal programming model. The criteria are classified into three basic groups: profitability, credit risk and solvency. Methods/Approach: Business performance is evaluated using a score for each bank, calculated as the weighted sum of relative values of individual indicators. Results: In the process of solving the corresponding goal programming problem, the weights are calculated. It is assumed that the goal of each bank is the highest profitability. Because of the market competition among banks, the weights of indicators depend on the performance of each bank. This method is applied to the five biggest Croatian banks (ZABA, PBZ, ERSTE, RBA and HYPO. Conclusion: For the observed period (2010, the highest priority is given to profitability and then to credit risk. The ranking is achieved by using a multicriteria model.

  6. Cigarettes, genetic background, and menopausal timing: the presence of single nucleotide polymorphisms in cytochrome P450 genes is associated with increased risk of natural menopause in European-American smokers

    Science.gov (United States)

    Butts, Samantha F.; Sammel, Mary D.; Greer, Christine; Rebbeck, Timothy R.; Boorman, David W.; Freeman, Ellen W.

    2016-01-01

    Objective This study aims to evaluate associations between variations in genes involved in the metabolism of environmental chemicals and steroid hormones and risk of menopause in smokers. Methods Survival analysis was performed on 410 eligible participants from the Penn Ovarian Aging study (ongoing for 14 years), a cohort study of late-reproductive-age women. Single nucleotide polymorphisms at the following loci were studied: COMT Val158Met, CYP1B1*4 Asn452Ser, CYP1B1*3 Leu432Val, and CYP3A4*1B. Results Significant interactions between smoking and single nucleotide polymorphisms were observed in European-American carriers of CYP3A4*1B and CYP1B1*3, supporting a greater risk of menopause entry compared with those not carrying these alleles. Among CYP1B1*3 carriers, smokers had a greater risk of menopause entry than nonsmokers (adjusted hazard ratio [HR], 2.26; 95% CI, 1.4–3.67; median time to menopause, 10.42 and 11.07 y, respectively). No association between smoking and menopause was identified in CYP1B1 wild types. Among CYP3A4*1B carriers, smokers were at greater risk for menopause entry than nonsmokers (adjusted HR, 15.1; 95% CI, 3.31–69.2; median time to menopause, 11.36 and 13.91 y, respectively). Risk of menopause entry in CYP3A4 wild types who smoked was far lower (adjusted HR, 1.59; 95% CI, 1.03–2.44). Heavily smoking CYP1B1*3 carriers (adjusted HR, 3.0; 95% CI, 1.54–5.84; median time to menopause, 10.41 y) and heavily smoking CYP3A4*1B carriers (adjusted HR, 17.79; 95% CI, 3.21–98.65; median time to menopause, 5.09 y) had the greatest risk of menopause entry. Conclusions Our finding that the risk of menopause entry in European-American smokers varies depending on genetic background represents a novel gene-environment interaction in reproductive aging. PMID:24448104

  7. Cigarettes, genetic background, and menopausal timing: the presence of single nucleotide polymorphisms in cytochrome P450 genes is associated with increased risk of natural menopause in European-American smokers.

    Science.gov (United States)

    Butts, Samantha F; Sammel, Mary D; Greer, Christine; Rebbeck, Timothy R; Boorman, David W; Freeman, Ellen W

    2014-07-01

    This study aims to evaluate associations between variations in genes involved in the metabolism of environmental chemicals and steroid hormones and risk of menopause in smokers. Survival analysis was performed on 410 eligible participants from the Penn Ovarian Aging study (ongoing for 14 years), a cohort study of late-reproductive-age women. Single nucleotide polymorphisms at the following loci were studied: COMT Val158Met, CYP1B1*4 Asn452Ser, CYP1B1*3 Leu432Val, and CYP3A4*1B. Significant interactions between smoking and single nucleotide polymorphisms were observed in European-American carriers of CYP3A4*1B and CYP1B1*3, supporting a greater risk of menopause entry compared with those not carrying these alleles. Among CYP1B1*3 carriers, smokers had a greater risk of menopause entry than nonsmokers (adjusted hazard ratio [HR], 2.26; 95% CI, 1.4-3.67; median time to menopause, 10.42 and 11.07 y, respectively). No association between smoking and menopause was identified in CYP1B1 wild types. Among CYP3A4*1B carriers, smokers were at greater risk for menopause entry than nonsmokers (adjusted HR, 15.1; 95% CI, 3.31-69.2; median time to menopause, 11.36 and 13.91 y, respectively). Risk of menopause entry in CYP3A4 wild types who smoked was far lower (adjusted HR, 1.59; 95% CI, 1.03-2.44). Heavily smoking CYP1B1*3 carriers (adjusted HR, 3.0; 95% CI, 1.54-5.84; median time to menopause, 10.41 y) and heavily smoking CYP3A4*1B carriers (adjusted HR, 17.79; 95% CI, 3.21-98.65; median time to menopause, 5.09 y) had the greatest risk of menopause entry. Our finding that the risk of menopause entry in European-American smokers varies depending on genetic background represents a novel gene-environment interaction in reproductive aging.

  8. Potential roles of the wearable cardioverter-defibrillator in acute phase care of patients at high risk of sudden cardiac death: A single-center Japanese experience.

    Science.gov (United States)

    Sasaki, Shingo; Shoji, Yoshihiro; Ishida, Yuji; Kinjo, Takahiko; Tsushima, Yuichi; Seno, Maiko; Nishizaki, Fumie; Itoh, Taihei; Izumiyama, Kei; Yokota, Takashi; Yokoyama, Hiroaki; Yamada, Masahiro; Horiuchi, Daisuke; Kimura, Masaomi; Higuma, Takumi; Tomita, Hirofumi; Okumura, Ken

    2017-01-01

    The wearable cardioverter-defibrillator (WCD) has been expected to play a role as an effective bridge therapy to implantable cardioverter-defibrillator (ICD) implantation in patients at high risk of ventricular tachyarrhythmias (VA). Although WCD has been available since April 2014 in Japan, its usefulness remains unclear. During the early period after hospitalization, patients at high risk of VA after excluding some elderly patients were prescribed WCD. The consecutive 50 patients with WCD use (median age 56 years, 38 for secondary prevention) were studied. We analyzed clinical efficacy and safety of WCD, and examined its potential roles. Of the 50 patients, 38 used WCD only during hospitalization. During WCD use [median 16 (IQR 8-33) days], all patients wore WCD for 98% of a day regardless of in or out-of-hospital use. Sustained VA was detected in 4 patients (8%; for primary prevention in 1) with 7 episodes, and 6 of 7 episodes required shock therapy. Of the 6 shock therapies, 4 were for sustained ventricular tachycardia with the median rate of 236beats/min (IQR 203-250), and the other 2 for ventricular fibrillation. Subsequently, only 27 patients (54%) of all underwent ICD implantation following the WCD use, because of reduced risk of VA after optimal pharmacological therapy or improvement in the left ventricular function. The WCD use for the acute phase care of patients at high risk of VA can be safe and effective, and may be useful for evaluating indication of ICD implantation. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  9. Prediction of lymphatic dissemination in endometrioid endometrial cancer: Comparison of three risk-stratification models in a single-institution cohort.

    Science.gov (United States)

    Tuomi, Taru; Pasanen, Annukka; Leminen, Arto; Bützow, Ralf; Loukovaara, Mikko

    2017-03-01

    To compare the performance characteristics of 3 risk-stratification models, referred to as Mayo, Helsinki and Milwaukee models, in predicting lymphatic dissemination in endometrial cancer. A total of 1052 patients with stage I-III endometrioid endometrial cancer were included in the study. The areas under curve were compared with the receiver operating characteristic curve area comparison test. Chi-square and Fisher exact test were used for comparing categorical variables. The Kaplan-Meier method and multivariable Cox regression models were used for survival analyses. The median follow-up time was 55months (range 1-108). Areas under curve were 0.781, 0.830 and 0.829 for the Mayo, Helsinki (P=0.285 vs. Mayo) and Milwaukee (P=0.292 vs. Mayo) models, respectively, in predicting lymphatic dissemination. The rates of false negatives and false positives were similar for all models. The lymphadenectomy rate decreased in the order of Mayo model (71.5%)>Helsinki model (62.4%)>Milwaukee model (48.8%). In patients with stage I cancer, disease specific survival was better for those who satisfied low-risk criteria according to any of the models. In patients with stage II-III cancer, this difference in survival was significant only for the Milwaukee model. Both lymphatic dissemination and high-risk tumor features as per the risk models were independent predictors of survival. The studied models had a similar accuracy in predicting lymphatic dissemination in endometrial cancer. Lymphadenectomy rate was lowest for the Milwaukee model. Survival analyses suggest that variables included in the models predict patient outcome independently of tumor stage. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Does left atrial appendage closure with a cardiac plug system reduce the stroke risk in nonvalvular atrial fibrillation patients? A single-center case series.

    Science.gov (United States)

    Danna, Paolo; Proietti, Riccardo; Sagone, Antonio; Arensi, Andrea; Viecca, Maurizio; Rago, Anna; Russo, Vincenzo

    2013-03-01

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it is associated with an increased stroke risk, due mainly to cardiac embolism from the left atrial appendage (LAA). Percutaneous LAA closure is a method to reduce stroke risk in AF without using anticoagulant agents. In this study we report data from an Italian experience with the LAA occluder Amplatzer Cardiac Plug (ACP) device (Aga Medical Corporation, Plymouth, MN, USA). The study was designed to evaluate the safety of LAA closure using ACP and the efficacy of the procedure in preventing strokes during a 1-year follow-up. Patients with permanent or paroxysmal AF, high stroke risk, and contraindication to warfarin therapy were selected for the procedure. The LAA closure was attempted in 37 patients and succeeded in 34 cases (91.9%). Four patients experienced serious complications (one cardiac tamponade requiring pericardiocentesis, two device embolizations, one low-rate response AF requiring artificial pacing). During a 1-year follow-up, ischemic stroke occurred in one of 34 patients, resulting in a stroke rate of 2.94%; thus there was a stroke rate reduction of 50.2% and 26.5% compared to the expected stroke rate, according to CHADS2 and CHA2 DS2 VASc score. None of the patients who received ACP experienced major bleeding during the follow-up. LAA closure using ACP is a relatively feasible procedure which can be performed by highly experienced operators to reduce stroke rate in patients with AF, high stroke risk, and contraindication to oral anticoagulants. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  11. A risk prediction score model for predicting occurrence of post-PCI vasovagal reflex syndrome: a single center study in Chinese population.

    Science.gov (United States)

    Li, Hai-Yan; Guo, Yu-Tao; Tian, Cui; Song, Chao-Qun; Mu, Yang; Li, Yang; Chen, Yun-Dai

    2017-08-01

    The vasovagal reflex syndrome (VVRS) is common in the patients undergoing percutaneous coronary intervention (PCI). However, prediction and prevention of the risk for the VVRS have not been completely fulfilled. This study was conducted to develop a Risk Prediction Score Model to identify the determinants of VVRS in a large Chinese population cohort receiving PCI. From the hospital electronic medical database, we identified 3550 patients who received PCI (78.0% males, mean age 60 years) in Chinese PLA General Hospital from January 1, 2000 to August 30, 2016. The multivariate analysis and receiver operating characteristic (ROC) analysis were performed. The adverse events of VVRS in the patients were significantly increased after PCI procedure than before the operation (all P predicting the incidence of VVRS (all P prediction score model for VVRS. ROC analysis showed that the risk prediction score model was effectively predictive of the incidence of VVRS in patients receiving PCI (c-statistic 0.76, 95% CI: 0.72-0.79, P prediction score is quite efficient in predicting the incidence of VVRS in patients receiving PCI. In which, the following factors may be involved, the femoral puncture site, female gender, hypertension, primary PCI, and over 2 stents implanted in LAD.

  12. Failure of the Obesity Surgery Mortality Risk Score (OS-MRS) to Predict Postoperative Complications After Bariatric Surgery. A Single-Center Series and Systematic Review.

    Science.gov (United States)

    García-García, Maria Luisa; Martín-Lorenzo, Juan Gervasio; Lirón-Ruiz, Ramón; Torralba-Martínez, José Antonio; García-López, José Antonio; Aguayo-Albasini, José Luis

    2017-06-01

    The obesity surgery mortality risk score (OS-MRS) was developed to determine the risk of postoperative mortality in patients undergoing bariatric surgery. The aim of the present study is to assess the utility of this score for preventing the risk of postoperative complications from bariatric surgery. Prospective study of 321 patients undergoing bariatric surgery to whom the OS-MRS was applied. Postoperative complications were classified according to the Clavien-Dindo system. The relation between the OS-MRS and the appearance of complications and mortality was analyzed. A Medline/Embase search was conducted using bariatric surgery, mortality, and complications as key words. Studies using the OS-MRS to predict morbidity and mortality were included. Of the 321 patients, 303 (94.3%) underwent gastric bypass and the remaining 18 (5.6%) a sleeve gastrectomy. The OS-MRS classified 178 patients as class A (55.5%), 129 as class B (40.2%), and 14 as class C (4.4%). According to the Clavien-Dindo system, 10.4% of the complications were ≥III. There was one death (class B). No significant association was found between the OS-MRS and the rate of complications. In our study, the OS-MRS is not correlated with the appearance of early complications or mortality. Future studies must focus on systems for predicting the appearance and severity of postoperative complications classified according to the Clavien-Dindo system, and not only on mortality.

