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Sample records for subgroups differences emerged

  1. Differences in Psychosocial Predictors of Obesity Among LGBT Subgroups.

    Science.gov (United States)

    Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

    2016-08-01

    The purpose of the current study was to examine the overall presence of and differences in rates of overweight/obesity among a large, nationally diverse sample of lesbian, gay, bisexual, transgender (LGBT)-identified individuals (i.e., cisgender lesbians, cisgender gay men, cisgender bisexual women, cisgender bisexual men, transgender women, and transgender men) and to identify specific psychosocial predictors of obesity within each of the six LGBT subgroups. A total of 2702 LGBT-identified participants participated in the online study. Participants completed a series of demographic questions (including weight and height) and the Depression Anxiety Stress Scale 21. The percentage of participants who were overweight/obese did not differ significantly across LGBT subgroups, with 61.1% of the total sample being overweight/obese. However, the percentage of participants who self-reported body mass indexes in the obese range differed significantly across the six LGBT subgroups, with the highest prevalence in transgender men (46.0%). In addition, the predictors of obesity varied by subgroup, with age a significant predictor for cisgender lesbians, cisgender gay men, and cisgender bisexual women, relationship status for cisgender bisexual women, employment status for both cisgender gay men and cisgender bisexual women, education level for cisgender lesbians, and depression, anxiety, and stress for cisgender gay men. None of the examined psychosocial factors emerged as predictors of obesity for cisgender bisexual men, transgender women, or transgender men. These findings suggest that there are substantial variations in the presence and predictors of obesity across LGBT subgroups that support the need for culturally tailored healthy weight promotion efforts within the LGBT community.

  2. Depression in later life : three etiologically different subgroups

    NARCIS (Netherlands)

    Van den Berg, M.D.; Oldehinkel, A.J.; Bouhuys, A.L.; Brilman, E.I.; Beekman, A.T.F.; Ormel, J.

    Background: Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and

  3. Pain rating schema: three distinct subgroups of individuals emerge when rating mild, moderate, and severe pain

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    Frey-Law LA

    2013-12-01

    Full Text Available Laura A Frey-Law,1 Jennifer E Lee,2,3 Alex M Wittry,4 Myles Melyon5 1Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, USA; 2Mount Mercy University, Department of Psychology, Cedar Rapids, IA, USA; ³College of Nursing, The University of Iowa, 4Department of Emergency Medicine, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA; 5Midwestern University, Glendale, AZ, USA Background: While the validity of pain assessment has been well documented, the underlying schema (ie, organized, preconceived ideas of how individuals interpret numerical pain ratings is not well understood. This study's objectives were to examine numerical pain intensity ratings, from (0 to 10 cm on the visual analog scale [VAS] across multiple severities of commonly experienced acute pain conditions to determine whether the ratings differed between these pain conditions and/or between individuals. Methods: A community sample (N=365, 66% female rated their anticipated pain intensity (VAS for threshold, mild, moderate, severe, and tolerance level, using several common pain conditions: headache, toothache, joint injury, delayed-onset muscle soreness, burns, and “general pain.” Results: Cluster analysis revealed three subgroups of individuals, suggesting three types of underlying pain rating schema: 1 Low Rating subgroup (low VAS pain intensity ratings across all the pain severity categories; 2 Low/High Rating subgroup (low VAS pain intensity rating for mild, but high VAS pain intensity rating for severe pain; and 3 High Rating subgroup (high VAS pain intensity ratings across all the pain severity categories. Overall, differences between pain conditions were small: muscle soreness pain intensity was consistently rated lower than the other pain types across severities. The highest pain ratings varied between joint injury and general pain, depending on severity level. No effects of sex or current experience of pain

  4. Baseline hospital performance and the impact of medical emergency teams: Modelling vs. conventional subgroup analysis

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    Hillman Ken

    2009-12-01

    Full Text Available Abstract Background To compare two approaches to the statistical analysis of the relationship between the baseline incidence of adverse events and the effect of medical emergency teams (METs. Methods Using data from a cluster randomized controlled trial (the MERIT study, we analysed the relationship between the baseline incidence of adverse events and its change from baseline to the MET activation phase using quadratic modelling techniques. We compared the findings with those obtained with conventional subgroup analysis. Results Using linear and quadratic modelling techniques, we found that each unit increase in the baseline incidence of adverse events in MET hospitals was associated with a 0.59 unit subsequent reduction in adverse events (95%CI: 0.33 to 0.86 after MET implementation and activation. This applied to cardiac arrests (0.74; 95%CI: 0.52 to 0.95, unplanned ICU admissions (0.56; 95%CI: 0.26 to 0.85 and unexpected deaths (0.68; 95%CI: 0.45 to 0.90. Control hospitals showed a similar reduction only for cardiac arrests (0.95; 95%CI: 0.56 to 1.32. Comparison using conventional subgroup analysis, on the other hand, detected no significant difference between MET and control hospitals. Conclusions Our study showed that, in the MERIT study, when there was dependence of treatment effect on baseline performance, an approach based on regression modelling helped illustrate the nature and magnitude of such dependence while sub-group analysis did not. The ability to assess the nature and magnitude of such dependence may have policy implications. Regression technique may thus prove useful in analysing data when there is a conditional treatment effect.

  5. Balance Impairments in Different Subgroups of Patients With Migraine.

    Science.gov (United States)

    Carvalho, Gabriela F; Bonato, Paolo; Florencio, Lidiane L; Pinheiro, Carina F; Dach, Fabiola; Bigal, Marcelo E; Bevilaqua-Grossi, Debora

    2017-03-01

    Patients with migraine often experience balance impairments. However, the relationship between clinical features - like aura and chronicity - and the severity of balance impairments is not well established. The objective of this study was to assess balance impairments in different subgroups of migraine patients. One hundred five subjects diagnosed according to the ICHD-III were recruited in the study. They were uniformly distributed among three groups: migraine with aura, migraine without aura, and chronic migraine. Thirty-five controls were also recruited in the study. Balance impairments were assessed in all subjects via the modified Sensory Organization test and the Limits of Stability test. The results in the four groups were compared using ANCOVA tests with age, BMI, presence of dizziness, level of physical activity, time of migraine onset, and medication intake as covariates. Subjects in the migraine with aura and the chronic migraine groups showed poorer balance control than control subjects in three of the four conditions tested using the modified Sensory Organization test: FirmCE: CG: 1.5 cm2 , 95%CI 1.3 to 1.7; M: 2.1 cm2 , 95%CI 1.6 to 2.6; MA: 4.5 cm2 , 95%CI 3.2 to 5.8; CM: 4.5 cm2 , 95%CI 3.0 to 6.0; P migraine without aura group (P migraine groups were found in the reaction time, movement velocity, endpoint excursion, and maximal excursion parameters (P  .05). There is evidence of balance control impairments in subjects with all subtypes of migraine compared to control subjects. The presence of aura and frequent migraine attacks reflect negatively in the postural control performance and may have a significant clinical impact in patients with migraine that should be addressed with appropriate clinical interventions. © 2016 American Headache Society.

  6. Does a subgroup of postpolio patients need different management?

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    Bridgens, Ruth

    2015-07-01

    Throughout the 30 years of postpolio syndrome (PPS) research, there have been many puzzling anomalies in the data and not enough information to make sense of them. It is therefore welcome that Winberg et al have examined physical activity in relation to life satisfaction, sex and age. They hypothesized that activity would decrease with age and found the opposite. This result is not so surprising as Ostlund et al found that vitality was associated with older age and that younger age was associated with more pain, increasing physical fatigue, decreasing sleep quality and reducing activity. This commentary will examine past postpolio research with unexpected results in order to describe a subgroup of patients who may be more susceptible to overusing muscles and have particular exercise and activity needs. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media

    DEFF Research Database (Denmark)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse

    2015-01-01

    OBJECTIVE: The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to...

  8. Revealing the genomic differences between two subgroups in Lactobacillus gasseri.

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    Tada, Ipputa; Tanizawa, Yasuhiro; Endo, Akihito; Tohno, Masanori; Arita, Masanori

    2017-01-01

    Being an autochthonous species in humans, Lactobacillus gasseri is widely used as a probiotic for fermented products. We thoroughly compared the gene contents of 75 L. gasseri genomes and identified two intraspecific groups by the average nucleotide identity (ANI) threshold of 94%. Group I, with 48 strains, possessed 53 group-specific genes including the gassericin T cluster (9 genes) and N-acyl homoserine lactone lactonase. Group II, with 27 strains, including the type strain ATCC 33323, possessed group-specific genes with plasmid- or phage-related annotations. The genomic differences provide evidences for demarcating a new probiotic group within L. gasseri.

  9. Classification of low back-related leg pain: do subgroups differ in disability and psychosocial factors?

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    Walsh, Jeremy; Hall, Toby

    2009-01-01

    It has been proposed that patients with low back-related leg pain can be classified according to pain mechanisms into four distinct subgroups: Central Sensitization (CS), Denervation (D), Peripheral Nerve Sensitization (PNS), and Musculoskeletal (M). The purpose of this study was to determine whether there were any differences in terms of disability and psychosocial factors between these four subgroups. Forty-five subjects with low back-related leg pain completed the Oswestry Disability Index, the hospital Anxiety and Depression Scale, and the Fear Avoidance Beliefs Questionnaire. Subsequently, an examiner blinded to the questionnaire results classified the subjects into one of the four subgroups, according to the findings of the self-administered Leeds Assessment of Neuropathic Signs and Symptoms questionnaire and a physical examination. It was found that the PNS subgroup had significantly greater disability compared to all other subgroups and significantly greater fear avoidance beliefs about physical activity compared to the CS and D subgroups. This highlights the importance of sub-classification but also the need to take into account disability and psychosocial factors in the management of low back-related leg pain.

  10. Dietary and physical activity behaviors of New York City children from different ethnic minority subgroups.

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    Vangeepuram, Nita; Mervish, Nancy; Galvez, Maida P; Brenner, Barbara; Wolff, Mary S

    2012-01-01

    To examine racial/ethnic differences in diet and physical activity behaviors in ethnic minority New York City children. Cross-sectional data from a community-based study of 486 6- to 8-year-old children were used. Race/ethnicity was derived using a caregiver's report of child's race and Hispanic ancestry. Dietary intake was obtained by 24-hour diet recalls using the Nutrition Data System for Research. Physical activity was assessed with pedometers and caregiver interviews. We compared diet and activity measures across racial/ethnic subgroups using chi-square and analysis of variance tests. Multivariate analyses adjusted for age, gender, body mass index, and caregiver education (with breastfeeding history and total energy intake included in diet models). Participants (N = 486) were categorized as Mexican (29.4%), Dominican (8.4%), Puerto Rican (20.6%), other/mixed Hispanic (14.0%), or non-Hispanic black (27.6%). Obesity rates were lower in non-Hispanic blacks (18%) than in Hispanics (31%). Mexicans had the lowest obesity rates among Hispanic subgroups (25%), and Dominicans had the highest (39%). There were differences in mean daily servings of food groups, with Mexicans having healthier diets and Puerto Ricans and non-Hispanic Blacks having less healthy diets. Sedentary time was lower in Mexicans than in other groups in adjusted models. Examination of additional models, including home language, did not show significant differences in the estimates. Diet and activity behaviors varied across racial/ethnic subgroups. Specifically, Mexican children had healthier diets, the least amount of sedentary time, and the lowest rates of obesity among the Hispanic subgroups examined. Targeted interventions in ethnic subgroups may be warranted to address specific behaviors. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Can I retake it? Exploring subgroup differences and criterion-related validity in promotion retesting.

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    Van Iddekinge, Chad H; Morgeson, Frederick P; Schleicher, Deidra J; Campion, Michael A

    2011-09-01

    Despite recent interest in the practice of allowing job applicants to retest, surprisingly little is known about how retesting affects 2 of the most critical factors on which staffing procedures are evaluated: subgroup differences and criterion-related validity. We examined these important issues in a sample of internal candidates who completed a job-knowledge test for a within-job promotion. This was a useful context for these questions because we had job-performance data on all candidates (N = 403), regardless of whether they passed or failed the promotion test (i.e., there was no direct range restriction). We found that retest effects varied by subgroup, such that females and younger candidates improved more upon retesting than did males and older candidates. There also was some evidence that Black candidates did not improve as much as did candidates from other racial groups. In addition, among candidates who retested, their retest scores were somewhat better predictors of subsequent job performance than were their initial test scores (rs = .38 vs. .27). The overall results suggest that retesting does not negatively affect criterion-related validity and may even enhance it. Furthermore, retesting may reduce the likelihood of adverse impact against some subgroups (e.g., female candidates) but increase the likelihood of adverse impact against other subgroups (e.g., older candidates). PsycINFO Database Record (c) 2011 APA, all rights reserved

  12. Differences in end-range lumbar flexion during slumped sitting and forward bending between low back pain subgroups and genders

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    Hoffman, Shannon L.; Johnson, Molly B.; Zou, Dequan; Van Dillen, Linda R.

    2012-01-01

    Patterns of lumbar posture and motion are associated with low back pain (LBP). Research suggests LBP subgroups demonstrate different patterns during common tasks. This study assessed differences in end-range lumbar flexion during two tasks between two LBP subgroups classified according to the Movement System Impairment model. Additionally, the impact of gender differences on subgroup differences was assessed. Kinematic data were collected. Subjects in the Rotation (Rot) and Rotation with Extension (RotExt) LBP subgroups were asked to sit slumped and bend forward from standing. Lumbar end-range flexion was calculated. Subjects reported symptom behavior during each test. Compared to the RotExt subgroup, the Rot subgroup demonstrated greater end-range lumbar flexion during slumped sitting and a trend towards greater end-range lumbar flexion with forward bending. Compared to females, males demonstrated greater end-range lumbar flexion during slumped sitting and forward bending. A greater proportion of people in the Rot subgroup reported symptoms with each test compared to the RotExt subgroup. Males and females were equally likely to report symptoms with each test. Gender differences were not responsible for LBP subgroup differences. Subgrouping people with LBP provides insight into differences in lumbar motion within the LBP population. Results suggesting potential consistent differences across flexion-related tasks support the presence of stereotypical movement patterns that are related to LBP. PMID:22261650

  13. Differences in end-range lumbar flexion during slumped sitting and forward bending between low back pain subgroups and genders.

    Science.gov (United States)

    Hoffman, Shannon L; Johnson, Molly B; Zou, Dequan; Van Dillen, Linda R

    2012-04-01

    Patterns of lumbar posture and motion are associated with low back pain (LBP). Research suggests LBP subgroups demonstrate different patterns during common tasks. This study assessed differences in end-range lumbar flexion during two tasks between two LBP subgroups classified according to the Movement System Impairment model. Additionally, the impact of gender differences on subgroup differences was assessed. Kinematic data were collected. Subjects in the Rotation (Rot) and Rotation with Extension (RotExt) LBP subgroups were asked to sit slumped and bend forward from standing. Lumbar end-range flexion was calculated. Subjects reported symptom behaviour during each test. Compared to the RotExt subgroup, the Rot subgroup demonstrated greater end-range lumbar flexion during slumped sitting and a trend towards greater end-range lumbar flexion with forward bending. Compared to females, males demonstrated greater end-range lumbar flexion during slumped sitting and forward bending. A greater proportion of people in the Rot subgroup reported symptoms with each test compared to the RotExt subgroup. Males and females were equally likely to report symptoms with each test. Gender differences were not responsible for LBP subgroup differences. Subgrouping people with LBP provides insight into differences in lumbar motion within the LBP population. Results suggesting potential consistent differences across flexion-related tasks support the presence of stereotypical movement patterns that are related to LBP. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks.

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    Hemming, Rebecca; Sheeran, Liba; van Deursen, Robert; Sparkes, Valerie

    2017-07-21

    A multidimensional classification approach suggests that motor control impairment subgroups exist in non-specific chronic low back pain (NSCLBP). Differences in sitting lumbar posture have been identified between two such subgroups [flexion pattern (FP) and active extension pattern (AEP)] and healthy individuals; however, functional spinal movement has not been explored. This study will evaluate whether NSCLBP subgroups exhibit regional spinal kinematic differences, compared to healthy individuals, during functional tasks. Observational, cross-sectional study design. Spinal kinematics of 50 NSCLBP subjects (27 FP, 23 AEP) and 28 healthy individuals were investigated using 3D motion analysis (Vicon™) during functional tasks [reaching upwards, step down, step up, lifting, and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor]. Mean sagittal angle for the total thoracic, total lumbar, upper thoracic, lower thoracic, upper lumbar, and lower lumbar regions between groups was compared. Significant differences were observed in lower thoracic and upper lumbar regions between NSCLBP subgroups during most tasks. Significant differences were observed between the FP and healthy group in the lower thoracic region during stand-to-sit-to-stand tasks and bending (and returning from) to retrieve a pen from the floor. All significant results demonstrated the FP group to operate in comparatively greater flexion. The thoraco-lumbar spine discriminated between FP and AEP, and FP and healthy groups during functional tasks. FP individuals demonstrated more kyphotic thoraco-lumbar postures, which may be pain provocative. No significant differences were observed between AEP and healthy groups, suggesting that alternative mechanisms may occur in AEP.

  15. [Association between anxiety and quality of life in different subgroups irritable bowel syndrome].

    Science.gov (United States)

    Fosado-Gayosso, M; Casillas-Guzmán, G B; Serralde-Zúñiga, A E; Pérez-Hernández, J L; Higuera-de la Tijera, M F; Pérez-Torres, E; Abdo-Francis, J M

    2011-01-01

    Irritable Bowel Syndrome (IBS) is a frequent functional digestive disorder. Several studies have established the relationship between IBS and anxiety. Also it has been described a negative impact on quality of life in patients who suffer it, but in our country none of these studies have used ROME III criteria for evaluation. To know the frequency of anxiety in the different subgroups of IBS and its impact on quality of life. The study was conducted in patients who attended for first time to the outpatient clinic of our hospital for ten months. Adult patients who met the criteria of IBS were included. We applied the SF-36 quality of life questionnaire and the Hamilton anxiety scale. One hundred and two patients who met for IBS criteria were included, of which 85% had anxiety. The IBS-C was the most frequent subgroup. Divided by subgroups, found that 52%, 85.1%, 90% and 80.9% had anxiety for IBS-C, IBS-D, IBS-M and IBS-NC respectively, without significant difference between groups. Patients with anxiety had lower quality of life scores in the categories of physical health, mental health and change in the state of health, (54.2 ± 18 vs. 72 ± 16, 52.8 ± 20 vs. 74 ± 14, 48 ± 28 vs. 59 ± 32) with respect to those who have no anxiety (p anxiety was not associated to any subgroup in particular of IBS, the presence of this influenced adversely and significantly on the quality of life of patients who suffer it.

  16. Different outcomes in subgroups of patients with long-term musculoskeletal pain

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    Jan Sture Skouen

    2009-10-01

    Full Text Available Former studies have questioned the effectiveness of multidisciplinary rehabilitation for working-age adults with musculoskeletal pain problems. The lack of analysis within subgroups may explain why an effect of treatment of long-term musculoskeletal pain was not documented in former studies. In this article three later studies on long-term musculoskeletal pain patients are presented. The challenge of these studies was to identify subgroups of patients who benefit from different types of treatments. This article present the main findings of a large RCT with up till 54 months of follow-up among 664 persons sicklisted for musculoskeletal pain. It was hypothesised that different categories of patients need different treatment programs in order to get back to work. Patients with different prognoses for return to work were identified by means of a screening instrument, and it was tested whether those with poor prognosis need more extensive multidisciplinary treatment, compared to patients with less psychosocial and physical problems. Also, the effect of different treatment programs among patients with different diagnoses (ICD-9, low back pain and chronic widespread pain and among men and women was examined. The results of the three studies support the authors’ hypothesis that different categories of patients need different treatment programs. A higher percentage of return to work was demonstrated when the right treatment was given to the right patient, and considerable cost effectiveness was demonstrated

  17. Twitch and nontwitch motoneuron subgroups in the oculomotor nucleus of monkeys receive different afferent projections.

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    Wasicky, Richard; Horn, Anja K E; Büttner-Ennever, Jean A

    2004-11-08

    Motoneurons in the primate oculomotor nucleus can be divided into two categories, those supplying twitch muscle fibers and those supplying nontwitch muscle fibers. Recent studies have shown that twitch motoneurons lie within the classical oculomotor nucleus (nIII), and nontwitch motoneurons lie around the borders. Nontwitch motoneurons of medial and inferior rectus are in the C group dorsomedial to nIII, whereas those of inferior oblique and superior rectus lie near the midline are in the S group. In this anatomical study, afferents to the twitch and nontwitch subgroups of nIII have been anterogradely labeled by injections of tritiated leucine into three areas and compared. 1) Abducens nucleus injections gave rise to silver grain deposits over all medial rectus subgroups, both twitch and nontwitch. 2) Laterally placed vestibular complex injections that included the central superior vestibular nucleus labeled projections only in twitch motoneuron subgroups. However, injections into the parvocellular medial vestibular nucleus (mvp), or Y group, resulted in labeled terminals over both twitch and nontwitch motoneurons. 3) Pretectal injections that included the nucleus of the optic tract (NOT), and the olivary pretectal nucleus (OLN), labeled terminals only over nontwitch motoneurons, in the contralateral C group and in the S group. Our study demonstrates that twitch and nontwitch motoneuron subgroups do not receive identical afferent inputs. They can be controlled either in parallel, or independently, suggesting that they have basically different functions. We propose that twitch motoneurons primarily drive eye movements and nontwitch motoneurons the tonic muscle activity, as in gaze holding and vergence, possibly involving a proprioceptive feedback system. 2004 Wiley-Liss, Inc.

  18. Internalin profiling and multilocus sequence typing suggest four Listeria innocua subgroups with different evolutionary distances from Listeria monocytogenes

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    Wang Jun

    2010-03-01

    Full Text Available Abstract Background Ecological, biochemical and genetic resemblance as well as clear differences of virulence between L. monocytogenes and L. innocua make this bacterial clade attractive as a model to examine evolution of pathogenicity. This study was attempted to examine the population structure of L. innocua and the microevolution in the L. innocua-L. monocytogenes clade via profiling of 37 internalin genes and multilocus sequence typing based on the sequences of 9 unlinked genes gyrB, sigB, dapE, hisJ, ribC, purM, gap, tuf and betL. Results L. innocua was genetically monophyletic compared to L. monocytogenes, and comprised four subgroups. Subgroups A and B correlated with internalin types 1 and 3 (except the strain 0063 belonging to subgroup C and internalin types 2 and 4 respectively. The majority of L. innocua strains belonged to these two subgroups. Subgroup A harbored a whole set of L. monocytogenes-L. innocua common and L. innocua-specific internalin genes, and displayed higher recombination rates than those of subgroup B, including the relative frequency of occurrence of recombination versus mutation (ρ/θ and the relative effect of recombination versus point mutation (r/m. Subgroup A also exhibited a significantly smaller exterior/interior branch length ratio than expected under the coalescent model, suggesting a recent expansion of its population size. The phylogram based on the analysis with correction for recombination revealed that the time to the most recent common ancestor (TMRCA of L. innocua subgroups A and B were similar. Additionally, subgroup D, which correlated with internalin type 5, branched off from the other three subgroups. All L. innocua strains lacked seventeen virulence genes found in L. monocytogenes (except for the subgroup D strain L43 harboring inlJ and two subgroup B strains bearing bsh and were nonpathogenic to mice. Conclusions L. innocua represents a young species descending from L. monocytogenes and

  19. Internalin profiling and multilocus sequence typing suggest four Listeria innocua subgroups with different evolutionary distances from Listeria monocytogenes.

    Science.gov (United States)

    Chen, Jianshun; Chen, Qiaomiao; Jiang, Lingli; Cheng, Changyong; Bai, Fan; Wang, Jun; Mo, Fan; Fang, Weihuan

    2010-03-31

    Ecological, biochemical and genetic resemblance as well as clear differences of virulence between L. monocytogenes and L. innocua make this bacterial clade attractive as a model to examine evolution of pathogenicity. This study was attempted to examine the population structure of L. innocua and the microevolution in the L. innocua-L. monocytogenes clade via profiling of 37 internalin genes and multilocus sequence typing based on the sequences of 9 unlinked genes gyrB, sigB, dapE, hisJ, ribC, purM, gap, tuf and betL. L. innocua was genetically monophyletic compared to L. monocytogenes, and comprised four subgroups. Subgroups A and B correlated with internalin types 1 and 3 (except the strain 0063 belonging to subgroup C) and internalin types 2 and 4 respectively. The majority of L. innocua strains belonged to these two subgroups. Subgroup A harbored a whole set of L. monocytogenes-L. innocua common and L. innocua-specific internalin genes, and displayed higher recombination rates than those of subgroup B, including the relative frequency of occurrence of recombination versus mutation (rho/theta) and the relative effect of recombination versus point mutation (r/m). Subgroup A also exhibited a significantly smaller exterior/interior branch length ratio than expected under the coalescent model, suggesting a recent expansion of its population size. The phylogram based on the analysis with correction for recombination revealed that the time to the most recent common ancestor (TMRCA) of L. innocua subgroups A and B were similar. Additionally, subgroup D, which correlated with internalin type 5, branched off from the other three subgroups. All L. innocua strains lacked seventeen virulence genes found in L. monocytogenes (except for the subgroup D strain L43 harboring inlJ and two subgroup B strains bearing bsh) and were nonpathogenic to mice. L. innocua represents a young species descending from L. monocytogenes and comprises four subgroups: two major subgroups A and B

  20. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media.

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    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse; Faber, Christian Emil; Johansen, Eva Charlotte Jung; Godballe, Christian

    2015-10-01

    The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to investigate possible predictors for clinical success. Longitudinal observational study. Secondary care units. Four hundred ninety-one families were enrolled in the study. The Otitis Media-6 questionnaire was applied in the assessment of child quality of life. Caregivers completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube treatment. A diagnosis of rAOM was found to predict baseline quality of life. Children with rAOM with or without OME were found to suffer significantly more than children with only OME before treatment. Factors associated with disease severity were found to predict clinical success. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  1. Subgroups of Paediatric Acute Lymphoblastic Leukaemia Might Differ Significantly in Genetic Predisposition to Asparaginase Hypersensitivity.

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    Nóra Kutszegi

    Full Text Available L-asparaginase (ASP is a key element in the treatment of paediatric acute lymphoblastic leukaemia (ALL. However, hypersensitivity reactions (HSRs to ASP are major challenges in paediatric patients. Our aim was to investigate genetic variants that may influence the risk to Escherichia coli-derived ASP hypersensitivity. Sample and clinical data collection was carried out from 576 paediatric ALL patients who were treated according to protocols from the Berlin-Frankfurt-Münster Study Group. A total of 20 single nucleotide polymorphisms (SNPs in GRIA1 and GALNT10 genes were genotyped. Patients with GRIA1 rs4958351 AA/AG genotype showed significantly reduced risk to ASP hypersensitivity compared to patients with GG genotype in the T-cell ALL subgroup (OR = 0.05 (0.01-0.26; p = 4.70E-04, while no such association was found in pre-B-cell ALL. In the medium risk group two SNPs of GRIA1 (rs2055083 and rs707176 were associated significantly with the occurrence of ASP hypersensitivity (OR = 0.21 (0.09-0.53; p = 8.48E-04 and OR = 3.02 (1.36-6.73; p = 6.76E-03, respectively. Evaluating the genders separately, however, the association of rs707176 with ASP HSRs was confined only to females. Our results suggest that genetic variants of GRIA1 might influence the risk to ASP hypersensitivity, but subgroups of patients can differ significantly in this respect.

  2. Differences in MRI findings between subgroups of recent-onset childhood arthritis

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    Kirkhus, Eva [Oslo University Hospital, Rikshospitalet, Department of Radiology, Oslo (Norway); Flatoe, Berit; Smith, Hans-Joergen [Oslo University Hospital, Rikshospitalet and University of Oslo, Faculty of Medicine, Department of Radiology, Oslo (Norway); Riise, Oeystein [Oslo University Hospital, Rikshospitalet, Department of Pediatrics, Oslo (Norway); Reiseter, Tor [Oslo University Hospital, Ullevaal, Department of Radiology, Oslo (Norway)

    2011-04-15

    MRI is sensitive for joint inflammation, but its ability to separate subgroups of arthritis in children has been questioned. Infectious arthritis (IA), postinfectious arthritis (PA), transient arthritis (TA) and juvenile idiopathic arthritis (JIA) are subgroups that may need early, different treatment. To determine whether MRI findings differ in IA, PA/TA and JIA in recent-onset childhood arthritis. Fifty-nine children from a prospective study of incidence of arthritis (n = 216) were, based on clinical and biochemical criteria, examined by MRI. Joint fluid, synovium, bone marrow, soft tissue and cartilage were scored retrospectively and analysed by Pearson chi-square test and logistic regression analysis. Fifty-nine children had MRI of one station. IA was suggested by bone marrow oedema (OR 7.46, P = 0.011) and absence of T1-weighted and T2-weighted low signal intensity synovial tissue (OR 0.06, P = 0.015). Furthermore, soft-tissue oedema and reduced contrast enhancement in the epiphyses were more frequent in children with IA. JIA correlated positively with low signal intensity synovial tissue (OR 13.30, P < 0.001) and negatively with soft-tissue oedema (OR 0.20, P = 0.018). No significant positive determinants were found for PA/TA, but bone marrow oedema, soft-tissue oedema, irregular thickened synovium and low signal intensity synovial tissue was less frequent than in IA/JIA. In children with high clinical suspicion of recent onset arthritis, there was a significant difference in the distribution of specific MRI features among the diagnostic groups. (orig.)

  3. Neuropsychological test performance of Spanish speakers: is performance different across different Spanish-speaking subgroups?

    Science.gov (United States)

    Buré-Reyes, Annelly; Hidalgo-Ruzzante, Natalia; Vilar-López, Raquel; Gontier, Javier; Sánchez, Laura; Pérez-García, Miguel; Puente, Antonio E

    2013-01-01

    Even though theories and research have pointed out the importance of variables such as age, gender, or education on neuropsychological assessment, much less emphasis has been placed on language and culture. With the increasing population of Spanish speakers in North America and the limited amount of clinical and scholarly information currently available, neuropsychological assessment of this group has similarly become of increasing importance. Though several studies have been published over the last two decades, an assumption exists that all Spanish speakers, holding education and age constant, would perform similarly regardless of their origin. To address this assumption, a sample of 126 participants was tested from four different countries (Chile, Dominican Republic, Puerto Rico, and Spain). Participants were compared on the following commonly used neuropsychological tests: Verbal Serial Learning Curve, Rey- Osterrieth Complex Figure Test, Verbal Phonemic Fluency Test, the Stroop Color and Word Test, and the Trail Making Test. Analyses revealed significant differences across the groups in two of the five tests administered. Significant differences were observed in the delayed recall of the Serial Learning Test and in the Verbal Fluency Test. The findings highlight the importance of within-group differences between Spanish speakers.

  4. Emergency contraception: different bioethical perspectives

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2007-10-01

    Full Text Available Emergency contraceptives, in this case post-morning pills, are contraceptive methods used to avoid an unwanted pregnancy after an unprotected sexual intercourse. Their use is feeding a strong ethical debate between subjects for and against their prescription and leading some health professionals to conscientious objection. Among people contrary to prescription some oppose to it because of a general refuse of all contraceptive methods, others considering post-morning pills as abortive. Among people supporting prescription, some consider emergency contraception necessary to assure fundamental women’s rights, in particular the right to sexual auto-determination, while others prescribe emergency contraception only to avoid a greater demand for abortion. It is up to the Italian National Health Service warranting a correct balance between the two opposite positions, that can protect women’s right of access to health services.

  5. Identification of five chronic obstructive pulmonary disease subgroups with different prognoses in the ECLIPSE cohort using cluster analysis.

    Science.gov (United States)

    Rennard, Stephen I; Locantore, Nicholas; Delafont, Bruno; Tal-Singer, Ruth; Silverman, Edwin K; Vestbo, Jørgen; Miller, Bruce E; Bakke, Per; Celli, Bartolomé; Calverley, Peter M A; Coxson, Harvey; Crim, Courtney; Edwards, Lisa D; Lomas, David A; MacNee, William; Wouters, Emiel F M; Yates, Julie C; Coca, Ignacio; Agustí, Alvar

    2015-03-01

    Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that likely includes clinically relevant subgroups. To identify subgroups of COPD in ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints) subjects using cluster analysis and to assess clinically meaningful outcomes of the clusters during 3 years of longitudinal follow-up. Factor analysis was used to reduce 41 variables determined at recruitment in 2,164 patients with COPD to 13 main factors, and the variables with the highest loading were used for cluster analysis. Clusters were evaluated for their relationship with clinically meaningful outcomes during 3 years of follow-up. The relationships among clinical parameters were evaluated within clusters. Five subgroups were distinguished using cross-sectional clinical features. These groups differed regarding outcomes. Cluster A included patients with milder disease and had fewer deaths and hospitalizations. Cluster B had less systemic inflammation at baseline but had notable changes in health status and emphysema extent. Cluster C had many comorbidities, evidence of systemic inflammation, and the highest mortality. Cluster D had low FEV1, severe emphysema, and the highest exacerbation and COPD hospitalization rate. Cluster E was intermediate for most variables and may represent a mixed group that includes further clusters. The relationships among clinical variables within clusters differed from that in the entire COPD population. Cluster analysis using baseline data in ECLIPSE identified five COPD subgroups that differ in outcomes and inflammatory biomarkers and show different relationships between clinical parameters, suggesting the clusters represent clinically and biologically different subtypes of COPD.

  6. Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups.

    Science.gov (United States)

    Le, T Domi; Carney, Patricia A; Lee-Lin, Frances; Mori, Motomi; Chen, Zunqiu; Leung, Holden; Lau, Christine; Lieberman, David A

    2014-04-01

    Asian ethnic subgroups are often treated as a single demographic group in studies looking at cancer screening and health disparities. To evaluate knowledge and health beliefs associated with colorectal cancer (CRC) and CRC screening among Chinese, Korean, and Vietnamese subgroups, a survey assessed participants' demographic characteristics, healthcare utilization, knowledge, beliefs, attitudes associated with CRC and CRC screening. Exploratory factor analysis identified six factors accounting >60 % of the total variance in beliefs and attitudes. Cronbach's alpha coefficients assessed internal consistency. Differences among Asian subgroups were assessed using a Chi square, Fisher's exact, or Kruskal-Wallis test. Pearson's correlation coefficient assessed an association among factors. 654 participants enrolled: 238 Chinese, 217 Korean, and 199 Vietnamese. Statistically significant differences existed in demographic and health care provider characteristics, knowledge, and attitude/belief variables regarding CRC. These included knowledge of CRC screening modalities, reluctance to discuss cancer, belief that cancer is preventable by diet and lifestyle, and intention to undergo CRC screening. Chinese subjects were more likely to use Eastern medicine (52 % Chinese, 25 % Korean, 27 % Vietnamese; p Korean subjects were less likely to see herbs as a form of cancer prevention (34 % Chinese, 20 % Korean, 35 % Vietnamese; p Korean, 80 % Vietnamese; p < 0.0001). Important differences exist in knowledge, attitudes, and health beliefs among Asian subgroups. Understanding these differences will enable clinicians to deliver tailored, effective health messages to improve CRC screening and other health behaviors.

  7. Differences in fat and sodium intake across hypertension subgroups in the Mississippi Communities for Healthy Living (MCHL) Nutrition Intervention

    Science.gov (United States)

    The objective of this study is to examine differences between self-reported intakes of sodium, trans-fat, and total fat among hypertension (HTN) subgroups of participants in Mississippi Communities for Healthy Living nutrition education intervention. Dietary intake was measured using a food frequenc...

  8. Pain modulatory phenotypes differentiate subgroups with different clinical and experimental pain sensitivity

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Graven-Nielsen, Thomas

    2016-01-01

    between subgroups. Cuff algometry was performed on lower legs in 400 chronic pain patients to assess pressure pain threshold (cPPT), pressure pain tolerance (cPTT), temporal summation of pain (TSP: increase in pain scores to ten repeated stimulations), and conditioned pain modulation (CPM: increase in c......PPT during cuff pain conditioning on the contralateral leg). Heat detection (HDT) and heat pain thresholds (HPT) at clinical painful and non-painful body areas were assessed. Based on TSP and CPM four distinct groups were formed: Group 1 (n=85) had impaired CPM and facilitated TSP. Group 2 (n=148) had...... impaired CPM and normal TSP. Group 3 (n=45) had normal CPM and facilitated TSP. Group 4 (n=122) had normal CPM and normal TSP. Group 1 showed more pain regions compared with the other three groups (PTSP plays an important role in widespread pain. Group 1...

  9. Outcome of 24 years national surveillance in different hereditary colorectal cancer subgroups leading to more individualised surveillance

    DEFF Research Database (Denmark)

    Lindberg, Lars Joachim; Ladelund, Steen; Frederiksen, Birgitte Lidegaard

    2017-01-01

    BACKGROUND: Individuals with hereditary non-polyposis colorectal cancer (HNPCC) have a high risk of colorectal cancer (CRC). The benefits of colonic surveillance in Lynch syndrome and Amsterdam-positive (familial CRC type X familial colorectal cancer type X (FCCTX)) families are clear; only...... the interval between colonoscopies is debated. The potential benefits for families not fulfilling the Amsterdam criteria are uncertain. The aim of this study was to compare the outcome of colonic surveillance in different hereditary subgroups and to evaluate the surveillance programmes. METHODS: A prospective......, observational study on the outcome of colonic surveillance in different hereditary subgroups based on 24 years of surveillance data from the national Danish HNPCC register. RESULTS: We analysed 13 444 surveillance sessions, including 8768 incidence sessions and 20 450 years of follow-up. CRC was more incident...

  10. Prevalence of the most frequent ATC groups and subgroups in polypharmacized patients of Emergency medical service Belgrade

    Directory of Open Access Journals (Sweden)

    Petrov-Kiurski Miloranka

    2016-01-01

    Full Text Available Introduction: Anatomical Therapeutic Chemical (ATC classification system classifies active ingredients of drugs according to the organ or system on which they act and their therapeutic, pharmacological, and chemical properties. Objective: To establish the five most frequently used drug groups and subgroups according to ATC classification system in patients on polypharmacy in relation to age and gender, and to establish the five most frequent combinations of drugs used by patients on polypharmacy. Method: In the period from 2008 until 2013, one EMS doctor surveyed his patients in the field regarding drugs they were using. In 688 patients on polypharmacy, we have analyzed the prevalence of drugs according to the ACT classification system. Results: Most frequently used drugs belonged to C, N, A, R and M group of ATC classification. Of statistical significance is that Female patients were more often using drugs for treatment of musculoskeletal diseases, anti-inflammatory and antirheumatic drugs and anxiolytics, whereas male patients were using predominantly drugs from R category and antiarrhythmics. Difference is statistically significant. Also statistically significant is that patients younger than 65 have more often used lipid-lowering drugs, antiepileptic, anxiolytics, antidepressants and drugs for treatment of respiratory diseases, whereas patient older than 65 have more often used drugs for treatment of cardiovascular diseases and vasodilatating drugs. Combination of drugs that act on cardiovascular, nervous and digestive system was the most frequently used combination. Conclusion: The most often used drugs belonged to C, N, A, R and MATC group, and the most frequent combination of drugs was the combination of drugs used for treatment of cardiovascular system, nervous and digestive system. Women are using drugs for treatment of musculoskeletal system, including antinflammatory and antirheumatic drugs, as well as anxyolytics more often than men

  11. The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups.

    Science.gov (United States)

    Jin, Yuchang; Xu, Jiuping; Liu, Dongyue

    2014-12-01

    This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4%. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. One year following the earthquake, 40.1 and 51.1% of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected.

  12. Distinct Wound Healing and Quality-of-Life Outcomes in Subgroups of Patients With Venous Leg Ulcers With Different Symptom Cluster Experiences.

    Science.gov (United States)

    Finlayson, Kathleen; Miaskowski, Christine; Alexander, Kimberly; Liu, Wei-Hong; Aouizerat, Bradley; Parker, Christina; Maresco-Pennisi, Diane; Edwards, Helen

    2017-05-01

    Adults with venous leg ulcers frequently experience multiple symptoms that may influence quality of life (QOL). The objective of this study was to identify patient subgroups based on their experience with a pain-depression-fatigue-sleep disturbance symptom cluster and to identify differences in patient characteristics and wound-healing and QOL outcomes between the subgroups. Secondary data analysis from previous longitudinal studies of 247 patients with venous leg ulcers. Latent class analysis identified subgroups of patients with distinct experiences with the symptom cluster of pain, depression, fatigue, and sleep disturbance. Hierarchical regression analysis identified relationships between the subgroups and QOL outcomes. Survival analysis identified differences between the subgroups and ulcer healing. Latent class analysis found 67% of patients were in a mild symptom subgroup (i.e., experiencing no or mild pain, depressive symptoms, fatigue, or sleep disturbance). One-third of the samples were in a severe symptom subgroup, who reported moderate-to-severe levels of these symptoms. Compared with the mild subgroup, patients in the severe subgroup had poorer QOL scores (t = 8.06, P ulcer healing, decreased QOL, and membership in the severe symptom subgroup. These findings suggest that comprehensive symptom assessment is needed to identify patients at higher risk for poor outcomes and enable early intervention. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. Driver style and driver skill – Clustering sub-groups of drivers differing in their potential danger in traffic

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

    mirrored the self-reported frequency of aberrant driving behaviors. K-means cluster analysis revealed four distinct clusters that differed in the frequency of aberrant driving behavior and driving skills, as well as individual characteristics and driving related factors such as annual mileage, accident...... frequency and number of tickets and fines. These differences between the clusters suggest that two of the sub-groups are less safe than the two others. The present findings highlight the need to look into driver’s attitudes towards safety, in order to improve the motivation to drive safely. Information from...

  14. Prevalence of the most frequent ATC groups and subgroups in polypharmacized patients of Emergency medical service Belgrade

    OpenAIRE

    Petrov-Kiurski Miloranka; Živanović Slavoljub R.

    2016-01-01

    Introduction: Anatomical Therapeutic Chemical (ATC) classification system classifies active ingredients of drugs according to the organ or system on which they act and their therapeutic, pharmacological, and chemical properties. Objective: To establish the five most frequently used drug groups and subgroups according to ATC classification system in patients on polypharmacy in relation to age and gender, and to establish the five most frequent combinations of drugs used by patients on polyphar...

  15. Gender Differences in Intimate Partner Homicides Among Ethnic Sub-Groups of Asians.

    Science.gov (United States)

    Sabri, Bushra; Campbell, Jacquelyn C; Dabby, Firoza Chic

    2016-03-01

    This study explored differences in intimate partner homicides (IPHs) among Asian Americans. Data from newspapers and femicide reports by different state coalitions on 125 intimate partner killings occurring between 2000 and 2005 were analyzed. Men were the perpetrators in nearly 9 out of 10 cases of Asian IPHs. Gender differences were found in ages of victims and perpetrators, types of relationship between partners, and methods of killing. Most homicides occurred among South-east Asians, and East Asians had the highest within-group proportion of suicides. The findings call for culturally competent risk assessment and intervention strategies to prevent IPHs among at-risk Asian Americans. © The Author(s) 2015.

  16. GENDER DIFFERENCES IN INTIMATE PARTNER HOMICIDES AMONG ETHNIC SUBGROUPS OF ASIANS

    Science.gov (United States)

    SABRI, BUSHRA; CAMPBELL, JACQUELYN C.; DABBY, FIROZA CHIC

    2013-01-01

    This study explored differences in intimate partner homicides (IPHs) among Asian Americans. Data from newspapers and femicide reports by different state coalitions on 125 intimate partner killings occurring between 2000 and 2005 was analyzed. Men were the perpetrators in nearly nine out of ten cases of Asian IPHs. Gender differences were found in ages of victims and perpetrators, types of relationship between partners, and methods of killing. Most homicides occurred among South-east Asians, and East Asians had the highest within group proportion of suicides. The findings call for culturally competent risk assessment and intervention strategies to prevent IPHs among at-risk Asian Americans. PMID:26391620

  17. In a secondary care setting, differences between neck pain subgroups classified using the Quebec task force classification system were typically small

    DEFF Research Database (Denmark)

    Rasmussen, Hanne; Kent, Peter; Kjaer, Per

    2015-01-01

    , differences in outcome were typically small in size and mostly differentiated the local NP subgroup from the other subgroups. A caveat to these results is that they were obtained in a cohort of chronic neck pain patients who only displayed small improvements over time and the results may not apply to other...

  18. Does classification of persons with fibromyalgia into Multidimensional Pain Inventory subgroups detect differences in outcome after a standard chronic pain management program?

    NARCIS (Netherlands)

    Verra, M.L.; Angst, F.; Brioschi, R.; Lehmann, S.A.; Keefe, F.J.; Staal, J.B.; Bie, R.A. de; Aeschlimann, A.

    2009-01-01

    INTRODUCTION: The present study aimed to replicate and validate the empirically derived subgroup classification based on the Multidimensional Pain Inventory (MPI) in a sample of highly disabled fibromyalgia (FM) patients. Second, it examined how the identified subgroups differed in their response to

  19. Discretization of Gene Expression Data Unmasks Molecular Subgroups Recurring in Different Human Cancer Types.

    Directory of Open Access Journals (Sweden)

    Manfred Beleut

    Full Text Available Despite the individually different molecular alterations in tumors, the malignancy associated biological traits are strikingly similar. Results of a previous study using renal cell carcinoma (RCC as a model pointed towards cancer-related features, which could be visualized as three groups by microarray based gene expression analysis. In this study, we used a mathematic model to verify the presence of these groups in RCC as well as in other cancer types. We developed an algorithm for gene-expression deviation profiling for analyzing gene expression data of a total of 8397 patients with 13 different cancer types and normal tissues. We revealed three common Cancer Transcriptomic Profiles (CTPs which recurred in all investigated tumors. Additionally, CTPs remained robust regardless of the functions or numbers of genes analyzed. CTPs may represent common genetic fingerprints, which potentially reflect the closely related biological traits of human cancers.

  20. Transmitter inputs to different motoneuron subgroups in the oculomotor and trochlear nucleus in monkey

    Directory of Open Access Journals (Sweden)

    Christina Zeeh

    2015-07-01

    Full Text Available In all vertebrates the eyes are moved by six pairs of extraocular muscles enabling horizontal, vertical and rotatory movements. Recent work showed that each extraocular muscle is controlled by two motoneuronal groups: 1. Motoneurons of singly-innervated muscle fibers (SIF that lie within the boundaries of motonuclei mediating a fast muscle contraction and 2. motoneurons of multiply-innervated muscle fibers (MIF in the periphery of motonuclei mediating a tonic muscle contraction. Currently only limited data about the transmitter inputs to the SIF and MIF motoneurons are available. Here we performed a quantitative study on the transmitter inputs to SIF and MIF motoneurons of individual muscles in the oculomotor and trochlear nucleus in monkey. Pre-labeled motoneurons were immunostained for GABA, glutamate decarboxylase, GABA-A receptor, glycine transporter 2, glycine receptor 1, and vesicular glutamate transporters (vGlut 1 and 2. The main findings were: 1. the inhibitory control of SIF motoneurons for horizontal and vertical eye movements differs. Unlike in previous primate studies a considerable GABAergic input was found to all SIF motoneuronal groups, whereas a glycinergic input was confined to motoneurons of the medial rectus muscle mediating horizontal eye movements and to those of the levator palpebrae muscle elevating the upper eyelid. Whereas SIF and MIF motoneurons of individual eye muscles do not differ numerically in their GABAergic, glycinergic and vGlut2 input, vGlut1 containing terminals densely covered the supraoculomotor area targeting medial rectus MIF motoneurons. It is reasonable to assume that the vGlut1 input affects the near response system in the supraoculomotor area, which houses the preganglionic neurons mediating pupillary constriction and accommodation and the medial rectus MIF motoneurones involved in vergence.

  1. Identification of prognostic different subgroups in triple negative breast cancer by Her2-neu protein expression.

    Science.gov (United States)

    Schmidt, Gilda; Meyberg-Solomayer, Gabriele; Gerlinger, Christoph; Juhasz-Böss, Ingolf; Herr, Daniel; Rody, Achim; Liedtke, Cornelia; Solomayer, Erich-Franz

    2014-12-01

    Many patients with triple negative breast cancer (TNBC) have a poor outcome, but not all of them. This study has the aim to analyse the prognostic impact of tumour size, nodal status, grading, Her2-neu (human epithelial growth factor receptor 2) score and Ki-67 index. The main goal of this analysis is to find out if there are any differences in survival between patients with TNBC and a Her2-neu score 0 versus 1+2. Retrospectively, we studied a cohort of 121 patients with TNBC, diagnosed at the Saarland University Medical Center between December 2004 and June 2013. We compared the disease-free survival (DFS) and overall survival (OS) in those women on the basis of the different Her2-neu scores (0 versus 1 or 2 with negative FISH). One hundred and twenty one patients were included in this study. 58.68 % of them had a T2-4 tumour. 39.67 % were nodal positive and 67.77 % had high-grade tumours. The Her2-neu score was determined in 119 patients. 54.62 % of them had a score 0. In the 103 patients with a Ki-67 determination, the mean index was 44.5 %. We found that tumour size, nodal status and Her2-neu score are important prognostic factors. Patients with a Her2-neu score 0 had a significantly poorer outcome regarding DFS and OS. In contrast, the expression level of Ki-67 and the grading do not seem to have any prognostic value in TNBC. Besides tumour stage, grading and nodal status, the Her2-neu score 0 is able to function as a prognostic factor in patients with TNBC.

  2. Differences in pain, function and coping in Multidimensional Pain Inventory subgroups of chronic back pain: a one-group pretest-posttest study

    Directory of Open Access Journals (Sweden)

    Staal J Bart

    2011-06-01

    Full Text Available Abstract Background Patients with non-specific back pain are not a homogeneous group but heterogeneous with regard to their bio-psycho-social impairments. This study examined a sample of 173 highly disabled patients with chronic back pain to find out how the three subgroups based on the Multidimensional Pain Inventory (MPI differed in their response to an inpatient pain management program. Methods Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry into the program. At program entry and at discharge after four weeks, participants completed the MPI, the MOS Short Form-36 (SF-36, the Hospital Anxiety and Depression Scale (HADS, and the Coping Strategies Questionnaire (CSQ. Pairwise analyses of the score changes of the mentioned outcomes of the three MPI subgroups were performed using the Mann-Whitney-U-test for significance. Results Cluster analysis identified three MPI subgroups in this highly disabled sample: a dysfunctional, interpersonally distressed and an adaptive copers subgroup. The dysfunctional subgroup (29% of the sample showed the highest level of depression in SF-36 mental health (33.4 ± 13.9, the interpersonally distressed subgroup (35% of the sample a modest level of depression (46.8 ± 20.4, and the adaptive copers subgroup (32% of the sample the lowest level of depression (57.8 ± 19.1. Significant differences in pain reduction and improvement of mental health and coping were observed across the three MPI subgroups, i.e. the effect sizes for MPI pain reduction were: 0.84 (0.44 - 1.24 for the dysfunctional subgroup, 1.22 (0.86 - 1.58 for the adaptive copers subgroup, and 0.53 (0.24 - 0.81 for the interpersonally distressed subgroup (p = 0.006 for pairwise comparison. Significant score changes between subgroups concerning activities and physical functioning could not be identified. Conclusions MPI subgroup classification showed significant differences in score changes for pain, mental health

  3. Platelet function changes in different cardiac surgery subgroups as evaluated with an innovative technology.

    Science.gov (United States)

    Gerrah, Rabin; Brill, Alex; Varon, David

    2007-07-01

    : During cardiac surgery, platelets undergo substantial changes. The purpose of this study was to assess platelet function and compare these changes between different cardiac operations using an innovative technology. : Perioperative platelet function was evaluated by the Impact test [cone and plate(let) analyzer (CPA)]. The Impact test yields 2 parameters for platelet function: average size (AS, the mean size of the platelet aggregates) and surface coverage (SC, the percentage of the surface covered by the platelet aggregates), which correspond to platelet aggregation and adhesion. The study groups were compared for platelet function results in various surgery stages and correlation with bleeding. : A significant decrease in surface coverage was detected on establishment of cardiopulmonary bypass, with an increase up to preoperative values at the end of the surgery in all groups. In contrast to operations performed on bypass, in patients operated without cardiopulmonary bypass, the postoperative AS and SC were higher than the preoperative values, 30.4 ± 8.1 μmol versus 23.3 ± 6.9 μmol, P = 0.02 in AS, and 7.6 ± 3.6% versus 5.2 ± 1.8%, P = 0.04 in SC. Preoperative AS and SC were the only parameters significantly (P = 0.01) and linearly (r = 0.6) related to postoperative bleeding. : Preoperative platelet function, as evaluated by the CPA, is an independent risk factor determining postoperative bleeding. The off-pump patients presented an increased platelet function at the end of surgery, a finding that can imply a higher risk of thrombosis. The impact test appears to be a useful tool to determine perioperative platelet function and help in prediction of postoperative bleeding.

  4. The asymmetry of the entrainment range induced by the difference in intrinsic frequencies between two subgroups within the suprachiasmatic nucleus

    Science.gov (United States)

    Gu, Changgui; Yang, Huijie

    2017-06-01

    The rhythms of physiological and behavioral activities in mammals, which are regulated by the main clock suprachiasmatic nucleus (SCN) in the brain, can not be only synchronized to the natural 24 h light-dark cycle, but also to cycles with artificial periods. The range of the artificial periods that the animal can be synchronized to is called entrainment range. In the absence of the light-dark cycle, the animal can also maintain the circadian rhythm with an endogenous period close to 24 h. Experiments found that the entrainment range is not symmetrical with respect to the endogenous period. In the present study, an explanation is given for the asymmetry based on a Kuramoto model which describes the neuronal network of the SCN. Our numerical simulations and theoretical analysis show that the asymmetry results from the difference in the intrinsic frequencies between two subgroups of the SCN, as well as the entrainment range is affected by the difference.

  5. Identifying Changes in Youth's Subgroup Membership over Time Based on Their Targeted Communication about Substance Use with Parents and Friends

    Science.gov (United States)

    Kam, Jennifer A.

    2011-01-01

    Using latent class/transition analyses, this study: (a) identified subgroups of youth based on their targeted communication about substance use with parents and friends, (b) examined subgroup differences in substance use, and (c) considered changes in subgroup membership over four years. Among 5,874 youth, five subgroups emerged, with parents-only…

  6. Identifying Differences in Early Literacy Skills Across Subgroups of Language-Minority Children: A Latent Profile Analysis.

    Science.gov (United States)

    Lonigan, Christopher J; Goodrich, J Marc; Farver, JoAnn M

    2017-12-18

    Despite acknowledgment that language-minority children come from a wide variety of home language backgrounds and have a wide range of proficiency in their first (L1) and second (L2) languages, it is unknown whether differences across language-minority children in relative and absolute levels of proficiency in L1 and L2 predict subsequent development of literacy-related skills. The purpose of this study was to identify subgroups of language-minority children and evaluate whether differences in level and rate of growth of early literacy skills differed across subgroups. Five-hundred and twenty-six children completed measures of Spanish and English language and early literacy skills at the beginning, middle, and end of the preschool year. Latent growth models indicated that children's early literacy skills were increasing over the course of the preschool year. Latent profile analysis indicated that language-minority children could be classified into nine distinct groups, each with unique patterns of absolute and relative levels of proficiency in L1 and L2. Results of three-step mixture models indicated that profiles were closely associated with level of early literacy skills at the beginning of the preschool year. Initial level of early literacy skills was positively associated with growth in code-related skills (i.e., print knowledge, phonological awareness) and inversely associated with growth in language skills. These findings suggest that language-minority children are a diverse group with regard to their L1 and L2 proficiencies and that growth in early literacy skills is most associated with level of proficiency in the same language. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. The effects of status on subgroup relations.

    Science.gov (United States)

    Hornsey, Matthew J; Hogg, Michael A

    2002-06-01

    Two experiments were conducted to assess the impact of status differentials on subgroup attitudes and behaviours. In Experiment 1, 73 math-science students were led to believe they had higher or lower status than humanities students. They then performed a non-interactive decision-making task during which they were categorized exclusively as a university student (superordinate condition), or as a university student and math-science student simultaneously (subgroups condition). Experiment 2 (N = 98) differed from Experiment 1 in that perceptions of relative subgroup status were measured rather than manipulated. Consistent with social identity theory, subgroup members tended to categorize themselves more at the superordinate (university) level the lower status they considered their subgroup to be. In Experiment 2, a series of interactions also emerged, showing that status and inter-subgroup bias were positively related when the participants had been categorized exclusively at the superordinate level. When superordinate and subgroup identities were activated simultaneously, perceptions of status had no effect on levels of bias. The results were interpreted in terms of participants' needs for identity enhancement and identity distinctiveness.

  8. Subgrouping Automata: automatic sequence subgrouping using phylogenetic tree-based optimum subgrouping algorithm.

    Science.gov (United States)

    Seo, Joo-Hyun; Park, Jihyang; Kim, Eun-Mi; Kim, Juhan; Joo, Keehyoung; Lee, Jooyoung; Kim, Byung-Gee

    2014-02-01

    Sequence subgrouping for a given sequence set can enable various informative tasks such as the functional discrimination of sequence subsets and the functional inference of unknown sequences. Because an identity threshold for sequence subgrouping may vary according to the given sequence set, it is highly desirable to construct a robust subgrouping algorithm which automatically identifies an optimal identity threshold and generates subgroups for a given sequence set. To meet this end, an automatic sequence subgrouping method, named 'Subgrouping Automata' was constructed. Firstly, tree analysis module analyzes the structure of tree and calculates the all possible subgroups in each node. Sequence similarity analysis module calculates average sequence similarity for all subgroups in each node. Representative sequence generation module finds a representative sequence using profile analysis and self-scoring for each subgroup. For all nodes, average sequence similarities are calculated and 'Subgrouping Automata' searches a node showing statistically maximum sequence similarity increase using Student's t-value. A node showing the maximum t-value, which gives the most significant differences in average sequence similarity between two adjacent nodes, is determined as an optimum subgrouping node in the phylogenetic tree. Further analysis showed that the optimum subgrouping node from SA prevents under-subgrouping and over-subgrouping. Copyright © 2013. Published by Elsevier Ltd.

  9. Cluster analysis differentiates high and low community functioning in schizophrenia: Subgroups differ on working memory but not other neurocognitive domains.

    Science.gov (United States)

    Alden, Eva C; Cobia, Derin J; Reilly, James L; Smith, Matthew J

    2015-10-01

    Schizophrenia is characterized by impairment in multiple aspects of community functioning. Available literature suggests that community functioning may be enhanced through cognitive remediation, however, evidence is limited regarding whether specific neurocognitive domains may be treatment targets. We characterized schizophrenia subjects based on their level of community functioning through cluster analysis in an effort to identify whether specific neurocognitive domains were associated with variation in functioning. Schizophrenia (SCZ, n=60) and control (CON, n=45) subjects completed a functional capacity task, social competence role-play, functional attainment interview, and a neuropsychological battery. Multiple cluster analytic techniques were used on the measures of functioning in the schizophrenia subjects to generate functionally-defined subgroups. MANOVA evaluated between-group differences in neurocognition. The cluster analysis revealed two distinct groups, consisting of 36 SCZ characterized by high levels of community functioning (HF-SCZ) and 24 SCZ with low levels of community functioning (LF-SCZ). There was a main group effect for neurocognitive performance (pcluster analysis classified schizophrenia subjects in HF-SCZ and LF-SCZ using a multidimensional assessment of community functioning. Moreover, HF-SCZ demonstrated rather preserved verbal working memory relative to LF-SCZ. The results suggest that verbal working memory may play a critical role in community functioning, and is a potential cognitive treatment target for schizophrenia subjects. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Different diagnostic values of imaging parameters to predict pseudoprogression in glioblastoma subgroups stratified by MGMT promoter methylation

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    Yoon, Ra Gyoung [Catholic Kwandong University International St. Mary' s Hospital, Department of Radiology, Catholic Kwandong University College of Medicine, Incheon (Korea, Republic of); Kim, Ho Sung; Shim, Woo Hyun; Kim, Sang Joon [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Paik, Wooyul [Dankook Unversity Hospital, Department of Radiology, Cheonan-si, Chungcheongnam-do (Korea, Republic of); Kim, Jeong Hoon [University of Ulsan College of Medicine, Asan Medical Center, Department of Neurosurgery, Seoul (Korea, Republic of)

    2017-01-15

    The aim of this study was to determine whether diffusion and perfusion imaging parameters demonstrate different diagnostic values for predicting pseudoprogression between glioblastoma subgroups stratified by O{sup 6}-mythylguanine-DNA methyltransferase (MGMT) promoter methylation status. We enrolled seventy-five glioblastoma patients that had presented with enlarged contrast-enhanced lesions on magnetic resonance imaging (MRI) one month after completing concurrent chemoradiotherapy and undergoing MGMT promoter methylation testing. The imaging parameters included 10 or 90 % histogram cutoffs of apparent diffusion coefficient (ADC10), normalized cerebral blood volume (nCBV90), and initial area under the time signal-intensity curve (IAUC90). The results of the areas under the receiver operating characteristic curve (AUCs) with cross-validation were compared between MGMT methylation and unmethylation groups. MR imaging parameters demonstrated a trend toward higher accuracy in the MGMT promoter methylation group than in the unmethylation group (cross-validated AUCs = 0.70-0.95 and 0.56-0.87, respectively). The combination of MGMT methylation status with imaging parameters improved the AUCs from 0.70 to 0.75-0.90 for both readers in comparison with MGMT methylation status alone. The probability of pseudoprogression was highest (95.7 %) when nCBV90 was below 4.02 in the MGMT promoter methylation group. MR imaging parameters could be stronger predictors of pseudoprogression in glioblastoma patients with the methylated MGMT promoter than in patients with the unmethylated MGMT promoter. (orig.)

  11. Medulloblastoma in China: Clinicopathologic Analyses of SHH, WNT, and Non-SHH/WNT Molecular Subgroups Reveal Different Therapeutic Responses to Adjuvant Chemotherapy

    Science.gov (United States)

    Ren, Yong; Yao, Yu; Li, Kay Ka-Wai; Ng, Ho-Keung; Mao, Ying; Zhou, Liang-Fu; Zhong, Ping

    2014-01-01

    Medulloblastoma (MB) is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT) or chemotherapy (CHT) is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE) tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS) rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT) and chemotherapy (CHT) were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT) was found significantly improving the survival of children (pmedulloblastoma (CMB) (OS pmedulloblastoma (DMB) (OS p = 0.361, EFS p = 0.834) and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055). Our study showed postoperative primary CHT significantly influence the survival of CMB, SHH subgroup and WNT subgroup but not in DMB and Non-SHH/WNT subgroup of MB. PMID:24932704

  12. Gp85 genetic diversity of avian leukosis virus subgroup J among different individual chickens from a native flock.

    Science.gov (United States)

    Li, Yang; Fu, Jiayuan; Cui, Shuai; Meng, Fanfeng; Cui, Zhizhong; Fan, Jianhua; Chang, Shuang; Zhao, Peng

    2017-05-01

    To compare the genetic diversity and quasispecies evolution of avian leukosis virus (ALV) among different individuals, 5 chickens, raised in Shandong Provice of China, were randomly selected from a local chicken flock associated with serious tumor cases. Blood samples were collected and inoculated into chicken embryo fibroblast and DF-1 cell lines for virus isolation and identification, respectively, of Marek's disease virus (MDV), reticuloendotheliosis virus (REV), and ALV. Five strains of ALV subgroup J (ALV-J) were identified, and the gp85 gene from each strain was amplified and cloned. For each strain, about 20 positive clones of gp85 gene were selected for sequence analyses and the variability of the quasispecies of the 5 strains was compared. The results showed that the nuclear acid length of gp85 gene of 5 ALV-J isolates is 921 bp, 921 bp, 924 bp, 918 bp, and 912 bp respectively, and amino acid homologies of different gp85 clones from the 5 ALV-J strains were 99.3 to 100%, 99.3 to 100%, 99.4 to 100%, 98.4 to 100%, 99.0 to 100%, respectively. The proportions of dominant quasispecies were 65.0%, 85.0%, 85.0%, 50.0%, 84.2%, respectively, and homology of the gp85 among these dominant quasispecies was 89.2 to 92.5%. These data demonstrated the composition of the ALV-J quasispecies varied among infected individuals even within the same flock, and the dominant quasispecies continued to evolve both for their proportion and gene mutation. © 2016 Poultry Science Association Inc.

  13. Medulloblastoma in China: clinicopathologic analyses of SHH, WNT, and non-SHH/WNT molecular subgroups reveal different therapeutic responses to adjuvant chemotherapy.

    Directory of Open Access Journals (Sweden)

    Zhen-Yu Zhang

    Full Text Available Medulloblastoma (MB is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT or chemotherapy (CHT is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT and chemotherapy (CHT were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT was found significantly improving the survival of children (p<0.001 while it was not a significant prognostic factor for adult patients. Moreover, patients in WNT subtype had better OS (p = 0.028 than others (SHH and Non-SHH/WNT subtypes given postoperative adjuvant therapies. Postoperative primary RT was found to be a strong prognostic factor influencing the survival in all histological and molecular subgroups (p<0.001. Postoperative primary CHT was found significantly to influence the survival of classic medulloblastoma (CMB (OS p<0.001, EFS p<0.001, SHH subgroup (OS p = 0.020, EFS p = 0.049 and WNT subgroup (OS p = 0.003, EFS p = 0.016 but not in desmoplastic/nodular medulloblastoma (DMB (OS p = 0.361, EFS p = 0.834 and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055. Our study showed postoperative primary CHT significantly influence the

  14. Uniformity under in vitro conditions: Changes in the phenotype of cancer cell lines derived from different medulloblastoma subgroups.

    Science.gov (United States)

    Chlapek, Petr; Zitterbart, Karel; Kren, Leos; Filipova, Lenka; Sterba, Jaroslav; Veselska, Renata

    2017-01-01

    Medulloblastoma comprises four main subgroups (WNT, SHH, Group 3 and Group 4) originally defined by transcriptional profiling. In primary medulloblastoma tissues, these groups are thought to be distinguishable using the immunohistochemical detection of β-catenin, filamin A, GAB1 and YAP1 protein markers. To investigate the utility of these markers for in vitro studies using medulloblastoma cell lines, immunoblotting and indirect immunofluorescence were employed for the detection of β-catenin, filamin A, GAB1 and YAP1 in both DAOY and D283 Med reference cell lines and the panel of six medulloblastoma cell lines derived in our laboratory from the primary tumor tissues of known molecular subgroups. Immunohistochemical detection of these markers was performed on formalin-fixed paraffin-embedded tissue of the matching primary tumors. The results revealed substantial divergences between the primary tumor tissues and matching cell lines in the immunoreactivity pattern of medulloblastoma-subgroup-specific protein markers. Regardless of the molecular subgroup of the primary tumor, all six patient-derived medulloblastoma cell lines exhibited a uniform phenotype: immunofluorescence showed the nuclear localization of YAP1, accompanied by strong cytoplasmic positivity for β-catenin and filamin A, as well as weak positivity for GAB1. The same immunoreactivity pattern was also found in both DAOY and D283 Med reference medulloblastoma cell lines. Therefore, we can conclude that various medulloblastoma cell lines tend to exhibit the same characteristics of protein marker expression under standard in vitro conditions. Such a finding emphasizes the importance of the analyses of primary tumors in clinically oriented medulloblastoma research and the urgent need to develop in vitro models of improved clinical relevance, such as 3D cultures and organotypic slice cultures.

  15. Antibody Prevalence and Factors Associated with Exposure to Orientia tsutsugamushi in Different Aboriginal Subgroups in West Malaysia

    Science.gov (United States)

    Tay, Sun Tee; Mohamed Zan, Hafizatul Anis; Lim, Yvonne A. L.; Ngui, Romano

    2013-01-01

    Background Limited data is available on the current status of scrub typhus infection in the aboriginal population in Malaysia. This study was aimed to provide recent data on the degree of exposure of 280 individuals from seven aboriginal subgroups to Orientia tsutsugamushi (causative agent of scrub typhus) in West Malaysia. The environment, socioeconomic and behavioural risk factors associated with the disease were also investigated. Methods/Findings The antibody prevalence to O. tsutsugamushi ranged from 0 to 36.4% in seven subgroups, with high prevalence rates noted in subgroups involved in agricultural activity and the lowest prevalence rates noted in subgroups whose main occupations were associated to fishing. Univariate analysis indicated populations with age above 18 years (OR = 1.15, 95% CI = 1.02–1.30, P = 0.015), working (OR = 1.99, 95% CI = 1.01–3.92, P = 0.044), working at agriculture area (OR = 1.18, 95% CI = 0.98–1.42, P = 0.031), receiving household income less than US$ 166.7 (RM500) per month (OR = 2.43, 95% CI = 1.16–5.11, P = 0.016) and having close contact with animal pets (OR = 4.06, 95% CI = 1.20–13.76, P = 0.016) are significantly associated with exposure to O. tsutsugamushi. Multivariate analysis confirms that participants who are above 18 years old, receiving household income less than US$ 166.7 (RM500) per month and having close contact with animal pets are 3.6 times (95% CI = 1.81–7.03, PMalaysia. Awareness about the disease and education on the preventive measures are important in reducing the risk of acquiring scrub typhus in the population studied. PMID:23936576

  16. Subgroups based on thermal and pressure pain thresholds in women with chronic whiplash display differences in clinical presentation – an explorative study

    Directory of Open Access Journals (Sweden)

    Börsbo B

    2012-11-01

    Full Text Available Björn Börsbo,1,2 Gunilla M Liedberg,3 Mia Wallin,1,3 Björn Gerdle1,41Department of Medicine and Health Sciences, University of Linköping, Linköping, Sweden; 2Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jönköping, Sweden; 3Department of Social and Welfare Studies, University of Linköping, Norrköping, Sweden; 4Pain and Rehabilitation Centre, UHL, Östergötland County Council, Linköping, SwedenPurpose: To investigate the presence of subgroups in chronic whiplash-associated disorders (WAD based on pain thresholds for pressure (PPT, cold (CPT, and heat (HPT and to compare these subgroups with respect to symptomatology, disability, and health aspects. Methods: Two groups of female subjects – patients with chronic WAD (n = 28 and healthy controls (CON; n = 29 – were investigated. Quantitative sensory testing (QST for thermal thresholds and algometry for PPT at four sites in the body (over the trapezius and tibialis anterior bilaterally were determined. Habitual pain intensities, psychological strain, disability, and health aspects were registered using a questionnaire.Results: A cluster analysis based on PPT, CPT, and HPT identified two subgroups of chronic WAD: one sensitive subgroup (s-WAD; n = 21, and one less sensitive subgroup (ls-WAD; n = 6. S-WAD displayed widespread hyperalgesia, whereas ls-WAD had localized hyperalgesia in the neck area, with tendencies to supernormal values in remote areas of the body. Generally, s-WAD had a significantly worse situation than the CON with respect to symptomatology, disability, and health aspects. The ls-WAD group was intermediary between s-WAD and CON in these aspects.Conclusion: Different explanations, eg, severity of the pain condition per se, etiological factors, and pre-trauma differences in pain sensitivity, may exist for the differences in pain thresholds between the two subgroups. Future research should investigate the role of pain thresholds in the chronic

  17. Soil Acidobacterial 16S rRNA Gene Sequences Reveal Subgroup Level Differences between Savanna-Like Cerrado and Atlantic Forest Brazilian Biomes

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    Elisa C. P. Catão

    2014-01-01

    Full Text Available 16S rRNA sequences from the phylum Acidobacteria have been commonly reported from soil microbial communities, including those from the Brazilian Savanna (Cerrado and the Atlantic Forest biomes, two biomes that present contrasting characteristics of soil and vegetation. Using 16S rRNA sequences, the present work aimed to study acidobacterial diversity and distribution in soils of Cerrado savanna and two Atlantic forest sites. PCA and phylogenetic reconstruction showed that the acidobacterial communities found in “Mata de galeria” forest soil samples from the Cerrado biome have a tendency to separate from the other Cerrado vegetation microbial communities in the direction of those found in the Atlantic Forest, which is correlated with a high abundance of Acidobacteria subgroup 2 (GP2. Environmental conditions seem to promote a negative correlation between GP2 and subgroup 1 (GP1 abundance. Also GP2 is negatively correlated to pH, but positively correlated to high Al3+ concentrations. The Cerrado soil showed the lowest Acidobacteria richness and diversity indexes of OTUs at the species and subgroups levels when compared to Atlantic Forest soils. These results suggest specificity of acidobacterial subgroups to soils of different biomes and are a starting point to understand their ecological roles, a topic that needs to be further explored.

  18. Differences in pain intensity in anti- and pro-nociceptive pain profile subgroups in patients with knee osteoarthritis.

    Science.gov (United States)

    Bossmann, Tanja; Brauner, Torsten; Horstmann, Thomas

    2018-01-01

    Facilitated temporal summation is one component of central sensitization. The aim of this exploratory study was to classify pro-, eu- and antinociceptive subgroups based on wind-up ratio cut-off scores in patients with knee osteoarthritis (OA).  A total of 56 patients with knee OA met the inclusion criteria. Temporal summation was measured and wind-up ratio was calculated. Reference values of 180 healthy subjects were used to define wind-up ratio cut-off scores. Twenty-seven percent of patients showed a pro-nociceptive pain profile. Sixteen percent of patients showed an anti-nociceptive pain profile. A eu-nociceptive pain profile was present in 57% of patients. Central pain sensitization was present in approximately a third of knee OA patients. The results should be confirmed in larger studies.

  19. In a secondary care setting, differences between neck pain subgroups classified using the Quebec task force classification system were typically small

    DEFF Research Database (Denmark)

    Rasmussen, Hanne; Kent, Peter; Kjaer, Per

    2015-01-01

    BACKGROUND: The component of the Quebec Task Force Classification System that subgroups patients based on the extent of their radiating pain and neurological signs has been demonstrated to have prognostic implications for patients with low back pain but has not been tested on patients with neck...... collected, routine clinical data. Patients were classified into Local NP only, NP + arm pain above the elbow, NP + arm pain below the elbow, and NP with signs of nerve root involvement (NP + NRI). Outcome was pain intensity and activity limitation. Associations were tested in longitudinal linear mixed...... and patients with NP + NRI had experienced the largest improvements in pain intensity. Similar results were obtained for activity limitation. CONCLUSIONS: This study found baseline and outcome differences between neck pain subgroups classified using the Quebec Task Force Classification System. However...

  20. Methoxyflurane Analgesia in Adult Patients in the Emergency Department: A Subgroup Analysis of a Randomized, Double-blind, Placebo-controlled Study (STOP!).

    Science.gov (United States)

    Coffey, Frank; Dissmann, Patrick; Mirza, Kazim; Lomax, Mark

    2016-11-01

    Acute pain remains highly prevalent in the Emergency Department (ED) setting. This double-blind, randomized, placebo-controlled UK study investigated the efficacy and safety of low-dose methoxyflurane analgesia for the treatment of acute pain in the ED in the adult population of the STOP! trial. Patients presenting to the ED requiring analgesia for acute pain (pain score of 4-7 on the Numerical Rating Scale) due to minor trauma were randomized in a 1:1 ratio to receive methoxyflurane (up to 6 mL) or placebo (normal saline), both via a Penthrox(®) (Medical Developments International Limited, Scoresby, Australia) inhaler. Rescue medication (paracetamol/opioids) was available immediately upon request. Change from baseline in visual analog scale (VAS) pain intensity was the primary endpoint. 300 adult and adolescent patients were randomized; data are presented for the adult subgroup (N = 204). Mean baseline VAS pain score was ~66 mm in both groups. The mean change from baseline to 5, 10, 15 and 20 min was greater for methoxyflurane (-20.7, -27.4, -33.3 and -34.8 mm, respectively) than placebo (-8.0, -11.1, -12.3 and -15.2 mm, respectively). The primary analysis showed a highly significant treatment effect overall across all four time points (-17.4 mm; 95% confidence interval: -22.3 to -12.5 mm; p methoxyflurane [versus 20 min with placebo; (hazard ratio: 2.32; 95% CI: 1.63, 3.30; p methoxyflurane-treated patients experienced pain relief within 1-10 inhalations. 22.8% of placebo-treated patients requested rescue medication within 20 min compared with 2.0% of methoxyflurane-treated patients (p = 0.0003). Methoxyflurane treatment was rated 'Excellent', 'Very Good' or 'Good' by 77.6% of patients, 74.5% of physicians and 72.5% of nurses. Treatment-related adverse events (mostly dizziness/headache) were reported by 42.2% of patients receiving methoxyflurane and 14.9% of patients receiving placebo; none caused withdrawal and the majority were mild and

  1. Therapy-Emergent Drug Resistance to Integrase Strand Transfer Inhibitors in HIV-1 Patients: A Subgroup Meta-Analysis of Clinical Trials.

    Directory of Open Access Journals (Sweden)

    Jiangzhou You

    Full Text Available Integrase strand transfer inhibitors (INSTIs are a novel class of anti-HIV agents that show high activity in inhibiting HIV-1 replication. Currently, licensed INSTIs include raltegravir (RAL, elvitegravir (EVG and dolutegravir (DTG; these drugs have played a critical role in AIDS therapy, serving as additional weapons in the arsenal for treating patients infected with HIV-1. To date, long-term data regarding clinical experience with INSTI use and the emergence of resistance remain scarce. However, the literature is likely now sufficiently comprehensive to warrant a meta-analysis of resistance to INSTIs.Our team implemented a manuscript retrieval protocol using Medical Subject Headings (MeSH via the Web of Science, MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases. We screened the literature based on inclusion and exclusion criteria and then performed a quality analysis and evaluation using RevMan software, Stata software, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE. We also performed a subgroup analysis. Finally, we calculated resistance rates and risk ratios (RRs for the three types of drugs.We identified 26 references via the database search. A meta-analysis of the RAL data revealed that the resistance rate was 3.9% (95% CI = 2.9%-4.9% for the selected randomized controlled trials (RCTs. However, the RAL resistance rate reached 40.9% (95% CI = 8.8%-72.9% for the selected observational studies (OBSs. The rates of resistance to RAL that were associated with HIV subtypes A, B, and C as well as with more complex subtypes were 0.1% (95% CI = -0.7%-0.9%, 2.5% (95% CI = 0.5%-4.5%, 4.6% (95% CI = 2.7%-6.6% and 2.2% (95% CI = 0.7%-3.7%, respectively. The rates of resistance to EVG and DTG were 1.2% (95% CI = 0.2%-2.2% and 0.1% (95% CI = -0.2%-0.5%, respectively. Furthermore, we found that the RRs for antiviral resistance were 0.414 (95% CI = 0.210-0.816 between DTG and RAL and 0

  2. The stable subgroup graph

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    Behnaz Tolue

    2018-07-01

    Full Text Available In this paper we introduce stable subgroup graph associated to the group $G$. It is a graph with vertex set all subgroups of $G$ and two distinct subgroups $H_1$ and $H_2$ are adjacent if $St_{G}(H_1\\cap H_2\

  3. Updating the Trainability Tests Literature on Black-White Subgroup Differences and Reconsidering Criterion-Related Validity

    Science.gov (United States)

    Roth, Philip L.; Buster, Maury A.; Bobko, Philip

    2011-01-01

    A number of applied psychologists have suggested that trainability test Black-White ethnic group differences are low or relatively low (e.g., Siegel & Bergman, 1975), though data are scarce. Likewise, there are relatively few estimates of criterion-related validity for trainability tests predicting job performance (cf. Robertson & Downs,…

  4. Alcohol consumption before and after a significant reduction of alcohol prices in 2004 in Finland: were the effects different across population subgroups?

    Science.gov (United States)

    Helakorpi, Satu; Mäkelä, Pia; Uutela, Antti

    2010-01-01

    To examine trends in adult alcohol consumption by age, gender and education from 1982 to 2008 and evaluate the effects that a significant reduction in alcohol prices in 2004 had on alcohol consumption in different population subgroups. The study population comprised respondents aged 25-64 (n = 79,100) replying to nationally representative annual postal surveys from 1982 to 2008 (average response rate 72%). The main measurements were the prevalence of respondents who had drunk at least eight (men) or five (women) drinks in the previous week ('moderate to heavy drinkers') and prevalence of those who weekly (men) or monthly (women) drank six or more drinks on a single occasion ('heavy episodic drinkers') (one 'drink' containing 11-13 g ethanol). Logistic models were used to test differences across population subgroups in the changes in drinking. Following the reduction of alcohol prices in 2004, drinking increased among men and women aged 45-64. Among men, both moderate to heavy drinking and heavy episodic drinking increased in the lowest educational group. Among women, moderate to heavy drinking increased mostly in the lowest and intermediate educational groups, while the highest increases for heavy episodic drinking were in the intermediate and highest female educational groups. Alcohol consumption increased especially among those aged 45-64 and among lower educated people following the reduction in alcohol prices in 2004 in Finland.

  5. Escitalopram in the treatment of social anxiety disorder: analysis of efficacy for different clinical subgroups and symptom dimensions

    DEFF Research Database (Denmark)

    Stein, Dan J; Kasper, Siegfried; Andersen, Elisabeth Anne Wreford

    2004-01-01

    Escitalopram has demonstrated efficacy for the acute treatment of social anxiety disorder (SAD) in two placebo-controlled trials and for long-term treatment in a relapse-prevention study. Social anxiety disorder is a heterogeneous disorder. This study questions whether this new selective serotonin...... of the primary efficacy scale, the Liebowitz Social Anxiety Scale (LSAS), was undertaken, and a determination made of whether treatment effects were similar for the different symptom dimensions. Escitalopram was effective in both younger and older patients, in male and female patients, and in patients with more...... and less severe social anxiety symptoms. The LSAS factor analysis showed six factors, which were differentially associated with different areas of disability. Escitalopram was significantly superior to placebo for all six symptom dimensions. The treatment effects of escitalopram were independent of gender...

  6. Internalin profiling and multilocus sequence typing suggest four Listeria innocua subgroups with different evolutionary distances from Listeria monocytogenes

    OpenAIRE

    Chen, Jianshun; Chen, Qiaomiao; Jiang, Lingli; Cheng, Changyong; Bai, Fan; Wang, Jun; Mo, Fan; Fang, Weihuan

    2010-01-01

    Abstract Background Ecological, biochemical and genetic resemblance as well as clear differences of virulence between L. monocytogenes and L. innocua make this bacterial clade attractive as a model to examine evolution of pathogenicity. This study was attempted to examine the population structure of L. innocua and the microevolution in the L. innocua-L. monocytogenes clade via profiling of 37 internalin genes and multilocus sequence typing based on the sequences of 9 unlinked genes gyrB, sigB...

  7. Prospectively measured thyroid hormones and thyroid peroxidase antibodies in relation to risk of different breast cancer subgroups: a Malmö Diet and Cancer Study.

    Science.gov (United States)

    Brandt, Jasmine; Borgquist, Signe; Manjer, Jonas

    2015-08-01

    Thyroid hormone level has been positively associated with breast cancer risk and with breast cancer cell proliferation and growth. Although breast cancer is a heterogeneous disease, this is the first study assessing pre-diagnostic levels of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), and thyroid peroxidase antibodies (TPO-Ab) in relation to breast cancer subgroups and aggressiveness. The Malmö Diet and Cancer Study collected blood samples from 17,035 women between 1991 and 1996. Free T3, free T4, TSH, and TPO-Ab were analyzed in 676 incident breast cancer cases and 680 controls. Breast tumors were classified according to tumor size, axillary lymph node involvement, histological grade, histological type, hormone receptor status (ER, PgR), as well as Ki67, cyclin D1, and p27. Odds ratios of different breast cancer subgroups were calculated using a logistic regression analysis adjusted for potential confounders. High fT4 was associated with a statistically significant higher risk of overall breast cancer, small, grade I, ER-positive, PgR-positive, and cyclin D1 low tumors. The associations for ER and PgR were verified in a heterogeneity analysis. Low TPO-Ab was associated with a higher risk of overall breast cancer, ductal, large, ER-positive, PgR-positive, cyclin D1 low, and p27 high tumors. The heterogeneity analysis verified the association for tumor size. Free T3 was not associated with overall breast cancer risk, but in the heterogeneity analysis, high fT3 was associated with tumor size and expression of p27. There were no strong associations between TSH and overall breast cancer risk or any tumor subgroup. High pre-diagnostic fT4 levels and low pre-diagnostic TPO-Ab levels were associated with an increased risk of breast cancer. This increase was mainly limited to a higher incidence rate of less aggressive breast cancer subgroups.

  8. G-protein coupled receptor expression patterns delineate medulloblastoma subgroups

    Science.gov (United States)

    2013-01-01

    Background Medulloblastoma is the most common malignant brain tumor in children. Genetic profiling has identified four principle tumor subgroups; each subgroup is characterized by different initiating mutations, genetic and clinical profiles, and prognoses. The two most well-defined subgroups are caused by overactive signaling in the WNT and SHH mitogenic pathways; less is understood about Groups 3 and 4 medulloblastoma. Identification of tumor subgroup using molecular classification is set to become an important component of medulloblastoma diagnosis and staging, and will likely guide therapeutic options. However, thus far, few druggable targets have emerged. G-protein coupled receptors (GPCRs) possess characteristics that make them ideal targets for molecular imaging and therapeutics; drugs targeting GPCRs account for 30-40% of all current pharmaceuticals. While expression patterns of many proteins in human medulloblastoma subgroups have been discerned, the expression pattern of GPCRs in medulloblastoma has not been investigated. We hypothesized that analysis of GPCR expression would identify clear subsets of medulloblastoma and suggest distinct GPCRs that might serve as molecular targets for both imaging and therapy. Results Our study found that medulloblastoma tumors fall into distinct clusters based solely on GPCR expression patterns. Normal cerebellum clustered separately from the tumor samples. Further, two of the tumor clusters correspond with high fidelity to the WNT and SHH subgroups of medulloblastoma. Distinct over-expressed GPCRs emerge; for example, LGR5 and GPR64 are significantly and uniquely over-expressed in the WNT subgroup of tumors, while PTGER4 is over-expressed in the SHH subgroup. Uniquely under-expressed GPCRs were also observed. Our key findings were independently validated using a large international dataset. Conclusions Our results identify GPCRs with potential to act as imaging and therapeutic targets. Elucidating tumorigenic pathways

  9. Existence of a dictatorial subgroup in social choice with independent subgroup utility scales, an alternative proof

    NARCIS (Netherlands)

    Khmelnitskaya, Anna Borisovna; van Deemen, Adrian; Rusinowska, Agnieszka

    2010-01-01

    Social welfare orderings for different scales of individual utility measurement in distinct population subgroups are studied. In Khmelnitskaya (2000), employing the continuous version of Arrow’s impossibility theorem, it was shown that for combinations of independent subgroups scales every

  10. Cytogenetic Prognostication Within Medulloblastoma Subgroups

    Science.gov (United States)

    Shih, David J.H.; Northcott, Paul A.; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M.; Garzia, Livia; Peacock, John; Mack, Stephen C.; Wu, Xiaochong; Rolider, Adi; Morrissy, A. Sorana; Cavalli, Florence M.G.; Jones, David T.W.; Zitterbart, Karel; Faria, Claudia C.; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A.; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G.; Liau, Linda M.; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K.; Thompson, Reid C.; Bailey, Simon; Lindsey, Janet C.; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M.C.; Scherer, Stephen W.; Phillips, Joanna J.; Gupta, Nalin; Fan, Xing; Muraszko, Karin M.; Vibhakar, Rajeev; Eberhart, Charles G.; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J.; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F.; Weiss, William A.; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R.; Rubin, Joshua B.; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M.; Gajjar, Amar; Packer, Roger J.; Rutkowski, Stefan; Pomeroy, Scott L.; French, Pim J.; Kloosterhof, Nanne K.; Kros, Johan M.; Van Meir, Erwin G.; Clifford, Steven C.; Bourdeaut, Franck; Delattre, Olivier; Doz, François F.; Hawkins, Cynthia E.; Malkin, David; Grajkowska, Wieslawa A.; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T.; Pfister, Stefan M.; Taylor, Michael D.

    2014-01-01

    Purpose Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Patients and Methods Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Results Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Conclusion Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. PMID

  11. Low Back Pain Subgroups using Fear-Avoidance Model Measures: Results of a Cluster Analysis

    Science.gov (United States)

    Beneciuk, Jason M.; Robinson, Michael E.; George, Steven Z.

    2012-01-01

    Objectives The purpose of this secondary analysis was to test the hypothesis that an empirically derived psychological subgrouping scheme based on multiple Fear-Avoidance Model (FAM) constructs would provide additional capabilities for clinical outcomes in comparison to a single FAM construct. Methods Patients (n = 108) with acute or sub-acute low back pain (LBP) enrolled in a clinical trial comparing behavioral physical therapy interventions to classification based physical therapy completed baseline questionnaires for pain catastrophizing (PCS), fear-avoidance beliefs (FABQ-PA, FABQ-W), and patient-specific fear (FDAQ). Clinical outcomes were pain intensity and disability measured at baseline, 4-weeks, and 6-months. A hierarchical agglomerative cluster analysis was used to create distinct cluster profiles among FAM measures and discriminant analysis was used to interpret clusters. Changes in clinical outcomes were investigated with repeated measures ANOVA and differences in results based on cluster membership were compared to FABQ-PA subgrouping used in the original trial. Results Three distinct FAM subgroups (Low Risk, High Specific Fear, and High Fear & Catastrophizing) emerged from cluster analysis. Subgroups differed on baseline pain and disability (p’s<.01) with the High Fear & Catastrophizing subgroup associated with greater pain than the Low Risk subgroup (p<.01) and the greatest disability (p’s<.05). Subgroup × time interactions were detected for both pain and disability (p’s<.05) with the High Fear & Catastrophizing subgroup reporting greater changes in pain and disability than other subgroups (p’s<.05). In contrast, FABQ-PA subgroups used in the original trial were not associated with interactions for clinical outcomes. Discussion These data suggest that subgrouping based on multiple FAM measures may provide additional information on clinical outcomes in comparison to determining subgroup status by FABQ-PA alone. Subgrouping methods for

  12. Rescue of avian leukosis subgroup-J-associated acutely transforming viruses carrying different lengths of the v-fps oncogene and analysis of their tumorigenicity.

    Science.gov (United States)

    Wang, Yixin; Fang, Lichun; Li, Jianliang; Li, Yang; Cui, Shuai; Sun, Xiaolong; Chang, Shuang; Zhao, Peng; Cui, Zhizhong

    2016-12-01

    In our previous study, six subgroup J strains of avian leukosis virus (ALV-J)-associated acutely transforming viruses carrying different lengths of the v-fps oncogene, designated as Fu-J and Fu-J1-5, were isolated and characterized from fibrosarcomas in ALV-J-infected chickens. In the present study, the oncogenic potential of Fu-J and Fu-J1-5 was investigated using a reverse genetics technique. Six replication-defective viruses, named rFu-J and rFu-J1-5, were rescued with the replication-competent rescued ALV-J strain rSDAU1005 as a helper virus by co-transfection of chicken embryo fibroblast monolayers with infectious clone plasmids. Experimental bird studies were performed, demonstrating that only the rescued rFu-J virus carrying the complete v-fps oncogene with rSDAU1005 as the helper virus could induce acute fibrosarcoma after inoculation in specific-pathogen-free (SPF) chickens. These results provide direct evidence that the replication-defective acutely transforming Fu-J virus, with the complete v-fps oncogene, was associated with acute fibrosarcoma in chickens infected with ALV-J in the field, as reported previously.

  13. Effects of preoperative aspirin on cardiocerebral and renal complications in non-emergent cardiac surgery patients: a sub-group and cohort study.

    Directory of Open Access Journals (Sweden)

    Longhui Cao

    Full Text Available BACKGROUND AND OBJECTIVE: Postoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery. METHODS: An observational cohort study was performed on consecutive patients (n = 1879 receiving cardiac surgery at this institution. The patients excluded from the study were those with preoperative anticoagulants, unknown aspirin use, or underwent emergent cardiac surgery. Outcome events included were 30-day mortality, renal failure, readmission and a composite outcome--major adverse cardiocerebral events (MACE that include permanent or transient stroke, coma, perioperative myocardial infarction (MI, heart block and cardiac arrest. RESULTS: Of all patients, 1145 patients met the inclusion criteria and were divided into two groups: those taking (n = 858 or not taking (n = 287 aspirin within 5 days preceding surgery. Patients with aspirin presented significantly more with history of hypertension, diabetes, peripheral arterial disease, previous MI, angina and older age. With propensity scores adjusted and multivariate logistic regression, however, this study showed that preoperative aspirin therapy (vs. no aspirin significantly reduced the risk of MACE (8.4% vs. 12.5%, odds ratio [OR] 0.585, 95% CI 0.355-0.964, P = 0.035, postoperative renal failure (2.6% vs. 5.2%, OR 0.438, CI 0.203-0.945, P = 0.035 and dialysis required (0.8% vs. 3.1%, OR 0.230, CI 0.071-0.742, P = 0.014, but did not significantly reduce 30-day mortality (4.1% vs. 5.8%, OR 0.744, CI 0.376-1.472, P = 0.396 nor it increased readmissions in the patients undergoing cardiac surgery. CONCLUSIONS: Preoperative aspirin therapy is associated with a significant decrease in the risk of MACE and renal failure and did not increase readmissions in patients undergoing non-emergent cardiac surgery.

  14. Molecular subgroups of medulloblastoma

    Science.gov (United States)

    Northcott, Paul A; Dubuc, Adrian M; Pfister, Stefan; Taylor, Michael D

    2014-01-01

    Recent efforts at stratifying medulloblastomas based on their molecular features have revolutionized our understanding of this morbidity. Collective efforts by multiple independent groups have subdivided medulloblastoma from a single disease into four distinct molecular subgroups characterized by disparate transcriptional signatures, mutational spectra, copy number profiles and, most importantly, clinical features. We present a summary of recent studies that have contributed to our understanding of the core medulloblastoma subgroups, focusing largely on clinically relevant discoveries that have already, and will continue to, shape research. PMID:22853794

  15. The congruence subgroup problem

    Indian Academy of Sciences (India)

    Home; Journals; Proceedings – Mathematical Sciences; Volume 114; Issue 4. The Congruence Subgroup Problem. M S Raghunathan. Invited Articles Volume 114 ... Author Affiliations. M S Raghunathan1. School of Mathematics, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400 005, India ...

  16. Subgroups Among Opiate Addicts

    Science.gov (United States)

    Berzins, Juris I.; And Others

    1974-01-01

    The principal objective of the present investigation was to delineate homogeneous MMPI profile subgroups (types) through multivariate clustering procedures and to compare the derived (replicable) types on measures of the components of "sociopathy" as well as on other psychometric devices. (Author)

  17. 'Doing differences': the emergence of differences in issue framing in multi-actor conversations

    NARCIS (Netherlands)

    Dewulf, A.; Bouwen, R.

    2007-01-01

    In this paper we analyze how differences in issue framing emerge in multi-stakeholder conversations. From a discursive approach to issue framing we draw on conversational studies of disagreement, difference and conflict to build up a theoretical framework. This leads us to understand differences in

  18. Differences between girls and boys in emerging language skills

    DEFF Research Database (Denmark)

    Eriksson, Mårten; Marschik, Peter B; Tulviste, Tiia

    2012-01-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.......08 to 2.06. The results showed that girls are slightly ahead of boys in early communicative gestures, in productive vocabulary, and in combining words. The difference increased with age. Boys were not found to be more variable than girls. Despite extensive variation in language skills between language...... communities, the difference between girls and boys remained. This suggests that the difference is caused by robust factors that do not change between language communities....

  19. Intertumoral Heterogeneity within Medulloblastoma Subgroups.

    Science.gov (United States)

    Cavalli, Florence M G; Remke, Marc; Rampasek, Ladislav; Peacock, John; Shih, David J H; Luu, Betty; Garzia, Livia; Torchia, Jonathon; Nor, Carolina; Morrissy, A Sorana; Agnihotri, Sameer; Thompson, Yuan Yao; Kuzan-Fischer, Claudia M; Farooq, Hamza; Isaev, Keren; Daniels, Craig; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Lee, Ji Yeoun; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Vasiljevic, Alexandre; Faure-Conter, Cecile; Jouvet, Anne; Giannini, Caterina; Nageswara Rao, Amulya A; Li, Kay Ka Wai; Ng, Ho-Keung; Eberhart, Charles G; Pollack, Ian F; Hamilton, Ronald L; Gillespie, G Yancey; Olson, James M; Leary, Sarah; Weiss, William A; Lach, Boleslaw; Chambless, Lola B; Thompson, Reid C; Cooper, Michael K; Vibhakar, Rajeev; Hauser, Peter; van Veelen, Marie-Lise C; Kros, Johan M; French, Pim J; Ra, Young Shin; Kumabe, Toshihiro; López-Aguilar, Enrique; Zitterbart, Karel; Sterba, Jaroslav; Finocchiaro, Gaetano; Massimino, Maura; Van Meir, Erwin G; Osuka, Satoru; Shofuda, Tomoko; Klekner, Almos; Zollo, Massimo; Leonard, Jeffrey R; Rubin, Joshua B; Jabado, Nada; Albrecht, Steffen; Mora, Jaume; Van Meter, Timothy E; Jung, Shin; Moore, Andrew S; Hallahan, Andrew R; Chan, Jennifer A; Tirapelli, Daniela P C; Carlotti, Carlos G; Fouladi, Maryam; Pimentel, José; Faria, Claudia C; Saad, Ali G; Massimi, Luca; Liau, Linda M; Wheeler, Helen; Nakamura, Hideo; Elbabaa, Samer K; Perezpeña-Diazconti, Mario; Chico Ponce de León, Fernando; Robinson, Shenandoah; Zapotocky, Michal; Lassaletta, Alvaro; Huang, Annie; Hawkins, Cynthia E; Tabori, Uri; Bouffet, Eric; Bartels, Ute; Dirks, Peter B; Rutka, James T; Bader, Gary D; Reimand, Jüri; Goldenberg, Anna; Ramaswamy, Vijay; Taylor, Michael D

    2017-06-12

    While molecular subgrouping has revolutionized medulloblastoma classification, the extent of heterogeneity within subgroups is unknown. Similarity network fusion (SNF) applied to genome-wide DNA methylation and gene expression data across 763 primary samples identifies very homogeneous clusters of patients, supporting the presence of medulloblastoma subtypes. After integration of somatic copy-number alterations, and clinical features specific to each cluster, we identify 12 different subtypes of medulloblastoma. Integrative analysis using SNF further delineates group 3 from group 4 medulloblastoma, which is not as readily apparent through analyses of individual data types. Two clear subtypes of infants with Sonic Hedgehog medulloblastoma with disparate outcomes and biology are identified. Medulloblastoma subtypes identified through integrative clustering have important implications for stratification of future clinical trials. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Subgroup differences and determinants of patient-reported mental and physical health at hospital discharge among patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Rasmussen, T. B.; Herning, M.; Johansen, P. P.

    2017-01-01

    Purpose: (i) To describe patient-reported outcomes (PROs) at hospital-discharge across three diagnostic IHD sub-groups; chronic ischemic heart disease/stable angina (IHD/AP), non-ST-elevation myocardial infarction/unstable angina (NSTEMI/UAP) and ST-elevation myocardial infarction (STEMI), and (i......) to examine determinants among demographic-, clinical- and self-report health behavior characteristics for PROs at hospital discharge in patients with IHD....

  1. Subgroup differences and determinants of patient-reported mental and physical health at hospital discharge among patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Rasmussen, T B; Herning, M; Johansen, P P

    Purpose: (i) To describe patient-reported outcomes (PROs) at hospital-discharge across three diagnostic IHD sub-groups; chronic ischemic heart disease/stable angina (IHD/AP), non-ST-elevation myocardial infarction/unstable angina (NSTEMI/UAP) and ST-elevation myocardial infarction (STEMI), and (i......) to examine determinants among demographic-, clinical- and self-report health behavior characteristics for PROs at hospital discharge in patients with IHD....

  2. Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation.