  13. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study.

    Science.gov (United States)

    Kiuchi, Aki; Ohashi, Yasushi; Tai, Reibin; Aoki, Toshiyuki; Mizuiri, Sonoo; Ogura, Toyoko; Aikawa, Atsushi; Sakai, Ken

    2016-10-23

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients ( r = -0.33, p protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61-15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  14. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    Directory of Open Access Journals (Sweden)

    Aki Kiuchi

    2016-10-01

    Full Text Available Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9% had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = −0.33, p < 0.001 and those with lower glomerular filtration rate (r = 0.47, p < 0.001. The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR = 4.94; 95% confidence interval (CI = 1.61–15.42, p = 0.012 and cardiovascular events (HR = 9.37; 95% CI = 2.49–37.34, p = 0.006, but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  15. Remote pre-procedural ischemic stroke as the greatest risk in carotid‑stenting‑associated stroke and death: a single center's experience.

    Science.gov (United States)

    Rašiová, Mária; Špak, Ľubomír; Farkašová, Ľudmila; Pataky, Štefan; Koščo, Martin; Hudák, Marek; Moščovič, Matej; Leško, Norbert

    2017-08-01

    The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. It is crucial to accurately select the patients who would benefit from carotid procedure, and to rule out those for whom the procedure might be hazardous. Remote ischemic stroke is a known risk factor for stroke recurrence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) in patients with and without remote pre-procedural ischemic stroke, to analyze periprocedural risk in other specific patient subgroups treated with CAS, and to determine the impact of observed variables on all-cause mortality during long-term follow-up. We conducted a retrospective review of prospectively collected data from all patients treated with protected CAS between June 20, 2008 and December 31, 2015. Patient age, gender, type of carotid stenosis (symptomatic versus asymptomatic), side of stenosis (right or left carotid artery), type of cerebral protection (proximal versus distal), presence of comorbidities (remote ischemic pre-procedural ischemic stroke, coronary artery disease, diabetes mellitus, peripheral artery disease), previous ipsilateral carotid endarterectomy (CEA), contralateral carotid occlusion (CCO) and previous contralateral CAS/CEA were analyzed to identify higher CAS risk and to determine the impact of these variables on all-cause mortality during follow-up. Survival data were obtained from the Health Care Surveillance Authority registry. Mean follow-up was 1054 days (interquartile range 547.3; 1454.8). Remote pre-procedural ischemic stroke was defined as any-territory ischemic stroke >6 months prior to CAS. Primary periprocedural endpoint incidence (stroke/death) in 502 patients was 3.8% (N.=19) of all patients, 5

  16. Do Angiotensin-Converting Enzyme Inhibitors Reduce the Risk of Symptomatic Radiation Pneumonitis in Patients With Non-Small Cell Lung Cancer After Definitive Radiation Therapy? Analysis of a Single-Institution Database

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hongmei [Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. of China (China); Liao, Zhongxing, E-mail: zliao@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhuang, Yan; Xu, Ting; Nguyen, Quynh-Nhu; Levy, Lawrence B.; O' Reilly, Michael [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gold, Kathryn A. [Department of Thoracic Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gomez, Daniel R. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-12-01

    Purpose: Preclinical studies have suggested that angiotensin-converting enzyme inhibitors (ACEIs) can mitigate radiation-induced lung injury. We sought here to investigate possible associations between ACEI use and the risk of symptomatic radiation pneumonitis (RP) among patients undergoing radiation therapy (RT) for non–small cell lung cancer (NSCLC). Methods and Materials: We retrospectively identified patients who received definitive radiation therapy for stages I to III NSCLC between 2004 and 2010 at a single tertiary cancer center. Patients must have received a radiation dose of at least 60 Gy for a single primary lung tumor and have had imaging and dosimetric data available for analysis. RP was quantified according to Common Terminology Criteria for Adverse Events, version 3.0. A Cox proportional hazard model was used to assess potential associations between ACEI use and risk of symptomatic RP. Results: Of 413 patients analyzed, 65 were using ACEIs during RT. In univariate analysis, the rate of RP grade ≥2 seemed lower in ACEI users than in nonusers (34% vs 46%), but this apparent difference was not statistically significant (P=.06). In multivariate analysis of all patients, ACEI use was not associated with the risk of symptomatic RP (hazard ratio [HR] = 0.66; P=.07) after adjustment for sex, smoking status, mean lung dose (MLD), and concurrent carboplatin and paclitaxel chemotherapy. Subgroup analysis showed that ACEI use did have a protective effect from RP grade ≥2 among patients who received a low (≤20-Gy) MLD (P<.01) or were male (P=.04). Conclusions: A trend toward reduction in symptomatic RP among patients taking ACEIs during RT for NSCLC was not statistically significant on univariate or multivariate analyses, although certain subgroups may benefit from use (ie, male patients and those receiving low MLD). The evidence at this point is insufficient to establish whether the use of ACEIs does or does not reduce the risk of RP.

  17. Single nucleotide variants in metastasis-related genes are associated with breast cancer risk, by lymph node involvement and estrogen receptor status, in women with European and African ancestry.

    Science.gov (United States)

    Roberts, Michelle R; Sucheston-Campbell, Lara E; Zirpoli, Gary R; Higgins, Michael; Freudenheim, Jo L; Bandera, Elisa V; Ambrosone, Christine B; Yao, Song

    2017-03-01

    Single nucleotide polymorphisms (SNPs) in pathways influencing lymph node (LN) metastasis and estrogen receptor (ER) status in breast cancer may partially explain inter-patient variability in prognosis. We examined 154 SNPs in 12 metastasis-related genes for associations with breast cancer risk, stratified by LN and ER status, in European-American (EA) and African-American (AA) women. Two-thousand six hundred and seventy-one women enrolled in the Women's Circle of Health Study were genotyped. Pathway analyses were conducted using the adaptive rank truncated product (ARTP) method, with p ARTP  ≤ 0.10 as significant. Multi-allelic risk scores were created for the ARTP-significant gene(s). Single-SNP and risk score associations were modeled using logistic regression, with false discovery rate (FDR) P-value adjustment. Although single-SNP associations were not significant at p FDR  women, significant ARTP gene-level associations included CDH1 with LN+ (p ARTP  = 0.10; multi-allelic OR = 1.13, 95%CI 1.07-1.19, p FDR  = 0.0003) and SIPA1 with ER- breast cancer (p ARTP  = 0.10; multi-allelic OR = 1.16, 95%CI 1.02-1.31, p FDR  = 0.03). In EA women, MTA2 was associated with overall breast cancer risk (p ARTP  = 0.004), regardless of ER status, and with LN- disease (p ARTP  = 0.01). Also significant were SATB1 in ER- (p ARTP  = 0.03; multi-allelic OR = 1.12, 95%CI 1.05-1.20, p FDR  = 0.003) and KISS1 in LN- (p ARTP  = 0.10; multi-allelic OR = 1.18, 95%CI 1.08-1.29, p FDR  = 0.002) analyses. Among LN+ cases, significant ARTP associations were observed for SNAI1, CD82, NME1, and CTNNB1 (multi-allelic OR = 1.09, 95%CI 1.04-1.14, p FDR  = 0.001). Our findings suggest that variants in several metastasis genes may affect breast cancer risk by LN or ER status, although verification in larger studies is required. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Maternal characteristics during pregnancy and risk factors for positive HIV RNA at delivery: a single-cohort observational study (Brescia, Northern Italy

    Directory of Open Access Journals (Sweden)

    Magoni Michele

    2011-02-01

    Full Text Available Abstract Background Detectable HIV RNA in mothers at delivery is an important risk factor for HIV transmission to newborns. Our hypothesis was that, in migrant women, the risk of detectable HIV RNA at delivery is greater owing to late HIV diagnosis. Therefore, we examined pregnant women by regional provenance and measured variables that could be associated with detectable HIV RNA at delivery. Methods A observational retrospective study was conducted from January 1999 to May 2008. Univariate and multivariable regression analyses (generalized linear models were used, with detectable HIV RNA at delivery as dependent variable. Results The overall population comprised 154 women (46.8% migrants. Presentation was later in migrant women than Italians, as assessed by CD4-T-cell count at first contact (mean 417/mm3 versus 545/mm3, respectively; p = 0.003. Likewise, HIV diagnosis was made before pregnancy and HAART was already prescribed at the time of pregnancy in more Italians (91% and 75%, respectively than migrants (61% and 42.8%, respectively. A subgroup of women with available HIV RNA close to term (i.e., ≤30 days before labour was studied for risk factors of detectable HIV RNA (≥50 copies/ml at delivery. Among 93 women, 25 (26.9% had detectable HIV RNA. A trend toward an association between non-Italian nationality and detectable HIV RNA at delivery was demonstrated by univariate analysis (relative risk, RR = 1.86; p = 0.099. However, by multivariable regression analysis, the following factors appeared to be more important: lack of stable (i.e., ≥14 days antiretroviral therapy at the time of HIV RNA testing (RR = 4.3; p 3, RR = 0.94; p = 0.038. Conclusions These results reinforce the importance of extensive screening for HIV infection, earlier initiation of antiretroviral therapy and stricter monitoring of pregnant women to reduce the risk of detectable HIV RNA at delivery. Public health interventions should be particularly targeted to migrant

  19. Sudden disintegration of ice in the glacial-proglacial transition zone of the largest glacier in Austria

    Science.gov (United States)

    Kellerer-Pirklbauer, Andreas; Avian, Michael; Hirschmann, Simon; Lieb, Gerhard Karl; Seier, Gernot; Sulzer, Wolfgang; Wakonigg, Herwig

    2017-04-01

    Rapid deglaciation does not only reveal a landscape which is prone to rapid geomorphic changes and sediment reworking but also the glacier ice itself might be in a state of disintegration by ice melting, pressure relief, crevasse formation, ice collapse or changes in the glacier's hydrology. In this study we considered the sudden disintegration of glacier ice in the glacial-proglacial transition zone of Pasterze Glacier. Pasterze Glacier is a typical alpine valley glacier and covers currently some 16.5 km2 making it to the largest glacier in Austria. This glacier is an important site for alpine mass tourism in Austria related to a public high alpine road and a cable car which enable access to the glacier rather easily also for unexperienced mountaineers. Spatial focus in our research is given on two particular study areas where several ice-mass movement events occurred during the 2015- and 2016-melting seasons. The first study area is a crevasse field at the lower third of the glacier tongue. This lateral crevasse field has been substantially modified during the last two melting seasons particularly because of thermo-erosional effects of a glacial stream which changed at this site from subglacial (until 2015) to glacier-lateral revealing a several tens of meters high unstable ice cliff prone to ice falls of different magnitudes. The second study area is located at the proglacial area. At Pasterze Glacier the proglacial area is widely influenced by dead-ice bodies of various dimensions making this area prone to slow to sudden geomorphic changes caused by ice mass changes. A particular ice-mass movement event took place on 20.09.2016. Within less than one hour the surface of the proglacial area changed substantially by tilting, lateral shifting, and subsidence of the ground accompanied by complete ice disintegration of once-debris covered ice. To understand acting processes at both areas of interest and to quantify mass changes we used field observations, terrain

  20. Analyzing Perceptions of Wellbeing in Relation to Refinería Esmeraldas, The Largest Oil Refinery in Ecuador

    Science.gov (United States)

    Toledo, K. S.; Valdivia, G.