    Science.gov (United States)

    Thomas, Chloe; Sadler, Susi; Breeze, Penny; Squires, Hazel; Gillett, Michael; Brennan, Alan

    2017-08-21

    To evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits. Economic analysis using the School for Public Health Research Diabetes Prevention Model. England 2015-2016. Adults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%-6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline body mass index, baseline HbA1c and working status. The proposed NHS DPP: an intensive lifestyle intervention focusing on dietary advice, physical activity and weight loss. Comparator: no diabetes prevention intervention. Incremental costs, savings and return on investment, quality-adjusted life-years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective. Intervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100 000 DPP interventions given, 3552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2%-6.4% and those aged 40-74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect. The DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the

  3. Identifying Tinnitus Subgroups With Cluster Analysis

    Science.gov (United States)

    Tyler, Richard; Coelho, Claudia; Tao, Pan; Ji, Haihong; Noble, William; Gehringer, Anne; Gogel, Stephanie

    2009-01-01

    Purpose We believe it is important to uncover tinnitus subgroups to identify subsets of patients most likely to benefit from different treatments. We review strategies for subgrouping based on etiology, subjective reports, the audiogram, psychoacoustics, imaging, and cluster analysis. Method Preliminary results of a 2-step cluster analysis based on 246 participants from whom we had 26 categorical and 25 continuous variables were determined. Results A 4-cluster solution suggested the following subgroups: (a) constant distressing tinnitus, (b) varying tinnitus that is worse in noise, (c) tinnitus patients who are copers and whose tinnitus is not influenced by touch (somatic modulation), and (d) tinnitus patients who are copers but whose tinnitus is worse in quiet environments. Conclusions Subgroups of tinnitus patients can be identified by using statistical approaches. The subgroups we identify here represent a preliminary attempt at identifying such patients. One next step would be to explore clinical trials of tinnitus treatments based on subgroup analyses or on using subgroups in the selection criteria. PMID:19056922

  4. Different causes of referral to ophthalmology emergency room.

    Science.gov (United States)

    Jafari, Alireza Keshtkar; Bozorgui, Shima; Shahverdi, Nooshin; Ameri, Ahmad; Akbari, Mohammad Reza; Salmasian, Hojat

    2012-01-01

    Eye-related complaints compose approximately 1-6% of complaints of patients referring to general emergency ward around the world. Eye injuries are the most common cause of referral to eye emergency ward. To understand the impact of eye injuries in Iran and to plan preventive strategies, it is important to understand the complete magnitude of the problem with regard to true population-based data and standard reproducible definitions. The main goal of this study was to identify the major causes of referrals to eye emergency ward in patients with eye-related complaints in an eye referral Hospital in Iran. In a cross-sectional study, 3150 patients who referred to Farabi Hospital emergency ward, Tehran, Iran, from January to December 2007 were included in the study and their detailed information were recorded. The patients' demographic data, medical history and final diagnosis were recorded in a questionnaire. The mean age of patients was 33.2±16.8 years and 2380 patients (75.6%) were males. While 299 patients (9.5%) were referred for non-urgent reasons, work-related injuries were the most common cause of referral (955 patients; 30.3%). In patients referred due to trauma (1950 patients), work-related injuries occurred in 955 patients (49%) and occurred accidentally (by chance) in 819 patients (42%). The majority of patients referred with traumatic injuries were males (1708 patients; 87.6% versus 242 patients; 12.4%). The most common etiologies of eye trauma (1950 patients) were metal filings (814 patients; 41.8%), blunt trauma (338 patients; 17.3%), fireworks (236 patients; 12.1%) and sharp objects (222 patients; 11.4%). Globe injury was diagnosed in 1865 patients (95.7%) of trauma cases. In patients referred due to non-traumatic reason (1200 patients), eye infection occurred in 482 patients (40.2%) and 299 patients (24.9%) were referred for non-urgent reasons. There was little difference between the frequency of non-trauma-related problems among genders (672 male

  5. Different causes of referral to ophthalmology emergency room

    Directory of Open Access Journals (Sweden)

    Alireza Keshtkar Jafari

    2012-01-01

    Full Text Available Background: Eye-related complaints compose approximately 1-6% of complaints of patients referring to general emergency ward around the world. Eye injuries are the most common cause of referral to eye emergency ward. To understand the impact of eye injuries in Iran and to plan preventive strategies, it is important to understand the complete magnitude of the problem with regard to true population-based data and standard reproducible definitions. Aim: The main goal of this study was to identify the major causes of referrals to eye emergency ward in patients with eye-related complaints in an eye referral Hospital in Iran. Settings and Design: In a cross-sectional study, 3150 patients who referred to Farabi Hospital emergency ward, Tehran, Iran, from January to December 2007 were included in the study and their detailed information were recorded. Materials and Methods: The patients′ demographic data, medical history and final diagnosis were recorded in a questionnaire. Results: The mean age of patients was 33.2±16.8 years and 2380 patients (75.6% were males. While 299 patients (9.5% were referred for non-urgent reasons, work-related injuries were the most common cause of referral (955 patients; 30.3%. In patients referred due to trauma (1950 patients, work-related injuries occurred in 955 patients (49% and occurred accidentally (by chance in 819 patients (42%. The majority of patients referred with traumatic injuries were males (1708 patients; 87.6% versus 242 patients; 12.4%. The most common etiologies of eye trauma (1950 patients were metal filings (814 patients; 41.8%, blunt trauma (338 patients; 17.3%, fireworks (236 patients; 12.1% and sharp objects (222 patients; 11.4%. Globe injury was diagnosed in 1865 patients (95.7% of trauma cases. In patients referred due to non-traumatic reason (1200 patients, eye infection occurred in 482 patients (40.2% and 299 patients (24.9% were referred for non-urgent reasons. There was little difference

  6. Post hoc analysis of a single IV infusion of zoledronic acid versus daily oral risedronate on lumbar spine bone mineral density in different subgroups with glucocorticoid-induced osteoporosis.

    Science.gov (United States)

    Roux, C; Reid, D M; Devogelaer, J-P; Saag, K; Lau, C S; Reginster, J-Y; Papanastasiou, P; Bucci-Rechtweg, C; Su, G; Sambrook, P N

    2012-03-01

    This study summarizes the treatment effect of zoledronic acid infusion on lumbar spine bone mineral density in different subgroups with glucocorticoid-induced osteoporosis. Zoledronic acid is significantly more effective than risedronate in increasing lumbar spine (LS) bone mineral density (BMD) in both prevention and treatment of glucocorticoid-induced osteoporosis. Introduction In patients on glucocorticoids, a single zoledronic acid infusion significantly increased BMD versus daily oral risedronate. We assessed treatment effect on LS BMD in different patient subgroups at month 12 that contributed to the risk of osteoporosis in addition to glucocorticoids. Methods Patients randomized to a single IV infusion of zoledronic acid 5 mg or risedronate (5 mg/day) and stratified based on glucocorticoids duration [treatment (>3 months) and prevention (≤ 3 months) subpopulations]were subgrouped by age; gender; menopausal status in women; dose and duration of prednisone during the trial; and baseline serum 25-OH vitamin D, LS BMD T-score, creatinine clearance, and concomitant medication use. Results At month 12, zoledronic acid significantly increased LS BMD versus risedronate in patients ≤ 74 years (Pinduced osteoporosis across a wide range of patients.

  7. Finite groups all of whose minimal subgroups are NE-subgroups

    Indian Academy of Sciences (India)

    subgroup of . In this article, we investigate the structure of under the assumption that subgroups of prime order are *-subgroups of . The finite groups, all of whose minimal subgroups of the generalized Fitting subgroup are *-subgroups ...

  8. Pain and Fatigue Variability Patterns Distinguish Subgroups of Fibromyalgia Patients.

    Science.gov (United States)

    Bartley, Emily J; Robinson, Michael E; Staud, Roland

    2017-12-15

    The current study examined between- and within-subject variability in pain-related symptoms as predictors of pain and fatigue, and identified patient subgroups based upon symptom variability characteristics. Two hundred and fifty-six fibromyalgia (FM) patients completed daily diaries up to a period of 154 days and reported on symptoms of pain intensity, pain unpleasantness, fatigue, anxiety, and depressed mood. Measures of health status, quality of life, and somatic symptoms were obtained at baseline, and hierarchical linear modeling and cluster analyses were employed. Significant intra- and inter-individual variability in daily FM symptoms was observed. Higher levels of pain were associated with greater fluctuations in pain unpleasantness, fatigue, and depressed mood. Similar effects were observed for fatigue and individual variability in anxiety also emerged as a robust predictor. Three FM subgroups were revealed: low variability in symptoms (Cluster 1), high symptom variability (Cluster 2), and a mixed variability group characterized by low fluctuation in pain unpleasantness; moderate pain, fatigue, and depressed mood variability; and high anxiety variability (Cluster 3). Cluster 3 exhibited lower social functioning and higher levels of pain, compared to Cluster 1. These findings support the dynamic nature of FM pain and suggest the presence of FM subgroups based upon variation in mood and pain symptomatology. Fibromyalgia patients display significant intra- and inter-individual variability in pain, mood, and fatigue. Subgroups in mood and pain-related variability emerged, with phenotypic clusters differing across levels of pain intensity and social functioning. Better understanding of the processes impacting pain variability may facilitate targeted treatments for the control of pain. Copyright © 2017. Published by Elsevier Inc.

  9. Socioeconomic Differences in Code-Focused Emergent Literacy Skills

    Science.gov (United States)

    Strang, Tara M.; Piasta, Shayne B.

    2016-01-01

    In the present study, we examined patterns of code-focused emergent literacy skill growth for children from lower and higher socioeconomic (SES) families enrolled at a high-quality early childhood center. Measures of letter name knowledge, letter sound knowledge, alliteration, and rhyming were collected at three time points over the course of the…

  10. Are there distinct cognitive and motivational sub-groups of children with ADHD?

    Science.gov (United States)

    Lambek, Rikke; Sonuga-Barke, Edmund; Tannock, Rosemary; Sørensen, Anne Virring; Damm, Dorte; Thomsen, Per Hove

    2017-11-16

    Attention-deficit/hyperactivity disorder (ADHD) is proposed to be a neuropsychologically heterogeneous disorder that encompasses two distinct sub-groups, one with executive function (EF) deficits and one with delay aversion (DA). However, such claims have often been based on studies that have operationalized neuropsychological deficits using a categorical approach - using intuitive but rather arbitrary, clinical cut-offs. The current study applied an alternative empirical approach to sub-grouping in ADHD, latent profile analysis (LPA), and attempted to validate emerging subgroups through clinically relevant correlates. One-hundred medication-naïve children with ADHD and 96 typically developing children (6-14 years) completed nine EF and three DA tasks as well as an odor identification test. Parents and teachers provided reports of the children's behavior (ADHD and EF). Models of the latent structure of scores on EF and DA tests were contrasted using confirmatory factor analysis (CFA). LPA was carried out based on factor scores from the CFA and sub-groups were compared in terms of odor identification and behavior. A model with one DA and two EF factors best fit the data. LPA resulted in four sub-groups that differed in terms of general level of neuropsychological performance (ranging from high to very low), odor identification, and behavior. The sub-groups did not differ in terms of the relative EF and DA performance. Results in the ADHD group were replicated in the control group. While EF and DA appear to be dissociable constructs; they do not yield distinct sub-groups when sub-grouping is based on a statistical approach such as LPA.

  11. Motor and non-motor symptoms of Parkinson's disease and their impact on quality of life and on different clinical subgroups.

    Science.gov (United States)

    Berganzo, K; Tijero, B; González-Eizaguirre, A; Somme, J; Lezcano, E; Gabilondo, I; Fernandez, M; Zarranz, J J; Gómez-Esteban, J C

    The aim of the present study is to analyse the influence that motor and non-motor symptoms have on the quality of life (QoL) of patients with Parkinson's disease (PD), and to study the relationship between the two types of symptoms. This cross-sectional study included 103 patients with PD (55 men and 48 women). Quality of life was measured on the PDQ-39 scale. The UPDRS scale (I-IV) was also used, and different items were grouped to analyse the presence of tremor, rigidity, bradykinesia, and axial symptoms. The non-motor symptoms scale (NMSS) was administered to assess non-motor symptoms. We performed correlation analyses between different scales to analyse the influence of motor and non-motor symptoms on QoL. Correlations were observed between the PDQ-39 summary index (PDQ39_SI) and the NMSS (correlation coefficient [cc], 0.56; pcc, 0.44; pcc, 0.37; pcc, 0.384; pcc, 0.299; pcc, 0.194; pmotor symptoms, and a tremor-associated phenotype in which these symptoms are less prevalent. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Refractory anaemia with excess of blasts in transformation re-evaluated with the WHO criteria: identification of subgroups with different survival.

    Science.gov (United States)

    Breccia, Massimo; Latagliata, Roberto; Carmosino, Ida; Gentilini, Fabiana; D'Elia, Gianna Maria; Levi, Anna; Natalino, Fiammetta; Frustaci, Annamaria; De Cuia, Maria Rosaria; Alimena, Giuliana

    2007-01-01

    One of the major changes suggested by the World Health Organization (WHO) classification with respect to the French-American-British (FAB) proposal for myelodysplastic syndromes (MDS) was to lower the bone marrow (BM) blast count from 30 to 20%, thus eliminating the refractory anaemia with excess of blasts in transformation (RAEB-t) category. However, a general consensus has not been reached, and several authors still retain RAEB-t as an MDS sub-entity. We re-evaluated our series of 74 patients classified as RAEB-t according to the FAB criteria by stratifying them into two subsets: patients with at least 5% peripheral blast (PB) cells but with BM blasts who, based on >5% PBs, should be included in the RAEB-II category according to the WHO criteria, with a group of 98 patients who were diagnosed as RAEB-II according to the WHO criteria. The findings showed that the aggregation of these two subsets appeared inappropriate, because patients of the two groups showed different clinical features and rates of acute transformation. In conclusion, the RAEB-t entity according to the FAB criteria, although including heterogeneous clinical patient subsets, should more likely be considered as an advanced stage of MDS, rather than a true acute myeloid leukaemia. 2007 S. Karger AG, Basel

  13. CD3(+)CD56(+) natural killer T cell activity in children with different forms of juvenile idiopathic arthritis and the influence of etanercept treatment on polyarticular subgroup.

    Science.gov (United States)

    Zhou, Juan; Ding, Yuan; Zhang, Yu; Feng, Ye; Tang, Xuemei; Zhao, Xiaodong

    2017-03-01

    Juvenile idiopathic arthritis (JIA) has three major onset types with widely varying clinical features. We assessed the natural killer T (NKT) cell function in patients with different JIA subtypes, and found systemic patients exhibited lower NKT cell counts, perforin and granzyme B expression, while the pauciarticular and polyarticular patients displayed higher perforin and granzyme B expression as compared with the controls. The synovial fluid had more NKT cells with higher levels of perforin, granzyme B, and tumour necrosis factor (TNF)-α than peripheral cells. The polyarticular patients that responded to etanercept had lower NKT cell counts, intracellular perforin, granzyme B and the mean fluorescence intensity of TNF-α than the patients that did not respond. Treatment with etanercept reduced the granzyme B and perforin, interferon (IFN)-γ and TNF-α expression in NKT cells in the responsive group. Therefore, a higher NKT cell function may indicate a decreased response to etanercept in polyarticular patients. Copyright © 2016. Published by Elsevier Inc.

  14. Sex Differences in Wild Chimpanzee Behavior Emerge during Infancy

    OpenAIRE

    Lonsdorf, Elizabeth V.; Catherine Markham, A.; Heintz, Matthew R.; Anderson, Karen?E.; Ciuk, David J.; Jane Goodall; Murray, Carson M.

    2014-01-01

    The role of biological and social influences on sex differences in human child development is a persistent topic of discussion and debate. Given their many similarities to humans, chimpanzees are an important study species for understanding the biological and evolutionary roots of sex differences in human development. In this study, we present the most detailed analyses of wild chimpanzee infant development to date, encompassing data from 40 infants from the long-term study of chimpanzees at ...

  15. Racial differences in Emergency Department visits for seizures.

    Science.gov (United States)

    Fantaneanu, Tadeu A; Hurwitz, Shelley; van Meurs, Katherine; Llewellyn, Nichelle; O'Laughlin, Kelli N; Dworetzky, Barbara A

    2016-08-01

    Seizures are a common reason for visiting the Emergency Department (ED). There is a growing body of literature highlighting disparities in seizure care related to race and ethnicity. Our goal was to identify racial and clinical characteristics of patients presenting to the ED with seizures and to determine factors associated with repeat ED visits for seizure. This was a retrospective study evaluating patients presenting with seizure as the primary reason for their ED visit between 01/01/2008 and 12/31/2008. Clinical data were collected from the electronic medical record (EMR) and compared between black and white patients and between patients with single and repeat ED seizure visits. Statistically significant variables were introduced in a logistic regression analysis with repeat ED visits as outcome. Of 38, 879 ED visits, 559 recorded 'seizure' as the primary reason for the visit. Compared to white patients (N=266), black patients (N=102) were more likely to have non-private insurance (p=0.005), less likely to have evidence of regular ambulatory care (p=0.02) and were more likely to have multiple visits within the calendar year (p=0.005). Black patient visits were more likely to have missed or ran out of antiepileptic drugs (AED) as the precipitant for their ED visit (pseizure care. Black patients were more likely to have multiple seizure visits to the ED when compared to white patients. This may suggest a disparity in access to care related to race between these two groups. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  16. Sex differences in wild chimpanzee behavior emerge during infancy.

    Directory of Open Access Journals (Sweden)

    Elizabeth V Lonsdorf

    Full Text Available The role of biological and social influences on sex differences in human child development is a persistent topic of discussion and debate. Given their many similarities to humans, chimpanzees are an important study species for understanding the biological and evolutionary roots of sex differences in human development. In this study, we present the most detailed analyses of wild chimpanzee infant development to date, encompassing data from 40 infants from the long-term study of chimpanzees at Gombe National Park, Tanzania. Our goal was to characterize age-related changes, from birth to five years of age, in the percent of observation time spent performing behaviors that represent important benchmarks in nutritional, motor, and social development, and to determine whether and in which behaviors sex differences occur. Sex differences were found for indicators of social behavior, motor development and spatial independence with males being more physically precocious and peaking in play earlier than females. These results demonstrate early sex differentiation that may reflect adult reproductive strategies. Our findings also resemble those found in humans, which suggests that biologically-based sex differences may have been present in the common ancestor and operated independently from the influences of modern sex-biased parental behavior and gender socialization.

  17. Criteria for phytoplasma 16Sr group/subgroup delineation and the need of a platform for proper registration of new groups and subgroups

    Science.gov (United States)

    As more phytoplasmas are discovered in emerging and re-emerging plant diseases worldwide, the scheme for classification of phytoplasmas into 16S rRNA gene RFLP (16Sr) groups and subgroups is experiencing an ongoing rapid expansion. Improper delineation or designation of new groups and subgroups can...

  18. Sex Differences in the Manifestation of ADHD in Emerging Adults

    Science.gov (United States)

    Fedele, David A.; Lefler, Elizabeth K.; Hartung, Cynthia M.; Canu, Will H.

    2012-01-01

    Objective: Given the mixed literature in the area, the aim of the current study was to determine whether sex differences exist in inattention, hyperactivity, and impairment in college adults with ADHD. Method: Individuals from three universities were recruited for the study. Participants with (n = 164) and without ADHD (n = 710) completed on-line…

  19. On distinguishing different models of a class of emergent Universe ...

    Indian Academy of Sciences (India)

    Souvik Ghose

    2018-02-20

    Feb 20, 2018 ... over, it is essential to incorporate a phase of inflation in early Universe in the standard Big-Bang cosmol- ogy as the present observations favour such an ... vational data permit us to distinguish between different models belonging to this class. It is straightforward to explain the present scheme. SNIa data ...

  20. Emergence of differing electronic communication norms within partially distributed teams

    NARCIS (Netherlands)

    Cheshin, A.; Kim, Y.; Bos, N.D.; Nan, N.; Olson, J.S.

    2013-01-01

    Modern organizations often consist of teams in which some people are collocated and some are remote. These teams are in-between being entirely virtual to entirely face-to-face and are referred to as partially distributed teams. Partially distributed teams function and operate in two different media

  1. Soft n-Ary Subgroups

    Directory of Open Access Journals (Sweden)

    D.R. Prince Williams

    2015-09-01

    Full Text Available Soft set theory plays a vital role in solving many complicated problems with inherited uncertainty. An n-ary algebraic systems is a generalization of algebraic structures and it is the most natural way for the further development, deeper understanding of their properties. In this paper, we apply soft set theory to an n-ary algebraic systems and introduce the notions of soft n-ary groups and soft n-ary subgroups. Further, some operations on soft sets are extended to the former. Finally, we provide the characterization of soft n-ary subgroups over an n-ary group (G,f and study their related properties.

  2. On Cosets and Normal Subgroups

    OpenAIRE

    B. O. ONASANYA; S.A.Ilori

    2014-01-01

    The paper [5] has worked on fuzzy cosets and fuzzy normal subgroups of a group, [8] has extended the idea to fuzzy middle coset. In addition to what has been done, we make a link between fuzzy coset and fuzzy middle coset and investigate some more properties of the fuzzy middle coset. [7] made attempt with some results needing adjustment. [2], [8] and [9] have shown that if f 2 F(Sn), the set of all fuzzy subgroups of Sn, is such that Imf has the highest order and f is constant on the conjuga...

  3. Hopf algebras and congruence subgroups

    CERN Document Server

    Sommerhauser, Yorck

    2007-01-01

    We prove that the kernel of the natural action of the modular group on the center of the Drinfel'd double of a semisimple Hopf algebra is a congruence subgroup. To do this, we introduce a class of generalized Frobenius-Schur indicators and endow it with an action of the modular group that is compatible with the original one.

  4. Erratum The congruence subgroup problem

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    . 299–308). The congruence subgroup problem. M S RAGHUNATHAN. There is unfortunately an error in the paper cited above in the very first page. We correct this error (which does not materially affect the rest of the paper in any way) below.

  5. Finite groups all of whose minimal subgroups are NE∗ -subgroups

    Indian Academy of Sciences (India)

    We prove the following theorem which is an improvement of a recent result due to Asaad and Ramadan (see Theorem 1.1 of [2]). Hence, Q8 will denote the quaternion group of order 8 and a group G is called Q8-free if no quotient group of any subgroup of G is isomorphic to Q8. Throughout this paper, L will denote the class.

  6. Different Leaders: Emergent Organizational and Intellectual Leadership in Children's Collaborative Learning Groups

    Science.gov (United States)

    Mercier, Emma M.; Higgins, Steven E.; da Costa, Laura

    2014-01-01

    This paper presents two studies that examine emergent leadership in children's collaborative learning groups. Building on research that finds that leadership moves are distributed among group members during learning activities, we examined whether there were patterns in the distribution of moves, resulting in different types of emergent leaders in…

  7. Outsourcing Strategies of Emerging Country Firms : Are they Different from Developed Country Multinationals?

    NARCIS (Netherlands)

    Fleury, A.; Arkader, R.; Größler, A.; Timenes Laugen, B.

    2010-01-01

    The purpose of the paper is to analyze differences in the sourcing strategies of manufacturing firms from emerging and from developed markets. More specifically, we test whether manufacturers from emerging markets have other objectives when sourcing from within their countries or from international

  8. Identifying subgroups of patients using latent class analysis

    DEFF Research Database (Denmark)

    Nielsen, Anne Mølgaard; Kent, Peter; Hestbæk, Lise

    2017-01-01

    BACKGROUND: Heterogeneity in patients with low back pain (LBP) is well recognised and different approaches to subgrouping have been proposed. Latent Class Analysis (LCA) is a statistical technique that is increasingly being used to identify subgroups based on patient characteristics. However, as ...

  9. An emergency dispatch model considering the urgency of the requirement for reliefs in different disaster areas

    Directory of Open Access Journals (Sweden)

    Liu Sheng

    2015-11-01

    Full Text Available Abstract: Purpose: Frequent sudden-onset disasters which have threatened the survival of human and the development of society force the public to pay an increasing attention to emergency management. A challenging task in the process of emergency management is emergency dispatch of reliefs. An emergency dispatch model considering the urgency of the requirement for reliefs in different disaster areas is proposed in this paper to dispatch reliefs reasonably and reduce the effect of sudden-onset disasters. Design/methodology/approach: Firstly, quantitative assessment on the urgency of the requirement for reliefs in different disaster areas is done by an evaluation method based on Fuzzy Comprehensive Evaluation and improved Evidence Reasoning which is proposed in this paper. And then based the quantitative results, an emergency dispatch model aiming to minimize the response time, the distribution cost and the unsatisfied rate of the requirement for reliefs is proposed, which reflects the requests of disaster areas under emergency, including the urgency of requirement, the economy of distribution and the equity of allocation. Finally, the Genetic Algorithm is improved based on the adaptive crossover and mutation probability function to solve the emergency dispatch model. Findings and Originality/value: A case that the Y hydraulic power enterprise carries on emergency dispatch of reliefs under continuous sudden-onset heavy rain is given to illustrate the availability of the emergency dispatch model proposed in this paper. The results show that the emergency dispatch model meets the distribution priority requirement of disaster area with the higher urgency, so thatreliefs are supplied more timely. Research limitations/implications: The emergency dispatch model faced to large scale sudden-onset disasters is complex. The quantity of reliefs that disaster area requires and the running time of vehicles are viewed as available information, and the problem

  10. Seedling emergence of tall fescue and wheat grass under different climate conditions in Iran

    Energy Technology Data Exchange (ETDEWEB)

    Behtari, B.; Luis, M. de

    2012-11-01

    Seedling emergence is one of the most important processes determining yield and the probability of crop failure. The ability to predict seedling emergence could enhance crop management by facilitating the implementation of more effective weed control strategies by optimizing the timing of weed control. The objective of the study was to select a seedling emergence thermal time model by comparing five different equations for tall fescue and wheat grass in two sites with different climate conditions (semiarid-temperate and humid-warm) in Iran. In addition, seedling emergence between two target species were studied. Among the five models compared, the Gompertz and Weibull models gave more successful results. In humid-warm conditions, the total emergence of wheat grass was higher than observed in tall fescue. In contrast, emergence was faster in tall fescue than wheat grass in both study sites. Given that early-emerging plants have been described as contributing more to crop yield than later-emerging ones, tall fescue is proposed as a more suitable specie for semiarid- temperate conditions in Iran. (Author) 31 refs.

  11. Validity of different pediatric early warning scores in the emergency department

    NARCIS (Netherlands)

    N. Seiger (Nienke); I.K. MacOnochie (Ian); R. Oostenbrink (Rianne); H.A. Moll (Henriëtte)

    2013-01-01

    textabstractObjective: Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. Methods: Ten different PEWS were evaluated in a large prospective cohort. We included

  12. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Science.gov (United States)

    Whittaker, William; Anselmi, Laura; Kristensen, Søren Rud; Lau, Yiu-Shing; Bailey, Simon; Bower, Peter; Checkland, Katherine; Elvey, Rebecca; Rothwell, Katy; Stokes, Jonathan; Hodgson, Damian

    2016-09-01

    Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators. Throughout 2014, 56 primary care practices (346,024 patients) in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients) providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access) in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866), and a 26.6% (95% CI -39.2% to -14.1%) relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184). There was an insignificant relative reduction of 3.1% in total emergency

  13. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Directory of Open Access Journals (Sweden)

    William Whittaker

    2016-09-01

    Full Text Available Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators.Throughout 2014, 56 primary care practices (346,024 patients in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866, and a 26.6% (95% CI -39.2% to -14.1% relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184. There was an insignificant relative reduction of 3.1% in

  14. Perceived discrimination and chronic health in adults from nine ethnic subgroups in the USA.

    Science.gov (United States)

    Carlisle, Shauna K

    2015-01-01

    This comparative analysis examines the association between chronic cardiovascular, respiratory and pain conditions, race, ethnicity, nativity, length of residency, and perceived discrimination among three racial and nine ethnic subgroups of Asian Americans (Vietnamese, Filipino, and Chinese), Latino-American (Cuban, Portuguese, and Mexican), and Afro-Caribbean American (Haitian, Jamaican, and Trinidadian/Tobagonian) respondents. Analysis used weighted Collaborative Psychiatric Epidemiology Surveys-merged data from the National Latino and Asian American Study and the National Survey of American Life. Logistic regression analysis was conducted to determine which groups within the model were more likely to report perceived discrimination effects. Afro-Caribbean subgroups were more likely to report perceived discrimination than Asian American and Latino-American subgroups were. Logistic regression revealed a significant positive association with perceived discrimination and chronic pain only for Latino-American respondents. Significant differences in reports of perceived discrimination emerged by race and ethnicity. Caribbean respondents were more likely to report high levels of perceived discrimination; however, they showed fewer significant associations related to chronic health conditions compared to Asian Americans and Latino-Americans. Examination of perceived discrimination across ethnic subgroups reveals large variations in the relationship between chronic health and discrimination by race and ethnicity. Examining perceived discrimination by ethnicity may reveal more complex chronic health patterns masked by broader racial groupings.

  15. Subgroup Achievement and Gap Trends: Massachusetts, 2010

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Massachusetts for 2010. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Massachusetts showed across-the-board gains--improvements in both reading and math at the basic, proficient and advanced levels for all racial/ethnic subgroups, low…

  16. Subgroup Achievement and Gap Trends: Kentucky, 2010

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Kentucky for 2010. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Kentucky showed mostly gains in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls.…

  17. [Differences in practice among physicians staffing an emergency department in relation to years of experience].

    Science.gov (United States)

    Busca, Pablo; Inchaurza, Estibaliz; Illarramendi, Aiora; Urbina, Ohiana; González, Laura; Miró, Òscar

    2015-06-01

    To determine differences in certain variables reflecting clinical practice in a group of emergency physicians with varying levels of experience and to explore whether differences are associated with experience. Retrospective observational study of differences in variables reflecting emergency physicians' practice between 2005 and 2012. We studied work variables (months worked, patients treated, caseload distribution according to triage levels), patient management variables (consultation with other specialists, admissions, ambulance requests), diagnostic procedures ordered (simple radiographs, laboratory tests, ultrasound or computed tomography imaging), and time patients discharged home spent in the department (arrival to discharge). We explored relationships between these variables and the emergency physician's experience using linear regression analysis, followed by the construction of multivariable models to adjust for physician characteristics. Data for 50 emergency medicine physicians, in 291 years of work, were analyzed. The specialists' experience ranged from 1 to 22 years (mean [SD], 9.5 [5.8] years). They attended between 47 and 158 patients monthly (mean, 86 [19] patients). The physicians' experience was inversely and independently related to the mean number of patients attended monthly and the percentage of patients assigned a triage level of 1 or 2. Experience was directly and independently related to discharged patients' time spent in the emergency department and number of simple radiographs ordered. All associations were small (R2<0.010), however. Those variables continued to show statistically significant associations after increasingly complex modeling to adjust for the following physician variables: physician, age, sex, specialty, residency training in the same hospital). The practice of emergency physicians with more accumulated experience shows slight but significant differences from the practice of less experienced physicians.

  18. Research methods for subgrouping low back pain

    DEFF Research Database (Denmark)

    Kent, Peter; Keating, Jennifer L; Leboeuf-Yde, Charlotte

    2010-01-01

    There is considerable clinician and researcher interest in whether the outcomes for patients with low back pain, and the efficiency of the health systems that treat them, can be improved by 'subgrouping research'. Subgrouping research seeks to identify subgroups of people who have clinically...... studies (a method framework). The aims of this debate article are: (1) to present a method framework to inform the design and evaluation of subgrouping research in low back pain, (2) to describe method options when investigating prognostic effects or subgroup treatment effects, and (3) to discuss...

  19. Differences between Girls and Boys in Emerging Language Skills: Evidence from 10 Language Communities

    Science.gov (United States)

    Eriksson, Marten; Marschik, Peter B.; Tulviste, Tiia; Almgren, Margareta; Perez Pereira, Miguel; Wehberg, Sonja; Marjanovic-Umek, Ljubica; Gayraud, Frederique; Kovacevic, Melita; Gallego, Carlos

    2012-01-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.08 to 2.06. The results showed that girls are…

  20. Sex differences in the emergence of leadership during competitions within and between groups.

    Science.gov (United States)

    Van Vugt, Mark; Spisak, Brian R

    2008-09-01

    This experiment investigated potential gender biases in the emergence of leadership in groups. Teams played a public-goods game under conditions of intra- or intergroup competition. We predicted and found a strong preference for female leaders during intragroup competition and male leaders during intergroup competition. Furthermore, during intragroup competition, a female leader was more instrumental than a male leader in raising group investments, but this pattern was reversed during intergroup competition. These findings suggest that particular group threats elicit specific gender-biased leader prototypes. We speculate about the evolutionary and cultural origins of these sex differences in the emergence of leadership.

  1. The role of groundwater governance in emergencies during different phases of natural disasters

    Science.gov (United States)

    Vrba, Jaroslav

    2016-03-01

    The establishment of water governance in emergency situations supports timely and effective reaction with regard to the risk and impact of natural disasters on drinking-water supplies and populations. Under such governance, emergency activities of governmental authorities, rescue and aid teams, water stakeholders, local communities and individuals are coordinated with the objective to prevent and/or mitigate disaster impact on water supplies, to reduce human suffering due to drinking-water failure during and in the post-disaster period, and to manage drinking-water services in emergency situations in an equitable manner. The availability of low-vulnerability groundwater resources that have been proven safe and protected by geological features, and with long residence time, can make water-related relief and rehabilitation activities during and after an emergency more rapid and effective. Such groundwater resources have to be included in water governance and their exploration must be coordinated with overall management of drinking-water services in emergencies. This paper discusses institutional and technical capacities needed for building effective groundwater governance policy and drinking-water risk and demand management in emergencies. Disaster-risk mitigation plans are described, along with relief measures and post-disaster rehabilitation and reconstruction activities, which support gradual renewal of drinking-water services on the level prior to the disaster. The role of groundwater governance in emergencies differs in individual phases of disaster (preparedness, warning, impact/relief, rehabilitation). Suggested activities and actions associated with these phases are summarized and analysed, and a mode of their implementation is proposed.

  2. Comparison of emergence times with different fresh gas flow rates following desflurane anaesthesia.

    Science.gov (United States)

    Jeong, Ji Seon; Yoon, Sung Wook; Choi, Sung Lark; Choi, Sung Hwan; Lee, Bong Yeong; Jeong, Mi Ae

    2014-12-01

    To investigate emergence times with different fresh gas flow rates, following desflurane anaesthesia. Patients undergoing surgery with desflurane anaesthesia were randomly assigned to receive fresh gas flow rates of 100% oxygen during emergence of 2 l/min (group D2), 4 l/min (group D4) or 6 l/min (group D6). Time to eye opening, spontaneous movement and extubation (emergence time) were assessed after desflurane discontinuation. The end-tidal concentration of desflurane and bispectral index were recorded at each of these timepoints. A total of 105 patients were included in the study, with 35 in each of the three groups. Mean times to extubation were 17.6 min, 9.9 min and 9.1 min in groups D2, D4 and D6, respectively. Times to eye opening, spontaneous movement and extubation in group D2 were significantly longer than in groups D4 and D6. These results suggest that there is the potential to predict emergence time based on fresh gas flow rate following desflurane anaesthesia. It should therefore be possible to use a low-flow technique during the emergence period, in addition to the maintenance period, without delaying recovery if the inhaled anaesthetic is stopped at the predicted time before the end of surgery. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Image and Imaging an Emergency Department: Expense and Benefit of Different Quality Assessment Methods

    Directory of Open Access Journals (Sweden)

    Carmen Andrea Pfortmueller

    2013-01-01

    Full Text Available Introduction. In this era of high-tech medicine, it is becoming increasingly important to assess patient satisfaction. There are several methods to do so, but these differ greatly in terms of cost, time, and labour and external validity. The aim of this study is to describe and compare the structure and implementation of different methods to assess the satisfaction of patients in an emergency department. Methods. The structure and implementation of the different methods to assess patient satisfaction were evaluated on the basis of a 90-minute standardised interview. Results. We identified a total of six different methods in six different hospitals. The average number of patients assessed was 5012, with a range from 230 (M5 to 20 000 patients (M2. In four methods (M1, M3, M5, and M6, the questionnaire was composed by a specialised external institute. In two methods, the questionnaire was created by the hospital itself (M2, M4.The median response rate was 58.4% (range 9–97.8%. With a reminder, the response rate increased by 60% (M3. Conclusion. The ideal method to assess patient satisfaction in the emergency department setting is to use a patient-based, in-emergency department-based assessment of patient satisfaction, planned and guided by expert personnel.

  4. Can the tinnitus spectrum identify tinnitus subgroups?

    Directory of Open Access Journals (Sweden)

    Karin M Heijneman

    2013-01-01

    Full Text Available The tinnitus spectrum is a psycho-acoustic metric of tinnitus. Previous work found a tight relation between the spectrum and the tone audiogram. This suggests that the spectrum and the audiogram provide essentially the same information, and the added value of the spectrum is limited. In order to test whether the spectrum shows tinnitus characteristics that cannot be inferred from the audiogram, we re-examined the relation between the tinnitus spectrum and the tone audiogram, in a group of 80 tinnitus patients. We defined three subgroups of patients, using the shape of their tinnitus spectrum: (1 patients with a spectrum, monotonously increasing with frequency (2 patients with a distinct peak in their spectrum, (3 all other patients. Patients in group 3 typically showed low frequency tinnitus spectra. In all three groups, the largest hearing loss was at high frequencies (>2 kHz. The mean audiograms of group 1 and 2 were remarkably similar; group 3 had an additional hearing loss for the lower frequencies (<2 kHz. The three groups did not differ with respect to age, sex, or tinnitus questionnaire outcomes. In subgroups 2 and 3, the shape of the spectrum clearly differed from that of the tone audiogram. In other words, the spectrum technique provided information that could not have been obtained by tone audiometry alone. Therefore, the spectrum measurement may develop into a technique that can differentiate between classes of tinnitus. This may eventually contribute to the effective management of tinnitus, as various classes of tinnitus may require different therapeutic interventions.

  5. Gender Differences in Acute and Chronic Pain in the Emergency Department: Results of the 2014 Academic Emergency Medicine Consensus Conference Pain Section

    National Research Council Canada - National Science Library

    Musey, Paul I; Linnstaedt, Sarah D; Platts‐Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A; Cone, David C

    2014-01-01

    .... The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED...

  6. The Emergence and Unfolding of Telemonitoring Practices in Different Healthcare Organizations

    Directory of Open Access Journals (Sweden)

    Jannie Kristine Bang Christensen

    2018-01-01

    Full Text Available Telemonitoring, a sub-category of telemedicine, is promoted as a solution to meet the challenges in Western healthcare systems in terms of an increasing population of people with chronic conditions and fragmentation issues. Recent findings from large-scale telemonitoring programs reveal that these promises are difficult to meet in complex real-life settings which may be explained by concentrating on the practices that emerge when telemonitoring is used to treat patients with chronic conditions. This paper explores the emergence and unfolding of telemonitoring practices in relation to a large-scale, inter-organizational home telemonitoring program which involved 5 local health centers, 10 district nurse units, four hospitals, and 225 general practice clinics in Denmark. Twenty-eight interviews and 28 h of observations of health professionals and administrative staff were conducted over a 12-month period from 2014 to 2015. This study’s findings reveal how telemonitoring practices emerged and unfolded differently among various healthcare organizations. This study suggests that the emergence and unfolding of novel practices is the result of complex interplay between existing work practices, alterations of core tasks, inscriptions in the technology, and the power to either adopt or ignore such novel practices. The study enhances our understanding of how novel technology like telemonitoring impacts various types of healthcare organizations when implemented in a complex inter-organizational context.

  7. Subgroup Analysis of Trials Is Rarely Easy (SATIRE: a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials

    Directory of Open Access Journals (Sweden)

    Malaga German

    2009-11-01

    Full Text Available Abstract Background Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1 to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2 to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3 to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. Methods We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. Discussion A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize

  8. Copepod (Crustacea) emergence from soils from everglades marshes with different hydroperiods

    Science.gov (United States)

    Loftus, W.F.; Reid, J.W.

    2000-01-01

    During a severe drought period in the winter and spring of 1989, we made three collections of dried marsh soils from freshwater sloughs in Everglades National Park, Florida, at sites characterized by either long or intermediate annual periods of flooding (hydroperiod). After rehydrating the soils in aquaria, we documented the temporal patterns of copepod emergence over two-week periods. The species richness of copepods in the rehydrated soils was lower than in pre-drought samples from the same slough sites. Only six of the 16 species recorded from the Everglades emerged in the aquarium tests. The long hydroperiod site had a slightly different assemblage and higher numbers of most species than the intermediate-hydroperiod sites. More individuals and species emerged from the early dry-season samples compared with samples taken later in the dry season. The harpacticoid, Cletocamptus deitersi, and the cyclopoid, Microcyclops rubellus, were abundant at most sites. The cyclopoids - Ectocyclops phaleratus, Homocyclops ater, and Paracyclops chiltoni - are new records for the Everglades. We infer that 1) only a subset of Everglades copepod species can survive drought by resting in soils; and that 2) survival ability over time differs by species.

  9. Subgroup Achievement and Gap Trends: Delaware

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Delaware students showed consistent gains in math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. There were mixed results in reading. Achievement gaps narrowed in both reading and math in…

  10. Subgroup Achievement and Gap Trends: Maine

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Maine students had across-the-board gains. There were improvements in both reading and math at the basic, proficient and advanced levels for the subgroups large enough to count, which were white students, low income students, and boys and girls. Results on…

  11. Subgroup Achievement and Gap Trends: Illinois

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Illinois students showed mostly gains in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. There was mixed progress made in narrowing achievement gaps in reading and math…

  12. Subgroup Achievement and Gap Trends: Florida

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Florida students showed gains almost across the board in both reading and math at the basic, proficient, and advanced levels for racial/ethnic subgroups, low income students, and boys and girls. Progress has been made in narrowing achievement gaps in both…

  13. ∗-supplemented subgroups of finite groups

    Indian Academy of Sciences (India)

    supplemented maximal and minimal subgroups of Sylow subgroups of finite groups, Proc. Amer. Math. Soc. 132(8) (2004) 2197–2204. [17] Wang Y, Wei H and Li Y, A generalization of Kramer's theorem and its applications,. Bull. Austral. Math.

  14. Cumulative subgroup analysis to reduce waste in clinical research for individualised medicine.

    Science.gov (United States)

    Song, Fujian; Bachmann, Max O

    2016-12-15

    Although subgroup analyses in clinical trials may provide evidence for individualised medicine, their conduct and interpretation remain controversial. Subgroup effect can be defined as the difference in treatment effect across patient subgroups. Cumulative subgroup analysis refers to a series of repeated pooling of subgroup effects after adding data from each of related trials chronologically, to investigate the accumulating evidence for subgroup effects. We illustrated the clinical relevance of cumulative subgroup analysis in two case studies using data from published individual patient data (IPD) meta-analyses. Computer simulations were also conducted to examine the statistical properties of cumulative subgroup analysis. In case study 1, an IPD meta-analysis of 10 randomised trials (RCTs) on beta blockers for heart failure reported significant interaction of treatment effects with baseline rhythm. Cumulative subgroup analysis could have detected the subgroup effect 15 years earlier, with five fewer trials and 71% less patients, than the IPD meta-analysis which first reported it. Case study 2 involved an IPD meta-analysis of 11 RCTs on treatments for pulmonary arterial hypertension that reported significant subgroup effect by aetiology. Cumulative subgroup analysis could have detected the subgroup effect 6 years earlier, with three fewer trials and 40% less patients than the IPD meta-analysis. Computer simulations have indicated that cumulative subgroup analysis increases the statistical power and is not associated with inflated false positives. To reduce waste of research data, subgroup analyses in clinical trials should be more widely conducted and adequately reported so that cumulative subgroup analyses could be timely performed to inform clinical practice and further research.

  15. Gender differences in the self-defining activities and identity experiences of adolescents and emerging adults.

    Science.gov (United States)

    Sharp, Erin Hiley; Coatsworth, J Douglas; Darling, Nancy; Cumsille, Patricio; Ranieri, Sonia

    2007-04-01

    Activity participation provides a unique context for adolescents and emerging adults to explore interests, talents, and skills and for identity work to occur. Research has found consistent gender differences in the types of activities in which males and females participate. The current study drew on Eudaimonistic identity theory to examine the subjective identity-related experiences of personal expressiveness, flow experiences, and goal-directed behaviour [Waterman, 1984; Waterman, 2004. Finding someone to be: Studies on the role of intrinsic motivation in identity formation. Identity, 4, 209-228] within a special type of activity, self-defining activities, or those activities that participants identify as being important to who they are as a person. This study also tested for gender and country differences in a sample of 572 adolescents and emerging adults from the United States, Italy, and Chile. Findings indicate gender and country differences in the types of self-defining activities for males and females, but no gender differences in the reported identity-related experiences within those activities. This finding held across the three countries. Results from Multivariate Analyses of Variance also indicate that identity-related experiences differ significantly across seven broad activity classes. Findings are discussed in the context of the growing literature on adolescent activity involvement and time use, gender, and their relations to identity exploration.

  16. Course of Antisocial Behavior during Emerging Adulthood: Developmental Differences in Personality.

    Science.gov (United States)

    Blonigen, Daniel M; Littlefield, Andrew K; Hicks, Brian M; Sher, Kenneth J

    2010-12-01

    Despite similar normative changes in antisocial behavior (AB) and traits of disinhibition and negative emotionality during "emerging adulthood," few studies have tested if there are developmental differences in personality over this period for distinct courses of AB. In a college cohort assessed at ages 18 and 25, we examined if mean-level changes on traits from the Tridimensional Personality Questionnaire varied by course of AB. Compared to persisters, those who desisted in AB from 18 to 25 exhibited a larger decrease on novelty seeking and larger increase on reward dependence. A significant mean-level decline was observed for harm avoidance, but was unrelated to AB course. Findings support theories of the co-development of personality and AB during emerging adulthood.

  17. Cross-cultural differences and sexual risk behavior of emerging adults.

    Science.gov (United States)

    Thomas, Tami L; Yarandi, Hossein N; Dalmida, Safiya George; Frados, Andrew; Klienert, Kathleen

    2015-01-01

    The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV. © The Author(s) 2014.

  18. Dysexecutive versus amnestic Alzheimer disease subgroups: analysis of demographic, genetic, and vascular factors.

    Science.gov (United States)

    Mez, Jesse; Cosentino, Stephanie; Brickman, Adam M; Huey, Edward D; Manly, Jennifer J; Mayeux, Richard

    2013-01-01

    The objective of this study was to compare the demographic and vascular characteristics and APOE genotypes of a dysexecutive subgroup of Alzheimer disease (AD) with an amnestic subgroup of AD early in the disease course. A total of 2224 participants from the National Alzheimer's Coordinating Center database who carried a diagnosis of mild cognitive impairment (n=1188) or mild AD (clinical dementia rating ≤1) (n=1036) were included in this study. A subset of the mild cognitive impairment (n=61) and mild AD (n=79) participants underwent an autopsy. A dysexecutive subgroup (n=587) was defined as having executive performance >1 SD worse than memory performance, and an amnestic subgroup (n=549) was defined conversely. Among the autopsy subset, the odds of an AD pathologic diagnosis were compared in the 2 subgroups. The demographics, APOE[Latin Small Letter Open E]4 status, and vascular risk factors were compared in the 2 subgroups. Among the autopsy subset, the odds of having an AD pathologic diagnosis did not differ between the dysexecutive and amnestic subgroups. Under an additive model, participants in the dysexecutive subgroup possessed the APOE[Latin Small Letter Open E]4 allele less frequently compared with those in the amnestic subgroup. The dysexecutive subgroup had a history of hypertension less frequently compared with the amnestic subgroup. These distinct characteristics add to accumulating evidence that a dysexecutive subgroup of AD may have a unique underlying pathophysiology.

  19. Differences and similarities of motivating and demotivating factors of emergency nursing care in rural and urban emergency units – A study of selected rural and urban emergency units in the Volta Region of Ghana

    Directory of Open Access Journals (Sweden)

    Confidence Alorse Atakro

    Full Text Available Objective: The objective of this study was to explore differences and similarities of motivating and demotivating factors of emergency nursing care in selected rural and urban emergency units in the Volta Region of Ghana. Materials and methods: This study was conducted at selected rural and urban emergency units in the Volta Region of Ghana. The study utilised qualitative exploratory descriptive design. Purposive sampling technique was employed in selecting emergency units and nurses. Data were collected through semi-structured interviews of 30 nurses. Data saturation was determined after interviewing 30 participants. Data analysis was done through qualitative content analysis. Results: Twenty-six (26 out of a total of thirty (30 participants were between the ages of twenty-five (25 and twenty-nine (29. Nurses working in the emergency units studied general nursing at the Nurses Training Colleges (NTCs. None of the respondents studied emergency nursing as a degree programme. Twenty four (24 out of thirty (30 participants had worked for about two years in emergency units. Four thematic categories that represented differences and similarities of motivating and demotivating factors for nurses in rural and urban emergency units were extracted from data. The thematic categories are: a Support from hospital management for provision of material resources; b Task shifting to nurses; c Stimulant for learning; d Interpersonal relations. Discussions: Evidence available in this study suggests that there are differences as well as similarities of motivating and demotivating factors within emergency units of rural and urban settings in the Volta Region of Ghana. Differences in resource allocation and task shifting was identified. Stimulating environments of emergency unit for learning and excellent interpersonal relations were found to be common motivations for both rural and urban emergency unit nurses. Keywords: Motivating, Demotivating, Emergency

  20. Differences between girls and boys in emerging language skills: evidence from 10 language communities.

    Science.gov (United States)

    Eriksson, Mårten; Marschik, Peter B; Tulviste, Tiia; Almgren, Margareta; Pérez Pereira, Miguel; Wehberg, Sonja; Marjanovič-Umek, Ljubica; Gayraud, Frederique; Kovacevic, Melita; Gallego, Carlos

    2012-06-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.08 to 2.06. The results showed that girls are slightly ahead of boys in early communicative gestures, in productive vocabulary, and in combining words. The difference increased with age. Boys were not found to be more variable than girls. Despite extensive variation in language skills between language communities, the difference between girls and boys remained. This suggests that the difference is caused by robust factors that do not change between language communities. ©2011 The British Psychological Society.

  1. Differential distributions of Synechococcus subgroups across the California Current System.

    Directory of Open Access Journals (Sweden)

    Ryan William Paerl

    2011-04-01

    Full Text Available Synechococcus is an abundant marine cyanobacterial genus composed of different populations that vary physiologically. Synechococcus narB gene sequences (encoding for nitrate reductase in cyanobacteria obtained previously from isolates and the environment (e.g. North Pacific Gyre Station ALOHA, Hawaii or Monterey Bay, California were used to develop quantitative PCR (qPCR assays. These qPCR assays were used to quantify populations from specific narB phylogenetic clades across the California Current System (CCS, a region composed of dynamic zones between a coastal-upwelling zone and the oligotrophic Pacific Ocean. Targeted populations (narB subgroups had different biogeographic patterns across the CCS, which appear to be driven by environmental conditions. Subgroups C_C1, D_C1 and D_C2 were abundant in coastal-upwelling to coastal-transition zone waters with relatively high to intermediate ammonium, nitrate and chl. a concentrations. Subgroups A_C1 and F_C1 were most abundant in coastal-transition zone waters with intermediate nutrient concentrations. E_O1 and G_O1 were most abundant at different depths of oligotrophic open-ocean waters (either in the upper mixed layer or just below. E_O1, A_C1 and F_C1 distributions differed from other narB subgroups and likely possess unique ecologies enabling them to be most abundant in waters between coastal and open-ocean waters. Different CCS zones possessed distinct Synechococcus communities. Core California Current (CC water possessed low numbers of narB subgroups relative to counted Synechococcus cells, and coastal-transition waters contained high abundances of Synechococcus cells and total number of narB subgroups. The presented biogeographic data provides insight on the distributions and ecologies of Synechococcus present in an eastern boundary current system.

  2. Cluster analysis of clinical data identifies fibromyalgia subgroups.

    Directory of Open Access Journals (Sweden)

    Elisa Docampo

    Full Text Available INTRODUCTION: Fibromyalgia (FM is mainly characterized by widespread pain and multiple accompanying symptoms, which hinder FM assessment and management. In order to reduce FM heterogeneity we classified clinical data into simplified dimensions that were used to define FM subgroups. MATERIAL AND METHODS: 48 variables were evaluated in 1,446 Spanish FM cases fulfilling 1990 ACR FM criteria. A partitioning analysis was performed to find groups of variables similar to each other. Similarities between variables were identified and the variables were grouped into dimensions. This was performed in a subset of 559 patients, and cross-validated in the remaining 887 patients. For each sample and dimension, a composite index was obtained based on the weights of the variables included in the dimension. Finally, a clustering procedure was applied to the indexes, resulting in FM subgroups. RESULTS: VARIABLES CLUSTERED INTO THREE INDEPENDENT DIMENSIONS: "symptomatology", "comorbidities" and "clinical scales". Only the two first dimensions were considered for the construction of FM subgroups. Resulting scores classified FM samples into three subgroups: low symptomatology and comorbidities (Cluster 1, high symptomatology and comorbidities (Cluster 2, and high symptomatology but low comorbidities (Cluster 3, showing differences in measures of disease severity. CONCLUSIONS: We have identified three subgroups of FM samples in a large cohort of FM by clustering clinical data. Our analysis stresses the importance of family and personal history of FM comorbidities. Also, the resulting patient clusters could indicate different forms of the disease, relevant to future research, and might have an impact on clinical assessment.

  3. Emergência de Bidens pilosa em diferentes profundidades de semeadura Seed emergence of Bidens pilosa at different sowing depths

    Directory of Open Access Journals (Sweden)

    M.C. Souza

    2009-03-01

    Full Text Available Bidens pilosa é uma das mais importantes plantas daninhas que ocorrem em lavouras anuais e perenes da região Centro-Sul do Brasil. A grande capacidade de produção de aquênios é uma das suas principais estratégias de sobrevivência, e o conhecimento das condições fundamentais para germinação e emergência das plântulas é essencial para predição do crescimento populacional e para a elaboração de plano de manejo de suas infestações e de seus biótipos resistentes aos herbicidas. Foram conduzidos ensaios em condições de casa de vegetação, onde foi avaliada a emergência de aquênios de B. pilosa em diferentes profundidades (0, 1, 2, 3, 4 e 5 cm. Os experimentos foram conduzidos nos meses de maio, agosto e novembro de 2006 e em março de 2007. Os resultados mostraram que a emergência de plântulas de picão-preto foi bastante afetada pela localização do aquênio no perfil do solo, ocorrendo expressiva redução a partir de 2 cm de profundidade. Essa característica da biologia reprodutiva do picão-preto é importante para a formação de densos bancos de sementes em solos submetidos ao preparo convencional, onde grande parte da chuva de sementes é nele incorporada.Bidens pilosa is one of the major weeds in annual and perennial crops in midsouthern Brazil. High seed production is one of its most important survival strategies and the knowledge of the fundamental conditions for seedling germination and emergence is essential to establish prediction models of its population growth and to elaborate management models for control and prevention of herbicide resistant populations. This research aimed to understand the importance of B. pilosa seed depth in the soil profile to enhance its germination and seedling emergence potential. Thus, four assays were carried out under greenhouse conditions and the seeds were sown at 0, 1, 2, 3, 4, and 5 cm from the soil surface. The emergence of B. pilosa seedlings was reduced as sowing depth

  4. Young children with language difficulties: a dimensional approach to subgrouping.

    Science.gov (United States)

    Jansen, Rianne; Ceulemans, Eva; Grauwels, Jolien; Maljaars, Jarymke; Zink, Inge; Steyaert, Jean; Noens, Ilse

    2013-11-01

    A dimensional approach was used to create bottom-up constructed subgroups that captured the behavioral heterogeneity in 36 Dutch-speaking children with language difficulties. Four subgroups were delineated based upon differences in cognitive ability, symbol understanding, joint attention and autism spectrum disorder related characteristics. Children with a different developmental disorder were found within a single cluster. Therefore, the results of this study suggest that bottom-up constructed subgroups might capture the heterogeneous behavioral profiles of young children with developmental difficulties in a more meaningful way. Furthermore, joint attention and symbol understanding seem important skills to assess in young children presenting with language difficulties. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

    Science.gov (United States)

    Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

    2014-12-01

    Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

  6. Emergence and early survival of early versus late seral species in Great Basin restoration in two different soil types

    Science.gov (United States)

    Shauna M. Uselman; Keirith A. Snyder; Elizabeth A. Leger; Sara E. Duke

    2015-01-01

    Comparing emergence and survival probabilities, early seral natives generally outperformed late seral natives when growing with exotics and had earlier emergence timing, although results differed among functional groups and soil types. In contrast, survival probabilities did not differ between the early and late seral mixes when growing without exotics. Within each...

  7. Eye disease, the fertility decline, and the emergence of global income differences

    DEFF Research Database (Denmark)

    Andersen, Thomas B.; Dalgaard, Carl-Johan Lars; Selaya, Pablo

    2014-01-01

    This research advances and empirically establishes the hypothesis that regional variation in the historical incidence of eye disease has influenced the current global distribution of per capita income. By reducing work life expectancy, high historical eye disease incidence has served to diminish...... the incentive to accumulate skills, thereby delaying the fertility transition and the take-off to sustained economic growth. As a consequence of a differential timing of the take-off to growth, prompted by differences in the inherent return to skill formation, global income disparities have emerged....

  8. Identification of subgroups among fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    D. Chaleil

    2012-09-01

    Full Text Available This paper presents some hypotheses concerning the identification of homogeneous subgroups among fibromyalgia (FM patients in order to improve the management of the disease. It also reviews the available literature about this subject. Three methods for subgrouping are discussed according to clinical features, biomarkers, and gait analysis. Clinical subgrouping based on cluster analysis has been used for the identification of homogeneous subgroups of patients and, more recently, homogeneous clinical features. So far, longitudinal studies using clinical subgroups to direct treatment and predict outcome are still required. Biomarkers in FM, which is a neurobiological disease, are of promising interest, nevertheless currently, none of them can be used to subgroup FM patients. Due to the fact that cortical and subcortical mechanisms of gait control share some cognitive functions which are involved in FM, gait markers have been proposed to evaluate and to subgroup FM patients, in clinical settings. Three out of 4 core FM symptoms are linked to gait markers. Kinesia measured by means of cranio-caudal power is correlated to pain, and could be proposed to assess pain behavior (kinesiophobia. Stride frequency, which is linked to physical component, allows the identification of a hyperkinetic subgroup. Moreover, SF has been correlated to fatigue during the 6 minute walking test. Stride regularity, which expresses the unsteadiness of gait, is correlated to cognitive dysfunction in FM. Decreased stride regularity allows the recognition of a homogeneous subgroup characterized by an increased anxiety and depression, and decreased cognitive functions. These results need further studies to be validated and so used in the daily clinical practice.

  9. Subgroup Analysis in Burnout: Relations Between Fatigue, Anxiety, and Depression

    Science.gov (United States)

    van Dam, Arno

    2016-01-01

    Several authors have suggested that burned out patients do not form a homogeneous group and that subgroups should be considered. The identification of these subgroups may contribute to a better understanding of the burnout construct and lead to more specific therapeutic interventions. Subgroup analysis may also help clarify whether burnout is a distinct entity and whether subgroups of burnout overlap with other disorders such as depression and chronic fatigue syndrome. In a group of 113 clinically diagnosed burned out patients, levels of fatigue, depression, and anxiety were assessed. In order to identify possible subgroups, we performed a two-step cluster analysis. The analysis revealed two clusters that differed from one another in terms of symptom severity on the three aforementioned measures. Depression appeared to be the strongest predictor of group membership. These results are considered in the light of the scientific debate on whether burnout can be distinguished from depression and whether burnout subtyping is useful. Finally, implications for clinical practice and future research are discussed. PMID:26869983

  10. Subgroup analysis in burnout: relations between fatigue, anxiety and depression

    Directory of Open Access Journals (Sweden)

    Arno eVan Dam

    2016-02-01

    Full Text Available Several authors have suggested that burned out patients do not form a homogeneous group and that subgroups should be considered. The identification of these subgroups may contribute to a better understanding of the burnout construct and lead to more specific therapeutic interventions. Subgroup analysis may also help clarify whether burnout is a distinct entity and whether subgroups of burnout overlap with other disorders such as depression and chronic fatigue syndrome. In a group of 113 clinically-diagnosed burned out patients, levels of fatigue, depression and anxiety were assessed. In order to identify possible subgroups, we performed a two-step cluster analysis. The analysis revealed two clusters that differed from one another in terms of symptom severity on the three aforementioned measures. Depression appeared to be the strongest predictor of group membership. These results are considered in the light of the scientific debate on whether burnout can be distinguished from depression and whether burnout subtyping is useful. Finally, implications for clinical practice and future research are discussed.

  11. SUBGR: A Program to Generate Subgroup Data for the Subgroup Resonance Self-Shielding Calculation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-06-06

    The Subgroup Data Generation (SUBGR) program generates subgroup data, including levels and weights from the resonance self-shielded cross section table as a function of background cross section. Depending on the nuclide and the energy range, these subgroup data can be generated by (a) narrow resonance approximation, (b) pointwise flux calculations for homogeneous media; and (c) pointwise flux calculations for heterogeneous lattice cells. The latter two options are performed by the AMPX module IRFFACTOR. These subgroup data are to be used in the Consortium for Advanced Simulation of Light Water Reactors (CASL) neutronic simulator MPACT, for which the primary resonance self-shielding method is the subgroup method.

  12. How can latent trajectories of back pain be translated into defined subgroups?

    DEFF Research Database (Denmark)

    Kongsted, Alice; Hestbæk, Lise; Kent, Peter

    2017-01-01

    descriptive definitions, as a way to apply the same definitions of mutually exclusive subgroups across populations. In this study, we investigated if the course trajectories of two LBP cohorts fitted with previously suggested trajectory subgroup definitions, how distinctly different these subgroups were......BACKGROUND: Similar types of trajectory patterns have been identified by Latent Class Analyses (LCA) across multiple low back pain (LBP) cohorts, but these patterns are impractical to apply to new cohorts or individual patients. It would be useful to be able to identify trajectory subgroups from......, and if the subgroup definitions matched with LCA-derived patterns. METHODS: Weekly measures of LBP intensity and frequency during 1 year were available from two clinical cohorts. We applied definitions of 16 possible trajectory subgroups to these observations and calculated the prevalence of the subgroups...

  13. Early development and the emergence of individual differences in behavior among littermates of wild rabbit pups.

    Science.gov (United States)

    Rödel, Heiko G; Bautista, Amando; Roder, Manuel; Gilbert, Caroline; Hudson, Robyn

    2017-05-01

    The ontogeny of associated individual differences in behavior and physiology during early postnatal life, and in particular the emergence of such differences among litter siblings, has been hardly explored in mammals under natural conditions. We studied such within-litter differences in behavior in European rabbit pups Oryctolagus cuniculus prior to weaning, and whether and how these differences co-varied with other individual characteristics such as postnatal body temperature and early growth. The study was conducted under semi-natural conditions in a colony of rabbits of wild origin, where the young were born and developed in nursery burrows. We equipped two siblings per litter with interscapular skin temperature loggers on postnatal day 2 and recorded temperature profiles for 48h. Individual body (skin) temperatures of pups within litters were repeatable across time, indicating the existence of consistent individual differences. Such differences within litters were associated with relative differences in pre-weaning growth, revealing that relatively warmer pups showed a greater increase in body mass during the nest period. Between postnatal days 12 and 17, after the pups had reached a developmental stage of greater mobility, we carried out different behavioral tests: a handling-restraint test, an open field test and a jump-down test from a platform. Individual responses in the former two tests were associated, as those pups showing a quicker struggling response to restraint during handling also exhibited greater exploratory activity in the open field. This correlation across contexts suggests the existence of personality types in wild rabbits at an early developmental stage. Furthermore, pups' behavioral responses were strongly associated with their relative within-litter body mass at testing. Animals with a lower body mass compared to their siblings showed a relatively quicker struggle response to handling restraint and covered a relatively larger distance in

  14. Discrete neurocognitive subgroups in fully or partially remitted bipolar disorder

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Knorr, Ulla; Vinberg, Maj

    2016-01-01

    significance difference pairwise comparison. RESULTS: Three discrete neurocognitive subgroups were detected: one that was cognitively intact (46.1%), one that was selectively impaired with deficits in processing speed (32.6%), and one that was globally impaired across verbal learning, working memory......, and executive skills (21.2%). The globally and selectively impaired subgroups were characterized by greater perceived stress and subjective cognitive complaints, poorer work and social adjustment, and reduced quality of life compared to patients who were cognitively intact. LIMITATIONS: The study design...

  15. Tracking cohesive subgroups over time in inferred social networks

    Science.gov (United States)

    Chin, Alvin; Chignell, Mark; Wang, Hao

    2010-04-01

    As a first step in the development of community trackers for large-scale online interaction, this paper shows how cohesive subgroup analysis using the Social Cohesion Analysis of Networks (SCAN; Chin and Chignell 2008) and Data-Intensive Socially Similar Evolving Community Tracker (DISSECT; Chin and Chignell 2010) methods can be applied to the problem of identifying cohesive subgroups and tracking them over time. Three case studies are reported, and the findings are used to evaluate how well the SCAN and DISSECT methods work for different types of data. In the largest of the case studies, variations in temporal cohesiveness are identified across a set of subgroups extracted from the inferred social network. Further modifications to the DISSECT methodology are suggested based on the results obtained. The paper concludes with recommendations concerning further research that would be beneficial in addressing the community tracking problem for online data.

  16. Emerging resistance against different fungicides in Lasiodiplodia theobromae, the cause of mango dieback in Pakistan

    Directory of Open Access Journals (Sweden)

    Rehman ur Ateeq

    2015-01-01

    Full Text Available Dieback of mango caused by Lasiodiplodia theobromae is among several diseases responsible for low crop production in Pakistan. To further complicate the issue, resistance in L. theobromae is emerging against different fungicides. L. theobromae was isolated from diseased samples of mango plants collected from various orchards in the Multan District. The efficacy of different fungicides viz. copper oxychloride, diethofencarb, pyrachlostrobin, carbendazim, difenoconazole, mancozeb, and thiophanate-methyl was evaluated in vitro using a poison food technique. Thiophanate-methyl at all concentrations was found to be the most effective among five systemic fungicides against L. theobromae, followed by carbendazim, difenoconazole and diethofencarb. The fungicides, i.e., thiophanate-methyl, difenoconazole, carbendazim and diethofencarb showed maximum efficacy with increasing concentration. The isolates of L. theobromae showed some resistance development against the tested fungicides when compared with previous work. These investigations provide new information about chemical selection for the control of holistic disease in mango growing zones of Pakistan.

  17. Heterogeneity in response during multisystemic therapy: Exploring subgroups and predictors

    NARCIS (Netherlands)

    Mertens, E.C.A.; Dekovic, M.; Asscher, J.J.; Manders, W.A.

    2017-01-01

    Multiple studies have shown that Multisystemic Therapy (MST) is, at group level, an effective treatment for adolescents showing serious externalizing problem behavior. The current study expands previous research on MST by, first, examining whether subgroups of participants who respond differently to

  18. Heterogeneity in response during Multisystemic Therapy : Exploring subgroups and predictors

    NARCIS (Netherlands)

    Mertens, E.C.A.; Dekovic, M.; Asscher, J.J.; Manders, W.A.

    2017-01-01

    Multiple studies have shown that Multisystemic Therapy (MST) is, at group level, an effective treatment for adolescents showing serious externalizing problem behavior. The current study expands previous research on MST by, first, examining whether subgroups of participants who respond differently to

  19. Risk factors associated with different types of intimate partner violence (IPV): an emergency department study.

    Science.gov (United States)

    Bazargan-Hejazi, Shahrzad; Kim, Eunjin; Lin, Johnny; Ahmadi, Alireza; Khamesi, Mojdeh T; Teruya, Stacey

    2014-12-01

    Domestic intimate partner violence (IPV) is a serious health care concern, which may be mitigated by early detection, screening, and intervention. We examine posited predictors in IPV and non-IPV groups, and in four different IPV profiles. Possible factors include 1) alcohol use, 2) drug use, 3) depression, 4) impulsivity, 5) age, and 6) any childhood experience in observing parental violence. We also introduce a new "Five Steps in Screening for IPV" quick reference tool, which may assist emergency physicians in detection and treatment. This was a cross-sectional study using survey data from 412 inner-city emergency department patients. Associations were explored using a chi-squared test of independence, independent-samples t-tests, and a one-way analysis of variance. Nearly 16% had experienced IPV. As a group, they were younger, and more depressed and impulsive than the non-IPV group. They were more likely to engage in binge drinking, use drugs, and had more childhood exposure to violence. In the IPV group, 31% were perpetrators, 20% victims, and 49% both victims and perpetrators. The latter group was younger, more impulsive and depressed, used drugs, and was more likely to have observed parental violence as a child. Correlates in groups affected by IPV indicate the same general risk factors, which seem to more acutely affect those who are both perpetrators and victims. Alcohol and drug use, depressive symptoms, and childhood exposure to violence may be factors and signs for which emergency physicians should screen in the context of IPV. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Clinical Subgroups in Bilateral Meniere Disease

    Science.gov (United States)

    Frejo, Lidia; Soto-Varela, Andres; Santos-Perez, Sofía; Aran, Ismael; Batuecas-Caletrio, Angel; Perez-Guillen, Vanesa; Perez-Garrigues, Herminio; Fraile, Jesus; Martin-Sanz, Eduardo; Tapia, Maria C.; Trinidad, Gabriel; García-Arumi, Ana María; González-Aguado, Rocío; Espinosa-Sanchez, Juan M.; Marques, Pedro; Perez, Paz; Benitez, Jesus; Lopez-Escamez, Jose A.

    2016-01-01

    Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD. PMID:27822199

  1. On the same side of the faultline: Inclusion in the leader’s subgroup and employee performance

    NARCIS (Netherlands)

    Meyer, B.; Shemla, M.; Li, J.; Wegge, J.

    Extending theory on faultlines and subgroups, we argue that faultlines splitting a team into homogeneous subgroups can have different effects on team members' individual performance, depending on different intra-subgroup processes. Specifically, we propose that the effect of faultline strength on

  2. Genetic diversity among phytoplasmas infecting Opuntia species: virtual RFLP analysis identifies new subgroups in the peanut witches'-broom phytoplasma group.

    Science.gov (United States)

    Cai, Hong; Wei, Wei; Davis, Robert E; Chen, Hairu; Zhao, Yan

    2008-06-01

    Phytoplasmas were detected in cactus (Opuntia species) plants exhibiting witches'-broom disease symptoms in Yunnan Province, south-western China. Comparative and phylogenetic analyses of 16S rRNA gene sequences indicated that an overwhelming majority of the cactus-infecting phytoplasmas under study belonged to the peanut witches'-broom phytoplasma group (16SrII). Genotyping through use of computer-simulated restriction fragment length polymorphism (RFLP) analysis of 16S rRNA genes revealed a remarkable genetic diversity among these cactus-infecting phytoplasma strains. Based on calculated coefficients of RFLP pattern similarities, seven new 16SrII subgroups were recognized, bringing the total of described group 16SrII subgroups to 12 worldwide. Geographical areas differed from one another in the extent of genetic diversity among cactus-infecting phytoplasma strains. The findings have implications for relationships between ecosystem distribution and the emergence of group 16SrII subgroup diversity.

  3. North/South Differences Among Italian Emerging Adults Regarding Criteria Deemed Important for Adulthood and Life Satisfaction

    Science.gov (United States)

    Piumatti, Giovanni; Garro, Maria; Pipitone, Laura; Di Vita, Angela Maria; Rabaglietti, Emanuela

    2016-01-01

    The main goal of this study was to compare Northern and Southern Italian emerging adult university students, regarding the importance attributed to criteria for adulthood and the levels of life and education satisfaction. Self-report questionnaires were filled by 475 Northern and Southern Italian University students (Age M = 22.91, 76% females, n = 359). Multivariate analysis of variance revealed that Southern emerging adults were more likely to place importance on family capacities, norm compliance, interdependence and role transitions as criteria for achieving adulthood than Northern emerging adults. Regarding gender differences, females were more likely to believe in the importance of norm compliance than males, while males were more likely to espouse the importance of legal transitions. Finally, emerging adults from the North reported higher levels of life satisfaction than their Southern counterparts. We interpreted these findings in light of socio-economical and gender socialization differences among Northern and Southern Italian emerging adults. PMID:27298636

  4. Folate, vitamin B12 and Homocysteine status in the post-folic acid fortification era in different subgroups of the Brazilian population attended to at a public health care center.

    Science.gov (United States)

    Barnabé, Aline; Aléssio, Ana Cláudia Morandi; Bittar, Luis Fernando; de Moraes Mazetto, Bruna; Bicudo, Angélica M; de Paula, Erich V; Höehr, Nelci Fenalti; Annichino-Bizzacchi, Joyce M

    2015-02-19

    Folate and vitamin B12 are essential nutrients, whose deficiencies are considerable public health problems worldwide, affecting all age groups. Low levels of these vitamins have been associated with high concentrations of homocysteine (Hcy) and can lead to health complications. Several genetic polymorphisms affect the metabolism of these vitamins. The aims of this study were to assess folate, vitamin B12 and homocysteine status in distinct Brazilian individuals after the initiation of folic acid fortification by Brazilian authorities and to investigate the effects of RFC1 A80G, GCPII C1561T and MTHFR C677T polymorphisms on folate, vitamin B12 and Hcy levels in these populations. A total of 719 individuals including the elderly, children, as well as pregnant and lactating women were recruited from our health care center. Folate, vitamin B12 and Hcy levels were measured by conventional methods. Genotype analyses of RFC1 A80G, GCPII C1561T and MTHFR C677T polymorphisms were performed by PCR-RFLP. The overall prevalence of folate and vitamin B12 deficiencies were 0.3% and 4.9%, respectively. Folate deficiency was observed only in the elderly (0.4%) and pregnant women (0.3%), whereas vitamin B12 deficiency was observed mainly in pregnant women (7.9%) and the elderly (4.2%). Plasma Hcy concentrations were significantly higher in the elderly (33.6%). Pregnant women carrying the MTHFR 677TT genotype showed lower serum folate levels (p = 0.042) and higher Hcy levels (p = 0.003). RFC1 A80G and GCPII C1561T polymorphisms did not affect folate and Hcy levels in the study group. After a multivariate analysis, Hcy levels were predicted by variables such as folate, vitamin B12, gender, age and RFC1 A80G polymorphism, according to the groups studied. Our results suggest that folate deficiency is practically nonexistent in the post-folic acid fortification era in the subgroups evaluated. However, screening for vitamin B12 deficiency may be particularly relevant in our

  5. Racial Differences in Opiate Administration for Pain Relief at an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Dickason, R. Myles

    2015-05-01

    Full Text Available Introduction: The decision to treat pain in the emergency department (ED is a complex, idiosyncratic process. Prior studies have shown that EDs undertreat pain. Several studies demonstrate an association between analgesia administration and race. This is the first Midwest single institution study to address the question of race and analgesia, in addition to examining the effects of both patient and physician characteristics on race-based disparities in analgesia administration. Methods: This was a retrospective chart review of patients presenting to an urban academic ED with an isolated diagnosis of back pain, migraine, or long bone fracture (LBF from January 1, 2007 to December 31, 2011. Demographic and medication administration information was collected from patient charts by trained data collectors blinded to the hypothesis of the study. The primary outcome was the proportion of African-Americans who received analgesia and opiates, as compared to Caucasians, using Pearson’s chi-squared test. We developed a multiple logistic regression model to identify which physician and patient characteristics correlated with increased opiate administration. Results: Of the 2,461 patients meeting inclusion criteria, 57% were African-American and 30% Caucasian (n=2136. There was no statistically significant racial difference in the administration of any analgesia (back pain: 86% vs. 86%, p=0.81; migraine: 83% vs. 73%, p=0.09; LBF: 94% vs. 90%, p=0.17, or in opiate administration for migraine or LBF. African-Americans who presented with back pain were less likely to receive an opiate than Caucasians (50% vs. 72%, p<0.001. Secondary outcomes showed that higher acuity, older age, physician training in emergency medicine, and male physicians were positively associated with opiate administration. Neither race nor gender patient-physician congruency correlated with opiate administration. Conclusion: No race-based disparity in overall analgesia administration was

  6. Exploring Individual Differences in Irregular Word Recognition among Children with Early-Emerging and Late-Emerging Word Reading Difficulty

    Science.gov (United States)

    Steacy, Laura M.; Kearns, Devin M.; Gilbert, Jennifer K.; Compton, Donald L.; Cho, Eunsoo; Lindstrom, Esther R.; Collins, Alyson A.

    2017-01-01

    Models of irregular word reading that take into account both child- and word-level predictors have not been evaluated in typically developing children and children with reading difficulty (RD). The purpose of the present study was to model individual differences in irregular word reading ability among 5th grade children (N = 170), oversampled for…

  7. Genetic and molecular alterations across medulloblastoma subgroups.

    Science.gov (United States)

    Skowron, Patryk; Ramaswamy, Vijay; Taylor, Michael D

    2015-10-01

    Medulloblastoma is the most common malignant brain tumour diagnosed in children. Over the last few decades, advances in radiation and chemotherapy have significantly improved the odds of survival. Nevertheless, one third of all patients still succumb to their disease, and many long-term survivors are afflicted with neurocognitive sequelae. Large-scale multi-institutional efforts have provided insight into the transcriptional and genetic landscape of medulloblastoma. Four distinct subgroups of medulloblastoma have been identified, defined by distinct transcriptomes, genetics, demographics and outcomes. Integrated genomic profiling of each of these subgroups has revealed distinct genetic alterations, driving pathways and in some instances cells of origin. In this review, we highlight, in a subgroup-specific manner, our current knowledge of the genetic and molecular alterations in medulloblastoma and underscore the possible avenues for future therapeutic intervention.

  8. Differences in access to services in rural emergency departments of Quebec and Ontario.

    Directory of Open Access Journals (Sweden)

    Richard Fleet

    Full Text Available Rural emergency departments (EDs are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers.Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario.All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013. There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001 and most the consultant support and ICU (92% vs 31%, p < .0001. Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers.Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

  9. Cluster Analysis of Clinical Data Identifies Fibromyalgia Subgroups

    Science.gov (United States)

    Docampo, Elisa; Collado, Antonio; Escaramís, Geòrgia; Carbonell, Jordi; Rivera, Javier; Vidal, Javier; Alegre, José

    2013-01-01

    Introduction Fibromyalgia (FM) is mainly characterized by widespread pain and multiple accompanying symptoms, which hinder FM assessment and management. In order to reduce FM heterogeneity we classified clinical data into simplified dimensions that were used to define FM subgroups. Material and Methods 48 variables were evaluated in 1,446 Spanish FM cases fulfilling 1990 ACR FM criteria. A partitioning analysis was performed to find groups of variables similar to each other. Similarities between variables were identified and the variables were grouped into dimensions. This was performed in a subset of 559 patients, and cross-validated in the remaining 887 patients. For each sample and dimension, a composite index was obtained based on the weights of the variables included in the dimension. Finally, a clustering procedure was applied to the indexes, resulting in FM subgroups. Results Variables clustered into three independent dimensions: “symptomatology”, “comorbidities” and “clinical scales”. Only the two first dimensions were considered for the construction of FM subgroups. Resulting scores classified FM samples into three subgroups: low symptomatology and comorbidities (Cluster 1), high symptomatology and comorbidities (Cluster 2), and high symptomatology but low comorbidities (Cluster 3), showing differences in measures of disease severity. Conclusions We have identified three subgroups of FM samples in a large cohort of FM by clustering clinical data. Our analysis stresses the importance of family and personal history of FM comorbidities. Also, the resulting patient clusters could indicate different forms of the disease, relevant to future research, and might have an impact on clinical assessment. PMID:24098674

  10. Sex differences in clinical presentation, management and outcome in emergency department patients with chest pain.

    Science.gov (United States)

    Hess, Erik P; Perry, Jeffery J; Calder, Lisa A; Thiruganasambandamoorthy, Venkatesh; Roger, Veronique L; Wells, George A; Stiell, Ian G

    2010-09-01

    We sought to assess sex differences in clinical presentation, management and outcome in emergency department (ED) patients with chest pain, and to measure the association between female sex and coronary angiography within 30 days. We conducted a prospective cohort study in an urban academic ED between Jul. 1, 2007, and Apr. 1, 2008. We enrolled patients over 24 years of age with chest pain and possible acute coronary syndrome (ACS). Among the 970 included patients, 386 (39.8%) were female. Compared with men, women had a lower prevalence of known coronary artery disease (21.0% v. 34.2%, p women as having a low (stress testing between sexes, there was a lower rate of acute myocardial infarction (AMI) (4.7% v. 8.4%, p = 0.03) and positive stress test results (4.4% v. 7.9%, p = 0.03) in women. Women were less frequently referred for coronary angiography (9.3% v. 18.9%, p Women had a lower rate of AMI and a lower rate of positive stress test results despite similar rates of testing between sexes. Although women were less frequently referred for coronary angiography, these data suggest that sex differences in management were likely appropriate for the probability of disease.

  11. Differences between users and non-users of emergency contraception after a recognized unprotected intercourse

    DEFF Research Database (Denmark)

    Sørensen, M B; Pedersen, B L; Nyrnberg, L E

    2000-01-01

    Knowledge of emergency contraception is crucial but might not transform into use. Factors influencing decision-making related to use of emergency contraception after an unprotected intercourse and the characteristics of users of emergency contraception (EC) were assessed. In an abortion clinic...... setting, 217 women referred for termination of pregnancy were asked to fill in a questionnaire. Of the 217 women, 139 (64%) were aware of pregnancy risk but only 9 (4%) had used EC after the unprotected intercourse. 42% were estimated to have sufficient knowledge to use hormonal emergency contraception...

  12. Gender Differences in CDC Guideline Compliance for STIs in Emergency Departments.

    Science.gov (United States)

    Kane, Bryan G; Guillaume, Alexander W D; Evans, Elizabeth M; Goyke, Terrence E; Eygnor, Jessica K; Semler, Lauren; Dusza, Stephen W; Greenberg, Marna Rayl

    2017-04-01

    Sexually transmitted infections (STIs) are a common reason for emergency department (ED) visits. The objective of this study was to determine if there were gender differences in adherence to Centers for Disease Control and Prevention (CDC) STI diagnosis and treatment guidelines, as documented by emergency providers. We performed a retrospective chart review to identify patients treated for urethritis, cervicitis, and pelvic inflammatory disease (PID) in the EDs of three hospitals in a Pennsylvania network during a calendar year. Cases were reviewed to assess for compliance with CDC guidelines. We used descriptive statistics to assess the distributions of study variables by patient sex. In the analysis we used Student's t-tests, chi-square tests, and logistic regression. Statistical significance was set at p ≤ 0.05. We identified 286 patient records. Of these, we excluded 39 for the following reasons: incorrect disease coding; the patient was admitted and treated as an inpatient for his/her disease; or the patient left the ED after refusing care. Of the 247 participants, 159 (64.4%) were female. Females were significantly younger (26.6 years, SD=8.0) than males (31.2, SD=11.5%), (95% confidence interval [CI] [2.0- 7.0], p=0.0003). All of the males (n=88) in the cohort presented with urethritis; 25.8% of females presented with cervicitis, and 74.2% with PID. Physician compliance for the five CDC criteria ranged from 68.8% for patient history to 93.5% for patient diagnostic testing, including urine pregnancy and gonorrhea/chlamydia cultures. We observed significant differences by patient sex. Fifty-four percent of the charts had symptoms recorded for female patients that were consistent with CDC characteristics for diagnostic criteria compared to over 95% for males, OR=16.9; 95% CI [5.9-48.4], pCDC guidelines for the diagnosis and treatment of urethritis, cervicitis, and PID. Specifically medical records of men were more likely to have complete documentation of

  13. Differences in rural and urban outcomes: a national inspection of emergency general surgery patients.

    Science.gov (United States)

    Chaudhary, Muhammad Ali; Shah, Adil A; Zogg, Cheryl K; Changoor, Navin; Chao, Grace; Nitzschke, Stephanie; Havens, Joaquim M; Haider, Adil H

    2017-10-01

    About 19% of the United States population lives in rural areas and is served by only 10% of the physician workforce. If this misdistribution represents a shortage of available surgeons, it is possible that outcomes for rural patients may suffer. The objective of this study was to explore differences in outcomes for emergency general surgery (EGS) conditions between rural and urban hospitals using a nationally representative sample. Data from the 2007-2011 National Inpatient Sample were queried for adult patients (≥18 years) with a primary diagnosis consistent with an EGS condition, as defined by the American Association for the Surgery of Trauma. Urban and rural patients were matched on patient-level factors using coarsened exact matching. Differences in outcomes including mortality, morbidity, length of stay (LOS), and total cost of hospital care were assessed using multivariable regression models. Analogous counterfactual models were used to further examine hypothetical outcomes, assuming that all patients had been treated at urban centers. A total of 3,749,265 patients were admitted with an EGS condition during the study period. Of 3259 hospitals analyzed, 40.2% (n = 1310) were rural; they treated 14.6% of patients. Relative to urban centers, EGS patients treated at rural centers had higher odds of in-hospital mortality (odds ratio [OR]: 1.24; 95% confidence interval [CI]: 1.21-1.28) and lower odds of major complications (OR: 0.98; 95% CI: 0.96-0.99). Rural patients had 0.51 d (95% CI: 0.50-0.53) shorter LOS and $744 (95% CI: 712-774) higher cost of hospitalization compared to urban patients. In counterfactual models overall odds of death decreased by 0.05%, whereas the overall odds of complications increased by 0.02%. Overall difference in LOS and total costs were comparable with absolute differences of 0.08 d and $98, respectively. Despite the statistically significant difference in mortality and cost of care at rural versus urban hospitals, the

  14. On Preferential sylow fuzzy subgroups | Makamba | Quaestiones ...

    African Journals Online (AJOL)

    In this paper, for a prime p, we propose some plausible denitions for the notion of Sylow fuzzy p-subgroup of a nite group. We derive a number of results for nite fuzzy groups using one of the proposed denitions. We also discuss some of the relationships between various proposed denitions for suitability, including the crisp ...

  15. Zero-sum problems with subgroup weights

    Indian Academy of Sciences (India)

    In this note, we generalize some theorems on zero-sums with weights from [1], [4] and [5] in two directions. In particular, we consider Z Z p d for a general and subgroups of Z p ∗ as weights. Author Affiliations. S D Adhikari1 A A Ambily2 B Sury2. Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211 ...

  16. Interpretation of Subgroup Effects in Published Trials

    DEFF Research Database (Denmark)

    Hancock, Mark J; Kjær, Per; Korsholm, Lars

    2013-01-01

    that report on treatment effect modifiers (subgroups) for specific physical therapy interventions. The key messages are: (1) point estimates of treatment modifier effect size (interaction effect) and their confidence intervals can be calculated using group-level data when individual patient-level data...

  17. Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients

    OpenAIRE

    Lee SY; Jeong YY; Lee BH; Kim JE

    2018-01-01

    Sook Young Lee, Yun Yong Jeong, Byung Ho Lee, Ji Eun Kim Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI) of remifentanil can reduce emergence cough effectively, and sex-related differences in effect-site concentration (Ce) of remifentanil have been evaluated in young patients. In this study, we deter...

  18. Emergence of Sex Differences in the Development of Substance Use and Abuse during Adolescence

    Science.gov (United States)

    Kuhn, Dr. Cynthia

    2015-01-01

    Substance use and abuse begins during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse., Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. PMID:26049025

  19. Validity of different pediatric early warning scores in the emergency department.

    Science.gov (United States)

    Seiger, Nienke; Maconochie, Ian; Oostenbrink, Rianne; Moll, Henriëtte A

    2013-10-01

    Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. Ten different PEWS were evaluated in a large prospective cohort. We included children aged <16 years who had presented to the ED of a university hospital in The Netherlands (2009-2012). The validity of the PEWS for predicting ICU admission or hospitalization was expressed by the area under the receiver operating characteristic (ROC) curves. These PEWS were validated in 17 943 children. Two percent of these children were admitted to the ICU, and 16% were hospitalized. The areas under the ROC curves for predicting ICU admission, ranging from 0.60 (95% confidence interval [CI]: 0.57-0.62) to 0.82 (95% CI: 0.79-0.85), were moderate to good. The area under the ROC curves for predicting hospitalization was poor to moderate (range: 0.56 [95% CI: 0.55-0.58] to 0.68 [95% CI: 0.66-0.69]). The sensitivity and specificity derived from the ROC curves ranged widely for both ICU admission (sensitivity: 61.3%-94.4%; specificity: 25.2%-86.7%) and hospital admission (sensitivity: 36.4%-85.7%; specificity: 27.1%-90.5%). None of the PEWS had a high sensitivity as well as a high specificity. PEWS can be used to detect children presenting to the ED who are in need of an ICU admission. Scoring systems, wherein the parameters are summed to a numeric value, were better able to identify patients at risk than triggering systems, which need 1 positive parameter.

  20. Emergence of sex differences in the development of substance use and abuse during adolescence.

    Science.gov (United States)

    Kuhn, Cynthia

    2015-09-01

    Substance use and abuse begin during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse. Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Pediatric RSV Infection During Two Winter Seasons in British Columbia: A Role for Subgroup Analysis in Young Children?

    Directory of Open Access Journals (Sweden)

    E Wilson

    1990-01-01

    Full Text Available Using a panel of eight monoclonal antibodies directed against the G, F and NP proteins of respiratory syncytial virus, 167 virus isolates from nasopharyngeal washing cultures at British Columbia Children’s Hospital during two consecutive epidemics were subgrouped. Slides made and frozen at the time of virus isolation or prepared from recovered frozen passage material, were assayed by indirect immunofluorescence. Of 85 strains tested in 1987–88, 54 (64% were subgroup A, and 31 (36% subgroup B. By contrast, of 82 strains tested in 1988–89 five (6% were subgroup A and 77 (94% subgroup B. Review of patient charts did not reveal significant differences in clinical course of patients infected with the two subgroups, but the risk of infection with subgroup A was significantly greater than the risk of subgroup B infection in younger patients.

  2. Latent class analysis derived subgroups of low back pain patients - do they have prognostic capacity?

    DEFF Research Database (Denmark)

    Mølgaard Nielsen, Anne; Hestbaek, Lise; Vach, Werner

    2017-01-01

    BACKGROUND: Heterogeneity in patients with low back pain is well recognised and different approaches to subgrouping have been proposed. One statistical technique that is increasingly being used is Latent Class Analysis as it performs subgrouping based on pattern recognition with high accuracy. Pr...

  3. Subgrouping of Readers Based on Performance Measures: A Latent Profile Analysis

    Science.gov (United States)

    Wolff, Ulrika

    2010-01-01

    By using latent profile analysis eight stable and interpretable subgroups of readers were identified. The basis for subgrouping was different performance measures with four aspects of reading in focus: reading of continuous texts, reading of document texts, word reading and reading speed. Participants were 9-year-old Swedish students included in…

  4. Distinguishing between Subgroups of Adolescents Who Self-Harm

    Science.gov (United States)

    Hargus, Emily; Hawton, Keith; Rodham, Karen

    2009-01-01

    The differences in factors associated with subgroups of adolescents in the continuum of deliberate self-harm (DSH) phenomena were investigated. In an anonymous self-report survey of 6,020 adolescents aged 15 and 16 years, 3.2% of adolescents (5.3% females, 1.3% males) reported DSH with intent to die, 2.8% (4.3% females; 1.5% males) reported DSH…

  5. Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups.

    Science.gov (United States)

    Lerner, Matthew D; De Los Reyes, Andres; Drabick, Deborah A G; Gerber, Alan H; Gadow, Kenneth D

    2017-07-01

    Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure. Children with ASD (N = 283; 82% boys; M age  = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM-IV-TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory-4R (CASI-4R). External validators included child psychotropic medication status, frequency of ASD-relevant school-based services, and the Autism Diagnostic Observation Schedule (ADOS-2). Four distinct subgroups emerged that ranged from large between-informant discrepancy (informant-specific) to relative lack of discrepancy (i.e. informant agreement; cross-situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school-based special education services, and an ADOS-2 diagnosis. These differential associations would not have been identified based solely on CASI-4R scores from one informant. The degree of parent-teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost-effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in

  6. Dissociation between two subgroups of the suprachiasmatic nucleus affected by the number of damped oscillated neurons

    Science.gov (United States)

    Gu, Changgui; Yang, Huijie; Rohling, Jos HT

    2017-03-01

    In mammals, the main clock located in the suprachiasmatic nucleus (SCN) of the brain synchronizes the body rhythms to the environmental light-dark cycle. The SCN is composed of about 2 ×104 neurons which can be classified into three oscillatory phenotypes: self-sustained oscillators, damped oscillators, and arrhythmic neurons. Exposed to an artificial external light-dark cycle with a period of 22 h instead of 24 h , two subgroups of the SCN can become desynchronized (dissociated). The ventrolateral (VL) subgroup receives photic input and is entrained to the external cycle and a dorsomedial (DM) subgroup oscillates with its endogenous (i.e., free running) period and is synchronized to the external light-dark cycle through coupling from the VL. In the present study, we examined the effects of damped oscillatory neurons on the dissociation between VL and DM under an external 22 h cycle. We found that, with increasing numbers of damped oscillatory neurons located in the VL, the dissociation between the VL and DM emerges, but if these neurons are increasingly present in the DM the dissociation disappears. Hence, the damped oscillatory neurons in different subregions of the SCN play distinct roles in the dissociation between the two subregions of the SCN. This shows that synchrony between SCN subregions is affected by the number of damped oscillatory neurons and the location of these cells. We suggest that more knowledge on the number and the location of these cells may explain why some species do show a dissociation between the subregions and others do not, as the distribution of oscillatory types of neurons offers a plausible and novel candidate mechanism to explain heterogeneity.

  7. Racial disparities in emergency general surgery: Do differences in outcomes persist among universally insured military patients?

    Science.gov (United States)

    Zogg, Cheryl K; Jiang, Wei; Chaudhary, Muhammad Ali; Scott, John W; Shah, Adil A; Lipsitz, Stuart R; Weissman, Joel S; Cooper, Zara; Salim, Ali; Nitzschke, Stephanie L; Nguyen, Louis L; Helmchen, Lorens A; Kimsey, Linda; Olaiya, Samuel T; Learn, Peter A; Haider, Adil H

    2016-05-01

    Racial disparities in surgical care are well described. As many minority patients are also uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30-/90-/180- day outcomes exist within a universally insured population of military-/civilian-dependent emergency general surgery (EGS) patients and ascertain whether differences in outcomes differentially persist in care received at military versus civilian hospitals and among sponsors who are enlisted service members versus officers. It also considered longer-term outcomes of EGS care. Five years (2006-2010) of TRICARE data, which provides insurance to active/reserve/retired members of the US Armed Services and dependents, were queried for adults (≥18 years) with primary EGS conditions, defined by the AAST. Risk-adjusted survival analyses assessed race-associated differences in mortality, major acute care surgery-related morbidity, and readmission at 30/90/180 days. Models accounted for clustering within hospitals and possible biases associated with missing race using reweighted estimating equations. Subanalyses considered restricted effects among operative interventions, EGS diagnostic categories, and effect modification related to rank and military- versus civilian-hospital care. A total of 101,011 patients were included: 73.5% white, 14.5% black, 4.4% Asian, and 7.7% other. Risk-adjusted survival analyses reported a lack of worse mortality and readmission outcomes among minority patients at 30, 90, and 180 days. Major morbidity was higher among black versus white patients (hazard ratio [95% confidence interval): 30 days, 1.23 [1.13-1.35]; 90 days, 1.18 [1.09-1.28]; and 180 days, 1.15 [1.07-1.24], a finding seemingly driven by appendiceal disorders (hazard ratio, 1.69-1.70). No other diagnostic categories were significant. Variations in military- versus civilian-managed care and in outcomes for

  8. Gender Differences in Emergency Department Visits and Detox Referrals for Illicit and Nonmedical Use of Opioids

    Directory of Open Access Journals (Sweden)

    Hyeon-Ju Ryoo

    2016-05-01

    Full Text Available Introduction: Visits to the emergency department (ED for use of illicit drugs and opioids have increased in the past decade. In the ED, little is known about how gender may play a role in drug-related visits and referrals to treatment. This study performs gender-based comparison analyses of drug-related ED visits nationwide. Methods: We performed a cross-sectional analysis with data collected from 2004 to 2011 by the Drug Abuse Warning Network (DAWN. All data were coded to capture major drug categories and opioids. We used logistic regression models to find associations between gender and odds of referral to treatment programs. A second set of models were controlled for patient “seeking detox,” or patient explicitly requesting for detox referral. Results: Of the 27.9 million ED visits related to drug use in the DAWN database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women (95% CI [2.56, 2.80]. Men were more likely than women to be referred to detox programs for any illicit drugs (OR 1.12, 95% CI [1.02-1.22], for each of the major illicit drugs (e.g., cocaine: OR 1.27, 95% CI [1.15-1.40], and for prescription opioids (OR 1.30, 95% CI [1.17-1.43]. This significant association prevailed after controlling for “seeking detox.” Conclusion: Women are less likely to receive referrals to detox programs than men when presenting to the ED regardless of whether they are “seeking detox.” Future research may help determine the cause for this gender-based difference and its significance for healthcare costs and health outcomes.

  9. North-south differences in US emergency department visits for acute allergic reactions.

    Science.gov (United States)

    Rudders, Susan A; Espinola, Janice A; Camargo, Carlos A

    2010-05-01

    In a previous study, latitude was positively associated with EpiPen prescription rates. To determine whether a similar geographic difference exists for emergency department (ED) visits for acute allergic reactions (including anaphylaxis). We combined National Hospital Ambulatory Medical Care Survey data for ED visits to noninstitutional hospitals from 1993 to 2005. Acute allergic reactions were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes 995.0, 995.60-995.69, 995.1, 995.2, 995.3, 989.5, and 693.1, and visit rates were compared across standardized geographic divisions. Between 1993 and 2005, there were 17.3 million ED visits for acute allergic reactions, representing 1.3% (95% confidence interval [CI], 1.2%-1.3%) of all ED visits. Per 1000 population, the Northeast had 5.5 visits (95% CI, 4.7-6.2 visits) and the South had 4.9 visits (95% CI, 4.3-5.6 visits). In a multivariable model, the Northeast had a higher odds ratio (OR) than the South (1.13; 95% CI, 1.01-1.27; P = .04). The association was stronger when restricting the analysis to visits for food-related allergic reactions (OR, 1.33; 95% CI, 1.14-1.56; P < .001). The ED visit rates for acute allergic reactions are higher in northeastern vs southern regions. These observational data are consistent with the hypothesis that vitamin D may play an etiologic role in anaphylaxis, especially food-induced anaphylaxis.

  10. Identity as a moderator of gender differences in the emotional closeness of emerging adults' same- and cross-sex friendships.

    Science.gov (United States)

    Johnson, H Durell; Brady, Evelyn; McNair, Renae; Congdon, Darcy; Niznik, Jamie; Anderson, Samantha

    2007-01-01

    Closeness is an integral aspect of friendships, and males and females differ in their closeness experiences within these relationships. However, identity development and friendship type (e.g., same-sex versus cross-sex friendships) may moderate these gender differences. In an attempt to clarify the relationships among gender, identity, and friendship closeness, the current study examined gender and identity associations with reported emotional closeness in emerging adults' same- and cross-sex friendships. Responses from 181 college undergraduates (89 males and 92 females) indicated similar levels of emotional closeness reported for same- and cross-sex friendships. Results also indicated overall identity commitment and friendship identity commitment associations with same-sex friendship closeness. Examination of closeness reports for cross-sex friends revealed a significant association with overall identity commitment for emerging adult males. A significant association was not indicated for emerging adult females. The associations between identity and emotional closeness in same-sex friendships and male cross-sex friendships support previous studies that report differences in the role of these relationships for emerging adult males and females. Findings are discussed in terms of understanding the gender and identity differences in emerging adults' reports of friendship closeness.

  11. Effects of Different Sowing Depths and Soil Compactions on Emergence and Initial Growth of Pepper Varieties (Capsicum annum L.

    Directory of Open Access Journals (Sweden)

    R Shahriari

    2013-10-01

    Full Text Available One of the main problems in the mass production of pepper transplant is the stickiness of seed coat to the cotyledony leaves that can lead to no emergence or having poor emergence of pepper seedlings. Therefore, in order to evaluate the effects of different sowing depths and soil compactions on emergence and early seedlings growth of pepper, a greenhouse experiment was conducted in the Faculty of Agriculture, Ferdowsi University of Mashhad, Iran, in 2010, using a completely randomized design with factorial arrangement and four replications. The experimental factors included different levels of soil compactions (0 (no compaction, 150.5, 681.340 and 1201.7 Pa, different sowing depths (0 (surface, 1 and 2 cm and different pepper varieties (Olter, California Wonder, EM Bell, Anahiem and Iranian Falei. The results indicated that except the seed coat adherence to cotyledon leaves and the emergence percentage traits, the compaction treatments had a significant effect on (dry matter of seedlings, height, leaf area, number of abnormal seedling and mean emergence time were significant. In addition, sowing depth treatments had positive and significant effects on increasing the number of seedling with releasing seed coats from the cotyledony leaves.

  12. Topological groups with dense compactly generated subgroups

    Directory of Open Access Journals (Sweden)

    Hiroshi Fujita

    2002-04-01

    Full Text Available A topological group G is: (i compactly generated if it contains a compact subset algebraically generating G, (ii -compact if G is a union of countably many compact subsets, (iii 0-bounded if arbitrary neighborhood U of the identity element of G has countably many translates xU that cover G, and (iv finitely generated modulo open sets if for every non-empty open subset U of G there exists a finite set F such that F  U algebraically generates G. We prove that: (1 a topological group containing a dense compactly generated subgroup is both 0-bounded and finitely generated modulo open sets, (2 an almost metrizable topological group has a dense compactly generated subgroup if and only if it is both 0-bounded and finitely generated modulo open sets, and (3 an almost metrizable topological group is compactly generated if and only if it is -compact and finitely generated modulo open sets.

  13. Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes.

    Directory of Open Access Journals (Sweden)

    Xiuhong Li

    Full Text Available It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups.Children born SGA (N = 1050 from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001-2007 was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders.Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06] and math (-2.22 [-3.61, -0.84] scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44], but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]. Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG had lower mean reading (-4.81 [-8.50, -1.12] and math (-2.95 [-5.51, -0.38] scores. These differences were not mediated by Apgar score.Multiple-birth SGA subgroups (vs. singleton SGA or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain have poorer cognitive development up to 5 y.

  14. Factorizing profinite groups into two Abelian subgroups

    Directory of Open Access Journals (Sweden)

    Wolfgang Herfort

    2013-03-01

    Full Text Available We prove that the class of profinite groups $G$ that have a factorization $G=AB$with $A$ and $B$ abelian closed subgroups, is closed under taking strict projective limits.This is a generalization of a recent result by K.H.~Hofmann and F.G.~Russo.As an application we reprove their generalization of Iwasawa's structure theorem forquasihamiltonian pro-$p$ groups.

  15. A method for identifying genetic heterogeneity within phenotypically defined disease subgroups.

    Science.gov (United States)

    Liley, James; Todd, John A; Wallace, Chris

    2017-02-01

    Many common diseases show wide phenotypic variation. We present a statistical method for determining whether phenotypically defined subgroups of disease cases represent different genetic architectures, in which disease-associated variants have different effect sizes in two subgroups. Our method models the genome-wide distributions of genetic association statistics with mixture Gaussians. We apply a global test without requiring explicit identification of disease-associated variants, thus maximizing power in comparison to standard variant-by-variant subgroup analysis. Where evidence for genetic subgrouping is found, we present methods for post hoc identification of the contributing genetic variants. We demonstrate the method on a range of simulated and test data sets, for which expected results are already known. We investigate subgroups of individuals with type 1 diabetes (T1D) defined by autoantibody positivity, establishing evidence for differential genetic architecture with positivity for thyroid-peroxidase-specific antibody, driven generally by variants in known T1D-associated genomic regions.