    2016-12-01

    Refinería Esmeraldas, the largest oil refinery in Ecuador, has a great influence on the wellbeing of the mainly Afro-Ecuadorean neighborhoods that surround it. Understanding the extent of the refinery's influence on the local community is important as it contributes to a more effective planning for the predicted risks of environmental suffering associated with it, some of which may extend for generations to come. The problem of increased environmental burdens in low income communities of color, such as exposure to environmental pollutants, is often linked to improper regulation. Solutions are often framed in terms of stricter government policies, but equally important and more difficult to quantify factors, such as how pollution manifests in everyday life, also need to be addressed. This study uses primarily qualitative data, composed of structured interviews; spatial data; and audiovisual data, all of which was processed using analytic softwares such as Atlas.ti, Tableau, and ArcGIS, to map the experience of pollution and wellbeing in the city of Esmeraldas. The data was collected using a structured sample design, followed by snowball sampling in neighborhoods within the city. The findings indicate that the impacts of the refinery are not always direct, but rather affect various aspects of the life of Esmeraldeños. Several major wellbeing themes include Personal Trajectories, (Dis)able Bodies, and Urban Needs. These themes provide a more holistic understanding of life with pollution and help understand how people see themselves in relation to the refinery and how it affects their wellbeing. Grounded theory, which adopts an inductive approach, was used to analyze the everyday dimensions of the experience of pollution. The findings suggest that there are varying experiences of wellbeing in relation the refinery and that these have health, environmental, social, and physiological roots, which indicate possible connections between epigenetic manifestations and the

  1. Role of fomites in SARS transmission during the largest hospital outbreak in Hong Kong.

    Science.gov (United States)

    Xiao, Shenglan; Li, Yuguo; Wong, Tze-Wai; Hui, David S C

    2017-01-01

    The epidemic of severe acute respiratory syndrome (SARS) had a significant effect on global society in the early 2000s and the potential of its resurgence exists. Studies on the modes of transmission of SARS are limited though a number of outbreak studies have revealed the possible airborne route. To develop more specific and effective control strategies, we conducted a detailed mechanism-based investigation that explored the role of fomite transmission in the well-known Ward 8A outbreak. We considered three hypothetical transmission routes, i.e., the long-range airborne, fomite and combined routes, in 1,744 scenarios with combinations of some important parameters. A multi-agent model was used to predict the infection risk distributions of the three hypothetical routes. Model selection was carried out for different scenarios to compare the distributions of infection risk with that of the reported attack rates and select the hypotheses with the best fitness. Our results reveal that under the assumed conditions, the SARS coronavirus was most possible to have spread via the combined long-range airborne and fomite routes, and that the fomite route played a non-negligible role in the transmission.

  2. Role of fomites in SARS transmission during the largest hospital outbreak in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Shenglan Xiao

    Full Text Available The epidemic of severe acute respiratory syndrome (SARS had a significant effect on global society in the early 2000s and the potential of its resurgence exists. Studies on the modes of transmission of SARS are limited though a number of outbreak studies have revealed the possible airborne route. To develop more specific and effective control strategies, we conducted a detailed mechanism-based investigation that explored the role of fomite transmission in the well-known Ward 8A outbreak. We considered three hypothetical transmission routes, i.e., the long-range airborne, fomite and combined routes, in 1,744 scenarios with combinations of some important parameters. A multi-agent model was used to predict the infection risk distributions of the three hypothetical routes. Model selection was carried out for different scenarios to compare the distributions of infection risk with that of the reported attack rates and select the hypotheses with the best fitness. Our results reveal that under the assumed conditions, the SARS coronavirus was most possible to have spread via the combined long-range airborne and fomite routes, and that the fomite route played a non-negligible role in the transmission.

  3. Resale of recalled children's products online: an examination of the world's largest yard sale.

    Science.gov (United States)

    Brown Kirschman, Keri; Smith, Gary A

    2007-08-01

    To examine an online auction site for the presence and sale of children's products and toys previously recalled because of safety concerns. Targeted items were randomly selected from US Consumer Product Safety Commission (CPSC) press releases of recalled children's products dated 1992-2004. Auction listings from eBay were searched for the 150 targeted recalled items for 30 days. Item, seller, and buyer information were recorded from the auction listings. 190 auctions contained or were suspected to contain a recalled children's item from the target list. Most of the recalled items were listed for sale from addresses within the United States, with sellers from Canada, Australia, Great Britain, and Ireland also represented. On average, six bids were placed on each recalled item, with 70% of auctions eventuating in a sale. Recalled children's products were found to be available for sale online and were sold most of the time, presenting a risk of injury to children. Although the CPSC is charged with notifying the public of recalled items, these results suggest that potentially hazardous products are recirculating online. A multi-front initiative to decrease the presence of hazards in online auctions is needed. This initiative should include increased manufacturer efforts to improve recall return rates, a requirement by online auction sites that sellers verify non-recall status before item posting, and parental checks of government recall websites before item purchase. Investigation of parental understanding and awareness of recalls and the potential risks associated with recall announcements is needed.

  4. Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study.

    Science.gov (United States)

    Kovács, E; Sztruhár Jónásné, I; Karóczi, C K; Korpos, A; Gondos, T

    2013-10-01

    Exercise programs have important role in prevention of falls, but to date, there are conflicting findings about the effects of exercise programs on balance, functional performance and fall risk among cognitively impaired older adults. AIM. To investigate the effects of a multimodal exercise program on static and dynamic balance, and risk of falls in older adults with mild or moderate cognitive impairment. A randomized controlled study. A long-term care institute. Cognitively impaired individuals aged over 60 years. Eighty-six participants were randomized to an exercise group providing multimodal exercise program for 12 months or a control group which did not participate in any exercise program. The Performance Oriented Mobility Assessment scale, Timed Up and Go test, and incidence of falls were measured at baseline, at 6 months and at 12 months. There was a significant improvement in balance-related items of Performance Oriented Mobility Assessment scale in the exercise group both at 6 month and 12 month (PAssessment scale after the first 6-month treatment period (P=0.210), but in the second 6-month treatment period the POMA-G score improved significantly (P=0.001). There was no significant difference between groups regarding falls. Our results confirmed that a 12-month multimodal exercise program can improve the balance in cognitively impaired older adults. Based on our results, the multimodal exercise program may be a promising fall prevention exercise program for older adults with mild or moderate cognitive impairment improving static balance but it is supposed that more emphasis should be put on walking component of exercise program and environmental fall risk assessment.

  5. Adolescent gambling behaviour, a single latent construct and indicators of risk: findings from a national survey of New Zealand high school students

    Directory of Open Access Journals (Sweden)

    Fiona V. Rossen

    2016-08-01

    Full Text Available Abstract This study explores underlying latent construct/s of gambling behaviour, and identifies indicators of “unhealthy gambling”. Data were collected from Youth’07 a nationally representative sample of New Zealand secondary school students (N = 9107. Exploratory factor analyses, item-response theory analyses, multiple indicators-multiple causes, and differential item functioning analyses were used to assess dimensionality of gambling behaviour, underlying factors, and indicators of unhealthy gambling. A single underlying continuum of gambling behaviour was identified. Gambling frequency and ‘gambling because I can’t stop’ were most strongly associated with unhealthy gambling. Gambling to ‘feel better about myself’ and to ‘forget about things’ provided the most precise discriminants of unhealthy gambling. Multivariable analyses found that school connectedness was associated with lower levels of unhealthy gambling.

  6. Indoor and outdoor monitoring of volatile organic compounds in school buildings: indicators based on health risk assessment to single out critical issues.

    Science.gov (United States)

    de Gennaro, Gianluigi; Farella, Genoveffa; Marzocca, Annalisa; Mazzone, Antonio; Tutino, Maria

    2013-11-25

    Children are more sensitive to pollutants than adults and yet they spend large amounts of time in school environments where they are exposed to unknown levels of indoor pollutants. This study investigated the concentrations of the most abundant volatile organic compounds (VOCs) in eight naturally ventilated school buildings in Italy. The schools were chosen to include areas with different urbanization and traffic density characteristics in order to gather a more diverse picture of exposure risks in the different areas of the city. VOCs were sampled for one week in the presence/absence of pupils using diffusive samplers suitable for thermal desorption inside three classrooms at each school. The samples were then analyzed with thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS). In addition, outdoor measurements were carried out in the yard at each school. VOC identification and quantification, and indoor/outdoor concentration plots were used to identify pollutant sources. While some classrooms were found to have very low VOC levels, others had a significant indoor contribution or a prevalent outdoor contribution. High concentrations of terpenes were found in all monitored classrooms: a-pinene and limonene were in the range of 6.55-34.18 µg/m3 and 11.11-25.42 µg/m3 respectively. Outdoor concentrations were lower than indoors for each monitored school. Indicators based on health risk assessment for chronic health effects associated with VOCs (either carcinogenic or non-carcinogenic) were proposed to rank sites according to their hazard level.

  7. Deep, diverse and definitely different: unique attributes of the world's largest ecosystem

    Directory of Open Access Journals (Sweden)

    E. Ramirez-Llodra

    2010-09-01

    Full Text Available The deep sea, the largest biome on Earth, has a series of characteristics that make this environment both distinct from other marine and land ecosystems and unique for the entire planet. This review describes these patterns and processes, from geological settings to biological processes, biodiversity and biogeographical patterns. It concludes with a brief discussion of current threats from anthropogenic activities to deep-sea habitats and their fauna.

    Investigations of deep-sea habitats and their fauna began in the late 19th century. In the intervening years, technological developments and stimulating discoveries have promoted deep-sea research and changed our way of understanding life on the planet. Nevertheless, the deep sea is still mostly unknown and current discovery rates of both habitats and species remain high. The geological, physical and geochemical settings of the deep-sea floor and the water column form a series of different habitats with unique characteristics that support specific faunal communities. Since 1840, 28 new habitats/ecosystems have been discovered from the shelf break to the deep trenches and discoveries of new habitats are still happening in the early 21st century. However, for most of these habitats the global area covered is unknown or has been only very roughly estimated; an even smaller – indeed, minimal – proportion has actually been sampled and investigated. We currently perceive most of the deep-sea ecosystems as heterotrophic, depending ultimately on the flux on organic matter produced in the overlying surface ocean through photosynthesis. The resulting strong food limitation thus shapes deep-sea biota and communities, with exceptions only in reducing ecosystems such as inter alia hydrothermal vents or cold seeps. Here, chemoautolithotrophic bacteria play the role of primary producers fuelled by chemical energy sources rather than sunlight. Other ecosystems, such as seamounts, canyons or cold

  8. Deep, diverse and definitely different: unique attributes of the world's largest ecosystem

    Science.gov (United States)

    Ramirez-Llodra, E.; Brandt, A.; Danovaro, R.; de Mol, B.; Escobar, E.; German, C. R.; Levin, L. A.; Martinez Arbizu, P.; Menot, L.; Buhl-Mortensen, P.; Narayanaswamy, B. E.; Smith, C. R.; Tittensor, D. P.; Tyler, P. A.; Vanreusel, A.; Vecchione, M.

    2010-09-01

    The deep sea, the largest biome on Earth, has a series of characteristics that make this environment both distinct from other marine and land ecosystems and unique for the entire planet. This review describes these patterns and processes, from geological settings to biological processes, biodiversity and biogeographical patterns. It concludes with a brief discussion of current threats from anthropogenic activities to deep-sea habitats and their fauna. Investigations of deep-sea habitats and their fauna began in the late 19th century. In the intervening years, technological developments and stimulating discoveries have promoted deep-sea research and changed our way of understanding life on the planet. Nevertheless, the deep sea is still mostly unknown and current discovery rates of both habitats and species remain high. The geological, physical and geochemical settings of the deep-sea floor and the water column form a series of different habitats with unique characteristics that support specific faunal communities. Since 1840, 28 new habitats/ecosystems have been discovered from the shelf break to the deep trenches and discoveries of new habitats are still happening in the early 21st century. However, for most of these habitats the global area covered is unknown or has been only very roughly estimated; an even smaller - indeed, minimal - proportion has actually been sampled and investigated. We currently perceive most of the deep-sea ecosystems as heterotrophic, depending ultimately on the flux on organic matter produced in the overlying surface ocean through photosynthesis. The resulting strong food limitation thus shapes deep-sea biota and communities, with exceptions only in reducing ecosystems such as inter alia hydrothermal vents or cold seeps. Here, chemoautolithotrophic bacteria play the role of primary producers fuelled by chemical energy sources rather than sunlight. Other ecosystems, such as seamounts, canyons or cold-water corals have an increased

  9. STAR Formation Histories Across the Interacting Galaxy NGC 6872, the Largest-Known Spiral

    Science.gov (United States)

    Eufrasio, Rafael T.; Dwek, E.; Arendt, RIchard G.; deMello, Duilia F.; Gadotti, DImitri A.; Urrutia-Viscarra, Fernanda; deOliveira, CLaudia Mendes; Benford, Dominic J.