  16. Can Simulation Measure Differences in Task-Switching Ability Between Junior and Senior Emergency Medicine Residents?

    Directory of Open Access Journals (Sweden)

    Dustin Smith, MD

    2016-03-01

    Full Text Available Introduction: Work interruptions during patient care have been correlated with error. Task-switching is identified by the Accreditation Council for Graduate Medical Education (ACGME as a core competency for emergency medicine (EM. Simulation has been suggested as a means of assessing EM core competencies. We assumed that senior EM residents had better task-switching abilities than junior EM residents. We hypothesized that this difference could be measured by observing the execution of patient care tasks in the simulation environment when a patient with a ST-elevation myocardial infarction (STEMI interrupted the ongoing management of a septic shock case. Methods: This was a multi-site, prospective, observational, cohort study. The study population consisted of a convenience sample of EM residents in their first three years of training. Each subject performed a standardized simulated encounter by evaluating and treating a patient in septic shock. At a predetermined point in every sepsis case, the subject was given a STEMI electrocardiogram (ECG for a separate chest pain patient in triage and required to verbalize an interpretation and action. We scored learner performance using a dichotomous checklist of critical actions covering sepsis care, ECG interpretation and triaging of the STEMI patient. Results: Ninety-one subjects participated (30 postgraduate year [PGY]1s, 32 PGY2s, and 29 PGY3s. Of those, 87 properly managed the patient with septic shock (90.0% PGY1s, 100% PGY2, 96.6% PGY 3s; p=0.22. Of the 87 who successfully managed the septic shock, 80 correctly identified STEMI on the simulated STEMI patient (86.7% PGY1s, 96.9% PGY2s, 93.1% PGY3s; p=0.35. Of the 80 who successfully managed the septic shock patient and correctly identified the STEMI, 79 provided appropriate interventions for the STEMI patient (73.3% PGY1s, 93.8% PGY2s, 93.8% PGY3s; p=0.07. Conclusion: When management of a septic shock patient was interrupted with a STEMI ECG in a

  17. MPACT Subgroup Self-Shielding Efficiency Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Stimpson, Shane [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Liu, Yuxuan [Univ. of Michigan, Ann Arbor, MI (United States); Collins, Benjamin S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Clarno, Kevin T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-08-31

    Recent developments to improve the efficiency of the MOC solvers in MPACT have yielded effective kernels that loop over several energy groups at once, rather that looping over one group at a time. These kernels have produced roughly a 2x speedup on the MOC sweeping time during eigenvalue calculation. However, the self-shielding subgroup calculation had not been reevaluated to take advantage of these new kernels, which typically requires substantial solve time. The improvements covered in this report start by integrating the multigroup kernel concepts into the subgroup calculation, which are then used as the basis for further extensions. The next improvement that is covered is what is currently being termed as “Lumped Parameter MOC”. Because the subgroup calculation is a purely fixed source problem and multiple sweeps are performed only to update the boundary angular fluxes, the sweep procedure can be condensed to allow for the instantaneous propagation of the flux across a spatial domain, without the need to sweep along all segments in a ray. Once the boundary angular fluxes are considered to be converged, an additional sweep that will tally the scalar flux is completed. The last improvement that is investigated is the possible reduction of the number of azimuthal angles per octant in the shielding sweep. Typically 16 azimuthal angles per octant are used for self-shielding and eigenvalue calculations, but it is possible that the self-shielding sweeps are less sensitive to the number of angles than the full eigenvalue calculation.

  18. Factors contributing to emergency department care within 30 days of hospital discharge and potential ways to prevent it: differences in perspectives of patients, caregivers, and emergency physicians.

    Science.gov (United States)

    Suffoletto, Brian; Hu, Jennifer; Guyette, Maria; Callaway, Clifton

    2014-05-01

    Identifying needs in patients who utilize the emergency department (ED) soon after being discharged from inpatient care is essential for planning appropriate care-transition interventions. To examine differences in stakeholder perspectives on reasons for ED care soon after hospital discharge and interventions that could be useful to prevent these ED visits. A convenience sample of 135 patients who presented to an urban teaching hospital ED hospital discharge, their caregivers (when present), and emergency physicians were administered identical structured surveys. Concordance and agreement rates between patient-physician and patient-caregiver dyads were calculated. Concordances between stakeholders were poor, with weighted kappas ranging from 0.02 to 0.34 for patient-physician dyads and 0.03 to 0.68 for patient-caregiver dyads. Emergency physicians and caregivers identified factors between 1% and 42% of the time the patients did not. Less than half of any stakeholder could identify an intervention to potentially prevent the ED visit. Our findings suggest the difficulty in forming unified definitions for root cause of ED visits soon after hospital discharge and support the use of multiple stakeholders in identifying appropriate targets for care-transition interventions. © 2014 Society of Hospital Medicine.

  19. Differences Between Emergency Nurse Perception and Patient Reported Experience With an ED HIV and Hepatitis C Virus Screening Program.

    Science.gov (United States)

    White, Douglas A E; Anderson, Erik S; Pfeil, Sarah K; Graffman, Sarah E; Trivedi, Tarak K

    2016-03-01

    Nontargeted human immunodeficiency virus (HIV) screening and targeted hepatitis C virus (HCV) screening for selected high-risk patients (those born between 1945 and 1965 and those who report injection drug use) was integrated into our ED triage process and carried out by nurses. Determining whether emergency nurses accurately perceive what patients experience is important to know because staff misperceptions may pose a barrier to program adherence and sustainability. We performed a cross-sectional survey study of emergency nurses and patients to assess the accuracy of emergency nurses' perception of patient experience with the HIV/HCV screening program. Respondents evaluated their level of agreement using a 5-item Likert scale for 9 statements across 4 domains related to the patient experience with the screening process (satisfaction, sense of autonomy, sense of privacy, and comfort level). Surveys were completed by 65 of the 153 eligible emergency nurses (42%). Of the 1040 patients approached, 610 (59%) were eligible, and 491 of the 610 eligible patients (80%) completed surveys. Across all domains, statistically significant differences were found between emergency nurse perception and patient report, P < .001. Emergency nurses perceived patients to be less satisfied with the screening program, more uncomfortable with being asked screening questions, more concerned about privacy issues, and less likely to feel that the decision to decline screening was autonomous than were patients. Emergency nurses not only frequently misperceive how patients experience ED-based HIV/HCV screening, but these misperceptions are skewed toward the negative, representing a type of staff bias. Further research is recommended to determine if such misperceptions adversely affect implementation of screening. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  20. Parental height differences predict the need for an emergency Caesarean section

    NARCIS (Netherlands)

    Stulp, Gert; Verhulst, Simon; Pollet, Thomas V.; Nettle, Daniel; Buunk, Abraham P.

    2011-01-01

    More than 30% of all pregnancies in the UK require some form of assistance at delivery, with one of the more severe forms of assistance being an emergency Caesarean section (ECS). Previously it has been shown that the likelihood of a delivery via ECS is positively associated with the birth weight

  1. Emergence of methicillin-resistant Staphylococcus aureus (MRSA) in different animal species

    NARCIS (Netherlands)

    Cuny, Christiane; Friedrich, Alexander; Kozytska, Svetlana; Layer, Franziska; Nübel, Ulrich; Ohlsen, Knut; Strommenger, Birgit; Walther, Birgit; Wieler, Lothar; Witte, Wolfgang

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) in animals such as horses, pet animals and productive livestock has raised questions of a probable human origin and in more general of host specificity of S. aureus. Particular clonal lineages are obviously specific for humans (e.g.

  2. [Differences in the management of epileptic seizures between the elderly and younger adults treated in an emergency department].

    Science.gov (United States)

    Fernandez-Alonso, C; Matias-Guiu, J A; Castillo, C; Fuentes-Ferrer, M E; Gonzalez-Del Castillo, J; Martin-Sanchez, F J

    2014-09-16

    To study the differences in the management and short-term outcomes of adult patients treated in an emergency service for epileptic seizures, depending on whether they are elderly or not. This observational retrospective cohort study included all the patients over 15 years of age who were treated for epileptic seizures in the hospital emergency department of a tertiary and university hospital between 1 September and 31 December 2011. The variables collected were acute treatment and follow-up at 30 days after the index event in the emergency department. Altogether the sample included 114 patients with a mean age of 46.4 years (interquartile range: 32.6-74.3 years), of whom 34 (29.8%) were aged 65 years or over. The group of elderly persons presented a first epileptic episode (p = 0.001), with unknown precipitating factor (p = 0.02), structural causation (p emergency department (p emergency department (p = 0.001) and a prolonged hospital stay (p = 0.002) more frequently than the younger adults. Following a multivariable analysis, being elderly was an independent factor associated to a greater need for specific complementary tests (odds ratio = 3.7; 95% confidence interval = 1.3-10.3) and pharmacological intervention in the emergency department (odds ratio = 3.3; 95% confidence interval = 1.4-8.1). There were no statistically significant differences in the results between the two groups at 30 days in terms of return visits (p = 0.316) and mortality (p = 0.087). The treatment of epileptic seizures in the elderly in the emergency department is complex, if compared with younger adults, thereby making it necessary to use a greater amount of hospital resources.

  3. Distinct Histomorphology in Molecular Subgroups of Glioblastomas in Young Patients.

    Science.gov (United States)

    Neumann, Julia E; Dorostkar, Mario M; Korshunov, Andrey; Mawrin, Christian; Koch, Arend; Giese, Armin; Schüller, Ulrich

    2016-05-01

    Glioblastomas (GBMs) are malignant brain tumors that can be divided into different molecular subtypes based on genetics, global gene expression, and methylation patterns. Among these subgroups, "IDH" GBMs carry mutations within IDH1 or IDH2 The "K27" and "G34" subgroups are characterized by distinct mutations within Histone 3 (H3). These subtypes can be identified by sequencing methods and are particularly found in younger patients. To determine whether the molecular subtypes correlate with distinct histological features among the diverse histologic patterns of GBM, we performed a blinded assessment of the histology of GBMs of 77 patients ≤30 years old at the time of biopsy. The tumors were of the following molecular subtypes: IDH (n = 12), H3 K27M (n = 25), H3 G34R (n = 12), or no IDH/H3 mutations (n = 28). Of IDH-mutated cases, 75% had microcystic features or gemistocytic tumor cells. K27 GBMs had higher cell densities and pronounced nuclear pleomorphism, with 28% harboring tumor giant cells. All G34 GBMs had variable extents of a poorly differentiated/primitive neuroectodermal tumor-like morphology. GBMs without IDH/H3 mutations had foci of epitheliod-appearing cells. Thus, molecular GBM subgroups are associated with distinct histological patterns, suggesting that morphological features reflect the specific underlying molecular genetic abnormalities. © 2016 American Association of Neuropathologists, Inc. All rights reserved.

  4. The ABCs of Depression: Integrating Affective, Biological, and Cognitive Models to Explain the Emergence of the Gender Difference in Depression

    Science.gov (United States)

    Hyde, Janet Shibley; Mezulis, Amy H.; Abramson, Lyn Y.

    2008-01-01

    In adulthood, twice as many women as men are depressed, a pattern that holds in most nations. In childhood, girls are no more depressed than boys, but more girls than boys are depressed by ages 13 to 15. Although many influences on this emergent gender difference in depression have been proposed, a truly integrated, developmental model is lacking.…

  5. Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome.

    Science.gov (United States)

    Nagy-Szakal, Dorottya; Williams, Brent L; Mishra, Nischay; Che, Xiaoyu; Lee, Bohyun; Bateman, Lucinda; Klimas, Nancy G; Komaroff, Anthony L; Levine, Susan; Montoya, Jose G; Peterson, Daniel L; Ramanan, Devi; Jain, Komal; Eddy, Meredith L; Hornig, Mady; Lipkin, W Ian

    2017-04-26

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by unexplained persistent fatigue, commonly accompanied by cognitive dysfunction, sleeping disturbances, orthostatic intolerance, fever, lymphadenopathy, and irritable bowel syndrome (IBS). The extent to which the gastrointestinal microbiome and peripheral inflammation are associated with ME/CFS remains unclear. We pursued rigorous clinical characterization, fecal bacterial metagenomics, and plasma immune molecule analyses in 50 ME/CFS patients and 50 healthy controls frequency-matched for age, sex, race/ethnicity, geographic site, and season of sampling. Topological analysis revealed associations between IBS co-morbidity, body mass index, fecal bacterial composition, and bacterial metabolic pathways but not plasma immune molecules. IBS co-morbidity was the strongest driving factor in the separation of topological networks based on bacterial profiles and metabolic pathways. Predictive selection models based on bacterial profiles supported findings from topological analyses indicating that ME/CFS subgroups, defined by IBS status, could be distinguished from control subjects with high predictive accuracy. Bacterial taxa predictive of ME/CFS patients with IBS were distinct from taxa associated with ME/CFS patients without IBS. Increased abundance of unclassified Alistipes and decreased Faecalibacterium emerged as the top biomarkers of ME/CFS with IBS; while increased unclassified Bacteroides abundance and decreased Bacteroides vulgatus were the top biomarkers of ME/CFS without IBS. Despite findings of differences in bacterial taxa and metabolic pathways defining ME/CFS subgroups, decreased metabolic pathways associated with unsaturated fatty acid biosynthesis and increased atrazine degradation pathways were independent of IBS co-morbidity. Increased vitamin B6 biosynthesis/salvage and pyrimidine ribonucleoside degradation were the top metabolic pathways in ME/CFS without IBS as well as in the

  6. Heterogeneity in chronic fatigue syndrome - empirically defined subgroups from the PACE trial.

    Science.gov (United States)

    Williams, T E; Chalder, T; Sharpe, M; White, P D

    2017-06-01

    Chronic fatigue syndrome is likely to be a heterogeneous condition. Previous studies have empirically defined subgroups using combinations of clinical and biological variables. We aimed to explore the heterogeneity of chronic fatigue syndrome. We used baseline data from the PACE trial, which included 640 participants with chronic fatigue syndrome. Variable reduction, using a combination of clinical knowledge and principal component analyses, produced a final dataset of 26 variables for 541 patients. Latent class analysis was then used to empirically define subgroups. The most statistically significant and clinically recognizable model comprised five subgroups. The largest, 'core' subgroup (33% of participants), had relatively low scores across all domains and good self-efficacy. A further three subgroups were defined by: the presence of mood disorders (21%); the presence of features of other functional somatic syndromes (such as fibromyalgia or irritable bowel syndrome) (21%); or by many symptoms - a group which combined features of both of the above (14%). The smallest 'avoidant-inactive' subgroup was characterized by physical inactivity, belief that symptoms were entirely physical in nature, and fear that they indicated harm (11%). Differences in the severity of fatigue and disability provided some discriminative validation of the subgroups. In addition to providing further evidence for the heterogeneity of chronic fatigue syndrome, the subgroups identified may aid future research into the important aetiological factors of specific subtypes of chronic fatigue syndrome and the development of more personalized treatment approaches.

  7. Affiliative Subgroups in Preschool Classrooms: Integrating Constructs and Methods from Social Ethology and Sociometric Traditions.

    Science.gov (United States)

    Santos, António J; Daniel, João R; Fernandes, Carla; Vaughn, Brian E

    2015-01-01

    Recent studies of school-age children and adolescents have used social network analyses to characterize selection and socialization aspects of peer groups. Fewer network studies have been reported for preschool classrooms and many of those have focused on structural descriptions of peer networks, and/or, on selection processes rather than on social functions of subgroup membership. In this study we started by identifying and describing different types of affiliative subgroups (HMP- high mutual proximity, LMP- low mutual proximity, and ungrouped children) in a sample of 240 Portuguese preschool children using nearest neighbor observations. Next, we used additional behavioral observations and sociometric data to show that HMP and LMP subgroups are functionally distinct: HMP subgroups appear to reflect friendship relations, whereas LMP subgroups appear to reflect common social goals, but without strong, within-subgroup dyadic ties. Finally, we examined the longitudinal implications of subgroup membership and show that children classified as HMP in consecutive years had more reciprocated friendships than did children whose subgroup classification changed from LMP or ungrouped to HMP. These results extend previous findings reported for North American peer groups.

  8. The ergodic theory of lattice subgroups

    CERN Document Server

    Gorodnik, Alexander

    2010-01-01

    The results established in this book constitute a new departure in ergodic theory and a significant expansion of its scope. Traditional ergodic theorems focused on amenable groups, and relied on the existence of an asymptotically invariant sequence in the group, the resulting maximal inequalities based on covering arguments, and the transference principle. Here, Alexander Gorodnik and Amos Nevo develop a systematic general approach to the proof of ergodic theorems for a large class of non-amenable locally compact groups and their lattice subgroups. Simple general conditions on the spectral theory of the group and the regularity of the averaging sets are formulated, which suffice to guarantee convergence to the ergodic mean

  9. Relationship duration moderation of identity status differences in emerging adults' same-sex friendship intimacy.

    Science.gov (United States)

    Johnson, H Durell

    2012-12-01

    Previous research has not yielded consistent identity and intimacy associations for female and male emerging adults. Intimacy varies with time spent in a relationship, and relationship duration may explain variations in the identity process association with intimacy. Data from 278 female and 156 male emerging adults revealed relationship duration moderated the identity commitment and exploration associations with intimacy. Findings indicated longer relationship duration was associated with lower intimacy levels for high identity commitment/high exploration females, and longer relationship duration was associated with higher intimacy levels for high commitment/low exploration females. Findings also indicated longer relationship duration was associated with higher intimacy levels for high commitment/high exploration males, and longer relationship duration was associated with lower intimacy levels for low commitment/high exploration males. Findings are discussed with regards to the empirical importance of considering relationship characteristics when examining emerging adult identity process associations with friendship intimacy. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  10. Perception of differences between trauma care and other surgical emergencies: results from a national survey of surgeons.

    Science.gov (United States)

    Esposito, T J; Kuby, A M; Unfred, C; Young, H L; Gamelli, R L

    1994-12-01

    A national sample of 2500 surgeons was surveyed. Thirteen variables were analyzed to ascertain perceived differences between trauma care and other surgical emergencies, as well as to identify factors contributing to a preferential reluctance to treat trauma. The response rate was 60%. Trauma was perceived as most likely to occur at inconvenient times by 67% of respondents, more often complex (44%), and more demanding of specialized knowledge (39%). Trauma was viewed as less likely to be reimbursed by 35% and most often litigious by 30%. Fewer respondents perceived differences for risk of exposure to lethal pathogens and violence (26% and 9%) and personal or professional rewards (25%). Surgeons who prefer to treat trauma view it as more often demanding of specialized knowledge and more complex than other surgical emergencies. Surgeons who prefer not to treat trauma or take trauma call perceive it as never personally or professionally rewarding, more often disruptive to personal life, emotionally taxing, litigious, and inconvenient compared with other emergencies. Perception of dissimilar reimbursement and personal health risk are less often associated factors. Perceived differences in the litigious nature of cases are not based on fact. We conclude that the individual degree of reluctance or enthusiasm for trauma care in comparison with other emergencies is influenced by perception, personality, and myth rather than by logic and facts.

  11. Board diversity, the logic of difference & the logic of equivalence: a critical study of the emergence of corporate democracy

    Directory of Open Access Journals (Sweden)

    Ken Mcphail

    2010-01-01

    Full Text Available Within the corporate governance literature the notion of diversity has emerged as an important regulatory mechanism (See for example the Tyson Report 2003. This interest has emerged in part due to various national legislative reforms introducing mandatory quotas for female directors. As the debate surrounding these reforms emerges and begins to take form, it is important that the prevailing paradigm of democracy is not taken for granted but is subject to critical scrutiny. Drawing on Ernesto Laclau's On Populist Reason in particular, the paper attempts to problematize notions of difference and representational democracy that lie at the heart of the reforms. The aim of the paper is to stimulate further debate on the democratizing potential of the recent political interventions in the composition of the boards of directors.

  12. Identification of atopic dermatitis subgroups in children from two longitudinal birth cohorts

    NARCIS (Netherlands)

    Paternoster, Lavinia; Savenije, Olga E M; Heron, Jon; Evans, David M; Vonk, Judith M; Brunekreef, Bert; Wijga, Alet H; Henderson, A John; Koppelman, Gerard H; Brown, Sara J

    2017-01-01

    BACKGROUND: Atopic dermatitis (AD) is a prevalent disease with variable natural history. Longitudinal birth cohort studies provide an opportunity to define subgroups based on disease trajectories, which may represent different genetic and environmental pathomechanisms. OBJECTIVE: To investigate the

  13. TEST PREPARATION FOR THE GRE ANALYTICAL ABILITY MEASURE: DIFFERENTIAL EFFECTS FOR SUBGROUPS OF GRE TEST TAKERS

    National Research Council Canada - National Science Library

    Powers, Donald E

    1986-01-01

    ... on other sections of the GRE General Test. The results suggested little, if any, difference among subgroups of examinees with respect to their response to the particular kind of test preparation considered in the study...

  14. Individualizing antipsychotic treatment selection in schizophrenia: characteristics of empirically derived patient subgroups.

    Science.gov (United States)

    Correll, C U; Cañas, F; Larmo, I; Levy, P; Montes, J-M; Fagiolini, A; Papageorgiou, G; Rossi, A; Sturlason, R; Zink, M

    2011-03-01

    Treatment of schizophrenia with antipsychotic drugs is frequently sub-optimal. One reason for this may be heterogeneity between patients with schizophrenia. The objectives of this study were to identify patient, disease and treatment attributes that are important for physicians in choosing an antipsychotic drug, and to identify empirically subgroups of patients who may respond differentially to antipsychotic drugs. The survey was conducted by structured interview of 744 randomly-selected psychiatrists in four European countries who recruited 3996 patients with schizophrenia. Information on 39 variables was collected. Multiple component analysis was used to identify dimensions that explained the variance between patients. Three axes, accounting for 99% of the variance, were associated with disease severity (64%), socioeconomic status (27%) and patient autonomy (8%). These dimensions discriminated between six discrete patient subgroups, identified using ascending hierarchical classification analysis. The six subgroups differed regarding educational level, illness severity, autonomy, symptom presentation, addictive behaviors, comorbidities and cardiometabolic risk factors. Subgroup 1 patients had moderately severe physician-rated disease and addictive behaviours (23.2%); Subgroup 2 patients were well-integrated and autonomous with mild to moderate disease (6.7%); Subgroup 3 patients were less well-integrated with mild to moderate disease, living alone (11.2%); Subgroup 4 patients were women with low education levels (5.4%), Subgroup 5 patients were young men with severe disease (36.8%); and Subgroup 6 patients were poorly-integrated with moderately severe disease, needing caregiver support (16.7%). The presence of these subgroups, which require confirmation and extension regarding potentially identifiable biological markers, may help individualizing treatment in patients with schizophrenia. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  15. Treatment effect heterogeneity for univariate subgroups in clinical trials: Shrinkage, standardization, or else.

    Science.gov (United States)

    Varadhan, Ravi; Wang, Sue-Jane

    2016-01-01

    Treatment effect heterogeneity is a well-recognized phenomenon in randomized controlled clinical trials. In this paper, we discuss subgroup analyses with prespecified subgroups of clinical or biological importance. We explore various alternatives to the naive (the traditional univariate) subgroup analyses to address the issues of multiplicity and confounding. Specifically, we consider a model-based Bayesian shrinkage (Bayes-DS) and a nonparametric, empirical Bayes shrinkage approach (Emp-Bayes) to temper the optimism of traditional univariate subgroup analyses; a standardization approach (standardization) that accounts for correlation between baseline covariates; and a model-based maximum likelihood estimation (MLE) approach. The Bayes-DS and Emp-Bayes methods model the variation in subgroup-specific treatment effect rather than testing the null hypothesis of no difference between subgroups. The standardization approach addresses the issue of confounding in subgroup analyses. The MLE approach is considered only for comparison in simulation studies as the "truth" since the data were generated from the same model. Using the characteristics of a hypothetical large outcome trial, we perform simulation studies and articulate the utilities and potential limitations of these estimators. Simulation results indicate that Bayes-DS and Emp-Bayes can protect against optimism present in the naïve approach. Due to its simplicity, the naïve approach should be the reference for reporting univariate subgroup-specific treatment effect estimates from exploratory subgroup analyses. Standardization, although it tends to have a larger variance, is suggested when it is important to address the confounding of univariate subgroup effects due to correlation between baseline covariates. The Bayes-DS approach is available as an R package (DSBayes). © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Treatment effect heterogeneity for univariate subgroups in clinical trials: Shrinkage, standardization, or else

    Science.gov (United States)

    Varadhan, Ravi; Wang, Sue-Jane

    2016-01-01

    Treatment effect heterogeneity is a well-recognized phenomenon in randomized controlled clinical trials. In this paper, we discuss subgroup analyses with prespecified subgroups of clinical or biological importance. We explore various alternatives to the naive (the traditional univariate) subgroup analyses to address the issues of multiplicity and confounding. Specifically, we consider a model-based Bayesian shrinkage (Bayes-DS) and a nonparametric, empirical Bayes shrinkage approach (Emp-Bayes) to temper the optimism of traditional univariate subgroup analyses; a standardization approach (standardization) that accounts for correlation between baseline covariates; and a model-based maximum likelihood estimation (MLE) approach. The Bayes-DS and Emp-Bayes methods model the variation in subgroup-specific treatment effect rather than testing the null hypothesis of no difference between subgroups. The standardization approach addresses the issue of confounding in subgroup analyses. The MLE approach is considered only for comparison in simulation studies as the “truth” since the data were generated from the same model. Using the characteristics of a hypothetical large outcome trial, we perform simulation studies and articulate the utilities and potential limitations of these estimators. Simulation results indicate that Bayes-DS and Emp-Bayes can protect against optimism present in the naïve approach. Due to its simplicity, the naïve approach should be the reference for reporting univariate subgroup-specific treatment effect estimates from exploratory subgroup analyses. Standardization, although it tends to have a larger variance, is suggested when it is important to address the confounding of univariate subgroup effects due to correlation between baseline covariates. The Bayes-DS approach is available as an R package (DSBayes). PMID:26485117

  17. Subgrouping the autism "spectrum": reflections on DSM-5.

    Directory of Open Access Journals (Sweden)

    Meng-Chuan Lai

    Full Text Available DSM-5 has moved autism from the level of subgroups ("apples and oranges" to the prototypical level ("fruit". But making progress in research, and ultimately improving clinical practice, will require identifying subgroups within the autism spectrum.

  18. Notes on relatively hyperbolic groups and relatively quasiconvex subgroups

    OpenAIRE

    Matsuda, Yoshifumi; Oguni, Shin-ichi; Yamagata, Saeko

    2013-01-01

    We define relatively quasiconvex subgroups of relatively hyperbolic groups in the sense of Osin and show that such subgroups have expected properties. Also we state several definitions equivalent to the definition of relatively hyperbolic groups in the sense of Osin.

  19. Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship

    Directory of Open Access Journals (Sweden)

    Michael Chary

    2017-01-01

    Full Text Available Introduction: Medical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for emergency medicine (EM, but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student’s shift in an emergency department and that student’s clerkship performance. Methods: The authors conducted a retrospective case series by analyzing the performance and reflective statements of 116 students from a single medical school who participated in a required EM clerkship at one or two of four clinical sites from 2013-14. After each shift, an attending emergency physician evaluated the student according to the RIME (Reporter-Interpreter-Manager- Educator scheme. The authors developed software to extract the text from those comments, remove uninformative words and standardize the remaining words. The authors determined the most common words and two-word phrases that students used to describe their shift. The correlation between students’ final clerkship grades and the fraction of student comments with at least one content word was analyzed. Results: Of the 145 possible students, 116 were included for analysis. The other 29 were excluded as they were visiting students who did not receive a fi nal numeric grade. The correlation between final grade and the number of completed self-reflections was 0.32. The correlation between final grade and the average number of words in each self -reflection was 0.21. The first correlation is significantly greater than 0 (p=0.03, t-test, but the second correlation is not (p=0.16, t-test. The median final grade of those who wrote reflections on more tha n half of their shifts was significantly greater than those who wrote reflections half of the time, 83.675 versus 79

  20. Changing emergence of Shigella sero-groups in Bangladesh: observation from four different diarrheal disease hospitals.

    Directory of Open Access Journals (Sweden)

    Sumon Kumar Das

    Full Text Available BACKGROUND: Shigellosis continues to be a public health challenge for developing countries, including Bangladesh. The aim of the study is to demonstrate recent changes in Shigella sero-groups and their geographical diversity. METHODS: Data were extracted from data archive of four diarrheal disease surveillance systems. A 2% sub sample from urban Dhaka Hospital (2008-2011; n = 10,650, and 10% from urban Mirpur Treatment Centre (2009-2011; n = 3,585, were enrolled systematically; whereas, all patients coming from the Health and Demographic Surveillance System area in rural Matlab (2008-2011; n = 6,399 and rural Mirzapur (2010-2011; n = 2,812 were included irrespective of age, sex, and disease severity. A fresh stool specimen was collected for identification of Shigella spp. Of them, 315 (3% were positive for Shigella in Dhaka, 490 (8% from Matlab, 109 (3% from Mirpur and 369 (13% from Mirzapur and considered as analyzable sample size. RESULTS: Among all Shigella isolates regardless of age, significant decreases in percentage of S. flexneri over time was observed in Mirpur (55→29%; p value of χ(2-for trend = 0.019 and Mirzapur (59→47%; p = 0.025. A non-significant decrease was also seen in Dhaka (58→48%, while in Matlab there was a non-significant increase (73→81%. Similar patterns were observed among under-5 children at all sites. Emergence of S. sonnei was found in Dhaka (8→25%; p<0.001 and Mirpur (10→33%; p = 0.015, whereas it decreased in Mirzapur (32→23%; p = 0.056. The emergence of S. boydii was seen in all ages in Mirzapur [(3→28%; p<0.001; (3→27%; p<0.001]. On the other hand, we saw non-significant percent reductions in S. boydii in Dhaka [overall (25→16%; under-5 (16→9%]. Decreasing rates of Shigella dysenteriae were observed in Matlab, Mirpur and Mirzapur; whereas, in Dhaka it remained unchanged. CONCLUSION AND SIGNIFICANCE: Emergence of S. sonnei and S. boydii as important infectious

  1. Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship.

    Science.gov (United States)

    Chary, Michael; Leuthauser, Amy; Hu, Kevin; Hexom, Braden

    2017-01-01

    Medical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for emergency medicine (EM), but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student's shift in an emergency department and that student's clerkship performance. The authors conducted a retrospective case series by analyzing the performance and reflective statements of 116 students from a single medical school who participated in a required EM clerkship at one or two of four clinical sites from 2013-14. After each shift, an attending emergency physician evaluated the student according to the RIME (Reporter-Interpreter-Manager-Educator) scheme. The authors developed software to extract the text from those comments, remove uninformative words and standardize the remaining words. The authors determined the most common words and two-word phrases that students used to describe their shift. The correlation between students' final clerkship grades and the fraction of student comments with at least one content word was analyzed. Of the 145 possible students, 116 were included for analysis. The other 29 were excluded as they were visiting students who did not receive a final numeric grade. The correlation between final grade and the number of completed self-reflections was 0.32. The correlation between final grade and the average number of words in each self-reflection was 0.21. The first correlation is significantly greater than 0 (p=0.03, t-test), but the second correlation is not (p=0.16, t-test). The median final grade of those who wrote reflections on more than half of their shifts was significantly greater than those who wrote reflections half of the time, 83.675 versus 79.23 (p=0.05, 2-sample Kolmogorov-Smirnov test). Students who

  2. Additive subgroups of topological vector spaces

    CERN Document Server

    Banaszczyk, Wojciech

    1991-01-01

    The Pontryagin-van Kampen duality theorem and the Bochner theorem on positive-definite functions are known to be true for certain abelian topological groups that are not locally compact. The book sets out to present in a systematic way the existing material. It is based on the original notion of a nuclear group, which includes LCA groups and nuclear locally convex spaces together with their additive subgroups, quotient groups and products. For (metrizable, complete) nuclear groups one obtains analogues of the Pontryagin duality theorem, of the Bochner theorem and of the Lévy-Steinitz theorem on rearrangement of series (an answer to an old question of S. Ulam). The book is written in the language of functional analysis. The methods used are taken mainly from geometry of numbers, geometry of Banach spaces and topological algebra. The reader is expected only to know the basics of functional analysis and abstract harmonic analysis.

  3. The Importance of Risk and Subgroup Analysis of Nonparticipants in a Geriatric Intervention Study

    DEFF Research Database (Denmark)

    Rosted, E.; Poulsen, Ingrid; Hendriksen, C

    2016-01-01

    . Objectives. To compare patients characteristics, rates of acute readmission, and mortality after one and six months among older persons who agreed and those who declined to participate in a randomized controlled trial and to describe subgroups of nonparticipants. Design. Comparative study based...... on a randomized controlled trial. Setting. University hospital in the Capital Region of Denmark. Participants. Patients >70 years discharged home after a short Emergency Department stay. 399 were requested to participate; 271 consented, whereas 128 refused. Results. Refusers were more likely to be readmitted (p...... randomized study. Conclusion. We recommend that intervention studies among older people or other fragile patient groups include analysis of relevant risk and subgroup analyses of refusers....

  4. Depression, Suicidal Ideation, and Suicidal Attempt Presenting to the Emergency Department: Differences Between These Cohorts

    Directory of Open Access Journals (Sweden)

    Wirachin Hoonpongsimanont

    2014-03-01

    Full Text Available Introduction: The World Health Organization estimates that one million people die by suicide every year. Few studies have looked at factors associated with disposition in patients with chief complaints of depression, suicidal ideation (SI and suicidal attempts (SA who present to the emergency department (ED. Our objective was to assess individual determinants associated with ED disposition of patients in depressed patients presenting to the ED. Methods: We conducted a retrospective study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2008. We used logistic regression to identify factors associated with discharge, in SI, SA and depression patients. Independent variables included socio-demographic information, vital signs, mode of arrival, insurance status, place of residence and concomitant psychiatric diagnosis. Results: Of the 93,030 subjects, 2,314 met the inclusion criteria (1,362 depression, 353 SI and 599 SA. Patients who arrived by ambulance were less likely to be discharged (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.43-0.92. Hispanic patients and patients age 15 to 29 were likely to be discharged (OR 1.61, 95% CI 1.16-2.24 and OR 1.55, 95% CI 1.15-2.10 respectively. Insurance status and housing status were not significantly associated patient was being discharge from EDs. Conclusion: The Hispanic population had higher discharge rates, but the reasons are yet to be explored. Patients with SA and SI are discharged less frequently than those with depression, regardless of insurance type or housing status. [West J Emerg Med. 2014;15(2:211–216.

  5. Subgroup analysis in burnout : Relations between fatigue, anxiety, and depression.

    NARCIS (Netherlands)

    van Dam, A.

    2016-01-01

    Several authors have suggested that burned out patients do not form a homogeneous group and that subgroups should be considered. The identification of these subgroups may contribute to a better understanding of the burnout construct and lead to more specific therapeutic interventions. Subgroup

  6. Inattention, hyperactivity, and emergent literacy: different facets of inattention relate uniquely to preschoolers' reading-related skills.

    Science.gov (United States)

    Sims, Darcey M; Lonigan, Christopher J

    2013-01-01

    Although extant studies indicate that there is a strong association between attention deficit/hyperactivity disorder and reading ability in elementary school children, knowledge regarding the relation between inattentive and hyperactive/impulsive behaviors and emergent literacy in preschool children is less established. This study examined the unique and overlapping relations between measures that assess inattention and hyperactivity/impulsivity and emergent literacy skills in preschool children. Participants included 204 preschool children (M age = 56 months, 50.9% female, 79.8% European American). Behavioral rating scales were completed by teachers, and the Continuous Performance Test (CPT) and the Test of Preschool Early Literacy were completed by the preschoolers. Across measures, inattention was a unique correlate of emergent literacy skills, whereas hyperactivity/impulsivity was not. Both rating scales and the CPT indices of inattention were uniquely associated with emergent literacy skills. These results suggest that these measures are assessing different manifestations of inattention that are both unique correlates of early reading skills.

  7. Inattention, Hyperactivity, and Emergent Literacy: Different Facets of Inattention Relate Uniquely to Preschoolers’ Reading-Related Skills

    Science.gov (United States)

    Sims, Darcey M.; Lonigan, Christopher J.

    2012-01-01

    Objective Although extant studies indicate that there is a strong association between Attention Deficit/Hyperactivity Disorder (ADHD) and reading ability in elementary school children, knowledge regarding the relation between inattentive and hyperactive/impulsive behaviors and emergent literacy in preschool children is less established. This study examined the unique and overlapping relations between measures that assess inattention and hyperactivity/impulsivity and emergent literacy skills in preschool children. Method Participants included 204 preschool children (Mean age = 56 months; 50.9% female; 79.8% European American). Behavioral rating scales were completed by teachers and the Continuous Performance Test (CPT) and the Test of Preschool Early Literacy were completed by the preschoolers. Results Across measures, inattention was a unique correlate of emergent literacy skills whereas hyperactivity/impulsivity was not. Both rating scales and the CPT indices of inattention were uniquely associated with emergent literacy skills. Conclusions These results suggest that these measures are assessing different manifestations of inattention that are both unique correlates of early reading skills. PMID:23186142

  8. Chromosomal phylogeny of the Drosophila fasciola species subgroup revisited (Diptera, Drosophilidae

    Directory of Open Access Journals (Sweden)

    Nilda Maria Diniz

    2004-01-01

    Full Text Available The analysis of polytene chromosomes in 26 strains of seven species in the Drosophila fasciola subgroup, from several locations in Brazil, in addition to strains of two species belonging to the Drosophila mulleri subgroup (D. aldrichi and D. mulleri, enabled us to determine that the 3c inversion found in the latter species differ in one of its break points from that present in the species of the fasciola subgroup. Therefore, a change in the mulleri complex denomination from inversion 3c to inversion 3u is proposed. Accordingly, the fasciola subgroup is no longer a lesser phylogenetic part within the mulleri subgroup. Rather, it is directly related to the likely ancestor of the repleta group, called Primitive I. This information removes the main obstacle to considering the Drosophila fasciola subgroup as an ancestral group within the Drosophila repleta species group, according to the hypothesis of Throckmorton. Our data also support the conclusion that D. onca and D. carolinae are closely related species based on one new inversion in chromosome 4 (4f², in both species. D. fascioloides and D. ellisoni also form a pair of sister species based on the presence of fusions of chromosomes 2-4 and 3-5. D. rosinae is related only to the likely ancestor of the fasciola subgroup, where the 3c inversion was fixed.

  9. Patterns of subgrouping and spatial affiliation in a community of mantled howling monkeys (Alouatta palliata).

    Science.gov (United States)

    Bezanson, Michelle; Garber, Paul A; Murphy, John T; Premo, L S

    2008-03-01

    Studies of social affiliation and social spacing offer important insight into the dynamics of subgroup formation and social strategies in living primates. Among the 11 species in the genus Alouatta, mantled howlers (A. palliata) are the only species to consistently form large, stable social groups composed of several adult males and several adult females. In this study, we examine patterns of subgrouping, activity, and partner preferences in a troop of 26-29 wild mantled howling monkeys (including 12-13 marked individuals) inhabiting Isla de Ometepe, Nicaragua. During two study seasons in 2000 and 2001, we simultaneously monitored the size, composition, and activities of individuals in two to three different subgroups. A half-weight association index was used to calculate partner preferences and patterns of spatial association. Results indicate that our howler study troop fragmented into subgroups of 1-20 with subgroups averaging five and six individuals. Subgroup size and membership reflected individual patterns of social affiliation and social tolerance, and in general remained consistent across activities and from year to year. We also found evidence of cliques or social networks of three to four individuals embedded within larger subgroups. A small number of adult males appeared to play an important social role as the nucleus of clique formation. We argue that the persistence of strong male-male and male-female partner preferences in mantled howlers helps to explain the stability of relatively large multimale-multifemale groups.

  10. The Emergence of Sex Differences in Personality Traits in Early Adolescence: A Cross-Sectional, Cross-Cultural Study

    Science.gov (United States)

    De Bolle, Marleen; De Fruyt, Filip; McCrae, Robert R.; Löckenhoff, Corinna E.; Costa, Paul T.; Aguilar-Vafaie, Maria E.; Ahn, Chang-kyu; Ahn, Hyun-nie; Alcalay, Lidia; Allik, Jüri; Avdeyeva, Tatyana V.; Bratko, Denis; Brunner-Sciarra, Marina; Cain, Thomas R.; Chan, Wayne; Chittcharat, Niyada; Crawford, Jarret T.; Fehr, Ryan; Ficková, Emília; Gelfand, Michele J.; Graf, Sylvie; Gülgöz, Sami; Hřebíčková, Martina; Jussim, Lee; Klinkosz, Waldemar; Knežević, Goran; de Figueroa, Nora Leibovich; Lima, Margarida P.; Martin, Thomas A.; Marušić, Iris; Mastor, Khairul Anwar; Nakazato, Katsuharu; Nansubuga, Florence; Porrata, Jose; Purić, Danka; Realo, Anu; Reátegui, Norma; Rolland, Jean-Pierre; Schmidt, Vanina; Sekowski, Andrzej; Shakespeare-Finch, Jane; Shimonaka, Yoshiko; Simonetti, Franco; Siuta, Jerzy; Szmigielska, Barbara; Vanno, Vitanya; Wang, Lei; Yik, Michelle; Terracciano, Antonio

    2015-01-01

    Although large international studies have found consistent patterns of sex differences in personality traits among adults (i.e., women scoring higher on most facets), less is known about cross-cultural sex differences in adolescent personality and the role of culture and age in shaping them. The present study examines NEO Personality Inventory-3 (NEO-PI-3, McCrae, Costa, & Martin, 2005) informant ratings of adolescents from 23 cultures (N = 4,850) and investigates culture and age as sources of variability in sex differences of adolescents’ personality. The effect for Neuroticism (with females scoring higher than males) begins to take on its adult form around age 14. Girls score higher on Openness to Experience and Conscientiousness at all ages between 12 and 17 years. A more complex pattern emerges for Extraversion and Agreeableness, although by age 17, sex differences for these traits are highly similar to those observed in adulthood. Cross-sectional data suggest that (1) with advancing age, sex differences found in adolescents increasingly converge towards adult patterns with respect to both direction and magnitude; (2) girls display sex-typed personality traits at an earlier age than boys; and (3) the emergence of sex differences was similar across culture. Practical implications of the present findings are discussed. PMID:25603371

  11. The emergence of sex differences in personality traits in early adolescence: A cross-sectional, cross-cultural study.

    Science.gov (United States)

    De Bolle, Marleen; De Fruyt, Filip; McCrae, Robert R; Löckenhoff, Corinna E; Costa, Paul T; Aguilar-Vafaie, Maria E; Ahn, Chang-kyu; Ahn, Hyun-nie; Alcalay, Lidia; Allik, Jüri; Avdeyeva, Tatyana V; Bratko, Denis; Brunner-Sciarra, Marina; Cain, Thomas R; Chan, Wayne; Chittcharat, Niyada; Crawford, Jarret T; Fehr, Ryan; Ficková, Emília; Gelfand, Michele J; Graf, Sylvie; Gülgöz, Sami; Hřebíčková, Martina; Jussim, Lee; Klinkosz, Waldemar; Knežević, Goran; Leibovich de Figueroa, Nora; Lima, Margarida P; Martin, Thomas A; Marušić, Iris; Mastor, Khairul Anwar; Nakazato, Katsuharu; Nansubuga, Florence; Porrata, Jose; Purić, Danka; Realo, Anu; Reátegui, Norma; Rolland, Jean-Pierre; Schmidt, Vanina; Sekowski, Andrzej; Shakespeare-Finch, Jane; Shimonaka, Yoshiko; Simonetti, Franco; Siuta, Jerzy; Szmigielska, Barbara; Vanno, Vitanya; Wang, Lei; Yik, Michelle; Terracciano, Antonio

    2015-01-01

    Although large international studies have found consistent patterns of sex differences in personality traits among adults (i.e., women scoring higher on most facets), less is known about cross-cultural sex differences in adolescent personality and the role of culture and age in shaping them. The present study examines the NEO Personality Inventory-3 (McCrae, Costa, & Martin, 2005) informant ratings of adolescents from 23 cultures (N = 4,850), and investigates culture and age as sources of variability in sex differences of adolescents' personality. The effect for Neuroticism (with females scoring higher than males) begins to take on its adult form around age 14. Girls score higher on Openness to Experience and Conscientiousness at all ages between 12 and 17 years. A more complex pattern emerges for Extraversion and Agreeableness, although by age 17, sex differences for these traits are highly similar to those observed in adulthood. Cross-sectional data suggest that (a) with advancing age, sex differences found in adolescents increasingly converge toward adult patterns with respect to both direction and magnitude; (b) girls display sex-typed personality traits at an earlier age than boys; and (c) the emergence of sex differences was similar across cultures. Practical implications of the present findings are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  12. Emergent bimodal firing patterns implement different encoding strategies during gamma-band oscillations

    Directory of Open Access Journals (Sweden)

    Belén eDe Sancristóbal

    2013-03-01

    Full Text Available Upon sensory stimulation, primary cortical areas readily engage in narrow-band rhythmic activity between 30 to 90 Hz, the so-called gamma oscillations. Here we show that, when embedded in a balanced network, type-I excitable neurons entrained to the collective rhythm show a discontinuity in their firing rates between a slow and a fast spiking mode. This jump in the spiking frequencies is characteristic to type II neurons, but is not present in the frequency-current curve (f-I curve of isolated type I neurons. Therefore, this rate bimodality arises as an emerging network property in type I population models. We have studied the mechanisms underlying the generation of these two firing modes, in order to reproduce the spiking activity of in vivo cortical recordings, which is known to be highly irregular and sparse. We have also analyzed the relation between afferent inputs and the single unit activity, and between the latter and the LFP phase, in order to establish how the collective dynamics modulates the spiking activity of the individual neurons. Our results reveal that the inhibitory-excitatory balance allows two encoding mechanisms, phase and rate code, to coexist within the network.

  13. Sex Differences in Virtual Network Characteristics and Sexual Risk Behavior among Emerging Adults

    Science.gov (United States)

    Cook, Stephanie H.; Bauermeister, José A.; Zimmerman, Marc A.

    2016-01-01

    Emerging adults (EAs)ages 18 to 24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision-making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network data collected from EAs aged 18 to 24 years old across the United States (N=1,687) to examine how online norms (e.g., acceptance of HIV infections, other STIs, and pregnancy) and network characteristics (i.e., network size and density; ties' closeness, race, age, and sex similarities) were associated with participants' unprotected vaginal intercourse (UVI) in the last 30 days. Findings suggested that in male EAs, there was a strong association between sexual norms, structural characteristics, and sexual risk behavior compared to females. Researchers and practitioners may wish to address online peer norms and EAs' online network composition when developing online sexual risk prevention tools. PMID:28083447

  14. Patient experience of different regional models of urgent and emergency care: a cross-sectional survey study.

    Science.gov (United States)

    Foley, Conor; Droog, Elsa; Boyce, Maria; Healy, Orla; Browne, John

    2017-03-20

    To compare user experiences of 8 regional urgent and emergency care systems in the Republic of Ireland, and explore potential avenues for improvement. A cross-sectional survey. Several distinct models of urgent and emergency care operate in Ireland, as system reconfiguration has been implemented in some regions but not others. The Urgent Care System Questionnaire was used to explore service users' experiences with urgent and emergency care. Linear regression and logistic regression were used to detect regional variation in each of the 3 domains and overall ratings of care. A nationally representative sample (N=8002) of the general population was contacted by telephone, yielding 1205 participants who self-identified as having used urgent and emergency care services in the previous 3 months. Patient experience was assessed across 3 domains: entry into the system, progress through the system and patient convenience of the system. Participants were also asked to provide an overall rating of the care they received. Service users in Dublin North East gave lower ratings on the entry into the system scale than those in Dublin South (adjusted mean difference=-0.18; 95% CI -0.35 to -0.10; p=0.038). For overall ratings of care, service users in the Mid-West were less likely than those in Dublin North East to give an excellent rating (adjusted OR 0.57; 95% CI 0.35 to 0.92; p=0.022). Survey items relating to communication, and consideration of patients' needs were comparatively poorly rated. The use of public emergency departments and out-of-hours general practice care was associated with poorer patient experiences. No consistent relationship was found between the type of urgent and emergency care model in different regions and patient experience. Scale-level data may not offer a useful metric for exploring the impact of system-level service change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. Gender Differences in Longitudinal Links between Neighborhood Fear, Parental Support, and Depression among African American Emerging Adults

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2015-03-01

    Full Text Available The transition to adulthood is a developmental period marked by increased stress, especially among African Americans. In addition to stress related to emerging adulthood, neighborhood fear may contribute to depressive symptoms for African Americans. We examined gender differences in longitudinal associations between changes in perceived neighborhood fear, parental support, and depressive symptoms among African American youth who were in transition to adulthood. Five hundred and thirteen African American youths (235 males and 278 females were included in the study. An increase in perceived neighborhood fear was associated with an increase in depressive symptoms, and change in perceived maternal support was predictive of depressive symptoms among males, but not females. The findings suggest that policies and programs should help parents provide support to young adult children who live in violent neighborhoods as a strategy to prevent depressive symptoms during emerging adulthood.

  16. From Kaua'i to Hawai'i Island: Interisland Differences in Emergency Contraceptive Pill Availability.

    Science.gov (United States)

    Bullock, Holly; Tschann, Mary; Elia, Jennifer; Kaneshiro, Bliss; Salcedo, Jennifer

    2017-07-01

    Emergency contraceptive pills (ECPs) are medications used after unprotected intercourse, underprotected intercourse, or sexual assault to decrease the risk of pregnancy. Availability of ECPs in Hawai'i's retail pharmacies was last assessed in 2007, following over-the-counter access to levonorgestrel ECPs (LNG-ECP) for women age 18 years or older and prior to U.S. Food and Drug Administration (FDA) approval of prescription-only ulipristal acetate (UPA). We conducted a county-by-county subanalysis from a larger observational population-based study on statewide availability of ECPs in Hawai'i's pharmacies. In the original study, researchers called all 198 unique retail pharmacies in Hawai'i between December 2013 and June 2014. Only 3% of pharmacies had UPA immediately available on-site in the state, with UPA available on Kaua'i and O'ahu only. At least one form of LNG-ECPs was available in 82% of pharmacies in 2013-2014, roughly the same as 2007 (81%) (P=0.9) when Lana'i and Moloka'i lacked access. Currently, only Moloka'i lacks retail pharmacy access to ECPs. When controlling for general inflation, the 2013-2014 mean price for name brand LNG-ECP fell within the reported range of 2007 prices. Generic LNG-ECPs were substantially lower in price than name brand LNG-ECPs in 2007 and 2013-2014. Availability of UPA is limited and significantly lower compared to LNG-ECPs. Availability of LNG-ECPs statewide has remained stable and the arrival of generics has decreased prices.

  17. Torpor as an emergency solution in Galago moholi: heterothermy is triggered by different constraints.

    Science.gov (United States)

    Nowack, Julia; Mzilikazi, Nomakwezi; Dausmann, Kathrin H

    2013-05-01

    The expression of heterothermy in the African lesser bushbaby, Galago moholi, seems to be strikingly different to most other heterotherms: G. moholi uses its ability to enter torpor only rarely and torpor is only used by a small fraction of the population. The aim of this study was, therefore, to summarize the parameters of torpor use in G. moholi to conclude the general patterns and discuss them in comparison to other heterotherms to elucidate possible causes and constraints that underlie these differences in deployment of heterothermy. Our study was carried out on wild animals using temperature loggers and open-flow respirometry for measurements of body temperature and metabolic rate, respectively. G. moholi uses torpor only as a last resort and not as a routine, seasonal behavior. Nevertheless, we found that the general physiological patterns of torpor, e.g., torpor bout duration or entry and arousal times from torpor, were mainly consistent with those described for other nocturnal daily heterotherms. The greatest difference found was the unusual low rewarming rates during arousal from torpor, probably due to already depleted internal energy stores and thus inability to mobilize sufficient energy for endogenous heating. We therefore conclude that while general physiological parameters of heterothermy seem to have remained conserved in heterotherms, the underlying causes which elicit this physiological response, and thus the extent of expression and timing of heterothermy, have evolved very differently in different groups, depending on body mass and the specific habitat and lifestyle of the species.

  18. Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process

    Directory of Open Access Journals (Sweden)

    Brenda L Connors

    2016-03-01

    Full Text Available People vary in the way in which they approach decision making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals.