    2014-01-01

    NGC6872, hereafter the Condor, is a large spiral galaxy that is interacting with its closest companion, the S0 galaxy IC 4970. The extent of the Condor provides an opportunity for detailed investigation of the impact of the interaction on the current star formation rate and its history across the galaxy, on the age and spatial distribution of its stellar population, and on the mechanism that drives the star formation activity. To address these issues we analyzed the far-ultraviolet (FUV) to near-infrared (near-IR) spectral energy distribution of seventeen 10 kpc diameter regions across the galaxy, and derived their star formation history, current star formation rate, and stellar population and mass. We find that most of the star formation takes place in the extended arms, with very little star formation in the central 5 kpc of the galaxy, in contrast to what was predicted from previous numerical simulations. There is a trend of increasing star formation activity with distance from the nucleus of the galaxy, and no evidence for a recent increase in the current star formation rate due to the interaction. The nucleus itself shows no significant current star formation activity. The extent of the Condor also provides an opportunity to test the applicability of a single standard prescription for conversion of the FUV + IR (22 micrometer) intensities to a star formation rate for all regions. We find that the conversion factor differs from region to region, arising from regional differences in the stellar populations.

  10. Star formation histories across the interacting galaxy NGC 6872, the largest-known spiral

    Energy Technology Data Exchange (ETDEWEB)

    Eufrasio, Rafael T.; De Mello, Duilia F. [Physics Department, The Catholic University of America, Washington, DC 20064 (United States); Dwek, Eli; Arendt, Richard G.; Benford, Dominic J. [Observational Cosmology Laboratory, Code 665, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Gadotti, Dimitri A. [European Southern Observatory, Santiago (Chile); Urrutia-Viscarra, Fernanda; De Oliveira, Claudia Mendes, E-mail: rafael.t.eufrasio@nasa.gov [Departamento de Astronomia, Instituto de Astronomia, Geofísica e Ciências Atmosféricas da USP, Rua do Matão 1226, Cidade Universitária, 05508-090 São Paulo (Brazil)

    2014-11-01

    NGC 6872, hereafter the Condor, is a large spiral galaxy that is interacting with its closest companion, the S0 galaxy IC 4970. The extent of the Condor provides an opportunity for detailed investigation of the impact of the interaction on the current star formation rate and its history across the galaxy, on the age and spatial distribution of its stellar population, and on the mechanism that drives the star formation activity. To address these issues we analyzed the far-ultraviolet (FUV) to near-infrared (near-IR) spectral energy distribution of seventeen 10 kpc diameter regions across the galaxy, and derived their star formation history, current star formation rate, and stellar population and mass. We find that most of the star formation takes place in the extended arms, with very little star formation in the central 5 kpc of the galaxy, in contrast to what was predicted from previous numerical simulations. There is a trend of increasing star formation activity with distance from the nucleus of the galaxy, and no evidence for a recent increase in the current star formation rate due to the interaction. The nucleus itself shows no significant current star formation activity. The extent of the Condor also provides an opportunity to test the applicability of a single standard prescription for conversion of the FUV + IR (22 μm) intensities to a star formation rate for all regions. We find that the conversion factor differs from region to region, arising from regional differences in the stellar populations.

  11. The Determinants of Bank Internationalisation in Times of Financial Globalisation: Evidence from the World's Largest Banks (1980-2007)

    NARCIS (Netherlands)

    Westerhuis, Gerarda; Mulder, Arjen

    2015-01-01

    This article analyses the determinants of bank internationalisation, of the world's largest banks from the period 1980–2007. The purpose of the article is twofold. First, we show how a mixed-methods research design, in which we combine a variables-based research with three case studies, can

  12. Pay less, take more: the myth of quality of life at the Brazil’s largest drugstore chain counter

    Directory of Open Access Journals (Sweden)

    André Luiz Maranhão de Souza Leão

    2013-06-01

    Full Text Available Considering the role of cultural transformer that the brandoccupies in the contemporary and seeking to delineate the role played bymyth in this construction, we look at Pague Menos, the largest pharmacyretail network in the country, through a qualitative study based on Barthesiansemiology. Our results showed six myths, whose relationships reveal ametanarrative: the quality of life.

  13. Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial.

    Science.gov (United States)

    Kovács, E; Prókai, L; Mészáros, L; Gondos, T

    2013-06-01

    Exercise programmes have important role in prevention of falls, but to date, we have little knowledge about the effects of Adapted Physical Activity programme on balance of older women. The aim of this study was to investigate the effects of an Adapted Physical Activity programme on balance, risk of falls and quality of life in community-dwelling older women. This was a randomized controlled study. Community, in a local sport centre. Older women aged over 60 years. Seventy-six women were randomised to an exercise group providing Adapted Physical Activity programme for 25 weeks or a control group (in which they did not participate in any exercise programme). The one-leg stance test, Timed Up and Go test, incidence of fall and the quality of life (SF-36V2) were measured at baseline and after 25 weeks. The one-leg stance test and the Timed Up and Go test in the exercise group was significantly better than in the control group after the intervention period (P=0.005; P=0.001, respectively). The Physical Functioning, Vitality and General Health subdomains of quality of life were also significantly better in the exercise group compared to the control group (P=0.004; P=0.005; P=0.038, respectively). Relative risk was 0.40 (90% CI 0.174 to 0.920) and the number needed to treat was 5 (95% CI 2.3 to 23.3). This 25-week Adapted Physical Activity programme improves static balance, functional mobility, as well as Physical Functioning, Vitality and General Health subdomains of quality of life. Based on our results, the Adapted Physical Activity programme may be a promising fall prevention exercise programme improving static balance and functional mobility for community-dwelling older women.

  14. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center.

    Directory of Open Access Journals (Sweden)

    Yadong Zhang

    Full Text Available The aim of this study was to investigate the prevalence of erectile dysfunction (ED in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January-July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5. Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ, the Pain Catastrophizing Scale (PCS, NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18-60 years were enrolled. ED was found in 638/1406 patients (45.4%, and was categorized as mild in 291(45.6%, moderate in 297(46.6% and severe in50(7.7%. 192 patients from one center(mean age,31.3 years; range 18-57 years were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251, PHQ (r = 0.355 and PCS (r = 0.322scores (P<0.001.PHQ score correlated positively with NIH-CPSI (r = 0.586 and PCS(r = 0.662 scores (P<0.001.NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.

  15. Frequency and risks associated with Clostridium difficile-associated diarrhea after pediatric solid organ transplantation: a single-center retrospective review.

    Science.gov (United States)

    Ciricillo, J; Haslam, D; Blum, S; Kim, M-O; Liu, C; Paulsen, G; Courter, J; Danziger-Isakov, L

    2016-10-01

    Morbidity and mortality related to Clostridium difficile infection (CDI) has increased, but epidemiology and risk factors within pediatric solid organ transplant (SOT) recipients are uncertain. A retrospective cohort study of SOT recipients age ≤18 years at transplantation from 2010 to 2013 was performed. Patients with CDI were compared with matched CDI-negative controls with diarrhea. Of 202 patients, the majority were male (58%) and Caucasian (77%). Kidney (42%) was the most common organ transplanted, followed by liver (38%), heart (17%), and multivisceral/intestine (3%). Age ranged from 3 weeks to 18 years (median 4.7 years, mean 6.6; interquartile range [IQR] 1.5-11.2). In 104 SOT recipients, at least 1 unformed stool was tested; 25 patients were positive for CDI. Most testing occurred by 60 days post transplant (mean 164, median 57, IQR 14-227). First negative tests occurred concurrently (mean 153, median 54, IQR 13-214) to the 25 patients with CDI (mean 199, median 65, IQR 32-238). In univariable analyses, age, gender, ethnicity, obesity, and calcineurin inhibitor choice were not associated with CDI. Liver recipients were more likely to have CDI (18.4% liver, 4.7% kidney, 8.8% heart, P associated with CDI. Acid-blockade appeared protective (risk ratio 0.13, 95% confidence interval 0.02-0.78). CDI occurs in 12% of pediatric SOT recipients, but 24% of those tested with diarrhea were positive. In patients with diarrhea, prior hospitalization and antibiotic duration or intensity were not associated with CDI. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Deep vein thrombosis and/or pulmonary embolism concurrent with superficial vein thrombosis of the legs: cross-sectional single center study of prevalence and risk factors.

    Science.gov (United States)

    Hirmerova, J; Seidlerova, J; Subrt, I

    2013-08-01

    The aim of this paper was to assess the prevalence of concurrent deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in the patients with superficial vein thrombosis (SVT) of the legs and to find factors significantly and independently associated with coincident DVT/PE. In the setting of a tertiary referral hospital, patients with SVT, attending vascular clinic, underwent physical examination, laboratory testing and leg vein ultrasound (in the case of clinically suspected PE also perfusion/ventilation lung scan or/and helical CT pulmonary angiography). In statistical analysis, we used unpaired t-test, non-parametric Wilcoxon rank sum test, stepwise logistic regression and multivariable logistic regression model. We examined 138 patients (age 61.4 ± 13.9 years, 36.2% men), with ST mostly on varicose veins (89.9%). The prevalence of concurrent DVT/PE was 34.1%. Neither the clinical manifestation nor SVT localization differed significantly between the group with isolated SVT and that with coincident DVT/PE. Of all the assessed patients characteristics (age and sex, BMI, history of SVT, DVT or PE, hypercoagulable states, cardiovascular risk factors) only two factors were significantly and independently associated with the presence of concurrent DVT/PE. Log BMI was significantly higher in the patients with isolated SVT. Factor V Leiden (FVL) was proved as an independent risk factor for concomitant DVT/PE with odds ratio 2,531 (95% CI 1,064-6,016). The prevalence of concurrent DVT/PE in patients with SVT, referred to hospital vascular clinic was 34.1%. Lower BMI (log BMI, respectively) and the presence of FVL were significantly and independently associated with concurrent DVT/PE. Our results should be further investigated in a larger prospective study.

  17. Indoor and Outdoor Monitoring of Volatile Organic Compounds in School Buildings: Indicators Based on Health Risk Assessment to Single out Critical Issues

    Directory of Open Access Journals (Sweden)

    Gianluigi de Gennaro

    2013-11-01

    Full Text Available Children are more sensitive to pollutants than adults and yet they spend large amounts of time in school environments where they are exposed to unknown levels of indoor pollutants. This study investigated the concentrations of the most abundant volatile organic compounds (VOCs in eight naturally ventilated school buildings in Italy. The schools were chosen to include areas with different urbanization and traffic density characteristics in order to gather a more diverse picture of exposure risks in the different areas of the city. VOCs were sampled for one week in the presence/absence of pupils using diffusive samplers suitable for thermal desorption inside three classrooms at each school. The samples were then analyzed with thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS. In addition, outdoor measurements were carried out in the yard at each school. VOC identification and quantification, and indoor/outdoor concentration plots were used to identify pollutant sources. While some classrooms were found to have very low VOC levels, others had a significant indoor contribution or a prevalent outdoor contribution. High concentrations of terpenes were found in all monitored classrooms: a-pinene and limonene were in the range of 6.55–34.18 µg/m3 and 11.11–25.42 µg/m3 respectively. Outdoor concentrations were lower than indoors for each monitored school. Indicators based on health risk assessment for chronic health effects associated with VOCs (either carcinogenic or non-carcinogenic were proposed to rank sites according to their hazard level.

  18. Single nucleotide polymorphism of bone morphogenetic protein 4 gene: A risk factor of non-syndromic cleft lip with or without palate

    Directory of Open Access Journals (Sweden)

    Sathyaprasad Savitha

    2015-01-01

    Full Text Available Background: The bone morphogenetic protein (BMP signalling pathway is crucial in a number of developmental processes and is critical in the formation of variety of craniofacial elements including cranial neural crest, facial primordium, tooth, lip and palate. It is an important mediator in regulation of lip and palate fusion, cartilage and bone formation. Aim: To study the role of mutation of BMP4 genes in the aetiology of non-syndromic cleft lip with or without palate (NSCL ± P and identify it directly from human analyses. Materials and Methods: A case-control study was done to evaluate whether BMP4T538C polymorphism, resulting in an amino acid change of Val=Ala (V152A in the polypeptide, is associated with NSCL ± P in an Indian paediatric population. Genotypes of 100 patients with NSCL ± P and 100 controls (in whom absence of CL ± P was confirmed in three generations were detected using a polymerase chain reaction-restriction fragment length polymorphism strategy. Logistic regression was performed to evaluate allele and genotype association with NSCLP. Results: Results showed significant association between homozygous CC genotype with CL ± P (odds ratio [OR]-5.59 and 95% confidence interval [CI] = 2.85-10.99. The 538C allele carriers showed an increased risk of NSCL ± P as compared with 538 T allele (OR - 4.2% CI = 2.75-6.41. Conclusion: This study suggests an association between SNP of BMP4 gene among carriers of the C allele and increased risk for NSCLP in an Indian Population. Further studies on this aspect can scale large heights in preventive strategies for NSCLP that may soon become a reality.

  19. One single dose of 200 microg of antenatal RhIG halves the risk of anti-D immunization and hemolytic disease of the fetus and newborn in the next pregnancy.