  19. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    Science.gov (United States)

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  20. E-Book and Printed Book Reading in Different Contexts as Emergent Literacy Facilitator

    Science.gov (United States)

    Korat, Ofra; Segal-Drori, Ora

    2016-01-01

    Research Findings: We present 3 studies that focused on preschoolers' electronic book (e-book) reading in different contexts aimed at supporting children's early literacy. In Study 1 we researched the impact of children's age and number of independent readings on phonological awareness and word reading. We found that all age groups benefited from…

  1. Team negotiation: social, epistemic, economic, and psychological consequences of subgroup conflict.

    Science.gov (United States)

    Halevy, Nir

    2008-12-01

    Large collectives (e.g., organizations, political parties, nations) are seldom unitary players. Rather, they consist of different subgroups that often have conflicting interests. Nonetheless, negotiation research consistently regards negotiating teams, who represent these collectives, as monolithic parties with uniform interests. This article integrates concepts from social psychology, management, political science, and behavioral game theory to explore the effects of subgroup conflict on team negotiation. Specifically, the present research introduced a conflict of interests within negotiating teams and investigated how this internal conflict affects the outcome of the negotiation between teams. An experiment with 80 four-person teams found that conflict between subgroups had a detrimental effect on the performance of negotiating teams. This research also employed a recent model of motivated information processing in groups to investigate possible processes underlying the effect of subgroup conflict on team negotiation.

  2. AKT pathway genes define 5 prognostic subgroups in glioblastoma.

    Directory of Open Access Journals (Sweden)

    Anna Joy

    Full Text Available Activity of GFR/PI3K/AKT pathway inhibitors in glioblastoma clinical trials has not been robust. We hypothesized variations in the pathway between tumors contribute to poor response. We clustered GBM based on AKT pathway genes and discovered new subtypes then characterized their clinical and molecular features. There are at least 5 GBM AKT subtypes having distinct DNA copy number alterations, enrichment in oncogenes and tumor suppressor genes and patterns of expression for PI3K/AKT/mTOR signaling components. Gene Ontology terms indicate a different cell of origin or dominant phenotype for each subgroup. Evidence suggests one subtype is very sensitive to BCNU or CCNU (median survival 5.8 vs. 1.5 years; BCNU/CCNU vs other treatments; respectively. AKT subtyping advances previous approaches by revealing additional subgroups with unique clinical and molecular features. Evidence indicates it is a predictive marker for response to BCNU or CCNU and PI3K/AKT/mTOR pathway inhibitors. We anticipate Akt subtyping may help stratify patients for clinical trials and augment discovery of class-specific therapeutic targets.

  3. AKT Pathway Genes Define 5 Prognostic Subgroups in Glioblastoma

    Science.gov (United States)

    Smirnov, Ivan; Reiser, Mark; Misra, Anjan; Shapiro, William R.; Mills, Gordon B.; Kim, Seungchan; Feuerstein, Burt G.

    2014-01-01

    Activity of GFR/PI3K/AKT pathway inhibitors in glioblastoma clinical trials has not been robust. We hypothesized variations in the pathway between tumors contribute to poor response. We clustered GBM based on AKT pathway genes and discovered new subtypes then characterized their clinical and molecular features. There are at least 5 GBM AKT subtypes having distinct DNA copy number alterations, enrichment in oncogenes and tumor suppressor genes and patterns of expression for PI3K/AKT/mTOR signaling components. Gene Ontology terms indicate a different cell of origin or dominant phenotype for each subgroup. Evidence suggests one subtype is very sensitive to BCNU or CCNU (median survival 5.8 vs. 1.5 years; BCNU/CCNU vs other treatments; respectively). AKT subtyping advances previous approaches by revealing additional subgroups with unique clinical and molecular features. Evidence indicates it is a predictive marker for response to BCNU or CCNU and PI3K/AKT/mTOR pathway inhibitors. We anticipate Akt subtyping may help stratify patients for clinical trials and augment discovery of class-specific therapeutic targets. PMID:24984002

  4. AKT pathway genes define 5 prognostic subgroups in glioblastoma.

    Science.gov (United States)

    Joy, Anna; Ramesh, Archana; Smirnov, Ivan; Reiser, Mark; Misra, Anjan; Shapiro, William R; Mills, Gordon B; Kim, Seungchan; Feuerstein, Burt G

    2014-01-01

    Activity of GFR/PI3K/AKT pathway inhibitors in glioblastoma clinical trials has not been robust. We hypothesized variations in the pathway between tumors contribute to poor response. We clustered GBM based on AKT pathway genes and discovered new subtypes then characterized their clinical and molecular features. There are at least 5 GBM AKT subtypes having distinct DNA copy number alterations, enrichment in oncogenes and tumor suppressor genes and patterns of expression for PI3K/AKT/mTOR signaling components. Gene Ontology terms indicate a different cell of origin or dominant phenotype for each subgroup. Evidence suggests one subtype is very sensitive to BCNU or CCNU (median survival 5.8 vs. 1.5 years; BCNU/CCNU vs other treatments; respectively). AKT subtyping advances previous approaches by revealing additional subgroups with unique clinical and molecular features. Evidence indicates it is a predictive marker for response to BCNU or CCNU and PI3K/AKT/mTOR pathway inhibitors. We anticipate Akt subtyping may help stratify patients for clinical trials and augment discovery of class-specific therapeutic targets.

  5. Sex differences in the use of social information emerge under conditions of risk

    Directory of Open Access Journals (Sweden)

    Charlotte O. Brand

    2018-01-01

    Full Text Available Social learning provides an effective route to gaining up-to-date information, particularly when information is costly to obtain asocially. Theoretical work predicts that the willingness to switch between using asocial and social sources of information will vary between individuals according to their risk tolerance. We tested the prediction that, where there are sex differences in risk tolerance, altering the variance of the payoffs of using asocial and social information differentially influences the probability of social information use by sex. In a computer-based task that involved building a virtual spaceship, men and women (N = 88 were given the option of using either asocial or social sources of information to improve their performance. When the asocial option was risky (i.e., the participant’s score could markedly increase or decrease and the social option was safe (i.e., their score could slightly increase or remain the same, women, but not men, were more likely to use the social option than the asocial option. In all other conditions, both women and men preferentially used the asocial option to a similar degree. We therefore found both a sex difference in risk aversion and a sex difference in the preference for social information when relying on asocial information was risky, consistent with the hypothesis that levels of risk-aversion influence the use of social information.

  6. Classification tree analysis of race-specific subgroups at risk for a central venous catheter-related bloodstream infection.

    Science.gov (United States)

    Studnicki, James; Ekezue, Bola F; Tsulukidze, Maka; Honoré, Peggy; Moonesinghe, Ramal; Fisher, John

    2014-03-01

    Studies of racial disparities in patient safety events often do not use race-specific risk adjustment and do not account for reciprocal covariate interactions. These limitations were addressed by using classification tree analysis separately for black patients and white patients to identify characteristics that segment patients who have increased risks for a venous catheter-related bloodstream infection. A retrospective, cross-sectional analysis of 5,236,045 discharges from 103 Florida acute hospitals in 2005-2009 was conducted. Hospitals were rank ordered on the basis of the black/white Patient Safety Indicator (PSI) 7 rate ratio as follows: Group 1 (white rate higher), Group 2, (equivalent rates), Group 3, (black rate higher), and Group 4, (black rate highest). Predictor variables included 26 comorbidities (Elixhauser Comorbidity Index) and demographic characteristics. Four separate classification tree analyses were completed for each race/hospital group. Individual characteristics and groups of characteristics associated with increased PSI 7 risk differed for black and white patients. The average age for both races was different across the hospital groups (p < .01). Weight loss was the strongest single delineator and common to both races. The black subgroups with the highest PSI 7 risk were Medicare beneficiaries who were either < or = 25.5 years without hypertension or < or = 39.5 years without hypertension but with an emergency or trauma admission. The white subgroup with the highest PSI 7 risk consisted of patients < or = 45.5 years who had congestive heart failure but did not have either hypertension or weight loss. Identifying subgroups of patients at risk for a rare safety event such as PSI 7 should aid effective clinical decisions and efficient use of resources and help to guide patient safety interventions.

  7. Resolution and Characterization of Distinct cpn60-Based Subgroups of Gardnerella vaginalis in the Vaginal Microbiota

    Science.gov (United States)

    Paramel Jayaprakash, Teenus; Schellenberg, John J.; Hill, Janet E.

    2012-01-01

    Bacterial vaginosis (BV), characterized by a shift of the vaginal microbiota from a Lactobacillus-dominated community to a dense biofilm containing a complex mixture of organisms, is an important risk factor in poor reproductive health outcomes. The Nugent score, based on Gram stain, is used to diagnose BV and Gardnerella vaginalis abundance in the sample is one factor determining Nugent score. A high Nugent score is indicative of BV but does not always correspond to the presence of clinical symptoms. G. vaginalis is recognized as a heterogeneous group of organisms, which can also be part of the normal, healthy vaginal microbiome. In addition, asymptomatic BV and non-Gardnerella types of BV are being recognized. In an attempt to resolve the heterogeneous group of G. vaginalis, a phylogenetic tree of cpn60 universal target sequences from G. vaginalis isolates was constructed that indicates the existence of four subgroups of G. vaginalis. This subdivision, supported by whole genome similarity calculation of representative strains using JSpecies, demonstrates that these subgroups may represent different species. The cpn60 subgroupings did not correspond with the Piot biotyping scheme, but did show consistency with ARDRA genotyping and sialidase gene presence. Isolates from all four subgroups produced biofilm in vitro. We also investigated the distribution of G. vaginalis subgroups in vaginal samples from Kenyan women with Nugent scores consistent with BV, Intermediate and Normal microbiota (n = 44). All subgroups of G. vaginalis were detected in these women, with a significant difference (z = −3.372, n = 39, p = 0.001) in frequency of G. vaginalis subgroup B between BV and Normal groups. Establishment of a quantifiable relationship between G. vaginalis subgroup distribution and clinical status could have significant diagnostic implications. PMID:22900080

  8. Resolution and characterization of distinct cpn60-based subgroups of Gardnerella vaginalis in the vaginal microbiota.

    Directory of Open Access Journals (Sweden)

    Teenus Paramel Jayaprakash

    Full Text Available Bacterial vaginosis (BV, characterized by a shift of the vaginal microbiota from a Lactobacillus-dominated community to a dense biofilm containing a complex mixture of organisms, is an important risk factor in poor reproductive health outcomes. The Nugent score, based on Gram stain, is used to diagnose BV and Gardnerella vaginalis abundance in the sample is one factor determining Nugent score. A high Nugent score is indicative of BV but does not always correspond to the presence of clinical symptoms. G. vaginalis is recognized as a heterogeneous group of organisms, which can also be part of the normal, healthy vaginal microbiome. In addition, asymptomatic BV and non-Gardnerella types of BV are being recognized. In an attempt to resolve the heterogeneous group of G. vaginalis, a phylogenetic tree of cpn60 universal target sequences from G. vaginalis isolates was constructed that indicates the existence of four subgroups of G. vaginalis. This subdivision, supported by whole genome similarity calculation of representative strains using JSpecies, demonstrates that these subgroups may represent different species. The cpn60 subgroupings did not correspond with the Piot biotyping scheme, but did show consistency with ARDRA genotyping and sialidase gene presence. Isolates from all four subgroups produced biofilm in vitro. We also investigated the distribution of G. vaginalis subgroups in vaginal samples from Kenyan women with Nugent scores consistent with BV, Intermediate and Normal microbiota (n = 44. All subgroups of G. vaginalis were detected in these women, with a significant difference (z = -3.372, n = 39, p = 0.001 in frequency of G. vaginalis subgroup B between BV and Normal groups. Establishment of a quantifiable relationship between G. vaginalis subgroup distribution and clinical status could have significant diagnostic implications.

  9. Studying the operation of a VVER steam generator in the condensing mode at different parameters of emergency processes

    Science.gov (United States)

    Morozov, A. V.; Shlepkin, A. S.; Kalyakin, D. S.; Soshkina, A. S.

    2017-05-01

    The article presents the results of the experimental study of heat and mass transfer processes in an NPP steam generator during the operation of passive safety systems of new-generation VVER reactor installations. At the GE2M-PG test rig in the Leypunsky Institute for Physics and Power Engineering, two series of experiments corresponding to different stages of the accident were completed. In these experiments, the performance of VVER steam generator in the condensing mode with and without the removal of gas-vapor mixture from the "cold" header has been studied. As a result of the first series of experiments, it was found that, for any of the parameters of the emergency process, the steam generator's power does not drop below 80% of the original value. Furthermore, we revealed that the composition and physical properties of gases in the investigated concentration range did not notably affect the processes in the steam generator. In the second series of experiments without removal of noncondensable gases, the influence of parameters of the emergency process on the efficiency of heat transfer in the steam generator operating in the condensing mode was investigated. In order to study the heat transfer processes, we studied the change of the temperature difference between the media of the first and second circuits in our experiments. We found that the value of the temperature difference depends on both the mass of noncondensable gases accumulated in the tube bundle and their accumulation rate. The accumulation rate is determined by the power of the steam generator and the concentration of gases entering the steam generator. As a result of the analysis of experimental data, we obtained the analytical dependence reflecting change in the power of the steam generator operating in the emergency condensing mode.

  10. Report of the Production and Delivery Subgroup

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R; Zalesky, R

    2004-11-01

    The Production and Delivery Subgroup was tasked with evaluating the various options that could be used for hydrogen production and delivery in terms of availability/industry readiness, technical and economic barriers, and environmental considerations. Hydrogen can be produced using a variety of feedstocks and conversion technologies. The feedstock options include water, natural gas, coal, petroleum, methanol, ethanol, biomass, and organic waste streams. Ultimately, using these domestic resources we will be able to produce all the hydrogen we will need for the complete conversion of our transportation infrastructure. The various conversion technologies include electrolysis, reforming (principally of natural gas, but also ethanol and methanol), photobiological and photoelectrochemical, biofermentation, pyrolysis and gasification of biomass and coal, high temperature thermochemical, and catalytic membranes. All of these production technologies are being actively researched by DOE's Office of Hydrogen, Fuel Cells and Infrastructure Technologies (HFCIT); and other offices within DOE support work that complements the HFCIT Program activities. In addition, private industry is also dedicating significant resources to these efforts. In establishing the California Hydrogen Highway Network (CA H2 Net) we must utilize both distributed (that is, hydrogen that is produced at the point of use) as well as centralized production of hydrogen. Because of technical and economic barriers, most of the technologies for hydrogen production listed above will not become practical for either mode of hydrogen production in large quantities until at least the 2015-2030 timeframe. In the near term, that is, the transitional period between now and 2010 when we will establish a widely available hydrogen fueling infrastructure in California, the distributed production options of reforming and electrolysis will play the dominant role. In addition, production of hydrogen at centralized plants

  11. The emergence of different tail exponents in the distributions of firm size variables

    Science.gov (United States)

    Ishikawa, Atushi; Fujimoto, Shouji; Watanabe, Tsutomu; Mizuno, Takayuki

    2013-05-01

    We discuss a mechanism through which inversion symmetry (i.e., invariance of a joint probability density function under the exchange of variables) and Gibrat’s law generate power-law distributions with different tail exponents. Using a dataset of firm size variables, that is, tangible fixed assets K, the number of workers L, and sales Y, we confirm that these variables have power-law tails with different exponents, and that inversion symmetry and Gibrat’s law hold. Based on these findings, we argue that there exists a plane in the three dimensional space (logK,logL,logY), with respect to which the joint probability density function for the three variables is invariant under the exchange of variables. We provide empirical evidence suggesting that this plane fits the data well, and argue that the plane can be interpreted as the Cobb-Douglas production function, which has been extensively used in various areas of economics since it was first introduced almost a century ago.

  12. Obstetrical emergencies.

    Science.gov (United States)

    Biddle, D; Macintire, D K

    2000-05-01

    This article discusses different techniques that can be used in the diagnosis and treatment of obstetrical emergencies. Female reproductive emergencies commonly encountered by small animal practitioners include pyometra, dystocia, cesarean section, mastitis, eclampsia, uterine torsion, and uterine prolapse. A thorough knowledge of normal and abnormal reproductive behavior will aid the emergency veterinarian in successfully managing such cases. Timely diagnosis and treatment of these emergencies will often give a good outcome.

  13. Seletividade de herbicidas aplicados em pré-emergência sobre cultivares de batata Selectivity of herbicides applied in pre-emergence on different potato cultivars

    Directory of Open Access Journals (Sweden)

    José Munhoz Felipe

    2006-01-01

    Full Text Available O presente trabalho foi realizado na Estação Experimental Agrícola da BASF S.A., situada na rodovia SP 310, km 144, no município de Santo Antonio da Posse-(SP, em área de Latossolo Vermelho distrófico com textura média. Quatro experimentos foram desenvolvidos com o objetivo de avaliar a seletividade dos herbicidas dimethenamid, metribuzin e linuron, aplicados em diferentes doses, na condição de pré-emergência, sobre as características de produção e qualidade dos tubérculos de quatro cultivares de batata (Solanum tuberosum L.. Utilizou-se, em todos os experimentos, o delineamento experimental de blocos ao acaso, com cinco repetições e parcelas de 21 m² (3 x 7 m. Os tratamentos utilizados foram: testemunha capinada, dimethenamid nas doses de 0,75, 1,50 e 3,00 kg ha-1, metribuzin a 0,48 e 0,72 kg ha-1 e linuron a 1,50 e 2,00 kg ha-1. Foram realizadas três avaliações visuais de fitotoxicidade aos 24, 31, e 42 dias após a aplicação (DAA. A severidade das injúrias visuais verificadas nas plantas das diferentes cultivares de batata foi dependente do herbicida, da dose aplicada e da cultivar utilizada. O herbicida dimethenamid, na dose de 3,00 kg ha-1, foi o tratamento que proporcionou as maiores porcentagens visuais de área foliar injuriada, no entanto tais sintomas desapareceram completamente aos 42 DAA. Nenhum tratamento com herbicida interferiu negativamente na produção de tubérculos, na massa seca dos tubérculos e no tamanho final dos tubérculos colhidos.The present research was carried out at the Agricultural Experimental Station of BASF S.A., located in the SP 340, highway km 144, Santo Antonio de Posse, State of São Paulo, on a dystrophic dark Red Latosol (Rhodic Haplustox area, with medium texture. Four experiments were carried out to evaluate the selectivity of the herbicides dimethenamid, metribuzin and linuron, applied at different rates, in the pre-emergence condition, in the production characteristics and

  14. Sex differences in athletic performance emerge coinciding with the onset of male puberty.

    Science.gov (United States)

    Handelsman, David J

    2017-07-01

    Male performance in athletic events begins to exceed that of age-matched females during early adolescence, but the timing of this divergence relative to the onset of male puberty and the rise in circulating testosterone remains poorly defined. This study is a secondary quantitative analysis of four published sources which aimed to define the timing of the gender divergence in athletic performance and relating it to the rise in circulating testosterone due to male puberty. Four data sources reflecting elite swimming and running and jumping track and field events as well as hand-grip strength in nonathletes were analysed to define the age-specific gender differences through adolescence and their relationship to the rising circulating testosterone during male puberty. The onset and tempo of gender divergence were very similar for swimming, running and jumping events as well as the hand-grip strength in nonathletes, and all closely paralleled the rise in circulating testosterone in adolescent boys. The gender divergence in athletic performance begins at the age of 12-13 years and reaches adult plateau in the late teenage years with the timing and tempo closely parallel to the rise in circulating testosterone in boys during puberty. © 2017 John Wiley & Sons Ltd.

  15. Emergence and Stability of High-Pressure Resistance in Different Food-Borne Pathogens

    Science.gov (United States)

    Vanlint, Dietrich; Rutten, Nele; Michiels, Chris W.

    2012-01-01

    High hydrostatic pressure (HHP) processing is becoming a valuable nonthermal food pasteurization technique, although there is reasonable concern that bacterial HHP resistance could compromise the safety and stability of HHP-processed foods. While the degree of natural HHP resistance has already been shown to vary greatly among and within bacterial species, a still unresolved question remains as to what extent different food-borne pathogens can actually develop HHP resistance. In this study, we therefore examined and compared the intrinsic potentials for HHP resistance development among strains of Escherichia coli, Shigella flexneri, Salmonella enterica serovars Typhimurium and Enteritidis, Yersinia enterocolitica, Aeromonas hydrophila, Pseudomonas aeruginosa, and Listeria innocua using a selective enrichment approach. Interestingly, of all strains examined, the acquisition of extreme HHP resistance could be detected in only some of the E. coli strains, indicating that a specific genetic predisposition might be required for resistance development. Furthermore, once acquired, HHP resistance proved to be a very stable trait that was maintained for >80 generations in the absence of HHP exposure. Finally, at the mechanistic level, HHP resistance was not necessarily linked to derepression of the heat shock genes and was not related to the phenomenon of persistence. PMID:22344661

  16. Emergence and stability of high-pressure resistance in different food-borne pathogens.

    Science.gov (United States)

    Vanlint, Dietrich; Rutten, Nele; Michiels, Chris W; Aertsen, Abram

    2012-05-01

    High hydrostatic pressure (HHP) processing is becoming a valuable nonthermal food pasteurization technique, although there is reasonable concern that bacterial HHP resistance could compromise the safety and stability of HHP-processed foods. While the degree of natural HHP resistance has already been shown to vary greatly among and within bacterial species, a still unresolved question remains as to what extent different food-borne pathogens can actually develop HHP resistance. In this study, we therefore examined and compared the intrinsic potentials for HHP resistance development among strains of Escherichia coli, Shigella flexneri, Salmonella enterica serovars Typhimurium and Enteritidis, Yersinia enterocolitica, Aeromonas hydrophila, Pseudomonas aeruginosa, and Listeria innocua using a selective enrichment approach. Interestingly, of all strains examined, the acquisition of extreme HHP resistance could be detected in only some of the E. coli strains, indicating that a specific genetic predisposition might be required for resistance development. Furthermore, once acquired, HHP resistance proved to be a very stable trait that was maintained for >80 generations in the absence of HHP exposure. Finally, at the mechanistic level, HHP resistance was not necessarily linked to derepression of the heat shock genes and was not related to the phenomenon of persistence.

  17. A broader phenotype of persistence emerges from individual differences in response to extinction.

    Science.gov (United States)

    Sauce, Bruno; Wass, Christopher; Lewis, Michael; Matzel, Louis D

    2017-11-13

    The typical practice of averaging group performance during extinction gives the impression that responding declines gradually and homogeneously. However, previous studies of extinction in human infants have shown that some individuals persist in responding, whereas others abruptly cease responding. As predicted by theories of control, the infants who quickly resign typically display signs of sadness and despair when the expected reward is omitted. Using genetically diverse mice, here we observed a similar pattern of individual differences and the associated phenotypes. After learning to approach a food reward, upon extinction, some animals rapidly abandoned approach to the goal box, whereas other animals persisted in entering and searching the goal box. Interestingly, the persistent mice were slower to "give up" when confined to an inescapable pool of water (a test asserted to be indicative of susceptibility to depression) and exhibited a more extensive pattern of search for omitted rewards. Thus, extinction reveals a continuum in persistence, in which low values might reflect a susceptibility to the negative effects of stress and might predispose individuals to depression.

  18. Guidelines for infertility counselling in different countries: is there an emerging trend?

    Science.gov (United States)

    Blyth, Eric

    2012-07-01

    It is widely accepted that infertility and involuntary childlessness, and the decision to engage with assisted reproduction technology (ART) services as a patient, donor or surrogate can entail wide-ranging psychosocial issues. Psychosocial counselling has, therefore, become valued as an integral element of ART services. The objective of this study was to begin to map out what exists globally by the way of guidelines for infertility counselling. Data were analysed from formal guidelines produced by seven national infertility counselling bodies, onetransnational infertility counselling organization, reports of the American Society for Reproductive Medicine Ethics Committee and Practice Committee and the ESHRE Task Force on Ethics and Law. Additional sources of data were the International Infertility Counseling Organization and counselling colleagues internationally. Four broad areas concerning contemporary practice in infertility counselling are identified: (i) the legal mandate for counselling; (ii) eligibility credentials for individuals carrying out professional counselling activities; (iii) different forms of counselling and (iv) counselling practice in relation to specific elements of assisted reproduction treatment. Internationally, the development of infertility guidelines is best described as a 'work in progress', although key trends are evident.

  19. Pain Drawings Improve Subgrouping of Low Back Pain Patients.

    Science.gov (United States)

    Hüllemann, Philipp; Keller, Thomas; Kabelitz, Maria; Freynhagen, Rainer; Tölle, Thomas; Baron, Ralf

    2017-03-01

    Subgrouping of low back pain (LBP) patients may be improved when pain drawings are combined with the painDETECT (PD-Q) questionnaire. We hypothesized that (1) different LBP subgroups determined by their pain radiation show different clinical patterns and (2) the occurrence of neuropathic symptoms depends on pain radiation. A total of 19,263 acute ( 3 months) LBP patients were allocated prospectively into 4 groups based on the location of pain drawings on a manikin and compared regarding neuropathic pain components, functionality, depression, pain intensity, and surgical interventions. All items were investigated at baseline and follow-up visits. Group I was composed of patients with axial LBP without radiating pain; group II, LBP with radiation into the thigh; group III, LBP with radiation into the shank; and group IV, LBP with radiation into the feet. Side-dependent pain radiation was assessed additionally. Depression, functionality, and pain intensity showed no clinically relevant differences, whereas PD-Q scores and the probability to rate positive for neuropathic pain increased with more distally radiating pain. Surgery and medication intake were most frequent in group IV. Follow-up analyses showed that only axial LBP became more neuropathic, whereas pain intensity decreased over time. Radicular patterns of pain drawings in LBP patients indicate severe pain conditions with the most neuropathic components, while axial LBP has the fewest. For the categorization of LBP, pain drawings help explain the underlying mechanism of pain, which might further improve mechanism-based treatment when used in clinical routines and research. © 2016 World Institute of Pain.

  20. IGHV1, IGHV5 and IGHV7 subgroup genes in the rhesus macaque.

    Science.gov (United States)

    Bible, Jon M; Howard, Wendy; Robbins, Helena; Dunn-Walters, Deborah K

    2003-03-01

    The diversity of the antibody response is achieved, in part, by rearrangement of different immunoglobulin (Ig) genes. The Ig heavy chain is made up of a variable region (IGHV), a diversity region (IGHD) and a joining region (IGHJ). Human germline IGHV genes have been grouped into seven multigene subgroups. Size and usage of these subgroups is not equal, the IGHV3 subgroup is the most commonly used (36%), followed by IGHV1/7 (26%), then IGHV4, IGHV5, IGHV2, IGHV6 (15%, 12%, 4%, 3% respectively). The rhesus macaque (Macaca mulatta) is a useful non-human primate model for studies of infection and the database of germline Ig genes for the macaque is gradually growing to become a useful tool in the study of B-cell responses. The proportions of IGHV subgroup usage in the macaque are similar to those in man. Representatives from IGHV3 and IGHV4 subgroups for the macaque have been published, as have germline sequences of the IGHD and IGHJ genes. However, to date there have been no sequences published from the second largest IGHV subgroup, IGHV1. We report the isolation and sequencing of a genomic fragment containing an IGHV1 gene from the macaque. Polymerase chain reaction (PCR) primers designed from this sequence enabled us to amplify and sequence 25 new IGHV1 germline genes. We also isolated two IGHV7 genes, using the same primers, and two IGHV5 genes, using human IGHV5 primers.

  1. Performance Analysis of Different Backoff Algorithms for WBAN-Based Emerging Sensor Networks

    Directory of Open Access Journals (Sweden)

    Pervez Khan

    2017-03-01

    Full Text Available The Carrier Sense Multiple Access with Collision Avoidance (CSMA/CA procedure of IEEE 802.15.6 Medium Access Control (MAC protocols for the Wireless Body Area Network (WBAN use an Alternative Binary Exponential Backoff (ABEB procedure. The backoff algorithm plays an important role to avoid collision in wireless networks. The Binary Exponential Backoff (BEB algorithm used in different standards does not obtain the optimum performance due to enormous Contention Window (CW gaps induced from packet collisions. Therefore, The IEEE 802.15.6 CSMA/CA has developed the ABEB procedure to avoid the large CW gaps upon each collision. However, the ABEB algorithm may lead to a high collision rate (as the CW size is incremented on every alternative collision and poor utilization of the channel due to the gap between the subsequent CW. To minimize the gap between subsequent CW sizes, we adopted the Prioritized Fibonacci Backoff (PFB procedure. This procedure leads to a smooth and gradual increase in the CW size, after each collision, which eventually decreases the waiting time, and the contending node can access the channel promptly with little delay; while ABEB leads to irregular and fluctuated CW values, which eventually increase collision and waiting time before a re-transmission attempt. We analytically approach this problem by employing a Markov chain to design the PFB scheme for the CSMA/CA procedure of the IEEE 80.15.6 standard. The performance of the PFB algorithm is compared against the ABEB function of WBAN CSMA/CA. The results show that the PFB procedure adopted for IEEE 802.15.6 CSMA/CA outperforms the ABEB procedure.

  2. Associations of discrimination and violence with smoking among emerging adults: differences by gender and sexual orientation.

    Science.gov (United States)

    Blosnich, John R; Horn, Kimberly

    2011-12-01

    Lesbian, gay, and bisexual (i.e., sexual minority) populations have higher smoking prevalence than their heterosexual peers, but there is a lack of empirical study into why such disparities exist. This secondary analysis of data sought to examine associations of discrimination and violence victimization with cigarette smoking within sexual orientation groups. Data from the Fall 2008 and Spring 2009 National College Health Assessments were truncated to respondents of 18-24 years of age (n = 92,470). Since heterosexuals comprised over 90% of respondents, a random 5% subsample of heterosexuals was drawn, creating a total analytic sample of 11,046. Smoking status (i.e., never-, ever-, and current smoker) was regressed on general (e.g., not sexual orientation-specific) measures of past-year victimization and discrimination. To examine within-group differences, two sets of multivariate ordered logistic regression analyses were conducted: one set of models stratified by sexual orientation and another set stratified by gender-by-sexual-orientation groups. Sexual minorities indicated more experiences of violence victimization and discrimination when compared with their heterosexual counterparts and had nearly twice the current smoking prevalence of heterosexuals. After adjusting for age and race, lesbians/gays who were in physical fights or were physically assaulted had higher proportional odds of being current smokers when compared with their lesbian/gay counterparts who did not experience those stressors. When possible, lesbian/gay and bisexual groups should be analyzed separately, as analyses revealed that bisexuals had a higher risk profile than lesbians/gays. Further research is needed with more nuanced measures of smoking (e.g., intensity), as well as examining if victimization may interact with smoking cessation.

  3. A triangular fuzzy TOPSIS-based approach for the application of water technologies in different emergency water supply scenarios.

    Science.gov (United States)

    Qu, Jianhua; Meng, Xianlin; Yu, Huan; You, Hong

    2016-09-01

    Because of the increasing frequency and intensity of unexpected natural disasters, providing safe drinking water for the affected population following a disaster has become a global challenge of growing concern. An onsite water supply technology that is portable, mobile, or modular is a more suitable and sustainable solution for the victims than transporting bottled water. In recent years, various water techniques, such as membrane-assisted technologies, have been proposed and successfully implemented in many places. Given the diversity of techniques available, the current challenge is how to scientifically identify the optimum options for different disaster scenarios. Hence, a fuzzy triangular-based multi-criteria, group decision-making tool was developed in this research. The approach was then applied to the selection of the most appropriate water technologies corresponding to the different emergency water supply scenarios. The results show this tool capable of facilitating scientific analysis in the evaluation and selection of emergency water technologies for enduring security drinking water supply in disaster relief.

  4. Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study.

    Science.gov (United States)

    Schwalbe, Edward C; Lindsey, Janet C; Nakjang, Sirintra; Crosier, Stephen; Smith, Amanda J; Hicks, Debbie; Rafiee, Gholamreza; Hill, Rebecca M; Iliasova, Alice; Stone, Thomas; Pizer, Barry; Michalski, Antony; Joshi, Abhijit; Wharton, Stephen B; Jacques, Thomas S; Bailey, Simon; Williamson, Daniel; Clifford, Steven C

    2017-07-01

    International consensus recognises four medulloblastoma molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGrp3), and group 4 (MBGrp4), each defined by their characteristic genome-wide transcriptomic and DNA methylomic profiles. These subgroups have distinct clinicopathological and molecular features, and underpin current disease subclassification and initial subgroup-directed therapies that are underway in clinical trials. However, substantial biological heterogeneity and differences in survival are apparent within each subgroup, which remain to be resolved. We aimed to investigate whether additional molecular subgroups exist within childhood medulloblastoma and whether these could be used to improve disease subclassification and prognosis predictions. In this retrospective cohort study, we assessed 428 primary medulloblastoma samples collected from UK Children's Cancer and Leukaemia Group (CCLG) treatment centres (UK), collaborating European institutions, and the UKCCSG-SIOP-PNET3 European clinical trial. An independent validation cohort (n=276) of archival tumour samples was also analysed. We analysed samples from patients with childhood medulloblastoma who were aged 0-16 years at diagnosis, and had central review of pathology and comprehensive clinical data. We did comprehensive molecular profiling, including DNA methylation microarray analysis, and did unsupervised class discovery of test and validation cohorts to identify consensus primary molecular subgroups and characterise their clinical and biological significance. We modelled survival of patients aged 3-16 years in patients (n=215) who had craniospinal irradiation and had been treated with a curative intent. Seven robust and reproducible primary molecular subgroups of childhood medulloblastoma were identified. MBWNT remained unchanged and each remaining consensus subgroup was split in two. MBSHH was split into age-dependent subgroups corresponding to infant (<4·3 years; MBSHH-Infant; n=65) and

  5. Pubertal Development, Emotion Regulatory Styles, and the Emergence of Sex Differences in Internalizing Disorders and Symptoms in Adolescence

    Science.gov (United States)

    Alloy, Lauren B.; Hamilton, Jessica L.; Hamlat, Elissa J.; Abramson, Lyn Y.

    2016-01-01

    Adolescence marks the emergence of sex differences in internalizing symptoms and disorders, with girls at increased risk for depression and anxiety during the pubertal transition. However, the mechanisms through which puberty confers risk for internalizing psychopathology for girls, but not boys, remain unclear. We examined two pubertal indicators (pubertal status and timing) as predictors of the development of emotion regulation styles (rumination and emotional clarity) and depressive and anxiety symptoms and disorders in a three-wave study of 314 adolescents. Path analyses indicated that early pubertal timing, but not pubertal status, predicted increased rumination, but not decreased emotional clarity, in adolescent girls, but not boys. Additionally, rumination mediated the association between early pubertal timing and increased depressive, but not anxiety, symptoms and disorder onset among adolescent girls. These findings suggest that the sex difference in depression may result partly from early maturing girls’ greater tendency to develop ruminative styles than boys. PMID:27747141

  6. Why patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.

    Science.gov (United States)

    Masso, Malcolm; Bezzina, Andrew J; Siminski, Peter; Middleton, Rebekkah; Eagar, Kathy

    2007-08-01

    To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. Survey of staff and primary care patients in five ED in New South Wales, Australia using questionnaire based on reasons identified in published studies. Clinicians in the survey identify a broader spectrum of reasons for potential primary care cases presenting to the ED than the patients themselves report. Doctors reported on average 4.1 very important reasons and nurses 4.8 compared with patients 2.4 very important reasons. The main reasons identified by both doctors and nurses were similar and quite different to those identified by patients. Clinicians were more likely to emphasize cost and access issues rather than acuity and complexity issues. There was no difference within the clinician group between doctors and nurses nor by varying levels of experience. Furthermore doctors with significant experience in both primary care and emergency medicine did not differ from the overall clinicians' pattern. These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.

  7. Challenges in identifying asthma subgroups using unsupervised statistical learning techniques.

    Science.gov (United States)

    Prosperi, Mattia C F; Sahiner, Umit M; Belgrave, Danielle; Sackesen, Cansin; Buchan, Iain E; Simpson, Angela; Yavuz, Tolga S; Kalayci, Omer; Custovic, Adnan

    2013-12-01

    Unsupervised statistical learning techniques, such as exploratory factor analysis (EFA) and hierarchical clustering (HC), have been used to identify asthma phenotypes, with partly consistent results. Some of the inconsistency is caused by the variable selection and demographic and clinical differences among study populations. To investigate the effects of the choice of statistical method and different preparations of data on the clustering results; and to relate these to disease severity. Several variants of EFA and HC were applied and compared using various sets of variables and different encodings and transformations within a dataset of 383 children with asthma. Variables included lung function, inflammatory and allergy markers, family history, environmental exposures, and medications. Clusters and original variables were related to asthma severity (logistic regression and Bayesian network analysis). EFA identified five components (eigenvalues ≥ 1) explaining 35% of the overall variance. Variations of the HC (as linkage-distance functions) did not affect the cluster inference; however, using different variable encodings and transformations did. The derived clusters predicted asthma severity less than the original variables. Prognostic factors of severity were medication usage, current symptoms, lung function, paternal asthma, body mass index, and age of asthma onset. Bayesian networks indicated conditional dependence among variables. The use of different unsupervised statistical learning methods and different variable sets and encodings can lead to multiple and inconsistent subgroupings of asthma, not necessarily correlated with severity. The search for asthma phenotypes needs more careful selection of markers, consistent across different study populations, and more cautious interpretation of results from unsupervised learning.

  8. Diversity among mandarin varieties and natural sub-groups in aroma volatiles compositions.

    Science.gov (United States)

    Goldenberg, Livnat; Yaniv, Yossi; Doron-Faigenboim, Adi; Carmi, Nir; Porat, Ron

    2016-01-15

    Mandarins constitute a large, diverse and important group within the Citrus family. Here, we analysed the aroma volatiles compositions of 13 mandarin varieties belonging to seven genetically different natural sub-groups that included common mandarin (C. reticulata Blanco), clementine (C. clementina Hort. ex. Tan), satsuma (C. unshiu Marcovitch), Mediterranean mandarin (C. deliciosa Tenore), King mandarin (C. nobilis Loureiro), and mandarin hybrids, such as tangor (C. reticulata × C. sinensis) and tangelo (C. reticulata × C. paradisi). We found that mandarin varieties among tangors ('Temple', 'Ortanique'), tangelos ('Orlando', 'Minneola') and King ('King') had more volatiles, at higher levels, and were richer in sesquiterpene and ester volatiles, than other varieties belonging to the sub-groups common mandarin ('Ora', 'Ponkan'), clementine ('Oroval', 'Caffin'), satsuma ('Okitsu', 'Owari') and Mediterranean mandarin ('Avana', 'Yusuf Efendi'). Hierarchical clustering and principal component analysis accurately differentiated between mandarin varieties and natural sub-groups according to their aroma-volatile profiles. Although we found wide differences in aroma-volatiles compositions among varieties belonging to different natural sub-groups, we detected only minor differences among varieties within any natural sub-group. These findings suggest that selecting appropriate parents would enable manipulation of aroma-volatile compositions in future mandarin breeding programmes. © 2015 Society of Chemical Industry.

  9. Board Diversity, the Logic of Difference & the Logic of Equivalence: A Critical Study of the Emergence of Corporate Democracy

    Directory of Open Access Journals (Sweden)

    Ken Mcphail

    2010-06-01

    Full Text Available Within the corporate governance literature the notion of diversity has emerged as an important regulatory mechanism (See for example the Tyson Report 2003. This interest has emerged in part due to various national legislative reforms introducing mandatory quotas for female directors. As the debate surrounding these reforms emerges and begins to take form, it is important that the prevailing paradigm of democracy is not taken for granted but is subject to critical scrutiny. Drawing on Ernesto Laclau’s On Populist Reason in particular, the paper attempts to problematize notions of difference and representational democracy that lie at the heart of the reforms. The aim of the paper is to stimulate further debate on the democratizing potential of the recent political interventions in the composition of the boards of directors. Dentro de la literatura de gobierno corporativo la noción de diversidad ha surgido como un mecanismo de regulación importante (Ver por ejemplo el Informe Tyson 2003. Este interés ha surgido en parte debido a varias reformas legislativas que han introducido cuotas femeninas obligatorias en la dirección. Ya que el debate sobre estas reformas empieza a tomar forma, es importante que el paradigma de democracia prevaleciente no se tome por sentado sino que sea un tema de análisis crítico. Basándonos en el trabajo de Ernesto Laclaus On Populist Reason, este artículo intenta examinar las nociones de diferencia y democracia en la representación que subyacen en el centro de las reformas. El último objetivo de este artículo es estimular el debate sobre el potencial de democratización de las recientes regulaciones políticas sobre la composición de la dirección de los consejos.

  10. Identity Statuses throughout Adolescence and Emerging Adulthood: A Large-Scale Study into Gender, Age, and Contextual Differences

    Directory of Open Access Journals (Sweden)

    Margaux Verschueren

    2017-04-01

    Full Text Available Identity formation constitutes a core developmental task during adolescence and emerging adulthood. However, it remains unclear how identity formation may vary across age, gender, and context (education vs. employment in these developmental periods. The present study used a recently developed model to examine identity statuses or types in a sample of 7,906 Flemish individuals (14–30 years old; 64% female. As expected, achievement, foreclosure, moratorium, carefree diffusion, troubled diffusion, and an undifferentiated status emerged through cluster analysis. Women were overrepresented in the moratorium status (characterized by high exploration, whereas men were mainly situated in foreclosure and carefree diffusion statuses (both characterized by low exploration, but individuals in foreclosure having strong identity commitments as well. Individuals in the carefree and troubled diffusion statuses, which represent the least adaptive statuses, were youngest. High school students were overrepresented in the diffusion statuses and college students were mostly present in achievement (representing the most mature status and moratorium. Finally, employed individuals were overrepresented in foreclosure, whereas unemployed individuals were mainly situated in troubled diffusion. In sum, the present study systematically examined relationships between empirically-identified identity statuses and socio-demographic variables in a large-scale sample, generating important information on age, gender, and contextual differences in identity.

  11. Differences between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea

    Science.gov (United States)

    Lim, Meerae; Lee, Soojung

    2016-01-01

    Objective A considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. Methods This study analyzed suicide attempters who visited the emergency departments of seven selected university hospitals. A total of 269 medical records in which impulsivity of suicide attempt were confirmed were subject to be analyzed. The impulsivity of the suicide attempt was examined using a summative score of items 6 and 15 on the Suicide Intent Scale. Results A total of 48.0% of the participants were impelled by sudden inclinations to attempt suicide. Impulsive attempters were younger, unmarried and less physical illness than non-impulsive attempters, whereas no significant differences were found on psychiatric history and previous suicide history. Impulsive suicide attempters had suicide ideations that were not as severe (χ2=55.33, psuicide attempts were better than non-impulsive suicide attempts (t=-3.77, psuicide attempts were the result of sudden inclinations. Impulsive attempts were made in relatively earlier stages of suicide ideation; consequently, they have less intent than non-impulsive attempts. PMID:27482239

  12. Breast Cancer Prevalence and Mortality among Hispanic Subgroups in the United States, 2009–2013

    Directory of Open Access Journals (Sweden)

    Bijou R. Hunt

    2016-01-01

    Full Text Available Background. This paper presents data on breast cancer prevalence and mortality among US Hispanics and Hispanic subgroups, including Cuban, Mexican, Puerto Rican, Central American, and South American. Methods. Five-year average annual female breast cancer prevalence and mortality rates for 2009–2013 were examined using data from the National Health Interview Survey (prevalence and the National Center for Health Statistics and the American Community Survey (mortality rates. Results. Overall breast cancer prevalence among US Hispanic women was 1.03%. Although the estimates varied slightly by Hispanic subgroup, these differences were not statistically significant. The breast cancer mortality rate for Hispanics overall was 17.71 per 100,000 women. Higher rates were observed among Cubans (17.89, Mexicans (18.78, and Puerto Ricans (19.04, and a lower rate was observed among Central and South Americans (10.15. With the exception of the rate for Cubans, all Hispanic subgroup rates were statistically significantly different from the overall Hispanic rate. Additionally, all Hispanic subgroups rates were statistically significantly higher than the Central and South American rate. Conclusion. The data reveal significant differences in mortality across Hispanic subgroups. These data enable public health officials to develop targeted interventions to help lower breast cancer mortality among the highest risk populations.

  13. Personalized dementia care: proven effectiveness of psychosocial interventions in subgroups

    NARCIS (Netherlands)

    van Mierlo, L.D.; van der Roest, H.G.; Meiland, F.J.M.; Dröes, R.M.

    2010-01-01

    Many psychosocial intervention studies report effects in subgroups of people with dementia. Insight into the characteristics of these subgroups is important for care practice. This study reviews personal characteristics of people with dementia (living in the community or in an institution) that are

  14. Subgroup Achievement and Gap Trends: District of Columbia

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    The District's demographics are such that achievement trends could only be determined for African American, male and female, and low income subgroups. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), Washington, DC students showed gains in both reading and math at the basic, proficient, and advanced levels…

  15. A Systematic Approach to Subgroup Classification in Intellectual Disability

    Science.gov (United States)

    Schalock, Robert L.; Luckasson, Ruth

    2015-01-01

    This article describes a systematic approach to subgroup classification based on a classification framework and sequential steps involved in the subgrouping process. The sequential steps are stating the purpose of the classification, identifying the classification elements, using relevant information, and using clearly stated and purposeful…

  16. Characteristic properties of large subgroups in primary abelian groups

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Invariant properties of large subgroups. We start with some extensions of totally projective p-groups, namely: 1. p-torsion A-groups. Several details on A-groups appear in [7]. For example, any p- torsion abelian A-group is an isotype subgroup of a totally projective p-group with special properties described in [7]. Theorem 1.

  17. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey

    Directory of Open Access Journals (Sweden)

    Karayannis Nicholas V

    2012-02-01

    Full Text Available Abstract Background Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". Methods A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT, Treatment Based Classification (TBC, Pathoanatomic Based Classification (PBC, Movement System Impairment Classification (MSI, and O'Sullivan Classification System (OCS schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Results Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i loading strategies (MDT, TBC, PBC aimed at eliciting a phenomenon

  18. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey

    Science.gov (United States)

    2012-01-01

    Background Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP) patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". Methods A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT), Treatment Based Classification (TBC), Pathoanatomic Based Classification (PBC), Movement System Impairment Classification (MSI), and O'Sullivan Classification System (OCS) schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Results Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i) loading strategies (MDT, TBC, PBC) aimed at eliciting a phenomenon of centralisation of

  19. Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey.

    Science.gov (United States)

    Karayannis, Nicholas V; Jull, Gwendolen A; Hodges, Paul W

    2012-02-20

    Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP) patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT), Treatment Based Classification (TBC), Pathoanatomic Based Classification (PBC), Movement System Impairment Classification (MSI), and O'Sullivan Classification System (OCS) schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i) loading strategies (MDT, TBC, PBC) aimed at eliciting a phenomenon of centralisation of symptoms; and (ii) modified

  20. Visual field differences in visual word recognition can emerge purely from perceptual learning: evidence from modeling Chinese character pronunciation.

    Science.gov (United States)

    Hsiao, Janet Hui-Wen

    2011-11-01

    In Chinese orthography, a dominant character structure exists in which a semantic radical appears on the left and a phonetic radical on the right (SP characters); a minority opposite arrangement also exists (PS characters). As the number of phonetic radical types is much greater than semantic radical types, in SP characters the information is skewed to the right, whereas in PS characters it is skewed to the left. Through training a computational model for SP and PS character recognition that takes into account of the locations in which the characters appear in the visual field during learning, but does not assume any fundamental hemispheric processing difference, we show that visual field differences can emerge as a consequence of the fundamental structural differences in information between SP and PS characters, as opposed to the fundamental processing differences between the two hemispheres. This modeling result is also consistent with behavioral naming performance. This work provides strong evidence that perceptual learning, i.e., the information structure of word stimuli to which the readers have long been exposed, is one of the factors that accounts for hemispheric asymmetry effects in visual word recognition. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. High School Graduation Rates across English Learner Student Subgroups in Arizona. REL 2017-205

    Science.gov (United States)

    Huang, Min; Haas, Eric; Zhu, Niufeng; Tran, Loan

    2016-01-01

    Recent studies have documented differences in academic achievement between current and former English learner students. These differences validate calls for more focused analyses of achievement across English learner student subgroups. Specifically, there is interest in examining variation in academic success based on the amount of time a student…

  2. Multiplicity-adjusted semiparametric benefiting subgroup identification in clinical trials.

    Science.gov (United States)

    Schnell, Patrick M; Müller, Peter; Tang, Qi; Carlin, Bradley P

    2018-02-01

    Background A recent focus in the health sciences has been the development of personalized medicine, which includes determining the population for which a given treatment is effective. Due to limited data, identifying the true benefiting population is a challenging task. To tackle this difficulty, the credible subgroups approach provides a pair of bounding subgroups for the true benefiting subgroup, constructed so that one is contained by the benefiting subgroup while the other contains the benefiting subgroup with high probability. However, the method has so far only been developed for parametric linear models. Methods In this article, we develop the details required to follow the credible subgroups approach in more realistic settings by considering nonlinear and semiparametric regression models, supported for regulatory science by conditional power simulations. We also present an improved multiple testing approach using a step-down procedure. We evaluate our approach via simulations and apply it to data from four trials of Alzheimer's disease treatments carried out by AbbVie. Results Semiparametric modeling yields credible subgroups that are more robust to violations of linear treatment effect assumptions, and careful choice of the population of interest as well as the step-down multiple testing procedure result in a higher rate of detection of benefiting types of patients. The approach allows us to identify types of patients that benefit from treatment in the Alzheimer's disease trials. Conclusion Attempts to identify benefiting subgroups of patients in clinical trials are often met with skepticism due to a lack of multiplicity control and unrealistically restrictive assumptions. Our proposed approach merges two techniques, credible subgroups, and semiparametric regression, which avoids these problems and makes benefiting subgroup identification practical and reliable.

  3. Integrating business continuity, emergency preparedness and emergency response: How these seemingly different disciplines can come together to make a comprehensive integrated programme.

    Science.gov (United States)

    Halsne, Julia

    2015-01-01

    The East Bay Municipal Utility District provides potable water to approximately 1.3 million customers and treats wastewater for approximately 680,000 customers on the eastern side of San Francisco Bay in Northern California. Corporate policy requires the District to create and maintain an active emergency preparedness programme to manage its critical functions during an emergency and protect people, property and the environment. The policy also requires the District to create and maintain a business continuity programme to minimise disruptions of critical business functions and enhance its capability to recover operations. For these programmes to work effectively they must be coordinated. As the programmes at the District have evolved, the natural interrelationship, overlaps and integration have become inherent in their success. To ensure integration and coordination of these programmes, the District has developed management systems to effectively drive towards a seamless overarching programme.

  4. Fixed and Adaptive Parallel Subgroup-Specific Design for Survival Outcomes: Power and Sample Size

    Directory of Open Access Journals (Sweden)

    Miranta Antoniou

    2017-12-01

    Full Text Available Biomarker-guided clinical trial designs, which focus on testing the effectiveness of a biomarker-guided approach to treatment in improving patient health, have drawn considerable attention in the era of stratified medicine with many different designs being proposed in the literature. However, planning such trials to ensure they have sufficient power to test the relevant hypotheses can be challenging and the literature often lacks guidance in this regard. In this study, we focus on the parallel subgroup-specific design, which allows the evaluation of separate treatment effects in the biomarker-positive subgroup and biomarker-negative subgroup simultaneously. We also explore an adaptive version of the design, where an interim analysis is undertaken based on a fixed percentage of target events, with the option to stop each biomarker-defined subgroup early for futility or efficacy. We calculate the number of events and patients required to ensure sufficient power in each of the biomarker-defined subgroups under different scenarios when the primary outcome is time-to-event. For the adaptive version, stopping probabilities are also explored. Since multiple hypotheses are being tested simultaneously, and multiple interim analyses are undertaken, we also focus on controlling the overall type I error rate by way of multiplicity adjustment.