    Science.gov (United States)

    Koelewijn, Joke M; de Haas, Masja; Vrijkotte, Tanja G M; Bonsel, Gouke J; van der Schoot, C Ellen

    2008-08-01

    The objective was the evaluation of the effect of the Dutch national routine antenatal RhIG (anti-D) immunization prevention (RAADP) program comprising one single dose of 200 microg (1000 IU) of RhIG in the 30th week of pregnancy, restricted to women without a living child. A nationwide historic control study was performed. All newly detected anti-D-immunized para-1 in 1999, 2002, and 2004 were included and classified on the basis of received prophylaxis during the first pregnancy: antenatal and postnatal versus only postnatal RhIG. The numbers of D- parae-1 who delivered a D+ first child before the introduction (control group) or after the introduction (intervention group) of the RAADP were calculated from Vital Birth Statistics (8,700 and 12,000, respectively). Fifty-eight newly detected anti-D immunizations in the first trimester were observed in the control group and 39 in the intervention group, which resulted in a significant reduction of the prevalence of new anti-D immunizations from 0.67 percent (95% confidence interval [CI], 0.50%-0.84%) to 0.31 percent (95% CI, 0.21%-0.41%). No reduction was observed in anti-D immunizations newly detected at the 30th-week screening (0.25%). A nonsignificant risk reduction of the risk of severe hemolytic disease of the fetus and newborn (HDFN) was found (0.23% vs. 0.10%). The numbers needed to treat to prevent one anti-D-immunized pregnancy and one case of subsequent severe HDFN were 357 and 1255, respectively. RAADP of one single dose of 200 microg of RhIG in addition to postnatal RhIG (200 microg) halves the risk of anti-D immunization and subsequent severe HDFN.

  20. Automated anesthesia carts reduce drug recording errors in medication administrations - A single center study in the largest tertiary referral hospital in China.

    Science.gov (United States)

    Wang, Ying; Du, Yingying; Zhao, Yingying; Ren, Yang; Zhang, Wei

    2017-08-01

    To clinically evaluate a type of patented automated anesthesia cart in medication administrations in anesthesia. This was a prospectively randomized open label clinical trial. In 10 designated operating suits in the First Affiliated Hospital of Zhengzhou University, in China. 1066 cases originated from 10,812 medication administrations in anesthesia were randomized. 78 registered anesthesiologists managed the medication. The patients received medication administrations in anesthesia with either an automated or a conventional manual cart. American Society of Anesthesiologists (ASA) score, sex, duration of anesthesia and surgical specialty, errors in administration of medications (incorrect medication given (substitution), medication not given (omission) and drug recordings errors"), compliance and satisfaction were recorded. The total error rate was 7.3% with the automated anesthesia carts (1 in 14 administrations) and 11.9% with conventional manual carts (1 in 8 administrations). Automated anesthesia carts significantly reduced the drug recording error rate compared to conventional manual carts (Perrors omission errors was found between groups of automated anesthesia carts and conventional manual carts. The anesthesiologists' compliance with the automated anesthesia carts was unsatisfactory, and all the errors in medication recordings with the automated anesthesia carts were due to the incorrect use of the carts. Most of the participating anesthesiologists preferred the automated anesthesia carts (Perrors in medication administrations of anesthesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center.

    Science.gov (United States)

    Khan, Muhammad Shahid; Waheed, Shahan; Ali, Arif; Mumtaz, Narjis; Feroze, Asher; Noordin, Shahryar

    2015-01-01

    Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.

  2. Cheetah paradigm revisited: MHC diversity in the world's largest free-ranging population.

    Science.gov (United States)

    Castro-Prieto, Aines; Wachter, Bettina; Sommer, Simone

    2011-04-01

    For more than two decades, the cheetah (Acinonyx jubatus) has been considered a paradigm of disease vulnerability associated with low genetic diversity, particularly at the immune genes of the major histocompatibility complex (MHC). Cheetahs have been used as a classic example in numerous conservation genetics textbooks as well as in many related scientific publications. However, earlier studies used methods with low resolution to quantify MHC diversity and/or small sample sizes. Furthermore, high disease susceptibility was reported only for captive cheetahs, whereas free-ranging cheetahs show no signs of infectious diseases and a good general health status. We examined whether the diversity at MHC class I and class II-DRB loci in 149 Namibian cheetahs was higher than previously reported using single-strand conformation polymorphism analysis, cloning, and sequencing. MHC genes were examined at the genomic and transcriptomic levels. We detected ten MHC class I and four class II-DRB alleles, of which nine MHC class I and all class II-DRB alleles were expressed. Phylogenetic analyses and individual genotypes suggested that the alleles belong to four MHC class I and three class II-DRB putative loci. Evidence of positive selection was detected in both MHC loci. Our study indicated that the low number of MHC class I alleles previously observed in cheetahs was due to a smaller sample size examined. On the other hand, the low number of MHC class II-DRB alleles previously observed in cheetahs was further confirmed. Compared with other mammalian species including felids, cheetahs showed low levels of MHC diversity, but this does not seem to influence the immunocompetence of free-ranging cheetahs in Namibia and contradicts the previous conclusion that the cheetah is a paradigm species of disease vulnerability.

  3. 15 years of social crisis in the largest Circumpolar region: hygienic implications.

    Science.gov (United States)

    Tyrylgin, Mikhail A

    2007-01-01

    The aim of the study was to determine the nature and size of the hygienical impact of social crisis on the public health of the population of a Circumpolar region. The study was carried out in the Sakha (Yakutia) Republic (area 3.1 million km2; population nearly 1 million). The analysis of health indicators was done using demographic and hygienical methods, and 15-year (1989-2005) statistical data from the Federal State Statistic Service division in the Sakha Republic. The study has yielded reliable data on public health trends of the population in the Sakha Republic. During a period of 15 years of social crisis, the population has declined by 13%, mainly due to the departure of 1/3 of the non-Aboriginal population, which clearly demonstrated the negative nature of social changes. The natural increase rate has been reduced to a 1/ 3. Marriage and family institutions were affected seriously, with twice more children born to single mothers and 2.6-fold more to fathers of a foreign origin. Incidence rates of alcoholic psychosis, chronic alcoholism and drug abuse increased 3.1- to 4.2-fold; and mortality associated with psycho-emotional stress (circulatory diseases, external causes of injury, digestive system diseases), 1.7- to 3.1-fold. Rates of mortality due to circulatory, respiratory and malignant neoplastic diseases were 1.6- to 2.7-fold lower than those in Russia in general. Such low mortality due to degenerative diseases was predetermined by the small percent of the elderly in the age structure (8.4%), which was 2.5-fold lower compared to Russia and developed countries. The public health status of the residents of Circumpolar areas was extremely sensitive to socioeconomic changes. The social crisis had a multifactorial effect on lifestyle, quality of life-supporting infrastructure, and particularly, on the medical care system, with highly negative hygienical implications.

  4. After Macondo: how has Brazil reacted to the largest accidental marine oil spill in history?

    Energy Technology Data Exchange (ETDEWEB)

    Schwind, William Prescott [Thompson and Knight LLP, Houston, TX (United States); Porto, Nara Galeb [Thompson and Knight LLP, Dallas, TX (United States)

    2012-07-01

    The Macondo spill in the U.S. Gulf of Mexico was an undeniable and unprecedented environmental disaster. To many critics, however, the damage to the environment was exacerbated by harm to the economy, as a drilling moratorium and a regulatory slowdown practically eliminated new offshore drilling, cost both the nation and the region thousands of jobs and millions of dollars, and dealt a severe set-back to the offshore oil and gas industry in the United States. Over two years after the spill, the industry is still struggling to recover. What does Macondo mean for Brazil? As Brazil eyes its own abundant offshore oil and gas resources, the country is grappling with the environmental and political fallout of two recent spills that, while much smaller than Macondo, turned the public spotlight squarely on the possibility of a similar disaster in Brazilian waters. This article highlights the regulatory measures that were or are expected to be implemented in the United States and Brazil in the wake of Macondo, reviews the effects of the recent offshore spills in Brazil, and discusses evolutions in the contractual allocations of risks and responsibility in the international and the Brazilian oil and gas industry in response to Macondo. (author)

  5. Treatment of acromegaly patients with risk-adapted single or fractionated stereotactic high-precision radiotherapy. High local control and low toxicity in a pooled series

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, Jan Patrick [Mediclin Robert Janker Clinic and MediClin MVZ Bonn, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); University Hospital of Bonn, Department of Neurosurgery, Bonn (Germany); Kinfe, Thomas; Pintea, Bogdan [University Hospital of Bonn, Department of Neurosurgery, Bonn (Germany); Meyer, Almuth [HELIOS Klinikum Erfurt, Department of Endocrinology, Erfurt (Germany); Gerlach, Ruediger [HELIOS Klinikum Erfurt, Department of Neurosurgery, Erfurt (Germany); Surber, Gunnar; Hamm, Klaus [HELIOS Klinikum Erfurt, Department of Radiosurgery, Erfurt (Germany); Lammering, Guido [Mediclin Robert Janker Clinic and MediClin MVZ Bonn, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); Heinrich-Heine-University of Duesseldorf, Department of Radiotherapy and Radiation Oncology, Duesseldorf (Germany)

    2015-01-10

    The purpose of this work was to evaluate a prospectively initiated two-center protocol of risk-adapted stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) in patients with acromegaly. In total 35 patients (16 men/19 women, mean age 54 years) were prospectively included in a treatment protocol of SRS [planning target volume (PTV) < 4 ccm, > 2 mm to optic pathways = low risk] or SRT (PTV ≥ 4 ccm, ≤ 2 mm to optic pathways = high risk). The mean tumor volume was 3.71 ccm (range: 0.11-22.10 ccm). Based on the protocol guidelines, 21 patients were treated with SRS and 12 patients with SRT, 2 patients received both consecutively. The median follow-up (FU) reached 8 years with a 5-year overall survival (OS) of 87.3 % [confidence interval (CI): 70.8-95.6 %] and 5-year local control rate of 97.1 % (CI: 83.4-99.8 %). Almost 80 % (28/35) presented tumor shrinkage during FU. Endocrinological cure was achieved in 23 % and IGF-1 normalization with reduced medication was achieved in 40 % of all patients. An endocrinological response was generally achieved within the first 3 years, but endocrinological cure can require more than 8 years. A new adrenocorticotropic hypopituitarism occurred in 13 patients (46.4 %). A new visual field disorder and a new oculomotor palsy occurred in 1 patient, respectively. Patients with occurrence of visual/neurological impairments had a longer FU (p = 0.049). Our SRS/SRT protocol proved to be safe and successful in terms of tumor control and protection of the visual system. The timing and rate of endocrine improvements are difficult to predict. One has to accept an unavoidable rate of additional adrenocorticotropic hypopituitarism in the long term. (orig.) [German] Zielsetzung dieser Arbeit ist die Evaluation eines prospektiv angelegten Behandlungsprotokolls einer risikoadaptierten stereotaktischen Radiochirurgie (SRS) oder stereotaktischen Radiotherapie (SRT) von Patienten mit Akromegalie aus 2 Zentren. Insgesamt 35 Patienten (16

  6. Determination of the melon chloroplast and mitochondrial genome sequences reveals that the largest reported mitochondrial genome in plants contains a significant amount of DNA having a nuclear origin

    Directory of Open Access Journals (Sweden)

    Aranda Miguel A

    2011-08-01

    Full Text Available Abstract Background The melon belongs to the Cucurbitaceae family, whose economic importance among vegetable crops is second only to Solanaceae. The melon has a small genome size (454 Mb, which makes it suitable for molecular and genetic studies. Despite similar nuclear and chloroplast genome sizes, cucurbits show great variation when their mitochondrial genomes are compared. The melon possesses the largest plant mitochondrial genome, as much as eight times larger than that of other cucurbits. Results The nucleotide sequences of the melon chloroplast and mitochondrial genomes were determined. The chloroplast genome (156,017 bp included 132 genes, with 98 single-copy genes dispersed between the small (SSC and large (LSC single-copy regions and 17 duplicated genes in the inverted repeat regions (IRa and IRb. A comparison of the cucumber and melon chloroplast genomes showed differences in only approximately 5% of nucleotides, mainly due to short indels and SNPs. Additionally, 2.74 Mb of mitochondrial sequence, accounting for 95% of the estimated mitochondrial genome size, were assembled into five scaffolds and four additional unscaffolded contigs. An 84% of the mitochondrial genome is contained in a single scaffold. The gene-coding region accounted for 1.7% (45,926 bp of the total sequence, including 51 protein-coding genes, 4 conserved ORFs, 3 rRNA genes and 24 tRNA genes. Despite the differences observed in the mitochondrial genome sizes of cucurbit species, Citrullus lanatus (379 kb, Cucurbita pepo (983 kb and Cucumis melo (2,740 kb share 120 kb of sequence, including the predicted protein-coding regions. Nevertheless, melon contained a high number of repetitive sequences and a high content of DNA of nuclear origin, which represented 42% and 47% of the total sequence, respectively. Conclusions Whereas the size and gene organisation of chloroplast genomes are similar among the cucurbit species, mitochondrial genomes show a wide variety of sizes

  7. Determination of the melon chloroplast and mitochondrial genome sequences reveals that the largest reported mitochondrial genome in plants contains a significant amount of DNA having a nuclear origin.

    Science.gov (United States)

    Rodríguez-Moreno, Luis; González, Víctor M; Benjak, Andrej; Martí, M Carmen; Puigdomènech, Pere; Aranda, Miguel A; Garcia-Mas, Jordi

    2011-08-20

    The melon belongs to the Cucurbitaceae family, whose economic importance among vegetable crops is second only to Solanaceae. The melon has a small genome size (454 Mb), which makes it suitable for molecular and genetic studies. Despite similar nuclear and chloroplast genome sizes, cucurbits show great variation when their mitochondrial genomes are compared. The melon possesses the largest plant mitochondrial genome, as much as eight times larger than that of other cucurbits. The nucleotide sequences of the melon chloroplast and mitochondrial genomes were determined. The chloroplast genome (156,017 bp) included 132 genes, with 98 single-copy genes dispersed between the small (SSC) and large (LSC) single-copy regions and 17 duplicated genes in the inverted repeat regions (IRa and IRb). A comparison of the cucumber and melon chloroplast genomes showed differences in only approximately 5% of nucleotides, mainly due to short indels and SNPs. Additionally, 2.74 Mb of mitochondrial sequence, accounting for 95% of the estimated mitochondrial genome size, were assembled into five scaffolds and four additional unscaffolded contigs. An 84% of the mitochondrial genome is contained in a single scaffold. The gene-coding region accounted for 1.7% (45,926 bp) of the total sequence, including 51 protein-coding genes, 4 conserved ORFs, 3 rRNA genes and 24 tRNA genes. Despite the differences observed in the mitochondrial genome sizes of cucurbit species, Citrullus lanatus (379 kb), Cucurbita pepo (983 kb) and Cucumis melo (2,740 kb) share 120 kb of sequence, including the predicted protein-coding regions. Nevertheless, melon contained a high number of repetitive sequences and a high content of DNA of nuclear origin, which represented 42% and 47% of the total sequence, respectively. Whereas the size and gene organisation of chloroplast genomes are similar among the cucurbit species, mitochondrial genomes show a wide variety of sizes, with a non-conserved structure both in gene number

  8. Treatment for female patients with eating disorders in the largest medical prison in Japan.

    Science.gov (United States)

    Asami, Tomokuni; Yanase, Maya; Nomura, Toshiaki; Okubo, Yoshiro

    2015-01-01

    The number of offenders with eating disorders in women's prisons in Japan has grown annually over the last 15 years. Women's prisons have experienced significant difficulties in the management of patients with eating disorders who have body-critical complications arising from low body weight, in addition to behavioral problems. Patients in Japan's 185 correctional facilities who display high refractoriness or who present a physical risk are transferred to the Hachioji medical prison, a national specialty hospital operated by the Ministry of Justice. The medical prison must manage any psychosomatic problems necessary for the safety of inmates regardless of a patient's wishes. The most common conviction resulting in imprisonment of women with eating disorders was shoplifting ( n  = 44; 63%), with the second most common being drug-offenses ( n  = 17; 24%). While shoplifting is of concern in relation to eating disorders, a causal relationship remains unclear. Most patients in the shoplifting group did not have histories of antisocial and/or impulsive behaviors such as drug abuse, sexual deviation, self-injury, or other criminal activity. Instead, shoplifting appears to be an obsessive-compulsive behavior deeply rooted in the psychopathology of severe eating disorder patients. Patients in this group tended to have histories of relatively high education and steady employment, although most also had histories of prolonged eating disorders and unstable treatment. Although adherence to treatment was poor among patients with eating disorders in the medical prison, body weight and behavioral problems improved following treatment in the special compulsory environment, without severe sequelae or patient death. The Ministry of Justice recently established another specialized ward for the care for female patients with eating disorders. If greater emphasis is placed on early-stage, protective, medical treatment, the number of patients with eating disorders in prisons may

  9. Energy Sprawl Is the Largest Driver of Land Use Change in United States.

    Directory of Open Access Journals (Sweden)

    Anne M Trainor

    Full Text Available Energy production in the United States for domestic use and export is predicted to rise 27% by 2040. We quantify projected energy sprawl (new land required for energy production in the United States through 2040. Over 200,000 km2 of additional land area will be directly impacted by energy development. When spacing requirements are included, over 800,000 km2 of additional land area will be affected by energy development, an area greater than the size of Texas. This pace of development in the United States is more than double the historic rate of urban and residential development, which has been the greatest driver of conversion in the United States since 1970, and is higher than projections for future land use change from residential development or agriculture. New technology now places 1.3 million km2 that had not previously experienced oil and gas development at risk of development for unconventional oil and gas. Renewable energy production can be sustained indefinitely on the same land base, while extractive energy must continually drill and mine new areas to sustain production. We calculated the number of years required for fossil energy production to expand to cover the same area as renewables, if both were to produce the same amount of energy each year. The land required for coal production would grow to equal or exceed that of wind, solar and geothermal energy within 2-31 years. In contrast, it would take hundreds of years for oil production to have the same energy sprawl as biofuels. Meeting energy demands while conserving nature will require increased energy conservation, in addition to distributed renewable energy and appropriate siting and mitigation.

  10. Effect of Ambient Air Pollution on Hospitalization for Heart Failure in 26 of China's Largest Cities.

    Science.gov (United States)

    Liu, Hui; Tian, Yaohua; Song, Jing; Cao, Yaying; Xiang, Xiao; Huang, Chao; Li, Man; Hu, Yonghua

    2018-03-01

    There is growing interest in the association between ambient air pollution and congestive heart failure (CHF), but research data from developing countries are very limited. The primary aim of this study was to examine the association between short-term exposure to air pollution and hospital admission for CHF in China. A time-stratified case-crossover study was conducted between 2014 and 2015 in 26 large Chinese cities among 105,501 CHF hospitalizations. Conditional logistic regression models were applied to estimate the percentage changes in CHF admissions in relation to per interquartile range increases in air pollutant concentrations. Air pollution was positively associated with CHF hospitalizations. An interquartile range increase in fine particulate, particulate matter less than 10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone concentrations on the current day corresponded to 1.2% (95% confidence interval [CI] 0.5%, 1.8%), 1.3% (95% CI 0.5%, 2.0%), 1.0% (95% CI 0.2%, 1.7%), 1.6% (95% CI 0.6%, 2.5%), 1.2% (95% CI 0.5%, 1.9%), and 0.4% (95% CI -0.9%, 1.7%) increases in CHF admissions, respectively. In conclusion, our findings contribute to the limited scientific literature concerning the effects of air pollution on CHF risk for high-exposure settings typical in developing countries, which may have significant public health implications for prevention of CHF in China. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Niche overlap of congeneric invaders supports a single-species hypothesis and provides insight into future invasion risk: implications for global management of the Bactrocera dorsalis complex.

    Science.gov (United States)

    Hill, Matthew P; Terblanche, John S

    2014-01-01

    The invasive fruit fly, Bactrocera invadens, has expanded its range rapidly over the past 10 years. Here we aimed to determine if the recent range expansion of Bactrocera invadens into southern Africa can be better understood through niche exploration tools, ecological niche models (ENMs), and through incorporating information about Bactrocera dorsalis s.s., a putative conspecific species from Asia. We test for niche overlap of environmental variables between Bactrocera invadens and Bactrocera dorsalis s.s. as well as two other putative conspecific species, Bactrocera philippinensis and B. papayae. We examine overlap and similarity in the geographical expression of each species' realised niche through reciprocal distribution models between Africa and Asia. We explore different geographical backgrounds, environmental variables and model complexity with multiple and single Bactrocera species hypotheses in an attempt to predict the recent range expansion of B. invadens into northern parts of South Africa. Bactrocera invadens has a high degree of niche overlap with B. dorsalis s.s. (and B. philippinensis and B. papayae). Ecological niche models built for Bactrocera dorsalis s.s. have high transferability to describe the range of B. invadens, and B. invadens is able to project to the core range of B. dorsalis s.s. The ENMs of both Bactrocera dorsalis and B. dorsalis combined with B. philipenesis and B. papayae have significantly higher predictive ability to capture the distribution points in South Africa than for B. invadens alone. Consistent with other studies proposing these Bactrocera species as conspecific, niche similarity and overlap between these species is high. Considering these other Bactrocera dorsalis complex species simultaneously better describes the range expansion and invasion potential of B. invadens in South Africa. We suggest that these species should be considered the same-at least functionally-and global quarantine and management strategies applied

  12. Risk Factors for Ineffectiveness of Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament: A Single Institute Study.

    Science.gov (United States)

    Imagama, Shiro; Ando, Kei; Ito, Zenya; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Tanaka, Satoshi; Machino, Masaaki; Ota, Kyotaro; Nakashima, Hiroaki; Wakao, Norimitsu; Nishida, Yoshihiro; Matsuyama, Yukihiro; Ishiguro, Naoki

    2017-05-01

    Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is treated surgically with instrumented posterior decompression and fusion. However, the factors determining the outcome of this approach and the efficacy of additional resection of T-OPLL are unknown. To identify these factors in a prospective study at a single institution. The subjects were 70 consecutive patients with beak-type T-OPLL who underwent posterior decompression and dekyphotic fusion and had an average of 4.8 years of follow-up (minimum of 2 years). Of these patients, 4 (6%; group R) had no improvement or aggravation, were not ambulatory for 3 weeks postoperatively, and required additional T-OPLL resection; while 66 (group N) required no further T-OPLL resection. Clinical records, gait status, intraoperative ultrasonography, intraoperative neurophysiological monitoring (IONM), plain radiography, computed tomography and magnetic resonance imaging findings, and Japanese Orthopaedic Association (JOA) score were compared between the groups. Preoperatively, patients in group R had significantly higher rates of severe motor paralysis, nonambulatory status, positive prone and supine position test, no spinal cord floating in intraoperative ultrasonography, and deterioration of IONM at the end of surgery ( P < .05). In preoperative radiography, the OPLL spinal cord kyphotic angle difference in fused area, OPLL length, and OPLL canal stenosis were significantly higher in group R ( P < .05). At final follow-up, JOA scores improved similarly in both groups. Preoperative severe motor paralysis, nonambulatory status, positive prone and supine position test, radiographic spinal cord compression due to beak-type T-OPLL, and intraoperative residual spinal cord compression and deterioration of IONM were associated with ineffectiveness of posterior decompression and fusion with instrumentation. Our 2-stage strategy may be appropriate for beak-type T-OPLL surgery. Copyright © 2017 by the Congress of

  13. Niche Overlap of Congeneric Invaders Supports a Single-Species Hypothesis and Provides Insight into Future Invasion Risk: Implications for Global Management of the Bactrocera dorsalis Complex

    Science.gov (United States)

    Hill, Matthew P.; Terblanche, John S.

    2014-01-01

    Background The invasive fruit fly, Bactrocera invadens, has expanded its range rapidly over the past 10 years. Here we aimed to determine if the recent range expansion of Bactrocera invadens into southern Africa can be better understood through niche exploration tools, ecological niche models (ENMs), and through incorporating information about Bactrocera dorsalis s.s., a putative conspecific species from Asia. We test for niche overlap of environmental variables between Bactrocera invadens and Bactrocera dorsalis s.s. as well as two other putative conspecific species, Bactrocera philippinensis and B. papayae. We examine overlap and similarity in the geographical expression of each species’ realised niche through reciprocal distribution models between Africa and Asia. We explore different geographical backgrounds, environmental variables and model complexity with multiple and single Bactrocera species hypotheses in an attempt to predict the recent range expansion of B. invadens into northern parts of South Africa. Principal Findings Bactrocera invadens has a high degree of niche overlap with B. dorsalis s.s. (and B. philippinensis and B. papayae). Ecological niche models built for Bactrocera dorsalis s.s. have high transferability to describe the range of B. invadens, and B. invadens is able to project to the core range of B. dorsalis s.s. The ENMs of both Bactrocera dorsalis and B. dorsalis combined with B. philipenesis and B. papayae have significantly higher predictive ability to capture the distribution points in South Africa than for B. invadens alone. Conclusions/Significance Consistent with other studies proposing these Bactrocera species as conspecific, niche similarity and overlap between these species is high. Considering these other Bactrocera dorsalis complex species simultaneously better describes the range expansion and invasion potential of B. invadens in South Africa. We suggest that these species should be considered the same–at least

  14. Niche overlap of congeneric invaders supports a single-species hypothesis and provides insight into future invasion risk: implications for global management of the Bactrocera dorsalis complex.