  5. The interest of gait markers in the identification of subgroups among fibromyalgia patients.

    Science.gov (United States)

    Auvinet, Bernard; Chaleil, Denis; Cabane, Jean; Dumolard, Anne; Hatron, Pierre; Juvin, Robert; Lanteri-Minet, Michel; Mainguy, Yves; Negre-Pages, Laurence; Pillard, Fabien; Riviere, Daniel; Maugars, Yves-Michel

    2011-11-11

    Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia. A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was distinguished by high FIQ

  6. The interest of gait markers in the identification of subgroups among fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Auvinet Bernard

    2011-11-01

    Full Text Available Abstract Background Fibromyalgia (FM is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF, stride regularity (SR, and cranio-caudal power (CCP which measures kinesia. Methods A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y, and matched controls (44.1 ± 7.3 y. Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. Results SF was the most discriminating gait variable (73% of patients and controls. SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06. SR was correlated to FIQ (p = 0.01 and catastrophizing (p = 0.05 while CCP was correlated to pain (p = 0.01. The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a

  7. Are there distinct cognitive and motivational sub-groups of children with ADHD?

    DEFF Research Database (Denmark)

    Lambek, Rikke; Sonuga-Barke, Edmund; Tannock, Rosemary

    2017-01-01

    relevant correlates. One-hundred medication-naïve children with ADHD and 96 typically developing children (6–14 years) completed nine EF and three DA tasks as well as an odor identification test. Parents and teachers provided reports of the children's behavior (ADHD and EF). Models of the latent structure...... of scores on EF and DA tests were contrasted using confirmatory factor analysis (CFA). LPA was carried out based on factor scores from the CFA and sub-groups were compared in terms of odor identification and behavior. A model with one DA and two EF factors best fit the data. LPA resulted in four sub......-groups that differed in terms of general level of neuropsychological performance (ranging from high to very low), odor identification, and behavior. The sub-groups did not differ in terms of the relative EF and DA performance. Results in the ADHD group were replicated in the control group. While EF and DA appear...

  8. Eating disorder behavior and early maladaptive schemas in subgroups of eating disorders.

    Science.gov (United States)

    Unoka, Zsolt; Tölgyes, Tamás; Czobor, Pál; Simon, Lajos

    2010-06-01

    To examine relationship between Eating Disorder Behaviors (EDB) and Early Maladaptive Schemas (EMS) across eating disorder (ED) subgroups. EMS and ED behaviors were measured by Young Schema Questionnaire and Eating Behavior Severity Scale, respectively, among patients diagnosed with Restrictive or Binge/purging Anorexia, or bulimia nervosa. Canonical component analysis showed significant association between ED behaviors and EMSs. Canonical factor-pairs (EDB and EMS) revealed specific associations between certain patterns of EDBs, including binge-purging and physical exercise, and certain patterns of maladaptive cognitive schema, including Emotional deprivation, Abandonment, Enmeshments, Subjugation, and Emotional inhibition. ED subgroups significantly differred between the EMS and EDB canonical factors, respectively. Our findings indicate that EMS and EDB are associated, and that the factors that potentially mediate the association differ significantly among ED subgroups. These results are consistent with the notion that EMSs play a specific role in the development and maintenance of ED behaviors.

  9. Are They Thinking Differently: A Cross-Cultural Study on the Relationship of Thinking Styles and Emerging Roles in Computer-Supported Collaborative Learning

    National Research Council Canada - National Science Library

    Xiaoqing Gu; Huawen Wang; Jon Mason

    2017-01-01

    ...: In this study, a correlation analysis was used to explore the relationship between cultural factors and emerging roles among collaborating students from two universities in different countries (China and USA...

  10. A comparison of five recursive partitioning methods to find person subgroups involved in meaningful treatment-subgroup interactions

    NARCIS (Netherlands)

    Doove, L. L.; Dusseldorp, E.; Van Deun, K.; Van Mechelen, I.

    2014-01-01

    In case multiple treatment alternatives are available for some medical problem, the detection of treatment–subgroup interactions (i.e., relative treatment effectiveness varying over subgroups of persons) is of key importance for personalized medicine and the development of optimal treatment

  11. Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey

    Directory of Open Access Journals (Sweden)

    M. Saruc

    2003-06-01

    Full Text Available The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL, 321 (35.6%, motility disorder-like (ML, 281 (31.2%, and the combination (C of these symptoms, 298 (33.1%. All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-alpha (TNF-alpha and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-alpha and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.

  12. Emergent geometry, emergent forces

    Science.gov (United States)

    Selesnick, S. A.

    2017-10-01

    We give a brief account of some aspects of Finkelstein’s quantum relativity, namely an extension of it that derives elements of macroscopic geometry and the Lagrangians of the standard model including gravity from a presumed quantum version of spacetime. These emerge as collective effects in this quantal substrate. Our treatment, which is largely self-contained, differs mathematically from that originally given by Finkelstein. Dedicated to the memory of David Ritz Finkelstein

  13. Differences between orthopaedic evaluation and radiological reports of conventional radiographs in patients with minor trauma admitted to the emergency department.

    Science.gov (United States)

    Catapano, Michele; Albano, Domenico; Pozzi, Grazia; Accetta, Riccardo; Memoria, Sergio; Pregliasco, Fabrizio; Messina, Carmelo; Sconfienza, Luca Maria

    2017-11-01

    During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of delayed diagnosis in terms of patient management and therapeutic strategy. We retrospectively reviewed all cases of discrepancy between orthopaedists and radiologists, which were categorized according to anatomical location of injury, initial diagnosis and treatment, change in diagnosis and treatment. We used the Chi square test to compare the frequencies of discrepancies between patients ≤14 and >14years of age. From January to December 2016, 19,512 patients admitted to our emergency department performed at least an imaging examination; among these patients, 13,561 underwent XR in absence of an attending radiologist. A discrepant diagnosis was found in 337/13,561 (2.5%; 184 males; mean age: 36.7±23.7, range 2-95); 151/337 (45%) discrepancies were encountered in the lower limbs, with ankle being the most common site of misdiagnosis (64/151), and 103/337 (30%) in the upper limbs, with the elbow being the most frequent site in this district (35/103). We found 293/337 false negatives (87%) and 44/337 false positives (13%), with 134 and 13 patients needing treatment change, respectively. We found 85/337 discrepancies (25%) in patients ≤14 years of age, and 252/337 (75%) in those >14years. The distribution of discrepancies per anatomic district was significantly different (P<0.001) in these two groups of patients. A low rate of discrepancy between orthopaedists and radiologists in evaluating images of patients admitted to our emergency department was found, although treatment change occurred in about

  14. Sex-related Differences in Emergency Department Renal Colic Management: Females Have Fewer Computed Tomography Scans but Similar Outcomes.

    Science.gov (United States)

    Innes, Grant D; Scheuermeyer, Frank X; Law, Michael R; McRae, Andrew D; Weber, Bryce A; Boyda, Heidi N; Lonergan, Kevin; Andruchow, James E

    2016-10-01

    Sex-related differences occur in many areas of medicine. Emergency department (ED) studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex-based differences in the care and outcomes for ED patients with acute renal colic. This was a multicenter population-based retrospective observational cohort study using administrative data and supplemented by structured chart review. All patients seen in Calgary Health Region EDs between January 1 and December 31, 2014, with an ED diagnosis of renal colic based on the following ICD-10 codes were eligible for inclusion: calculus of kidney (N200), calculus of ureter (N201), calculus of kidney with calculus of ureter (N202), hydronephrosis with renal and ureteral calculous obstruction (N132), unspecified renal colic (N23), and unspecified urinary calculus (N209). ED visit data and test results were accessed in the regional ED clinical database. Stone characteristics were captured from diagnostic imaging reports. Regional hospital databases were used to identify subsequent ED encounters, hospital admissions, and surgical procedures within 60 days. Outcomes were stratified by sex. The primary outcome, intended as a marker of overall effectiveness of ED care, was the unscheduled 7-day ED revisit rate among patients who were discharged home after their index ED visit. Secondary outcomes included ED pain management as reflected by administration of narcotics or intravenous nonsteroidals, the performance of advanced imaging-either ultrasound (US) or computed tomography (CT), and the proportion of patients who required hospitalization or surgical intervention within 60 days. From January 1 to December 31, 2014, a total of 3,104 eligible patients were studied: 1,111 women (35.8%) and 1,993 men (64.2%). Baseline characteristics, access times, analgesic use, and admission rates were similar in both groups. Men were more likely to have CT (68.9% vs. 58

  15. Characterizing novice-expert differences in macrocognition: an exploratory study of cognitive work in the emergency department.

    Science.gov (United States)

    Schubert, Christiane C; Denmark, T Kent; Crandall, Beth; Grome, Anna; Pappas, James

    2013-01-01

    The objectives of this study are to elicit and document descriptions of emergency physician expertise, to characterize cognitive differences between novice and expert physicians, and to identify areas in which novices' skill and knowledge gaps are most pronounced. The nature of the differences between novices and experts needs to be explored to develop effective instructional modalities that accelerate the learning curve of inexperienced physicians who work in high-complexity environments. We interviewed novice emergency physicians (first-year residents) and attending physicians with significant expertise, working in an academic Level I trauma center in Southern California. With cognitive task analysis, we used task diagrams to capture nonroutine critical incidents that required the use of complex cognitive skills. Timelines were constructed to develop a detailed understanding of challenging incidents and the decisions involved as the incident unfolded, followed by progressive deepening to tease out situation-specific cues, knowledge, and information that experts and novices used. A thematic analysis of the interview transcripts was conducted to identify key categories. Using classification techniques for data reduction, we identified a smaller set of key themes, which composed the core findings of the study. Five interns and 6 attending physicians participated in the interviews. Novice physicians reported having difficulties representing the patient's story to attending physicians and other health care providers. Overrelying on objective data, novice physicians use linear thinking to move to diagnosis quickly and are likely to discount and explain away data that do not "fit" the frame. Experienced physicians draw on expertise to recognize cues and patterns while leaving room for altering or even changing their initial diagnosis. Whereas experts maintain high levels of spatial, temporal, and organizational systems awareness when overseeing treatment modalities of

  16. Subgroup biases in partially-distributed collaboration

    NARCIS (Netherlands)

    Bos, N; Olson, J.S.; Nan, N.; Cheshin, A.

    2009-01-01

    Modern organizations often bring together groups in which some people are collocated and some remote. These groups often take the form of loosely-organized networks rather than hierarchies. Partially distributed groups may have characteristics that are different from fully collocated or fully

  17. Seven and up: individual differences in male voice fundamental frequency emerge before puberty and remain stable throughout adulthood.

    Science.gov (United States)

    Fouquet, Meddy; Pisanski, Katarzyna; Mathevon, Nicolas; Reby, David

    2016-10-01

    Voice pitch (the perceptual correlate of fundamental frequency, F0) varies considerably even among individuals of the same sex and age, communicating a host of socially and evolutionarily relevant information. However, due to the almost exclusive utilization of cross-sectional designs in previous studies, it remains unknown whether these individual differences in voice pitch emerge before, during or after sexual maturation, and whether voice pitch remains stable into adulthood. Here, we measured the F0 parameters of men who were recorded once every 7 years from age 7 to 56 as they participated in the British television documentary Up Series. Linear mixed models revealed significant effects of age on all F0 parameters, wherein F0 mean, minimum, maximum and the standard deviation of F0 showed sharp pubertal decreases between age 7 and 21, yet remained remarkably stable after age 28. Critically, men's pre-pubertal F0 at age 7 strongly predicted their F0 at every subsequent adult age, explaining up to 64% of the variance in post-pubertal F0. This finding suggests that between-individual differences in voice pitch that are known to play an important role in men's reproductive success are in fact largely determined by age 7, and may therefore be linked to prenatal and/or pre-pubertal androgen exposure.

  18. Efficacy of Nintedanib in Idiopathic Pulmonary Fibrosis across Prespecified Subgroups in INPULSIS.

    Science.gov (United States)

    Costabel, Ulrich; Inoue, Yoshikazu; Richeldi, Luca; Collard, Harold R; Tschoepe, Inga; Stowasser, Susanne; Azuma, Arata

    2016-01-15

    In the two replicate, placebo-controlled, 52-week, phase III INPULSIS trials, nintedanib 150 mg twice daily significantly reduced the annual rate of decline in FVC, the primary endpoint, in subjects with idiopathic pulmonary fibrosis (IPF). It is unknown if this effect was uniform across all subjects treated with nintedanib. To investigate the potential association of demographic and clinical variables with the effect of nintedanib in subjects with IPF. Subgroup analyses of pooled data from the INPULSIS trials were prespecified. Subgroups were analyzed by sex, age (70%), baseline St. George's Respiratory Questionnaire (SGRQ) total score (≤40, >40), smoking status (never, ex/current), systemic corticosteroid use (yes/no), and bronchodilator use (yes/no). A total of 1,061 subjects were treated (nintedanib n = 638, placebo n = 423). There was no statistically significant difference in the effect of nintedanib for the primary endpoint or the key secondary endpoints of change from baseline in SGRQ total score or time to first acute exacerbation in any subgroup. Treatment effects for the key secondary endpoints seemed more pronounced in subjects with baseline FVC ≤70% predicted, because the majority of acute exacerbations and a greater deterioration in SGRQ total score occurred in placebo-treated subjects in this subgroup. Pooled data from the INPULSIS trials support a consistent effect of nintedanib across a range of IPF phenotypes by slowing disease progression across a number of prespecified subgroups.

  19. Somatosensory nociceptive characteristics differentiate subgroups in people with chronic low back pain: a cluster analysis.

    Science.gov (United States)

    Rabey, Martin; Slater, Helen; OʼSullivan, Peter; Beales, Darren; Smith, Anne

    2015-10-01

    The objectives of this study were to explore the existence of subgroups in a cohort with chronic low back pain (n = 294) based on the results of multimodal sensory testing and profile subgroups on demographic, psychological, lifestyle, and general health factors. Bedside (2-point discrimination, brush, vibration and pinprick perception, temporal summation on repeated monofilament stimulation) and laboratory (mechanical detection threshold, pressure, heat and cold pain thresholds, conditioned pain modulation) sensory testing were examined at wrist and lumbar sites. Data were entered into principal component analysis, and 5 component scores were entered into latent class analysis. Three clusters, with different sensory characteristics, were derived. Cluster 1 (31.9%) was characterised by average to high temperature and pressure pain sensitivity. Cluster 2 (52.0%) was characterised by average to high pressure pain sensitivity. Cluster 3 (16.0%) was characterised by low temperature and pressure pain sensitivity. Temporal summation occurred significantly more frequently in cluster 1. Subgroups were profiled on pain intensity, disability, depression, anxiety, stress, life events, fear avoidance, catastrophizing, perception of the low back region, comorbidities, body mass index, multiple pain sites, sleep, and activity levels. Clusters 1 and 2 had a significantly greater proportion of female participants and higher depression and sleep disturbance scores than cluster 3. The proportion of participants undertaking Low back pain, therefore, does not appear to be homogeneous. Pain mechanisms relating to presentations of each subgroup were postulated. Future research may investigate prognoses and interventions tailored towards these subgroups.

  20. Emerging and recurrent issues in drug development.

    Science.gov (United States)

    Anello, C

    This paper reviews several emerging and recurrent issues relating to the drug development process. These emerging issues include changes to the FDA regulatory environment, internationalization of drug development, advances in computer technology and visualization tools, and efforts to incorporate meta-analysis methodology. Recurrent issues include: renewed interest in statistical methods for handling subgroups in the design and analysis of clinical trials; renewed interest in alternatives to the 'intention-to-treat' analysis in the presence of non-compliance in randomized clinical trials; renewed interest in methodology to address the multiplicities resulting from a variety of sources inherent in the drug development process, and renewed interest in methods to assure data integrity. These emerging and recurrent issues provide a continuing challenge to the international community of statisticians involved in drug development. Moreover, the involvement of statisticians with different perspectives continues to enrich the field and contributes to improvement in the public health.

  1. Identity practices, ingroup projection, and the evaluation of subgroups: a study among Turkish-Dutch Sunnis.

    Science.gov (United States)

    Lie, Jessamina Lih Yan; Verkuyten, Maykel

    2012-01-01

    This research focuses on religious subgroup evaluations by examining the attitude of Turkish-Dutch Sunni Muslims towards Alevi and Shiite Muslims. Following the Ingroup Projection Model, it was expected that Sunni participants who practice Islam will project their self-defining subgroup practices on the superordinate Muslim category, which will be related to more ingroup bias towards Alevis, a Muslim subgroup that performs different religious practices. Two studies yielded consistent evidence that practicing Islam increased ingroup bias towards Alevis. Furthermore, in Study 2, we found evidence that the effect of practicing Islam on ingroup bias was mediated by relative ingroup prototypicality (RIP). Moreover, practicing Islam did not affect RIP in relation to Shiites who perform the same religious practices that we examined. These findings support the Ingroup Projection Model.

  2. Clinical differences among the elderly admitted to the emergency department for accidental or unexplained falls and syncope

    Directory of Open Access Journals (Sweden)

    Pasqualetti G

    2017-04-01

    Full Text Available Giuseppe Pasqualetti,1 Valeria Calsolaro,1 Giacomo Bini,1 Umberto Dell’Agnello,1 Marco Tuccori,2 Alessandra Marino,2 Alice Capogrosso-Sansone,2 Martina Rafanelli,3 Massimo Santini,4 Eugenio Orsitto,4 Andrea Ungar,3 Corrado Blandizzi,2 Fabio Monzani1 On behalf of the ANCESTRAL-ED study group 1Geriatrics Unit, 2Pharmacology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 3Syncope Unit, Geriatric and Intensive Care Medicine, AOU Careggi and University of Florence, Florence, 4Emergency Department, University Hospital of Pisa, Pisa, Italy Abstract: It is difficult to distinguish unexplained falls (UFs from accidental falls (AFs or syncope in older people. This study was designed to compare patients referred to the emergency department (ED for AFs, UFs or syncope. Data from a longitudinal study on adverse drug events diagnosed at the ED (ANCESTRAL-ED in older people were analyzed in order to select cases of AF, syncope, or UF. A total of 724 patients (median age: 81.0 [65–105] years, 66.3% female were consecutively admitted to the ED (403 AF, 210 syncope, and 111 UF. The number of psychotropic drugs was the only significant difference in patients with AF versus those with UF (odds ratio [OR] 1.44; 95% confidence interval 1.17–1.77. When comparing AF with syncope, female gender, musculoskeletal diseases, dementia, and systolic blood pressure >110 mmHg emerged as significantly associated with AF (OR 0.40 [0.27–0.58], 0.40 [0.24–0.68], 0.35 [0.14–0.82], and 0.31 [0.20–0.49], respectively, while valvulopathy and the number of antihypertensive drugs were significantly related to syncope (OR 2.51 [1.07–5.90] and 1.24 [1.07–1.44], respectively. Upon comparison of UF and syncope, the number of central nervous system drugs, female gender, musculoskeletal diseases, and SBP >110 mmHg were associated with UF (OR 0.65 [0.50–0.84], 0.52 [0.30–0.89], 0.40 [0.20–0.77], and 0.26 [0.13–0.55], respectively

  3. Demonstration of Microbial Subgroups among Normal Vaginal Microbiota Data

    OpenAIRE

    Lee, M.-L. T.

    2011-01-01

    In this study we identified subgroups of observations relating to the healthy vaginal microbiota. This microbiota resides in a dynamic environment that undergoes cyclic change during the menstrual cycle. Cluster analysis procedures were applied to divide a set of 226 normal microbiota observations into groups. Three subgroups containing 100, 65, and 61 observations were identified. Plots of principal components determined by canonical analysis were obtained to demonstrate graphically the clus...

  4. Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits

    Directory of Open Access Journals (Sweden)

    S. Mehta

    2016-01-01

    Full Text Available Objective. The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability. Methods. Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership. Results. In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p<0.05. Significant difference in disability was seen between the subgroups. Conclusions. The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

  5. On T-Characterized Subgroups of Compact Abelian Groups

    Directory of Open Access Journals (Sweden)

    Saak Gabriyelyan

    2015-06-01

    Full Text Available A sequence \\(\\{ u_n \\}_{n\\in \\omega}\\ in abstract additively-written Abelian group \\(G\\ is called a \\(T\\-sequence if there is a Hausdorff group topology on \\(G\\ relative to which \\(\\lim_n u_n =0\\. We say that a subgroup \\(H\\ of an infinite compact Abelian group \\(X\\ is \\(T\\-characterized if there is a \\(T\\-sequence \\(\\mathbf{u} =\\{ u_n \\}\\ in the dual group of \\(X\\, such that \\(H=\\{ x\\in X: \\; (u_n, x\\to 1 \\}\\. We show that a closed subgroup \\(H\\ of \\(X\\ is \\(T\\-characterized if and only if \\(H\\ is a \\(G_\\delta\\-subgroup of \\(X\\ and the annihilator of \\(H\\ admits a Hausdorff minimally almost periodic group topology. All closed subgroups of an infinite compact Abelian group \\(X\\ are \\(T\\-characterized if and only if \\(X\\ is metrizable and connected. We prove that every compact Abelian group \\(X\\ of infinite exponent has a \\(T\\-characterized subgroup, which is not an \\(F_{\\sigma}\\-subgroup of \\(X\\, that gives a negative answer to Problem 3.3 in Dikranjan and Gabriyelyan (Topol. Appl. 2013, 160, 2427–2442.

  6. A Bayesian subgroup analysis using collections of ANOVA models.

    Science.gov (United States)

    Liu, Jinzhong; Sivaganesan, Siva; Laud, Purushottam W; Müller, Peter

    2017-07-01

    We develop a Bayesian approach to subgroup analysis using ANOVA models with multiple covariates, extending an earlier work. We assume a two-arm clinical trial with normally distributed response variable. We also assume that the covariates for subgroup finding are categorical and are a priori specified, and parsimonious easy-to-interpret subgroups are preferable. We represent the subgroups of interest by a collection of models and use a model selection approach to finding subgroups with heterogeneous effects. We develop suitable priors for the model space and use an objective Bayesian approach that yields multiplicity adjusted posterior probabilities for the models. We use a structured algorithm based on the posterior probabilities of the models to determine which subgroup effects to report. Frequentist operating characteristics of the approach are evaluated using simulation. While our approach is applicable in more general cases, we mainly focus on the 2 × 2 case of two covariates each at two levels for ease of presentation. The approach is illustrated using a real data example. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Perceived Differences in the Management of Mental Health Patients in Remote and Rural Australia and Strategies for Improvement: Findings from a National Qualitative Study of Emergency Clinicians

    OpenAIRE

    Jelinek, G. A.; Weiland, T. J.; Mackinlay, C.; Hill, N.; Gerdtz, M. F.

    2011-01-01

    Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved. Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian emergency departments (EDs), stratified to represent states and territories and rural or metropolitan location. Content analysis of responses deve...

  8. The emergence of sex differences in risk for disordered eating attitudes during puberty: a role for prenatal testosterone exposure.

    Science.gov (United States)

    Culbert, Kristen M; Breedlove, S Marc; Sisk, Cheryl L; Burt, S Alexandra; Klump, Kelly L

    2013-05-01

    Research suggests that prenatal testosterone exposure may masculinize (i.e., lower) disordered eating (DE) attitudes and behaviors and influence the lower prevalence of eating disorders in males versus females. How or when these effects become prominent remains unknown, although puberty may be a critical developmental period. In animals, the masculinizing effects of early testosterone exposure become expressed during puberty when gonadal hormones activate sex-typical behaviors, including eating behaviors. This study examined whether the masculinizing effects of prenatal testosterone exposure on DE attitudes emerge during puberty in 394 twins from opposite-sex and same-sex pairs. Twin type (opposite sex vs. same sex) was used as a proxy for level of prenatal testosterone exposure because females from opposite-sex twin pairs are thought to be exposed to testosterone in utero from their male co-twin. Consistent with animal data, there were no differences in levels of DE attitudes between opposite-sex and same-sex twins during pre-early puberty. However, during mid-late puberty, females from opposite-sex twin pairs (i.e., females with a male co-twin) exhibited more masculinized (i.e., lower) DE attitudes than females from same-sex twin pairs (i.e., females with a female co-twin), independent of several "third variables" (e.g., body mass index [BMI], anxiety). Findings suggest that prenatal testosterone exposure may decrease DE attitudes and at least partially underlie sex differences in risk for DE attitudes after mid-puberty. © 2013 American Psychological Association

  9. Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury.

    Science.gov (United States)

    Wright, David W; Espinoza, Tamara R; Merck, Lisa H; Ratcliff, Jonathan J; Backster, Anika; Stein, Donald G

    2014-12-01

    Traumatic brain injury (TBI) is a major cause of death and disability worldwide. There is strong evidence that gender and sex play an important role across the spectrum of TBI, from pathophysiology to clinical care. In May 2014, Academic Emergency Medicine held a consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A TBI working group was formed to explore what was known about the influence of sex and gender on TBI and to identify gaps for future research. The findings resulted in four major recommendations to guide the TBI research agenda. © 2014 by the Society for Academic Emergency Medicine.

  10. Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits.

    Science.gov (United States)

    Mehta, S; Rice, D; McIntyre, A; Getty, H; Speechley, M; Sequeira, K; Shapiro, A P; Morley-Forster, P; Teasell, R W

    2016-01-01

    Objective. The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability. Methods. Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership. Results. In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p disability was seen between the subgroups. Conclusions. The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

  11. Personality style and impulsivity as determinants of suicidal subgroups.

    Science.gov (United States)

    Fazaa, Norman; Page, Stewart

    2009-01-01

    Studies on suicide have often been inadequate in the sense of failing to understand or conceptualize the dynamics of suicidal behavior from a comprehensive theoretical basis. The aim of the present study was therefore to examine Blatt's theory of Dependent and Self-critical personality dimensions (Blatt, 1974, Blatt & Shichman, 1983) in the context of actual suicidal behavior, and also to utilize these dimensions to facilitate our understanding of suicidal action. Ninety-six undergraduate students who had attempted suicide in the past were administered a series of measures related to suicidal behavior, involving impulsivity, intent, and lethality. Participants were also identified as Dependent or Self-critical in their basic personality orientation. Dependents and Self-critics engaged in contrasting suicidal behaviors along several parameters, with Self-critical individuals generally posing greater risk. These differences were congruent with Blatt's theoretical framework. Implications for suicide risk assessment, management, and treatment are discussed, with special reference to the importance of identifying distinctive suicidal subgroups identified by Dependent and Self-critical personality dimensions.

  12. Effect of Nintedanib in Subgroups of Idiopathic Pulmonary Fibrosis by Diagnostic Criteria.

    Science.gov (United States)

    Raghu, Ganesh; Wells, Athol U; Nicholson, Andrew G; Richeldi, Luca; Flaherty, Kevin R; Le Maulf, Florence; Stowasser, Susanne; Schlenker-Herceg, Rozsa; Hansell, David M

    2017-01-01

    In the absence of a surgical lung biopsy, patients diagnosed with idiopathic pulmonary fibrosis (IPF) in clinical practice could participate in the INPULSIS trials of nintedanib if they had honeycombing and/or traction bronchiectasis plus reticulation, without atypical features of usual interstitial pneumonia (UIP), on high-resolution computed tomography (HRCT). Thus, the patients in these trials represented patients with definite UIP and a large subgroup of patients with possible UIP. To investigate the potential impact of diagnostic subgroups on the progression of IPF and the effect of nintedanib. We conducted a post hoc subgroup analysis of patients with honeycombing on HRCT and/or confirmation of UIP by biopsy versus patients without either, using pooled data from the INPULSIS trials. Seven hundred twenty-three (68.1%) patients had honeycombing and/or biopsy, and 338 (31.9%) patients had no honeycombing or biopsy. In these subgroups, respectively, the adjusted annual rate of decline in FVC in patients treated with placebo was -225.7 and -221.0 ml/yr, and the nintedanib versus placebo difference in the adjusted annual rate of decline in FVC was 117.0 ml/yr (95% confidence interval, 76.3-157.8) and 98.9 ml/yr (95% confidence interval, 36.4-161.5). There was no significant treatment-by-subgroup interaction (P = 0.8139). Adverse events were similar between the subgroups. Patients with IPF diagnosed in clinical practice who had possible UIP with traction bronchiectasis on HRCT and had not undergone surgical lung biopsy had disease that progressed in a similar way, and responded similarly to nintedanib, to that of patients with honeycombing on HRCT and/or confirmation of UIP by biopsy.

  13. Social support and gender differences in coping with depression among emerging adults: a mixed-methods study

    National Research Council Canada - National Science Library

    Martínez-Hernáez, Angel; Carceller-Maicas, Natàlia; DiGiacomo, Susan M; Ariste, Santiago

    2016-01-01

    ...). The aims of this study were to explore the relationship between perceived social support and depression in a sample of emerging adults, and subsequently to identify the type of social support young...

  14. Differences in Flight Activity of Coleomegilla maculata and Hippodamia convergens (Coleoptera: Coccinellidae) Following Emergence, Mating, and Reproduction.

    Science.gov (United States)

    Abdel-Wahab, Ahmed H; Michaud, J P; Bayoumy, Mohamed H; Awadalla, Samir S; El-Gendy, Mohamed

    2017-12-08

    The flight activity of Coleomegilla maculata DeGeer and Hippodamia convergens Guerin-Meneville (Coleoptera: Coccinellidae) was examined by observing tethered beetles in the laboratory. C. maculata were fed eggs of Ephestia kuehniella Zeller, as were larval H. convergens, whereas adult H. convergens were fed Melanaphis sacchari (Zehntner) to induce egg maturation; adults of both species received water and diluted honey. A spot of magnetic paint was applied to one elytrum of each beetle, which then adhered to a small neodymium magnet attached to a thread. Beetles were permitted 1 h flight opportunities daily for 3-d periods, first as virgins on their fifth day of adult life, secondly after mating, thirdly after females began oviposition, and fourthly after prey were withheld and egg maturation and oviposition ceased. Both species exhibited low flight activity as virgins, and whereas C. maculata females increased their activity after mating, H. convergens females did not. Flight activity in C. maculata did not change with onset of oviposition, whereas it increased in H. convergens males, but not females. In contrast, H. convergens females increased their flight activity after cessation of oviposition, whereas C. maculata females did not. Female flight activity when either virgin or mated correlated weakly with fecundity in C. maculata, but not in H. convergens. Species differences are discussed in the context of nutritional ecology; H. convergens usually enters diapause immediately following emergence, and is more dependent on aphids for reproduction, whereas C. maculata develops and reproduces on a wider range of foods and is not so constrained. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Differences in police, ambulance, and emergency department reporting of traffic injuries on Karachi-Hala road, Pakistan

    Directory of Open Access Journals (Sweden)

    Lagarde Emmanuel

    2011-03-01

    Full Text Available Abstract Background Research undertaken in developing countries has assessed discrepancies in police reporting of Road Traffic Injury (RTI for urban settings only. The objective of this study was to assess differences in RTI reporting across police, ambulance, and hospital Emergency Department (ED datasets on an interurban road section in Pakistan. Methods The study setting was the 196-km long Karachi-Hala road section. RTIs reported to the police, Edhi Ambulance Service (EAS, and five hospital EDs in Karachi during 2008 (Jan to Dec were compared in terms of road user involved (pedestrians, motorcyclists, four-wheeled vehicle occupants and outcome (died or injured. Further, records from these data were matched to assess ascertainment of traffic injuries and deaths by the three datasets. Results A total of 143 RTIs were reported to the police, 531 to EAS, and 661 to hospital EDs. Fatality per hundred traffic injuries was twice as high in police records (19 per 100 RTIs than in ambulance (10 per 100 RTIs and hospital ED records (9 per 100 RTIs. Pedestrian and motorcyclist involvement per hundred traffic injuries was lower in police records (8 per 100 RTIs than in ambulance (17 per 100 RTIs and hospital ED records (43 per 100 RTIs. Of the 119 deaths independently identified after matching, police recorded 22.6%, EAS 46.2%, and hospital ED 50.4%. Similarly, police data accounted for 10.6%, EAS 43.5%, and hospital ED 54.9% of the 1 095 independently identified injured patients. Conclusions Police reporting, particularly of non-fatal RTIs and those involving vulnerable road users, should be improved in Pakistan.

  16. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy.

    Directory of Open Access Journals (Sweden)

    Pamela Barbadoro

    Full Text Available The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED for non-urgent visits.The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use.Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32-6.47 of re-admissions have been registered; the distribution shows a high frequency of events in the age 65-84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37-52.57. The regression model has shown the significant role played by age, type of structure (geriatric acute care, and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38-15.27 of the total number of respondents to the questionnaire (N = 504. The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3-7.8 p = 0.008, while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30-0.90.In the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization.

  17. Medical resource inventory model for emergency preparation with uncertain demand and stochastic occurrence time under considering different risk preferences at the airport.

    Directory of Open Access Journals (Sweden)

    Wei Pan

    Full Text Available With the high accident rate of civil aviation, medical resource inventory becomes more important for emergency management at the airport. Meanwhile, medical products usually are time-sensitive and short lifetime. Moreover, we find that the optimal medical resource inventory depends on multiple factors such as different risk preferences, the material shelf life and so on. Thus, it becomes very complex in a real-life environment. According to this situation, we construct medical resource inventory decision model for emergency preparation at the airport. Our model is formulated in such a way as to simultaneously consider uncertain demand, stochastic occurrence time and different risk preferences. For solving this problem, a new programming is developed. Finally, a numerical example is presented to illustrate the proposed method. The results show that it is effective for determining the optimal medical resource inventory for emergency preparation with uncertain demand and stochastic occurrence time under considering different risk preferences at the airport.

  18. A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception.

    Science.gov (United States)

    Shohel, Mohammad; Rahman, Mohammad Mahfuzur; Zaman, Asif; Uddin, Mir Muhammad Nasir; Al-Amin, Md Mamun; Reza, Hasan Mahmud

    2014-04-04

    Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12-24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given

  19. The Importance of Risk and Subgroup Analysis of Nonparticipants in a Geriatric Intervention Study

    Directory of Open Access Journals (Sweden)

    Elizabeth Rosted

    2016-01-01

    Full Text Available Background. A major concern in intervention studies is the generalizability of the findings due to refusal of intended participants to actually take part. In studies including ill older people the number of those declining to participate may be large and the concern is therefore relevant. Objectives. To compare patients characteristics, rates of acute readmission, and mortality after one and six months among older persons who agreed and those who declined to participate in a randomized controlled trial and to describe subgroups of nonparticipants. Design. Comparative study based on a randomized controlled trial. Setting. University hospital in the Capital Region of Denmark. Participants. Patients ≥70 years discharged home after a short Emergency Department stay. 399 were requested to participate; 271 consented, whereas 128 refused. Results. Refusers were more likely to be readmitted (p<0.001 or die (p=0.006. The largest subgroup of refusers described as “too ill” had the highest risk of readmission (OR = 3.00, 95% CI = 1.61–5.47, p=0.001 and of mortality within six months (OR = 3.50, 95% CI = 1.64–7.49, p=0.002. However, this seems not to have affected the results of our randomized study. Conclusion. We recommend that intervention studies among older people or other fragile patient groups include analysis of relevant risk and subgroup analyses of refusers.

  20. Serological relationships among subgroups in bovine viral diarrhea virus genotype 1 (BVDV-1).

    Science.gov (United States)

    Alpay, Gizem; Yeşilbağ, Kadir

    2015-01-30

    Bovine viral diarrhea virus (BVDV) has various economic impacts associated with diarrhea, poor performance, an increase in the frequency of other infections and lethal outcomes. Both genotypes, namely BVDV-1 and BVDV-2, as well as different subgroups within these genotypes have been reported worldwide. Understanding the serological differences among the BVDV subgroups is important for disease epidemiology and prevention as well as vaccination programs. The aim of this study was to determine the serological relatedness among the subgroups in BVDV-1. For that purpose, sheep hyperimmune sera were collected against representative strains from 6 of the subgroups of BVDV-1 (BVDV-1a, -1b, -1d, -1f, -1h and -1l). The serum samples that gave the peak antibody titer to the homologous strains were used to perform cross neutralization assays. The highest homologous antibody titer (1:5160) was obtained against BVDV-1h. Regarding the cross neutralizing (heterologous) antibodies, the lowest titer (1:20) was produced by the BVDV-1f antiserum against the BVDV-1a and BVDV1-b viruses. The highest cross neutralizing titer (1:2580) achieved by the BVDV-1h antiserum was against the BVDV-1b strain. The cross neutralization results indicated particular serological differences between the recently described subgroup (BVDV-1l) and BVDV-1a/-1b, which are widely used in commercial vaccines. Considering the cross neutralization titers, it is concluded that selected BVDV-1l and BVDV-1h strains can be used for the development of diagnostic and control tools. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. The effect of active video games by ethnicity, sex and fitness: subgroup analysis from a randomised controlled trial

    OpenAIRE

    Foley, Louise; Jiang, Yannan; Ni Mhurchu, Cliona; Jull, Andrew; Prapavessis, Harry; Rodgers,Anthony; Maddison, Ralph

    2014-01-01

    Background The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a rand...

  2. Contribution of Dietary Supplements to Nutritional Adequacy by Socioeconomic Subgroups in Adults of the United States

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2017-12-01

    Full Text Available Many Americans have inadequate intakes of several nutrients, and the Dietary Guidelines for Americans 2015–2020 identified vitamins A, C, D, and E, in addition to calcium, magnesium, iron, potassium, choline, and fiber as “underconsumed nutrients”. Based on nationally representative data on 10,698 adults from National Health and Nutrition Examination Surveys (NHANES, 2009–2012, assessments were made of socioeconomic differences, based on the Poverty Income Ratio (PIR, in terms of the association of dietary supplement use on nutrient intake and nutrient inadequacies. Compared to food alone, the use of any dietary supplement plus food was associated with significantly (p < 0.01 higher intakes of 15–16 of 19 nutrients examined in all socioeconomic groups; and significantly reduced rates of inadequacy for 10/17 nutrients in the subgroup PIR > 1.85 (not poor, but only 4–5/17 nutrients (calcium and vitamins A, C, D, E for the poor and nearly poor subgroups (PIR < 1.35 and PIR 1.35 to ≤1.85, respectively. An increased prevalence of intakes above the Tolerable Upper Intake Level (UL was seen for 3–9/13 nutrients, but all were less than 5% in the PIR subgroups. In conclusion, dietary supplement use was associated with an increased micronutrient intake, decreased inadequacies, and a slight increase in the prevalence of intakes above the UL, with greater benefits seen in the PIR > 1.85 subgroup.

  3. A Person-Centered Approach to Examining Heterogeneity and Subgroups Among Survivors of Sexual Assault

    Science.gov (United States)

    Masters, N. Tatiana; Stappenbeck, Cynthia A.; Kaysen, Debra; Kajumulo, Kelly F.; Davis, Kelly Cue; George, William H.; Norris, Jeanette; Heiman, Julia R.

    2015-01-01

    This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M=24.78, SD=2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across two cohorts of women using multiple-group LCA: Contact or Attempted assault (17% of the sample), Incapacitated assault (52%), and Forceful Severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the Forceful Severe category had higher levels of anxiety, depression, and trauma symptoms, higher proportions of incarceration and transactional sex, and more experiences with controlling and violent partners than did women in the other two groups. Women in the Forceful Severe category also reported a higher frequency of HED than women in the Incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery. PMID:26052619

  4. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...... use of a different format; Emerge as a whole, then, offered an opportunity to study a diverse set of future-oriented engagement practices. We conducted an event ethnography, in which a team of 11 researchers collaboratively developed accounts of the practices at play within Emerge and its workshops...

  5. Combined olmesartan, amlodipine, and hydrochlorothiazide therapy in randomized patients with hypertension: a subgroup analysis of the TRINITY study by age.

    Science.gov (United States)

    Lewin, Andrew J; Izzo, Joseph L; Melino, Michael; Lee, James; Fernandez, Victor; Heyrman, Reinilde

    2013-07-01

    no clinically relevant differences in the incidence of treatment-emergent adverse events between participants <65 and ≥ 65 years of age receiving triple-combination treatment. Triple-combination treatment with OM 40/AML 10/HCTZ 25 mg was well tolerated and more effective in lowering BP than the component dual-combination treatments in elderly and non-elderly subgroups.

  6. Developmental Trajectories of Physical and Indirect Aggression from Late Childhood to Adolescence: Sex Differences and Outcomes in Emerging Adulthood

    Science.gov (United States)

    Cleverley, Kristin; Szatmari, Peter; Vaillancourt, Tracy; Boyle, Michael; Lipman, Ellen

    2012-01-01

    Objective: Two common subtypes of aggression (physical and indirect) have been shown to develop concurrently throughout childhood and to uniquely predict maladjustment. However, nothing is known about psychiatric outcomes of joint trajectories of physical aggression (PA) and indirect aggression (IA) in emerging adulthood. Method: Trajectories of…

  7. Inattention, Hyperactivity, and Emergent Literacy: Different Facets of Inattention Relate Uniquely to Preschoolers' Reading-Related Skills

    Science.gov (United States)

    Sims, Darcey M.; Lonigan, Christopher J.

    2013-01-01

    Although extant studies indicate that there is a strong association between attention deficit/hyperactivity disorder and reading ability in elementary school children, knowledge regarding the relation between inattentive and hyperactive/impulsive behaviors and emergent literacy in preschool children is less established. This study examined the…

  8. Observed improvements in an intern's ability to initiate critical emergency skills in different cardiac arrest scenarios using high-fidelity simulation.

    Science.gov (United States)

    Starmer, David J; Duquette, Sean A; Guiliano, Dominic; Tibbles, Anthony; Miners, Andrew; Finn, Kevin; Stainsby, Brynne E

    2014-10-01

    Objective : The objective of this study was to report observed changes in an intern's ability to initiate critical emergency skills in different cardiac arrest scenarios with high-fidelity simulation over a 10-month period. Methods : One intern's performance was retrospectively analyzed using video recordings of 4 simulations at different stages in the training program. The key outcome was the duration of time expired for 4 critical skills, including activating the emergency response system, initiating cardiopulmonary resuscitation (CPR), using an automated external defibrillator (AED), and passively administrating oxygen. Results : The intern became more efficient in each subsequent simulation for activating the emergency response system and initiating CPR. The time to use the AED stayed relatively constant. The administration of oxygen was inconsistent. Conclusion : An improvement in the speed of applying emergency critical skills was observed with this intern. These improvements in skill may improve patient outcomes and survival rates. We propose further educational research with high-fidelity simulation in the area of assessing emergency skills.

  9. Latino Male Ethnic Subgroups: Patterns in College Enrollment and Degree Completion

    Science.gov (United States)

    Ponjuan, Luis; Palomin, Leticia; Calise, Angela

    2015-01-01

    This chapter examines Latino male ethnic subgroups and their college enrollment and degree completion patterns. The chapter also offers recommendations to improve Latino male ethnic subgroups' educational achievement.

  10. A comparison of subgroup analyses in grant applications and publications.

    NARCIS (Netherlands)

    Boonacker, C.W.; Hoes, A.W.; Liere-Visser, K. van; Schilder, A.G.M.; Rovers, M.M.

    2011-01-01

    In this paper, the authors compare subgroup analyses as outlined in grant applications and their related publications. Grants awarded by the Netherlands Organization for Health Research and Development (ZonMw) from 2001 onward that were finalized before March 1, 2010, were studied. Of the 79 grant

  11. Practical Algorithms for Subgroup Detection in Covert Networks

    DEFF Research Database (Denmark)

    Memon, Nasrullah; Wiil, Uffe Kock; Qureshi, Pir Abdul Rasool

    2010-01-01

    In this paper, we present algorithms for subgroup detection and demonstrated them with a real-time case study of USS Cole bombing terrorist network. The algorithms are demonstrated in an application by a prototype system. The system finds associations between terrorist and terrorist organisations...

  12. Active medulloblastoma enhancers reveal subgroup-specific cellular origins

    Science.gov (United States)

    Lin, Charles Y.; Erkek, Serap; Tong, Yiai; Yin, Linlin; Federation, Alexander J.; Zapatka, Marc; Haldipur, Parthiv; Kawauchi, Daisuke; Risch, Thomas; Warnatz, Hans-Jörg; Worst, Barbara C.; Ju, Bensheng; Orr, Brent A.; Zeid, Rhamy; Polaski, Donald R.; Segura-Wang, Maia; Waszak, Sebastian M.; Jones, David T.W.; Kool, Marcel; Hovestadt, Volker; Buchhalter, Ivo; Sieber, Laura; Johann, Pascal; Chavez, Lukas; Gröschel, Stefan; Ryzhova, Marina; Korshunov, Andrey; Chen, Wenbiao; Chizhikov, Victor V.; Millen, Kathleen J.; Amstislavskiy, Vyacheslav; Lehrach, Hans; Yaspo, Marie-Laure; Eils, Roland; Lichter, Peter; Korbel, Jan O.; Pfister, Stefan M.; Bradner, James E.; Northcott, Paul A.

    2016-01-01

    Summary Medulloblastoma is a highly malignant paediatric brain tumour, often inflicting devastating consequences on the developing child. Genomic studies have revealed four distinct molecular subgroups with divergent biology and clinical behaviour. An understanding of the regulatory circuitry governing the transcriptional landscapes of medulloblastoma subgroups, and how this relates to their respective developmental origins, is lacking. Using H3K27ac and BRD4 ChIP-Seq, coupled with tissue-matched DNA methylation and transcriptome data, we describe the active cis-regulatory landscape across 28 primary medulloblastoma specimens. Analysis of differentially regulated enhancers and super-enhancers reinforced inter-subgroup heterogeneity and revealed novel, clinically relevant insights into medulloblastoma biology. Computational reconstruction of core regulatory circuitry identified a master set of transcription factors, validated by ChIP-Seq, that are responsible for subgroup divergence and implicate candidate cells-of-origin for Group 4. Our integrated analysis of enhancer elements in a large series of primary tumour samples reveals insights into cis-regulatory architecture, unrecognized dependencies, and cellular origins. PMID:26814967

  13. Notes on discrete subgroups of Möbius transformations

    Indian Academy of Sciences (India)

    Abstract. Jørgensen's inequality gives a necessary condition for a nonelementary two generator subgroup of SL(2, C) to be discrete. By embedding SL(2, C) into. ˆU(1, 1; H), we obtain a new type of Jørgensen's inequality, which is in terms of the coefficients of involved isometries. We provide an example to show that this ...

  14. On approximation of Lie groups by discrete subgroups

    Indian Academy of Sciences (India)

    voila.fr; salah.suissi@yahoo.fr. MS received 11 August 2012; revised 27 January 2013. Abstract. A locally compact group G is said to be approximated by discrete sub- groups (in the sense of Tôyama) if there is a sequence of discrete subgroups ...

  15. Detection of Problem Gambler Subgroups Using Recursive Partitioning

    Science.gov (United States)

    Markham, Francis; Young, Martin; Doran, Bruce

    2013-01-01

    The multivariate socio-demographic risk factors for problem gambling have been well documented. While this body of research is valuable in determining risk factors aggregated across various populations, the majority of studies tend not to specifically identify particular subgroups of problem gamblers based on the interaction between variables. The…

  16. Leading Causes of Death among Asian American Subgroups (2003-2011.

    Directory of Open Access Journals (Sweden)

    Katherine G Hastings

    Full Text Available Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups.We examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese and non-Hispanic Whites (NHWs from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%. Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer's disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs.Our findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

  17. Delineation of motoneuron subgroups supplying individual eye muscles in the human oculomotor nucleus.

    Science.gov (United States)

    Che Ngwa, Emmanuel; Zeeh, Christina; Messoudi, Ahmed; Büttner-Ennever, Jean A; Horn, Anja K E

    2014-01-01

    The oculomotor nucleus (nIII) contains the motoneurons of medial, inferior, and superior recti (MR, IR, and SR), inferior oblique (IO), and levator palpebrae (LP) muscles. The delineation of motoneuron subgroups for each muscle is well-known in monkey, but not in human. We studied the transmitter inputs to human nIII and the trochlear nucleus (nIV), which innervates the superior oblique muscle (SO), to outline individual motoneuron subgroups. Parallel series of sections from human brainstems were immunostained for different markers: choline acetyltransferase combined with glutamate decarboxylase (GAD), calretinin (CR) or glycine receptor. The cytoarchitecture was visualized with cresyl violet, Gallyas staining and expression of non-phosphorylated neurofilaments. Apart from nIV, seven subgroups were delineated in nIII: the central caudal nucleus (CCN), a dorsolateral (DL), dorsomedial (DM), central (CEN), and ventral (VEN) group, the nucleus of Perlia (NP) and the non-preganglionic centrally projecting Edinger-Westphal nucleus (EWcp). DL, VEN, NP, and EWcp were characterized by a strong supply of GAD-positive terminals, in contrast to DM, CEN, and nIV. CR-positive terminals and fibers were confined to CCN, CEN, and NP. Based on location and histochemistry of the motoneuron subgroups in monkey, CEN is considered as the SR and IO motoneurons, DL and VEN as the B- and A-group of MR motoneurons, respectively, and DM as IR motoneurons. A good correlation between monkey and man is seen for the CR input, which labels only motoneurons of eye muscles participating in upgaze (SR, IO, and LP). The CCN contained LP motoneurons, and nIV those of SO. This study provides a map of the individual subgroups of motoneurons in human nIII for the first time, and suggests that NP may contain upgaze motoneurons. Surprisingly, a strong GABAergic input to human MR motoneurons was discovered, which is not seen in monkey and may indicate a functional oculomotor specialization.

  18. Differences between Impulsive and Non-Impulsive Suicide Attempts among Individuals Treated in Emergency Rooms of South Korea

    OpenAIRE

    Lim, Meerae; Lee, Soojung; Park, Jong-Ik

    2016-01-01

    Objective A considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. Methods This study analyzed suicide attempters who vis...

  19. Fever Phobia as a Reason for Pediatric Emergency Department Visits: Does the Primary Care Physician Make a Difference?

    Directory of Open Access Journals (Sweden)

    Erella Elkon-Tamir

    2017-01-01

    Full Text Available Background Fever is a source of considerable parental anxiety. Numerous studies have also confirmed similar anxiety among health care workers. This study analyzed caregiver knowledge of fever, and beliefs concerning children with a febrile illness, with an emphasis on the referring physician. Methods This was a cross-sectional study of 100 caregivers of children 3 months to 12 years old, treated at an urban tertiary care pediatric emergency department for fever. Caregiver knowledge was assessed with a questionnaire. Results Most caregivers correctly defined the threshold for fever as >38.0–38.3°C. Caregivers commonly believed that fever can cause brain damage and epilepsy; the frequency of this belief was not affected by whether they were referred to the emergency department by their pediatrician/family physician or by another physician or arrived without a referral. For a comfortable-appearing child with a temperature not above 38.0°C, both groups reported that they would give antipyretics in similar proportions (mean 31%. The majority of parents in both groups believed that teething could cause fever (mean 74%. Conclusion Caregivers in this study had limited knowledge of fever and its management in children, even if referred by their primary care physician. We suggest that there is a need for aggressive educational interventions to reduce parents’ fever phobia, in clinics as well as in pediatric emergency departments, and that this need may extend to the education of medical personnel as well.