    Directory of Open Access Journals (Sweden)

    Matthew P Hill

    Full Text Available BACKGROUND: The invasive fruit fly, Bactrocera invadens, has expanded its range rapidly over the past 10 years. Here we aimed to determine if the recent range expansion of Bactrocera invadens into southern Africa can be better understood through niche exploration tools, ecological niche models (ENMs, and through incorporating information about Bactrocera dorsalis s.s., a putative conspecific species from Asia. We test for niche overlap of environmental variables between Bactrocera invadens and Bactrocera dorsalis s.s. as well as two other putative conspecific species, Bactrocera philippinensis and B. papayae. We examine overlap and similarity in the geographical expression of each species' realised niche through reciprocal distribution models between Africa and Asia. We explore different geographical backgrounds, environmental variables and model complexity with multiple and single Bactrocera species hypotheses in an attempt to predict the recent range expansion of B. invadens into northern parts of South Africa. PRINCIPAL FINDINGS: Bactrocera invadens has a high degree of niche overlap with B. dorsalis s.s. (and B. philippinensis and B. papayae. Ecological niche models built for Bactrocera dorsalis s.s. have high transferability to describe the range of B. invadens, and B. invadens is able to project to the core range of B. dorsalis s.s. The ENMs of both Bactrocera dorsalis and B. dorsalis combined with B. philipenesis and B. papayae have significantly higher predictive ability to capture the distribution points in South Africa than for B. invadens alone. CONCLUSIONS/SIGNIFICANCE: Consistent with other studies proposing these Bactrocera species as conspecific, niche similarity and overlap between these species is high. Considering these other Bactrocera dorsalis complex species simultaneously better describes the range expansion and invasion potential of B. invadens in South Africa. We suggest that these species should be considered the same

  15. Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T

    DEFF Research Database (Denmark)

    Simone, Benedetto; De Stefano, Valerio; Leoncini, Emanuele

    2013-01-01

    individual data for the pooling. The Odds Ratio (OR) for first VTE associated with each variant, individually and combined with the others, were calculated with a random effect model, in heterozygotes and homozygotes (dominant model for FVL and PT20210A; recessive for C677T MTHFR). We analysed 31 databases......: 2.25-3.46, respectively), in double heterozygotes (OR = 3.42; 95 %CI 1.64-7.13), and in homozygous FVL or PT20210A (OR = 11.45; 95 %CI: 6.79-19.29; and OR: 6.74 (CI 95 % 2.19-20.72), respectively). The stratified analyses showed a stronger effect of FVL on individuals ≤ 45 years (p value...... for interaction = 0.036) and of PT20210A in women using oral contraceptives (p-value for interaction = 0.045). In this large pooled analysis, inclusive of large studies like MEGA, no effect was found for C677T MTHFR on VTE; FVL and PT20210A were confirmed to be moderate risk factors. Notably, double carriers...

  16. Single centre experience of combat-related vascular injury in victims of Syrian conflict: Retrospective evaluation of risk factors associated with amputation.

    Science.gov (United States)

    Şişli, Emrah; Kavala, Ali Aycan; Mavi, Mustafa; Sarıosmanoğlu, Osman Nejat; Oto, Öztekin

    2016-09-01

    To elucidate the risk factors associated with amputation in cases with combat-related vascular injury (CRVI). This retrospective study included 90 cases with CRVI treated between May 2011 and July 2013. The patients were divided into group I (n=69), in which the limb was salvaged and group II (n=21), in which the patients received amputation. The overall and the secondary amputation rates were 23% and 18%, respectively. There were no amputations with the MESS of nine or less, increasing proportions of amputations at 10 and 11, with a level of 12 leading to 100% amputation rate. The mortality rate was 2%. Among the 52 (58%) cases with the mangled extremity severity score (MESS) ≥7, the limb salvage rate was 60%. The patients in group II were more likely to have a combined artery and vein injury (p=0.042). They were also more likely to be injured as a result of an explosion (p=0.004). Along with the MESS (p7 seem to benefit from revascularisation with initiation of reperfusion at once. The validity of MESS merits further investigation with regard to the determination of a new cut-off value under ever developing medical management strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The development of online doctor reviews in China: an analysis of the largest online doctor review website in China.

    Science.gov (United States)

    Hao, Haijing

    2015-06-01

    Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers' attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95% CI 1.442-1.525) and an OR of 1

  18. Epidemiology of foot-and-mouth disease in Landhi Dairy Colony, Pakistan, the world largest Buffalo colony

    Directory of Open Access Journals (Sweden)

    Ahmad Munir

    2008-04-01

    Full Text Available Abstract Background Foot-and-mouth disease (FMD is endemic in Pakistan and causes huge economic losses. This work focus on the Landhi Dairy Colony (LDC, located in the suburbs of Karachi. LDC is the largest Buffalo colony in the world, with more than 300,000 animals (around 95% buffaloes and 5% cattle, as well as an unknown number of sheep and goats. Each month from April 2006 to April 2007 we collected mouth-swabs from apparently healthy buffaloes and cattle, applying a convenient sampling based on a two-stage random sampling scheme, in conjunction with participatory information from each selected farm. Furthermore, we also collected epithelium samples from animals with clinical disease, as well as mouth-swabs samples from those farms. In addition, we analysed a total of 180 serum samples randomly collecting 30 samples each month at the local slaughterhouse, from October 2006 to March 2007. Samples have been screened for FMDV by real-time RT-PCR and the partial or full 1D coding region of selected isolates has been sequenced. Serum samples have been analysed by applying serotype-specific antibody ELISA and non-structural proteins (NSP antibody ELISA. Results FMDV infection prevalence at aggregate level shows an endemic occurrence of FMDV in the colony, with peaks in August 2006, December 2006 and February 2007 to March 2007. A significant association of prevalence peaks to the rainy seasons, which includes the coldest time of the year and the muslimic Eid-festival, has been demonstrated. Participatory information indicated that 88% of all questioned farmers vaccinate their animals. Analysis of the serum samples showed high levels of antibodies for serotypes O, A, Asia 1 and C. The median endpoint-titre for all tested serotypes, except serotype C, in VNT titration is at a serum dilution of equal or above 1/100. All 180 serum samples collected have been tested for antibodies against the non-structural proteins and all but four have been found

  19. Health Insurance without Single Crossing

    DEFF Research Database (Denmark)

    Boone, Jan; Schottmüller, Christoph

    2017-01-01

    Standard insurance models predict that people with high risks have high insurance coverage. It is empirically documented that people with high income have lower health risks and are better insured. We show that income differences between risk types lead to a violation of single crossing...... in an insurance model where people choose treatment intensity. We analyse different market structures and show the following: If insurers have market power, the violation of single crossing caused by income differences and endogenous treatment choice can explain the empirically observed outcome. Our results do...

  20. Analysis of risk factors for pulmonary complications in patients with limited-stage small cell lung cancer. A single-centre retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Sas-Korczynska, Beata; Kamzol, Wojciech [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Clinic of Oncology and Department of Radiotherapy, Cracow (Poland); Luczynska, Elzbieta [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Department of Diagnostic Radiology, Cracow (Poland); Sokolowski, Andrzej [Cracow University of Economics, Department of Statistics, Cracow (Poland)

    2017-02-15

    The most effective therapy in patients with limited-stage small cell lung cancer (LS SCLC) seems to be chemotherapy (using platinum-based regimens) and thoracic radiotherapy (TRT), which is followed by prophylactic cranial irradiation. The analysed group comprised 217 patients who received combined treatment for LS SCLC, i.e. chemotherapy (according to cisplatin and etoposide schedule) and TRT (concurrent in 101 and sequential in 116 patients). The influence of chemoradiotherapy (ChT-RT) schedule on treatment results (frequency of complete response, survival rates, and incidence of treatment failure and complications) was evaluated, and the frequency and severity of pulmonary complications were analysed to identify risk factors. The 5-year survival rates in concurrent vs. sequential ChT-RT schedules were 27.3 vs. 11.7% (overall) and 28 vs. 14.3% (disease-free). The frequencies of adverse events in relation to concurrent vs. sequential therapy were 85.1 vs. 9.5% (haematological complications) and 58.4 vs. 38.8% (pulmonary fibrosis), respectively. It was found that concurrent ChT-RT (hazard ratio, HR 2.75), a total dose equal to or more than 54 Gy (HR 2.55), the presence of haematological complications (HR 1.89) and a lung volume receiving a dose equal to or greater than 20 Gy exceeding 31% (HR 1.06) were the risk factors for pulmonary complications. Pulmonary complications after ChT-RT developed in 82% of patients treated for LS SCLC. In comparison to the sequential approach, concurrent ChT-RT had a positive effect on treatment outcome. However, this is a factor that can impair treatment tolerance, which manifests in the appearance of side effects. (orig.) [German] Die wirksamste Therapie bei einem kleinzelligen Lungenkrebs im limitierten Stadium (LS SCLC) scheinen Chemotherapie (platinbasierte Regime) und thorakale Strahlentherapie (TRT) zu sein, begleitet von der prophylaktischen Schaedelbestrahlung. Analysiert wurden 217 Patienten, die eine kombinierte Behandlung

  1. The Clinical Value of Intraoperative Mobile Computed Tomography in Managing High-Risk Surgical Patients with Traumatic Brain Injury-A Single Tertiary Trauma Center Experience.

    Science.gov (United States)

    Chen, Ko-Ting; Lee, Shih-Tseng; Wu, Chieh-Tsai

    2017-02-01

    A subset of surgically treated patients with traumatic brain injury (TBI) cannot be stabilized by initial surgery. Mobile computed tomography (CT) provides real-time information for diagnosis in these TBI surgically high-risk (TBI-SHR) patients. The objective of this study was to analyze a 5-year series of TBI-SHR patients to evaluate the impact of intraoperative mobile CT (imCT) on prognosis. Of 1017 surgically treated patients with TBI retrospectively reviewed over a 5-year period (2009-2013), 59 patients required second operations within 72 hours of their initial surgery because of progressive or delayed hematomas (TBI-SHR group). Their clinical, radiographic, and intraoperative findings were compared among 19 patients who received imCT versus 40 patients who received fixed-unit CT. Our TBI-SHR group accounted for 5.8% of all surgically treated patients with TBI. The use of imCT led to a change in surgical plan in 56% of patients with TBI intraoperatively. Younger patients (≤55 years; P 20 mm Hg or acute brain swelling after adequate decompression (P = 0.003 and 0.004, respectively) significantly benefited from imCT in the TBI-SHR group. imCT also provided a quicker diagnosis (P < 0.001), led to a trend toward shorter intensive care unit stays (P = 0.077), and was associated with better neurologic outcomes at discharge days (P = 0.044). The use of imCT is associated with better neurologic outcomes at discharge days compared with the use of fixed-unit CT in TBI-SHR patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Indoor air pollution by emissions of fossil fuel single stoves: possibly a hitherto underrated risk factor in the development of carcinomas in the head and neck.

    Science.gov (United States)

    Dietz, A; Senneweld, E; Maier, H

    1995-02-01

    We have carried out three case-control studies on the relative risk of head and neck cancer in association with indoor air pollution. The studies performed at the Department of Otorhinolaryngology of the University of Heidelberg comprised 369 male patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx and 1476 healthy control subjects matched for sex, age, and residential area. The OR of laryngeal cancer related to daily exposure to fossil fuels due to stove-heating with oil, coal, gas, and wood for longer than 40 years was 2.5 (CI = 1.51 to 4.05). After adjustment for tobacco and alcohol, the OR declined slightly to 2.0 (CI = 1.10 to 3.46) but still was significant. Elevated ORs were also found for daily presence in a kitchen with an oil, coal, or wood oven for longer than 40 years (OR = 1.7, CI = 1.01 to 2.71; after tobacco and alcohol adjustment, OR = 1.4, CI = 0.76 to 2.41). The OR of pharyngeal cancer related to daily exposure to fossil fuels due to stove-heating with oil, coal, gas, and wood for longer than 40 years was 3.6 (CI = 2.04 to 6.41). After adjustment for tobacco and alcohol the OR declined slightly to 3.3 (CI = 1.43 to 7.55) but still was significant. Elevated ORs were also found for daily presence in a kitchen with an oil, coal, or wood oven for longer than 40 years (OR = 1.6, CI = 0.89 to 2.77; after tobacco and alcohol adjustment, OR = 2.5, CI = 1.03 to 6.30).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Factor V Leiden mutation and high FVIII are associated with an increased risk of VTE in women with breast cancer during adjuvant tamoxifen - results from a prospective, single center, case control study.

    Science.gov (United States)

    Kovac, Mirjana; Kovac, Zeljko; Tomasevic, Zorica; Vucicevic, Slavko; Djordjevic, Valentina; Pruner, Iva; Radojkovic, Dragica

    2015-01-01

    Estimates of the risk ratio of tamoxifen-associated venous thromboembolism (VTE) in breast cancer patients range from 2.4 to 7.1. The occurrence of thrombosis in patients with breast cancer complicates the clinical condition and causes a change of treatment. Our study was conducted in order to investigate the influence of patient-related risk factors for thrombosis development in breast cancer patients whose treatment included adjuvant tamoxifen. The prospective, single center, case control study included 150 breast cancer women, 50 whom developed venous thrombosis during adjuvant tamoxifen and 100 whom did not have thrombosis, as a control group. Patient-related risk factors such as: age, body mass index, previous VTE, varicose veins, concomitant diseases, the presence of prothrombotic mutations (FV Leiden, FII G20210A) and FVIII activity were evaluated in both groups. In respect of prothrombotic mutations, the FV Leiden mutation was present in a higher number of women from the VTE group (10/50 vs 7/100; P=0.020). Additionally, FVIII activity was significantly higher in the VTE group; median (IQR), of 1.79 (0.69) vs 1.45 (0.55); P1.5IU/ml, who were carriers of prothrombotic mutations, an OR of 3.76 (CI 95% 1.276-11.096; P=0.016) was obtained for VTE. The results of our study showed that the factor V Leiden mutation and high FVIII are associated with an increased risk of VTE in women with breast cancer during adjuvant tamoxifen. Copyright © 2014. Published by Elsevier B.V.

  4. Critical gaps in the world's largest electronic medical record: Ad Hoc nursing narratives and invisible adverse drug events.

    Science.gov (United States)

    Hurdle, John F; Weir, Charlene R; Roth, Beverly; Hoffman, Jennifer; Nebeker, Jonathan R

    2003-01-01

    The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs, operates one of the largest healthcare networks in the world. Its electronic medical record (EMR) is fully integrated into clinical practice, having evolved over several decades of design, testing, trial, and error. It is unarguably the world's largest EMR, and as such it makes an important case study for a host of timely informatics issues. The VHA consistently has been at the vanguard of patient safety, especially in its provider-oriented EMR. We describe here a study of a large set of adverse drug events (ADEs) that eluded a rigorous ADE survey based on prospective EMR chart review. These numerous ADEs were undetected (and hence invisible) in the EMR, missed by an otherwise sophisticated ADE detection scheme. We speculate how these invisible nursing ADE narratives persist and what they portend for safety re-engineering.

  5. Critical Gaps in the World’s Largest Electronic Medical Record: Ad Hoc Nursing Narratives and Invisible Adverse Drug Events

    Science.gov (United States)

    Hurdle, John F.; Weir, Charlene R.; Roth, Beverly; Hoffman, Jennifer; Nebeker, Jonathan R.

    2003-01-01

    The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs, operates one of the largest healthcare networks in the world. Its electronic medical record (EMR) is fully integrated into clinical practice, having evolved over several decades of design, testing, trial, and error. It is unarguably the world’s largest EMR, and as such it makes an important case study for a host of timely informatics issues. The VHA consistently has been at the vanguard of patient safety, especially in its provider-oriented EMR. We describe here a study of a large set of adverse drug events (ADEs) that eluded a rigorous ADE survey based on prospective EMR chart review. These numerous ADEs were undetected (and hence invisible) in the EMR, missed by an otherwise sophisticated ADE detection scheme. We speculate how these invisible nursing ADE narratives persist and what they portend for safety re-engineering. PMID:14728184

  6. The largest Fresco in Europe on cooling tower of nuclear power station of Cruas Meysse in Ardeche, France

    International Nuclear Information System (INIS)

    Di Mayo, J.L.

    1993-01-01

    The Nuclear Power Station Cruas Meysse is on the most important communication way of France, in the Rhone Valley, between the Rhin and the Mediterranean Sea. In the South of the Rhone Valley, the Nuclear Power Plant is situated near the very important site of 'Tricastin', the largest nuclear area in France. Cruas Meysse has a very good integration to the economy, social, and cultural scheme ; that's why EDF and the Ardeche Department had enter into partnership to associate art and technology of our time, and offer a work for everybody - 'Le Verseau' is the largest fresco in Europe - It gives a gigantic signalling system to the Ardeche Department, because the Nuclear Power Station has a very interesting position, close the motor way A7, the National 7 road, and the way of high speed train (TGV) an another symbol of the high French technology

  7. Texture and composition of Titan's equatorial region inferred from Cassini SAR inversion: Implications for aeolian transport at Saturn's largest moon

    OpenAIRE

    Lucas, Antoine; Rodriguez, Sébastien; Lemonnier, Florentin; Gall, Alice Le; Ferrari, Cécile; Paillou, Philippe; Narteau, Clément

    2017-01-01

    Sand seas on Titan may reflect the present and past climatic conditions. Understanding the morphodynamics and physico-chemical properties of Titan's dunes is therefore essential for a better comprehension of the climatic and geological history of the largest Saturn's moon. We derived quantitatively surface properties (texture, composition) from the modelling of microwave backscattered signal and Monte-Carlo inversion of despeckled Cassini/SAR data over sand sea. We show that dunes and interdu...

  8. Mapping Dynamics of Inundation Patterns of Two Largest River-Connected Lakes in China: A Comparative Study

    OpenAIRE

    Guiping Wu; Yuanbo Liu

    2016-01-01

    Poyang Lake and Dongting Lake are the two largest freshwater lakes in China. The lakes are located approximately 300 km apart on the middle reaches of the Yangtze River and are differently connected through their respective tributary systems, which will lead to different river–lake water exchanges and discharges. Thus, differences in their morphological and hydrological conditions should induce individual lake spatio-temporal inundation patterns. Quantitative comparative analyses of the dynam...

  9. Transcription initiation complexes and upstream activation with RNA polymerase II lacking the C-terminal domain of the largest subunit.

    OpenAIRE

    Buratowski, S; Sharp, P A

    1990-01-01

    RNA polymerase II assembles with other factors on the adenovirus type 2 major late promoter to generate pairs of transcription initiation complexes resolvable by nondenaturing gel electrophoresis. The pairing of the complexes is caused by the presence or absence of the C-terminal domain of the largest subunit. This domain is not required for transcription stimulation by the major late transcription factor in vitro.

  10. High HIV Burden in Men Who Have Sex with Men across Colombia’s Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study

    Science.gov (United States)

    Rubio Mendoza, Martha Lucía; Jacobson, Jerry Owen; Morales-Miranda, Sonia; Sierra Alarcón, Clara Ángela; Luque Núñez, Ricardo

    2015-01-01

    Background Among Latin America’s concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region’s third largest country. To date, surveillance studies have been limited to Bogota, while 80% of HIV cases and deaths originate from Colombia’s other cities and departments. The extent to which interventions should prioritize MSM outside of Bogota is unknown. Methods We recruited 2603 MSM using respondent-driven sampling from seven of Colombia’s largest cities. HIV prevalence was estimated by site from dried blood spot samples. Behavioral data were collected through face-to-face interviews and risk factors for HIV infection analyzed using weighted, multi-level logistical regression models accounting for recruitment patterns. Results Across cities, HIV prevalence averaged 15%, varied from 6% to 24% and was highest in Cali, Bogota, and Barranquilla. In the past 12 months, 65% of MSM had ≥ 5 casual male partners and 23% had a female partner. Across partnerships (i.e., casual, stable, and commercial), the proportion of MSM engaging in unprotected sex was ≥ 52% with male partners and ≥ 66% with female partners. Self-reported history of STI (24%) and past-year illicit drug use (38%) were also common. In multivariate analysis, age ≥ 35 (adjusted odds ratio [AOR], 19.2) and 25–39 (AOR, 5.6) relative to ≤ 18–24 years, identifying as homosexual relative to heterosexual (AOR 0.1), meeting casual partners on the Internet (adjusted odds ratio [AOR], 3.1) and age of sexual debut of ≤ 13 years (AOR, 3.1) predicted HIV infection. HIV testing and prevention messaging reached just 24% of MSM in the past year. Conclusions Findings support consistently elevated HIV burden among MSM throughout Colombia’s largest cities and a need for enhanced behavioral prevention and HIV testing, emphasizing men who use the Internet as well as physical venues to meet sex partners. PMID:26252496

  11. Procalcitonin for selecting the antibiotic regimen in outpatients with low-risk community-acquired pneumonia using a rapid point-of-care testing: A single-arm clinical trial

    Science.gov (United States)

    Masiá, Mar; Padilla, Sergio; Ortiz de la Tabla, Victoria; González, Matilde; Bas, Cristina; Gutiérrez, Félix

    2017-01-01

    Objective We aimed to assess the role of procalcitonin (PCT) to guide the initial selection of the antibiotic regimen for low-risk community-acquired pneumonia (CAP). Methods A single-arm clinical trial was conducted including outpatients with CAP and Pneumonia Severity Index risk classes I-II. Antimicrobial selection was based on the results of PCT measured with a rapid point-of-care testing. According to serum PCT levels, patients were assigned to two treatment strategies: oral azithromycin if PCT was Atypical organisms were more common in patients given azithromycin (18.5% vs 8.1%, respectively). The majority (93%) of patients with atypical pneumonia had low PCT levels. Clinical cure rates were 95.8% in the azithromycin group, 94.6% in the levofloxacin group, and 94.4% in the historical control group. No 30-day mortality or recurrences were observed, and the 3-year rates of recurrence and mortality were very low in both groups. Adverse events occurrence was also infrequent. Conclusion A PCT-guided strategy with a rapid point-of-care testing safely allowed selecting empirical narrow-spectrum antibiotics in outpatients with CAP. Trial registration The study is registered with ClinicalTrials.gov, number NCT02600806 PMID:28426811

  12. Performance of Multiple Risk Assessment Tools to Predict Mortality for Adult Respiratory Distress Syndrome with Extracorporeal Membrane Oxygenation Therapy: An External Validation Study Based on Chinese Single-center Data.

    Science.gov (United States)

    Huang, Lei; Li, Tong; Xu, Lei; Hu, Xiao-Min; Duan, Da-Wei; Li, Zhi-Bo; Gao, Xin-Jing; Li, Jun; Wu, Peng; Liu, Ying-Wu; Wang, Song; Lang, Yu-Heng

    2016-07-20

    There has been no external validation of survival prediction models for severe adult respiratory distress syndrome (ARDS) with extracorporeal membrane oxygenation (ECMO) therapy in China. The aim of study was to compare the performance of multiple models recently developed for patients with ARDS undergoing ECMO based on Chinese single-center data. A retrospective case study was performed, including twenty-three severe ARDS patients who received ECMO from January 2009 to July 2015. The PRESERVE (Predicting death for severe ARDS on VV-ECMO), ECMOnet, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score, a center-specific model developed for inter-hospital transfers receiving ECMO, and the classical risk-prediction scores of Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) were calculated. In-hospital and six-month mortality were regarded as the endpoints and model performance was evaluated by comparing the area under the receiver operating characteristic curve (AUC). The RESP and APACHE II scores showed excellent discriminate performance in predicting survival with AUC of 0.835 (95% confidence interval [CI], 0.659-1.010, P = 0.007) and 0.762 (95% CI, 0.558-0.965, P = 0.035), respectively. The optimal cutoff values were risk class 3.5 for RESP and 35.5 for APACHE II score, and both showed 70.0% sensitivity and 84.6% specificity. The excellent performance of these models was also evident for the pneumonia etiological subgroup, for which the SOFA score was also shown to be predictive, with an AUC of 0.790 (95% CI, 0.571-1.009, P = 0.038). However, the ECMOnet and the score developed for externally retrieved ECMO patients failed to demonstrate significant discriminate power for the overall cohort. The PRESERVE model was unable to be evaluated fully since only one patient died six months postdischarge. The RESP, APCHAE II, and SOFA scorings systems show good predictive value for intra

  13. GAME (Goals - Activity - Motor Enrichment): protocol of a single blind randomised controlled trial of motor training, parent education and environmental enrichment for infants at high risk of cerebral palsy.

    Science.gov (United States)

    Morgan, Catherine; Novak, Iona; Dale, Russell C; Guzzetta, Andrea; Badawi, Nadia

    2014-10-07

    Cerebral palsy is the most common physical disability of childhood and early detection is possible using evidence based assessments. Systematic reviews