  20. Clinical implications of medulloblastoma subgroups: incidence of CSF diversion surgery.

    Science.gov (United States)

    Schneider, Christian; Ramaswamy, Vijay; Kulkarni, Abhaya V; Rutka, James T; Remke, Marc; Tabori, Uri; Hawkins, Cynthia; Bouffet, Eric; Taylor, Michael D

    2015-03-01

    While medulloblastoma was initially thought to comprise a single homogeneous entity, it is now accepted that it in fact comprises 4 discrete subgroups, each with its own distinct demographics, clinical presentation, transcriptomics, genetics, and outcome. Hydrocephalus is a common complication of medulloblastoma and not infrequently requires CSF diversion. The authors report the incidence of CSF diversion surgery in each of the subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). The medical and imaging records for patients who underwent surgery for medulloblastoma at The Hospital for Sick Children were retrospectively reviewed. The primary outcome was the requirement for CSF diversion surgery either before or within 60 days of tumor resection. The modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH) was compared among subgroups. Of 143 medulloblastoma patients, treated from 1991 to 2013, sufficient data were available for 130 patients (15 with Wnt, 30 with Shh, 30 with Group 3, and 55 with Group 4 medulloblastomas). Of these, 28 patients (22%) ultimately underwent CSF diversion surgery: 0% with Wnt, 29% with Shh, 29% with Group 3, and 43% with Group 4 tumors. Patients in the Wnt subgroup had a lower incidence of CSF diversion than all other patients combined (p = 0.04). Wnt patients had a lower mCPPRH score (lower risk of CSF diversion, p = 0.045), were older, had smaller ventricles at diagnosis, and had no leptomeningeal metastases. The overall rate of CSF diversion surgery for Shh, Group 3, and Group 4 medulloblastomas is around 30%, but no patients in the present series with a Wnt medulloblastoma required shunting. The low incidence of hydrocephalus in patients with Wnt medulloblastoma likely reflects both host factors (age) and disease factors (lack of metastases). The absence of hydrocephalus in patients with Wnt medulloblastomas likely contributes to their excellent rate of survival and may also contribute to a higher quality

  1. Emergence and initial growth of seedlings of Rollinia mucosa (Jacq. Baill (Annonaceae in different substrates / Emergência e crescimento inicial de plântulas de biribá (Rollinia mucosa (Jacq. Baill (Annonaceae em diferentes substratos

    Directory of Open Access Journals (Sweden)

    Riselane de Lucena Alcântara Bruno

    2010-07-01

    Full Text Available This research aimed to evaluate the influence of different substrates on emergence and initial growth of Rollinia mucosa seedlings. The seeds were scarified in the opposite side of micropylar region and sown in four different substrates: washed sand (T1, vermiculite (T2, bioplant® (T3, plantmax® (T4, washed sand + vermiculite 1:1 (T5, washed sand + bioplant® 1:1 (T6, washed sand + plantmax® 1:1 (T7, washed sand + vermiculite 3:1 (T8, washed sand + bioplant® 3:1 (T9 and washed sand + plantmax® 3:1 (T10. The emergence percentage, the emergence speed index and growth of the seedlings (length and dry mass of root and aerial part were evaluated. The experimental design was completely randomized with ten treatments and four replications of 25 seeds. The data were submitted to analyses of variance and the averages were compared by the Tukey test. In relation to the emergence percentage and emergence speed index, it was observed that the commercial substrates had presented the lower values, alone or in combination with other substrates and that the sand + vermiculite substrate provided the best results. In general terms, the four substrata evaluated, isolated or in combination, presented no differences for the seedling growth during the 75 days of evaluation.O objetivo desse trabalho foi testar a influência de diferentes substratos na emergência e no crescimento inicial de plântulas de biribá. As sementes foram escarificadas na região oposta à de emissão da radícula e, em seguida, semeadas em diferentes substratos: areia lavada (T1; vermiculita (T2; bioplant® (T3; plantmax® (T4; areia lavada + vermiculita 1:1 (T5; areia lavada + bioplant® 1:1 (T6; areia lavada + plantmax® 1:1 (T7; areia lavada + vermiculita 3:1 (T8; areia lavada + bioplant® 3:1 (T9; e areia lavada + plantmax® 3:1 (T10. Foram avaliados porcentagem de emergência das plântulas, índice de velocidade de emergência e crescimento das plântulas (comprimento e massa seca

  2. Personality does not distinguish people with fibromyalgia but identifies subgroups of patients.

    Science.gov (United States)

    Torres, Xavier; Bailles, Eva; Valdes, Manuel; Gutierrez, Fernando; Peri, Josep-Maria; Arias, Anna; Gomez, Emili; Collado, Antonio

    2013-01-01

    The objectives were to compare the personality of fibromyalgia (FM) patients with other chronic painful and nonpainful disorders considering the confusion due to psychopathology and to assess the clustering of FM patients according to their personality profile. Differences in the NEO Five-Factor Inventory between FM, non-FM chronic pain and drug-resistant epileptic patients were assessed including the confounding effect of demographics and psychopathological status by multivariate regression analysis. Clustering of FM patients was assessed by two-step cluster analysis. Differences in clinical severity and psychosocial problems between subgroups and their outcome 6 months after multidisciplinary treatment were assessed. The final sample comprised 874 patients. Once the effect of confounding variables was considered, clinically nonsignificant differences in personality were observed between groups. FM patients could, however, be grouped into two clusters. Cluster 1 was characterized by higher neuroticism and lower extraversion and showed a worse pretreatment clinical state including more psychosocial problems. In spite of having reached a wider general improvement at 6-month follow-up, Cluster 1 patients remained more anxious and depressed. Identifying personality-based subgroups of FM might allow implementing specific preventive strategies. FM treatment might be optimized by increasing medication compliance, improving therapeutic alliance and testing different therapeutic options and treatment sequencing for each personality subgroup. © 2013.

  3. Differences in pathogenicity among strains of the same or different avian leukosis virus subgroups

    Czech Academy of Sciences Publication Activity Database

    Průková, Dana; Vernerová, Z.; Pilčík, Tomáš; Stepanets, Volodymyr; Indrová, Marie; Geryk, Josef; Plachý, Jiří; Hejnar, Jiří; Svoboda, Jan

    2007-01-01

    Roč. 36, č. 1 (2007), s. 15-27 ISSN 0307-9457 R&D Projects: GA ČR GA523/04/0489 Institutional research plan: CEZ:AV0Z50520514 Keywords : chicken * wasting disease * ALV Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.257, year: 2007

  4. Automatically high precision manufacturing technology for micro-optic subgroups; Techical Digest

    Science.gov (United States)

    Sure, Thomas; Guyenot, Volker; Gerhardt, Michael

    2005-05-01

    To realize the image quality of high end objectives, e. g. high NA microscope objectives working in the DUV spectral region the subgroups have to be manufactured with a mechanical precision which is difficult to achieve cost effectively. For high end microscope objectives the accuracy of the diameter of the lens mount must be within 1 µm, the run-out must be met within 1 µm and the distance of the lens vertex relative to the shoulder of the mount must fit within 1 µm. To realize the required precision, today various measurement techniques and production processes are used. Picking up the subgroups on different machining tools and measurement systems will loosen the accuracy. Here, we present the concept and the layout of a new manufacturing tool where we implemented the different measurement techniques in one CNC machining center.

  5. Mixture model analysis identifies irritable bowel syndrome subgroups characterised by specific profiles of gastrointestinal, extraintestinal somatic and psychological symptoms.

    Science.gov (United States)

    Polster, A; Van Oudenhove, L; Jones, M; Öhman, L; Törnblom, H; Simrén, M

    2017-09-01

    Current subgrouping of Irritable Bowel Syndrome (IBS) is exclusively based on stool consistency without considering other relevant gastrointestinal (GI), extraintestinal somatic or psychological features. To identify subgroups based on a comprehensive set of IBS-related parameters. Mixture model analysis was used, with the following input variables: 13 single-item scores from the IBS-specific Gastrointestinal Symptom Rating Scale, average stool consistency and frequency from a 7-day Bristol Stool Form diary, 12 single-item extraintestinal symptom scores from the Patient Health Questionnaire-12, and anxiety and depression subscale scores from the Hospital Anxiety and Depression scale. The resulting latent subgroups were compared regarding symptom profiles using analysis of variance followed by pair-wise comparisons. One hundred and seventy-two IBS patients (Rome III; 69% female; mean age 33.7 [range 18-60] years) were included. The optimal subgrouping showed six latent groups, characterised by: (I) constipation with low comorbidities, (II) constipation with high comorbidities, (III) diarrhoea with low comorbidities, (IV) diarrhoea and pain with high comorbidities, (V) mixed GI symptoms with high comorbidities, (VI) a mix of symptoms with overall mild severity. The subgroups showed differences in the distribution of Rome III-subtypes, IBS severity, presence of anxiety and depression, and gender, but not regarding age, IBS duration or reported post-infectious onset of IBS. This model-based subgrouping of IBS partly supports the distinction of subgroups based on bowel habits, but additionally distinguishes subgroups with or without co-morbid extraintestinal somatic and psychological symptoms. The resulting groups show specific profiles of symptom combinations. © 2017 John Wiley & Sons Ltd.

  6. Identification of Responders to Amiodarone: Subgroup Analysis of the EMIAT Study

    OpenAIRE

    Kehl, Victoria; Ulm, Kurt; Schmidt, G; Barthel, P.; Malik, Marek

    2003-01-01

    Clinical trials often judge the efficacy of a new treatment by comparing the survival patterns of patients who are randomly assigned to undergo the new or a standard/placebo treatment. Usually, the entire groups are analyzed, although certain subgroups of patients may react differently to the new treatment than others. Some patients taking the new treatment might benefit from it (the positive responders) while others may be harmed by it (the negative responders). We applied a newly developed ...

  7. Mood, Disability, and Quality of Life among a Subgroup of Rheumatoid Arthritis Individuals with Experiential Avoidance and Anxiety Sensitivity

    Directory of Open Access Journals (Sweden)

    S. Mehta

    2016-01-01

    Full Text Available Objective. The current study aimed to identify and characterize distinct RA subgroups based on their level of EA and AS and compares the difference among the subgroups in mood, disability, and quality of life. Methods. Individuals with chronic pain for at least 3 months were recruited from an academic rheumatoid clinic. Participants were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted to identify distinct subgroups of patients. Differences in clinical outcomes were compared using the Multivariate ANOVA based on cluster membership. Results. From a total of 223 participants, three distinct subgroups were formed based on cluster analysis. Cluster 1 (N=78 included those with low levels of both EA and AS. Cluster 2 (N=81 consisted of individuals with moderate levels of EA and low levels AS. Cluster 3 (N=64 included those with moderate levels of EA and high AS. Compared to those in Cluster 1, those in Cluster 3 had significantly higher levels of mood impairment and disability and lower quality of life (p<0.05. Significantly lower levels of mood impairment were seen in Cluster 1 compared to Cluster 2 (p<0.05. However, no significant difference in disability or quality of life was seen between the two groups. Conclusions. The three subgroups differed significantly in levels of impairment in mood, disability, and quality of life. However, levels of EA had a greater impact on disability and quality of life than AS.

  8. The association between space weather conditions and emergency hospital admissions for myocardial infarction during different stages of solar activity

    Science.gov (United States)

    Vencloviene, J.; Antanaitiene, J.; Babarskiene, R.

    2016-11-01

    A number of studies have established the effects of space weather on the human cardio-vascular system. We investigated whether geomagnetic storms (GS), solar proton events (SPEs), and X-class solar flare affect the risk of emergency hospitalization for acute myocardial infarction (MI) separately during declining (2004-2006) and rising (2010-2012) phases of solar activity. The data on hospital admissions for MI were obtained from the computer database of Lithuanian University of Health sciences from January 1, 2004 to December 31, 2012. We evaluated the associations between space weather conditions and the daily number of emergency admissions for MI by Poisson regression, controlling for seasonal variation and weekdays. During 2004-2006, an increase in the risk of hospital admission for MI was observed on days of the daily mean proton >10 MeV flux >100 pfu (by 63%, p10 MeV flux >100 pfu (by 52%, p=0.015) and on days of GS and 1-2 days after GS (by 17%, p=0.024). These findings suggest that the impact of hazardous space weather conditions on human health depends of the strength of space storm during the investigated period.

  9. Combined group ECC protection and subgroup parity protection

    Science.gov (United States)

    Gara, Alan G.; Chen, Dong; Heidelberger, Philip; Ohmacht, Martin

    2013-06-18

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

  10. Fast determination of structurally cohesive subgroups in large networks.

    Science.gov (United States)

    Sinkovits, Robert S; Moody, James; Oztan, B Tolga; White, Douglas R

    2016-11-01

    Structurally cohesive subgroups are a powerful and mathematically rigorous way to characterize network robustness. Their strength lies in the ability to detect strong connections among vertices that not only have no neighbors in common, but that may be distantly separated in the graph. Unfortunately, identifying cohesive subgroups is a computationally intensive problem, which has limited empirical assessments of cohesion to relatively small graphs of at most a few thousand vertices. We describe here an approach that exploits the properties of cliques, k-cores and vertex separators to iteratively reduce the complexity of the graph to the point where standard algorithms can be used to complete the analysis. As a proof of principle, we apply our method to the cohesion analysis of a 29,462-vertex biconnected component extracted from a 128,151-vertex co-authorship data set.

  11. Microscopic colitis: clinical findings, topography and persistence of histopathological subgroups.

    Science.gov (United States)

    Bjørnbak, C; Engel, P J H; Nielsen, P L; Munck, L K

    2011-11-01

    Uncertainty remains on topography and persistence of histological subgroups of microscopic colitis (MC). To assess longitudinal clinical, endoscopic, histological, and therapeutic description of MC subgroups including patients with incomplete findings of MC (MCi). Retrospective review of a consecutive cohort with MC and histological reassessment of MCi. Clinical characteristics of 168 patients with lymphocytic colitis (LC), 270 with collagenous colitis (CC) and 101 with MCi were similar. At colonoscopy 95% (95% CI: 91-98%) of CC and 98% (93-100%) of LC cases had diagnostic histopathology of MC in both left and right colon. Eight and three patients had characteristics of MC only in the left and right colon, respectively. Histology findings resembling coexistence of the other MC subtype was present in 48% (40-55%) with CC and 24% (18-31%) with LC. A first diagnosis of MC was made in 49 (30%) of 164 patients only at repeat endoscopy. Another 34 of 115 (30%) with MC in the first endoscopy did not fulfil the MC criteria at repeat endoscopy. Only seven cases had a primary endoscopy without histopathological abnormalities. Fifteen percentage of MCi were reclassified as MC. Ileal inflammation was present in 33 of 81 patients. Budesonide was efficacious in all MC subgroups irrespective of bile acid malabsorption. Clinical characteristics of microscopic colitis subgroups are indistinguishable. Biopsies from the left colon suffice to exclude microscopic colitis, and the histological diagnosis of microscopic colitis is inconsistent over time. Ileal inflammation is common. The term microscopic colitis should perhaps be considered one clinical entity and include lymphocytic colitis, collagenous colitis, and incomplete findings of microscopic colitis. © 2011 Blackwell Publishing Ltd.

  12. Irreducible almost simple subgroups of classical algebraic groups

    CERN Document Server

    Burness, Timothy C; Marion, Claude; Testerman, Donna M

    2015-01-01

    Let G be a simple classical algebraic group over an algebraically closed field K of characteristic p\\geq 0 with natural module W. Let H be a closed subgroup of G and let V be a nontrivial p-restricted irreducible tensor indecomposable rational KG-module such that the restriction of V to H is irreducible. In this paper the authors classify the triples (G,H,V) of this form, where V \

  13. Emergência e crescimento inicial de plântulas de Archontophoenix cunninghamiana H. Wendl. & Drude provenientes de sementes de diferentes plantas matrizes Emergence and seedling growth of Archontophoenix cunninghamiana H. Wendl. & Drude seeds from different mother plants

    Directory of Open Access Journals (Sweden)

    Cibele Chalita Martins

    2013-06-01

    Full Text Available A diversidade genética é um fator fundamental nos programas de melhoramento e seleção de plantas, dessa forma, o objetivo no trabalho foi avaliar genótipos de Archontophoenix cunninghamiana quanto à emergência e crescimento inicial das plântulas, no sentido de orientar a seleção de plantas matrizes. Os frutos maduros foram colhidos em dez plantas matrizes em Monte Alegre do Sul - SP, nos quais se avaliaram o peso e as dimensões e, nas sementes, também o peso e as dimensões, além do teor de água, emergência, índice de velocidade de emergência, diâmetro e comprimento da parte aérea e massa seca de plântulas. O delineamento utilizado foi o inteiramente casualizado e a comparação entre médias foi realizada pelo teste de Tukey (PGenetic diversity is a key factor in studies of plant breeding, thus the objective of this study was to evaluate genotypes of Archontophoenix cunninghamiana for germination and seed vigor in order to guide the selection of elite plants. Mature fruits were harvested from ten plants headquarters in Monte Alegre do Sul-SP, in which was assessed the weight and size. In seeds, these parameters were also evaluated in addition to water content, germination and vigor through the index of emergency speed, seedlings diameter and shoot length and dry weight of seedlings. The experimental design was completely randomized and the comparison between means was performed by Tukey test (P<0.05. The plants produced seeds with different physical and physiological characteristics, and it allows the identification and selection of elite plants producing seeds.

  14. Two subgroups of antipsychotic-naive, first-episode schizophrenia patients identified with a Gaussian mixture model on cognition and electrophysiology

    DEFF Research Database (Denmark)

    Bak, N.; Ebdrup, B.H.; Oranje, B

    2017-01-01

    different disease subgroups. We applied machine learning algorithms on measures of electrophysiology and cognition to identify potential subgroups of schizophrenia. Next, we explored subgroup differences regarding treatment response. Sixty-six antipsychotic-naive first-episode schizophrenia patients......Deficits in information processing and cognition are among the most robust findings in schizophrenia patients. Previous efforts to translate group-level deficits into clinically relevant and individualized information have, however, been non-successful, which is possibly explained by biologically...... day). A reduced principal component space based on 19 electrophysiological variables and 26 cognitive variables was used as input for a Gaussian mixture model to identify subgroups of patients. With support vector machines, we explored the relation between PANSS subscores and the identified subgroups...

  15. Mood, Disability, and Quality of Life among a Subgroup of Rheumatoid Arthritis Individuals with Experiential Avoidance and Anxiety Sensitivity.

    Science.gov (United States)

    Mehta, S; Rice, D; Janzen, S; Pope, J E; Harth, M; Shapiro, A P; Teasell, R W

    2016-01-01

    Objective. The current study aimed to identify and characterize distinct RA subgroups based on their level of EA and AS and compares the difference among the subgroups in mood, disability, and quality of life. Methods. Individuals with chronic pain for at least 3 months were recruited from an academic rheumatoid clinic. Participants were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted to identify distinct subgroups of patients. Differences in clinical outcomes were compared using the Multivariate ANOVA based on cluster membership. Results. From a total of 223 participants, three distinct subgroups were formed based on cluster analysis. Cluster 1 (N = 78) included those with low levels of both EA and AS. Cluster 2 (N = 81) consisted of individuals with moderate levels of EA and low levels AS. Cluster 3 (N = 64) included those with moderate levels of EA and high AS. Compared to those in Cluster 1, those in Cluster 3 had significantly higher levels of mood impairment and disability and lower quality of life (p impairment were seen in Cluster 1 compared to Cluster 2 (p disability or quality of life was seen between the two groups. Conclusions. The three subgroups differed significantly in levels of impairment in mood, disability, and quality of life. However, levels of EA had a greater impact on disability and quality of life than AS.

  16. Television viewing in low-income latino children: variation by ethnic subgroup and English proficiency.

    Science.gov (United States)

    Thompson, Darcy A; Matson, Pamela A; Ellen, Jonathan M

    2013-02-01

    Television viewing is associated with an increased risk for obesity in children. Latino children are at high risk for obesity and yet little is known about differences in television viewing habits within this population. The purpose of this study is to determine if hours of television viewed by young children with low-income Latina mothers differs by maternal ethnic subgroup and English language proficiency. This was a cross-sectional analysis of data from the Welfare, Children, & Families: A Three City Study. Participants were 422 low-income Latina mothers of Mexican and Puerto Rican descent with children ages 0-4 years old. The dependent variable was hours of daily television viewed by the child. The independent variable was maternal ethnic subgroup and English language proficiency. Analyses involved the use of multiple negative binomial regression models, which were adjusted for demographic variables. Multivariable regression analyses showed that compared to children with mothers of Mexican descent, children of mothers of Puerto Rican descent watch more daily television (television viewing (IRR=1.29, 95% CI 1.04, 1.61). No relationship was found for children of Puerto Rican descent. Child television viewing varies in low-income Latino children by maternal ethnic subgroup and English language proficiency. Interventionists must consider the varying sociocultural contexts of Latino children and their influence on television viewing.

  17. Physician-led team triage based on lean principles may be superior for efficiency and quality? A comparison of three emergency departments with different triage models

    Science.gov (United States)

    2012-01-01

    Background The management of emergency departments (EDs) principally involves maintaining effective patient flow and care. Different triage models are used today to achieve these two goals. The aim of this study was to compare the performance of different triage models used in three Swedish EDs. Using efficiency and quality indicators, we compared the following triage models: physician-led team triage, nurse first/emergency physician second, and nurse first/junior physician second. Methods All data of patients arriving at the three EDs between 08:00- and 21:00 throughout 2008 were collected and merged into a database. The following efficiency indicators were measured: length of stay (LOS) including time to physician, time from physician to discharge, and 4-hour turnover rate. The following quality indicators were measured: rate of patients left before treatment was completed, unscheduled return within 24 and 72 hours, and mortality rate within 7 and 30 days. Results Data from 147,579 patients were analysed. The median length of stay was 158 minutes for physician-led team triage, compared with 243 and 197 minutes for nurse/emergency physician and nurse/junior physician triage, respectively (p triage, 5.3% for nurse/emergency physician, and 9.6% for nurse/junior physician triage (p triage, 1.0%, compared with 2.1%, and 2.5% for nurse/emergency physician, and nurse/junior physician, respectively (p triage and 1.0% for the two other triage models (p triage seemed advantageous, both expressed as efficiency and quality indicators, compared with the two other models. PMID:22905993

  18. Gambaran Populasi Golongan Darah Subgroup A (A1, A2 di PMI Kulon Progo

    Directory of Open Access Journals (Sweden)

    Hieronymus Rayi Prasetya

    2017-08-01

    Full Text Available Subgroup A1 and A2 are the most important in the blood group A. Subgroup A1 has the A antigen more than A2 subgroup, the A2 subgroup can cause misidentification of blood group due to poor A antigen and genetic variation possessed. Misidentification of the blood group will increase the risk of transfusion reactions. This research aims to describe the A1 and A2 subgroup population in Kulon Progo district. This study was conducted with a cross sectional sampling technique. The sample in this study were taken from donors of blood group A in Kulon Progo Red Cross. Identification of A1 and A2 subgroup is done by using lectin (Dolichos biflorus extract. The result of the examination of 53 samples showed that 96,2% was A1 subgroup and 3,8% was A2 subgroup. Key words : Subgroup A1, Subgroup A2, Population, Kulon Progo

  19. Pain Sensitivity Subgroups in Individuals With Spine Pain: Potential Relevance to Short-Term Clinical Outcome

    Science.gov (United States)

    Bialosky, Joel E.; Robinson, Michael E.

    2014-01-01

    Background Cluster analysis can be used to identify individuals similar in profile based on response to multiple pain sensitivity measures. There are limited investigations into how empirically derived pain sensitivity subgroups influence clinical outcomes for individuals with spine pain. Objective The purposes of this study were: (1) to investigate empirically derived subgroups based on pressure and thermal pain sensitivity in individuals with spine pain and (2) to examine subgroup influence on 2-week clinical pain intensity and disability outcomes. Design A secondary analysis of data from 2 randomized trials was conducted. Methods Baseline and 2-week outcome data from 157 participants with low back pain (n=110) and neck pain (n=47) were examined. Participants completed demographic, psychological, and clinical information and were assessed using pain sensitivity protocols, including pressure (suprathreshold pressure pain) and thermal pain sensitivity (thermal heat threshold and tolerance, suprathreshold heat pain, temporal summation). A hierarchical agglomerative cluster analysis was used to create subgroups based on pain sensitivity responses. Differences in data for baseline variables, clinical pain intensity, and disability were examined. Results Three pain sensitivity cluster groups were derived: low pain sensitivity, high thermal static sensitivity, and high pressure and thermal dynamic sensitivity. There were differences in the proportion of individuals meeting a 30% change in pain intensity, where fewer individuals within the high pressure and thermal dynamic sensitivity group (adjusted odds ratio=0.3; 95% confidence interval=0.1, 0.8) achieved successful outcomes. Limitations Only 2-week outcomes are reported. Conclusions Distinct pain sensitivity cluster groups for individuals with spine pain were identified, with the high pressure and thermal dynamic sensitivity group showing worse clinical outcome for pain intensity. Future studies should aim to confirm

  20. Caffeine for Apnea of Prematurity trial: benefits may vary in subgroups.

    Science.gov (United States)

    Davis, Peter G; Schmidt, Barbara; Roberts, Robin S; Doyle, Lex W; Asztalos, Elizabeth; Haslam, Ross; Sinha, Sunil; Tin, Win

    2010-03-01

    To determine whether the benefits of caffeine vary in three subgroups of 2006 participants in the Caffeine for Apnea of Prematurity (CAP) trial. Post-hoc subgroup analyses were performed on the basis of: (1) indication for commencement of study drug: treat apnea, prevent apnea, or facilitate extubation; (2) positive pressure ventilation (PPV) at randomization: endotracheal tube (ETT), noninvasive ventilation, or none; and (3) timing of commencement of study drug: early or late (3 days). Outcomes assessed were those showing treatment effects in the original analyses. We investigated the consistency of caffeine effects by using regression models that incorporated treatment/subgroup factor interactions. There was little evidence of a differential treatment effect of caffeine in subgroups defined by the clinical indication for starting study drug. The size and direction of the caffeine effect on death or disability differed depending on PPV at randomization (P = .03). Odds ratios (95% CI) were: no support, 1.32 (0.81-2.14); noninvasive support, 0.73 (0.52-1.03); and ETT, 0.73 (0.57-0.94). Adjustment for baseline factors strengthened this effect (P = .02). Starting caffeine early resulted in larger reductions in days of respiratory support. Postmenstrual age at time of discontinuing PPV was shorter with earlier treatment (P = .01). Mean differences (95% CI) were: early, 1.35 weeks (0.90-1.81); and late 0.55 weeks (-0.11-0.99). Adjustment for baseline factors weakened this effect (P = .03). There is evidence of variable beneficial effects of caffeine. Infants receiving respiratory support appeared to derive more neurodevelopmental benefits from caffeine than infants not receiving support. Earlier initiation of caffeine may be associated with a greater reduction in time on ventilation. Copyright 2010 Mosby, Inc. All rights reserved.

  1. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST.

    Science.gov (United States)

    Pisano, Etta D; Hendrick, R Edward; Yaffe, Martin J; Baum, Janet K; Acharyya, Suddhasatta; Cormack, Jean B; Hanna, Lucy A; Conant, Emily F; Fajardo, Laurie L; Bassett, Lawrence W; D'Orsi, Carl J; Jong, Roberta A; Rebner, Murray; Tosteson, Anna N A; Gatsonis, Constantine A

    2008-02-01

    To retrospectively compare the accuracy of digital versus film mammography in population subgroups of the Digital Mammographic Imaging Screening Trial (DMIST) defined by combinations of age, menopausal status, and breast density, by using either biopsy results or follow-up information as the reference standard. DMIST included women who underwent both digital and film screening mammography. Institutional review board approval at all participating sites and informed consent from all participating women in compliance with HIPAA was obtained for DMIST and this retrospective analysis. Areas under the receiver operating characteristic curve (AUCs) for each modality were compared within each subgroup evaluated (age or= 65 years, dense vs nondense breasts at mammography, and pre- or perimenopausal vs postmenopausal status for the two younger age cohorts [10 new subgroups in toto]) while controlling for multiple comparisons (P film vs both vs neither), mammographic lesion type (mass, calcifications, or other), digital machine type, mammographic and pathologic size and diagnosis, existence of prior mammographic study at time of interpretation, months since prior mammographic study, and compressed breast thickness. Thirty-three centers enrolled 49 528 women. Breast cancer status was determined for 42,760 women, the group included in this study. Pre- or perimenopausal women younger than 50 years who had dense breasts at film mammography comprised the only subgroup for which digital mammography was significantly better than film (AUCs, 0.79 vs 0.54; P = .0015). Breast Imaging Reporting and Data System-based sensitivity in this subgroup was 0.59 for digital and 0.27 for film mammography. AUCs were not significantly different in any of the other subgroups. For women aged 65 years or older with fatty breasts, the AUC showed a nonsignificant tendency toward film being better than digital mammography (AUCs, 0.88 vs 0.70; P = .0025). Digital mammography performed significantly better

  2. Critical Reflections on Evolutionary Psychology and Sexual Selection Theory as Explanatory Account of Emergence of Sex Differences in Psychopathology: Comment on Martel (2013)

    Science.gov (United States)

    Hankin, Benjamin L.

    2014-01-01

    Martel (2013) proposed a meta-theory, based on sexual selection theory and broad evolutionary psychological (EP) principles, to account for well-known sex differences in the emergence of common behavioral and certain internalizing disorders across childhood and adolescence, respectively. This Comment first enumerates several strengths and then offers two primary critiques about Martel’s proposal. Martel provides an exceptional, integrative review that organizes several disparate literatures that hold promise to enhance understanding of such sex differences. At the same time, I raise critical questions regarding EP generally, and sexual selection theory specifically, as the meta-theoretical framework chosen to bind together these different influences and mechanisms as drivers of the sex difference in different psychopathologies. Indeed, it is not clear that EP is necessary—nor does it provide unique explanatory power—to explicate the emergence of sex differences in internalizing and externalizing disorders among youth. Moreover, Martel’s EP-based proposal pertains to adolescent-onset depression and social phobia but does not provide an explanation for known sex differences in other common childhood-onset and early adult-onset anxiety disorders. PMID:24188421

  3. Critical reflections on evolutionary psychology and sexual selection theory as explanatory account of emergence of sex differences in psychopathology: comment on Martel (2013).

    Science.gov (United States)

    Hankin, Benjamin L

    2013-11-01

    Martel (2013) proposed a metatheory, based on sexual selection theory and broad evolutionary psychological (EP) principles, to account for well-known sex differences in the emergence of common behavioral and certain internalizing disorders across childhood and adolescence, respectively. In this comment, I first enumerate several strengths and then offer 2 primary critiques about Martel's proposal. Martel provides an exceptional, integrative review that organizes several disparate literatures that hold promise to enhance understanding of such sex differences. At the same time, I raise critical questions regarding EP generally, and sexual selection theory specifically, as the metatheoretical framework chosen to bind together these different influences and mechanisms as drivers of the sex difference in different psychopathologies. Indeed, it is not clear that EP is necessary--nor does it provide unique explanatory power-to explicate the emergence of sex differences in internalizing and externalizing disorders among youth. Moreover, Martel's EP-based proposal pertains to adolescent-onset depression and social phobia but does not provide an explanation for known sex differences in other common childhood-onset and early adult-onset anxiety disorders. © 2013 American Psychological Association

  4. Dermatologic emergencies.

    Science.gov (United States)

    Chacon, Anna H

    2015-02-01

    Although dermatology may be regarded as a medical specialty with few emergencies, they do exist and range from primary cutaneous disorders to severe systemic conditions with skin manifestations. Prompt recognition for appropriate diagnosis and treatment often is necessary to improve a patient's prognosis and a single decision can mark the difference between life and death.

  5. Differences in the perception of characteristics of excellence of clinical tutors among residents and consultants at an emergency medicine residency program a qualitative research

    Directory of Open Access Journals (Sweden)

    Muna Saleem Aljahany

    2013-01-01

    Full Text Available Introduction: Defining exactly what characterizes a clinical tutor as excellent and another less effective, is an important task in assessing the effectiveness of clinical training and guiding faculty development. Aim: We aimed to evaluate those characteristics and measure differences in their perception among accomplished and non-accomplished consultants and residents in the Emergency Department. We also compared perceptions between the different groups of participants. Methods: The characteristics measured were extracted from an extensive search of previously published studies summarized in a review article. A qualitative study was conducted, using a 20 item questionnaire piloted from the refined characteristics (good indicator of reliability; Cronbach′s Alpha = 0.86. The questionnaire was distributed among all consultants and residents in Saudi Board of Emergency Medicine. Results: No significant difference between consultants′ and residents′ perception was found. "Sincere" was an exception 87.8% versus 55.1%, P = 0.013. Consultants′ specifications did not seem to affect perception on overall scores and its component sub-scores. Conclusion: Since results showed no relation between accomplished and non-accomplished consultants in perceiving those qualities, we excluded the lack of knowledge of those characteristics as a cause of being accomplished or non-accomplished. We suggest a greater dedication from program developers towards creating more opportunities to involve more consultants in basic Emergency Medicine training.

  6. Eating habits of obese patients in the Netherlands: a comparison between various subgroups and the general Dutch population.

    NARCIS (Netherlands)

    Drent, M.L.; Koppeschaar, H.P.F.

    1995-01-01

    It is still uncertain whether subgroups of obese subjects demonstrate different eating patterns. The aim of this report is to compare data on dietary intake obtained by different methods (dietary history and dietary diary) in several groups of obese patients in which the effects of weight-reducing

  7. Suicide Risk across Latent Class Subgroups: A Test of the Generalizability of the Interpersonal Psychological Theory of Suicide.

    Science.gov (United States)

    Ma, Jennifer S; Batterham, Philip J; Calear, Alison L; Han, Jin

    2018-01-06

    It remains unclear whether the Interpersonal Psychological Theory of Suicide (IPTS; Joiner, ) is generalizable to the population or holds more explanatory power for certain subgroups compared to others. The aim of this study was to (1) identify subgroups of individuals who endorsed suicide ideation in the past month based on a range of mental health and demographic variables, (2) compare levels of the IPTS constructs within these subgroups, and (3) test the IPTS predictions for suicide ideation and suicide attempt for each group. Latent class, negative binomial, linear, and logistic regression analyses were conducted on population-based data obtained from 1,321 adults recruited from Facebook. Among participants reporting suicide ideation, four distinct patterns of risk factors emerged based on age and severity of mental health symptoms. Groups with highly elevated mental health symptoms reported the highest levels of thwarted belongingness and perceived burdensomeness. Tests of the IPTS interactions provided partial support for the theory, primarily in young adults with elevated mental health symptoms. Lack of support found for the IPTS predictions across the subgroups and full sample in this study raise some questions around the broad applicability of the theory. © 2018 The American Association of Suicidology.

  8. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China.

    Science.gov (United States)

    Liu, Peng; Wang, Xining; Fan, Jiayin; Xiao, Wenxin; Wang, Yan

    2016-03-19

    A study on the relationships between ambient air pollutants (PM2.5, SO₂ and NO₂) and hospital emergency room visits (ERVs) for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM) with Poisson regression, which controls for long-time trends, the "day of the week" effect and meteorological parameters. An increase of 10 μg/m³ in PM2.5, SO₂ and NO₂ corresponded to a 1.4% (95% confidence interval (CI): 0.7%, 2.1%), 1.2% (95% CI: 0.5%, 1.9%), and 2.5% (95%: 0.8%, 4.2%) growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%), 0.8% (95%: -0.7%, 2.3%), and 3.1% (95%: 0.5%, 5.7%) rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure.

  9. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  10. Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials.

    Science.gov (United States)

    Haller, Julia A; Stalmans, Peter; Benz, Matthew S; Gandorfer, Arnd; Pakola, Stephen J; Girach, Aniz; Kampik, Anselm; Jaffe, Glenn J; Toth, Cynthia A

    2015-01-01

    To evaluate the efficacy of a single intravitreal injection of ocriplasmin 125 μg across relevant subpopulations of patients with symptomatic vitreomacular adhesion (VMA)/vitreomacular traction (VMT), including when associated with macular hole. Two multicenter, randomized, placebo-controlled, double-masked, 6-month studies. A total of 652 randomized patients (464 receiving ocriplasmin; 188 receiving placebo). A single intravitreal injection of ocriplasmin 125 μg or placebo in the study eye. Prespecified subgroup analyses were conducted to evaluate the effects on the proportion of patients with nonsurgical resolution of focal VMA at day 28, nonsurgical full-thickness macular hole (FTMH) closure at month 6, and categoric improvement in best-corrected visual acuity (BCVA) at month 6. Resolution of VMA at day 28 was achieved more often in younger patients (Treatment differences in favor of ocriplasmin were generally observed across each subgroup of subpopulations studied. Subgroup analyses confirmed the positive effect of ocriplasmin across relevant subpopulations. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  11. Subgroup analysis of Asian patients in the INPULSIS® trials of nintedanib in idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Taniguchi, Hiroyuki; Xu, Zuojun; Azuma, Arata; Inoue, Yoshikazu; Li, Huiping; Fujimoto, Tsuyoshi; Bailes, Zelie; Schlenker-Herceg, Rozsa; Kim, Dong S

    2016-11-01

    In the two-replicate randomized Phase III INPULSIS® trials in patients with idiopathic pulmonary fibrosis (IPF), nintedanib 150 mg bd significantly reduced the annual rate of decline in forced vital capacity (FVC) compared with placebo. The key secondary endpoints were time to first investigator-reported acute exacerbation and change from baseline in St George's Respiratory Questionnaire total score, both over 52 weeks. Here, we assessed the effect of nintedanib in Asian patients. Pre-specified subgroup analyses of the effect of nintedanib on the primary and key secondary endpoints in Asian versus White patients were undertaken based on pooled data from the two INPULSIS® trials. Safety data were analyzed descriptively. Of the treated patients, 322 were Asian (nintedanib n = 194; placebo n = 128) and 608 were White (nintedanib n = 360; placebo n = 248). In Asian patients, the nintedanib versus placebo difference in the adjusted annual rate of decline in FVC was 94.1 mL/year (95% CI: 33.7, 154.6). The treatment effect of nintedanib on the annual rate of decline in FVC in Asian and White patients was similar (treatment-by-subgroup interaction P = 0.72) and consistent with the overall population. No significant treatment-by-subgroup interaction was observed for the key secondary endpoints between Asian and White patients. In Asian patients, the most common adverse event in the nintedanib group was diarrhoea (56.2% of patients vs 15.6% for placebo). In pre-specified subgroup analyses of Asian versus White patients with IPF in the INPULSIS® trials, race did not influence the effect of nintedanib on disease progression. © 2016 Asian Pacific Society of Respirology.

  12. Physician-led team triage based on lean principles may be superior for efficiency and quality? A comparison of three emergency departments with different triage models

    Directory of Open Access Journals (Sweden)

    Burström Lena

    2012-08-01

    Full Text Available Abstract Background The management of emergency departments (EDs principally involves maintaining effective patient flow and care. Different triage models are used today to achieve these two goals. The aim of this study was to compare the performance of different triage models used in three Swedish EDs. Using efficiency and quality indicators, we compared the following triage models: physician-led team triage, nurse first/emergency physician second, and nurse first/junior physician second. Methods All data of patients arriving at the three EDs between 08:00- and 21:00 throughout 2008 were collected and merged into a database. The following efficiency indicators were measured: length of stay (LOS including time to physician, time from physician to discharge, and 4-hour turnover rate. The following quality indicators were measured: rate of patients left before treatment was completed, unscheduled return within 24 and 72 hours, and mortality rate within 7 and 30 days. Results Data from 147,579 patients were analysed. The median length of stay was 158 minutes for physician-led team triage, compared with 243 and 197 minutes for nurse/emergency physician and nurse/junior physician triage, respectively (p  Conclusions Physician-led team triage seemed advantageous, both expressed as efficiency and quality indicators, compared with the two other models.

  13. Nowruz Calendar and Its Emergence from Different Perspectives and Its Impact on Various Aspects of People's Lives

    Directory of Open Access Journals (Sweden)

    Nina Behzadi

    2017-01-01

    Full Text Available This paper is a brief research about the meaning of Nowruz from different perspectives and its impact on people's interactions, which is celebrated at the dawn of spring in this ancient Iranian land. In different periods this ancient holiday has been seen with different opinions and its effects are all reflecting new life, happiness, love, blessing, birth, and growth, which are visible beautifully in nature. This paper is done by library and field studies and investigates the meanings and spiritual influences of this tradition in the culture, poetry, literature, philosophy, religious beliefs of the people of this land from the different perspectives (Islam - Zoroastrianism, etc.. By reviewing these theories on Nowruz and comparing it with present-day life, valuable results can be achieved so they can be used in the ups and downs of life.

  14. Emergence and initial development of Mimosa caesalpiniifolia Benth. seedlings for different substrates = Emergência e desenvolvimento inicial de plântulas de Mimosa caesalpiniifolia Benth. em função de diferentes substratos

    Directory of Open Access Journals (Sweden)

    Rômulo Magno Oliveira de Freitas

    2012-04-01

    Full Text Available The present study assessed the effects of different substrates on the emergence and initial development of Mimosa caesalpiniifolia Benth seedlings. For this purpose an experiment was done in a greenhouse of the Department of Plant Sciences of Universidade Federal Rural do Semi-Árido (UFERSA, Mossoró-RN. The statistical design was completely randomized (CRD, where treatments were composed of nine substrates (T1: vermiculite, T2: coconut fiber, T3: trade hortimix®, T4: vermiculite, coconut fiber and compost (1: 1:1, T5: coconut fiber and compost (1:1, T6: coconut fiber and compost (1:2,T7: vermiculite and compost (1:1, T8, vermiculite and compost organic (1:2 and T9: organic compost. All treatments were represented by four replications containing 25 seeds. The following variables were evaluated: emergency percentage, emergence rate index, length of shoot and root, stem diameter, dry leaves, stem, root and total leaf area, specific leaf area, leaf area ratio, and leaf weight ratio. Data were submitted to the Tukey test at 5% probability. The coconut fiber substrates, commercial hortimix® and vermiculite proved superior promoted good emergence and early development of seedlings. The mixture of vermiculite, coconut fiber and compost (1:1:1, coconut fiber and compost (1:1, coconut fiber and compost (1:2 and organic compost and vermiculite (1: 1 was not shown to be adequate for the cultivation of seedlings. There was no emergency in the pure organic compound in the mixture of compost and vermiculite (1:2.Key words - Vermiculite. Organic compost. Coconut fiber. Sabiá. Substrates. = Objetivou-se com o presente trabalho avaliar o efeito de diferentes substratos na emergência e desenvolvimento inicial de plântulas de sabiá (Mimosa caesalpiniifolia Benth.. Para isso, foi instalado um experimento em casa de vegetação do Departamento de Ciências Vegetais da Universidade Federal Rural do Semi-árido (UFERSA, Mossoró-RN. O delineamento estat

  15. A 6-gene signature identifies four molecular subgroups of neuroblastoma

    LENUS (Irish Health Repository)

    Abel, Frida

    2011-04-14

    Abstract Background There are currently three postulated genomic subtypes of the childhood tumour neuroblastoma (NB); Type 1, Type 2A, and Type 2B. The most aggressive forms of NB are characterized by amplification of the oncogene MYCN (MNA) and low expression of the favourable marker NTRK1. Recently, mutations or high expression of the familial predisposition gene Anaplastic Lymphoma Kinase (ALK) was associated to unfavourable biology of sporadic NB. Also, various other genes have been linked to NB pathogenesis. Results The present study explores subgroup discrimination by gene expression profiling using three published microarray studies on NB (47 samples). Four distinct clusters were identified by Principal Components Analysis (PCA) in two separate data sets, which could be verified by an unsupervised hierarchical clustering in a third independent data set (101 NB samples) using a set of 74 discriminative genes. The expression signature of six NB-associated genes ALK, BIRC5, CCND1, MYCN, NTRK1, and PHOX2B, significantly discriminated the four clusters (p < 0.05, one-way ANOVA test). PCA clusters p1, p2, and p3 were found to correspond well to the postulated subtypes 1, 2A, and 2B, respectively. Remarkably, a fourth novel cluster was detected in all three independent data sets. This cluster comprised mainly 11q-deleted MNA-negative tumours with low expression of ALK, BIRC5, and PHOX2B, and was significantly associated with higher tumour stage, poor outcome and poor survival compared to the Type 1-corresponding favourable group (INSS stage 4 and\\/or dead of disease, p < 0.05, Fisher\\'s exact test). Conclusions Based on expression profiling we have identified four molecular subgroups of neuroblastoma, which can be distinguished by a 6-gene signature. The fourth subgroup has not been described elsewhere, and efforts are currently made to further investigate this group\\'s specific characteristics.

  16. Cost-Effectiveness of Endovascular Stroke Therapy: A Patient Subgroup Analysis From a US Healthcare Perspective.

    Science.gov (United States)

    Kunz, Wolfgang G; Hunink, M G Myriam; Sommer, Wieland H; Beyer, Sebastian E; Meinel, Felix G; Dorn, Franziska; Wirth, Stefan; Reiser, Maximilian F; Ertl-Wagner, Birgit; Thierfelder, Kolja M

    2016-11-01

    Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients' initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location. A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting. Model input parameters were obtained from the literature, including recently pooled outcome data of 5 randomized controlled trials (ESCAPE [Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke], EXTEND-IA [Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial], MR CLEAN [Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands], REVASCAT [Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within 8 Hours of Symptom Onset], and SWIFT PRIME [Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment]). Probabilistic sensitivity analysis was performed to estimate uncertainty of the model results. Net monetary benefits, incremental costs, incremental effectiveness, and incremental cost-effectiveness ratios were derived from the probabilistic sensitivity analysis. The willingness-to-pay was set to $50 000/QALY. Overall, EVT+SC was cost-effective compared with SC (incremental cost: $4938, incremental effectiveness: 1.59 QALYs, and incremental cost-effectiveness ratio: $3110/QALY) in 100% of simulations. In all patient subgroups, EVT+SC led to gained QALYs (range: 0.47-2.12), and mean incremental cost-effectiveness ratios were considered cost

  17. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  18. The effect of active video games by ethnicity, sex and fitness: subgroup analysis from a randomised controlled trial.

    Science.gov (United States)

    Foley, Louise; Jiang, Yannan; Ni Mhurchu, Cliona; Jull, Andrew; Prapavessis, Harry; Rodgers, Anthony; Maddison, Ralph

    2014-04-03

    The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a randomised controlled trial (RCT). A two-arm, parallel RCT was conducted in overweight or obese children (n=322; aged 10-14 years) to determine the effect of active video games on body composition. Statistically significant overall treatment effects favouring the intervention group were found for body mass index, body mass index z-score and percentage body fat at 24 weeks. For these outcomes, pre-specified subgroup analyses were conducted among important baseline demographic (ethnicity, sex) and prognostic (cardiovascular fitness) groups. No statistically significant interaction effects were found between the treatment and subgroup terms in the main regression model (p=0.36 to 0.93), indicating a consistent treatment effect across these groups. Preliminary evidence suggests an active video games intervention had a consistent positive effect on body composition among important subgroups. This may support the use of these games as a pragmatic public health intervention to displace sedentary behaviour with physical activity in young people.

  19. The Emergence of Sex Differences in Personality Traits in Early Adolescence: A Cross-Sectional, Cross-Cultural Study

    Czech Academy of Sciences Publication Activity Database

    De Bolle, M.; De Fruyt, F.; McCrae, R. R.; Löckenhoff, C. E.; Costa, P.T., Jr.; Aguilar-Vafaie, M.E.; Ahn, C.; Ahn, H.; Alcalay, L.; Allik, J.; Avdeyeva, T.V.; Bratko, D.; Brunner-Sciarra, M.; Cain, T.R.; Chan, W.; Chittcharat, N.; Crawford, J.T.; Fehr, R.; Ficková, E.; Gelfand, M.J.; Graf, Sylvie; Gulgoz, S.; Hřebíčková, Martina; Jussim, L.; Klinkosz, W.; Knezevic, G.; Leibovich de Figueroa, N.; Lima, M.P.; Martin, T. A.; Marušić, I.; Mastor, K. A.; Nakazato, K.; Nansubuga, F.; Porrata, J.; Purić, D.; Realo, A.; Reátegui, N.; Rolland, J. P.; Schmidt, V.; Sekowski, A.; Shakespeare-Finch, J.; Shimonaka, Y.; Simonetti, F.; Siuta, J.; Szmigielska, B.; Vanno, V.; Wang, L.; Yik, M.

    2015-01-01

    Roč. 108, č. 1 (2015), s. 171-185 ISSN 0022-3514 R&D Projects: GA ČR GA13-25656S Institutional support: RVO:68081740 Keywords : personality * sex differences * adolescence * cross-cultural Subject RIV: AN - Psychology Impact factor: 4.736, year: 2015

  20. Do gender differences in audio-visual benefit and visual influence in audio-visual speech perception emerge with age?

    Directory of Open Access Journals (Sweden)

    Magnus eAlm

    2015-07-01

    Full Text Available Gender and age have been found to affect adults’ audio-visual (AV speech perception. However, research on adult aging focuses on adults over 60 years, who have an increasing likelihood for cognitive and sensory decline, which may confound positive effects of age-related AV-experience and its interaction with gender. Observed age and gender differences in AV speech perception may also depend on measurement sensitivity and AV task difficulty. Consequently both AV benefit and visual influence were used to measure visual contribution for gender-balanced groups of young (20-30 years and middle-aged adults (50-60 years with task difficulty varied using AV syllables from different talkers in alternative auditory backgrounds. Females had better speech-reading performance than males. Whereas no gender differences in AV benefit or visual influence were observed for young adults, visually influenced responses were significantly greater for middle-aged females than middle-aged males. That speech-reading performance did not influence AV benefit may be explained by visual speech extraction and AV integration constituting independent abilities. Contrastingly, the gender difference in visually influenced responses in middle adulthood may reflect an experience-related shift in females’ general AV perceptual strategy. Although young females’ speech-reading proficiency may not readily contribute to greater visual influence, between young and middle-adulthood recurrent confirmation of the contribution of visual cues induced by speech-reading proficiency may gradually shift females AV perceptual strategy towards more visually dominated responses.

  1. Evaluation of Lymphocyte Subgroups in Children With Down Syndrome.

    Science.gov (United States)

    Yılmaz, Cahide; Doğan, Murat; Başarslan, Fatmagül; Yılmaz, Nebi; Yuca, Sevil; Bulan, Keziban; Kaya, Avni; Çaksen, Hüseyin

    2015-09-01

    In this study, lymphocyte subgroups including blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were analyzed in children with Down syndrome (DS). The study includes 85 children with DS, followed at Department of Pediatrics, Faculty of Medicine, Yüzüncü Yil University and 64 healthy age-matched control participants. Blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were examined in both the groups. Significantly decreased blood CD3, CD4, and CD19 values were found in the study group (P < .05) when compared with the control group. In conclusion, we would like to emphasize that blood CD3, CD4, and CD19 levels were found to be decreased in children with DS. Based on these finding, we think that these decreased lymphocyte subgroups might be responsible for increased susceptibility to infections in children with DS. © The Author(s) 2013.

  2. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same...... relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful....

  3. CHROMOSOMAL CHANGES IN RENAL ONCOCYTOMAS - EVIDENCE THAT T(5-11)(Q35-Q13) MAY CHARACTERIZE A 2ND SUBGROUP OF ONCOCYTOMAS

    NARCIS (Netherlands)

    VANDENBERG, E; DIJKHUIZEN, T; STORKEL, S; DELARIVIERE, GB; MENSINK, HJA; OOSTERHUIS, JW; DEJONG, B; Dam, A.

    Many of the reported oncocytomas have different chromosome abnormalities, indicating that they comprise a cytogenetically heterogenous group of tumors consisting of potentially cytogenetic subgroups. We have performed cytogenetic studies on nine renal oncocytomas. Clonal abnormalities were present

  4. Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults

    Science.gov (United States)

    Bhatia, Ramona; Greene, George J.

    2016-01-01

    Abstract Purpose: Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been well-studied among emerging adults (18–29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults. Methods: From 2012 to 2013, 206 participants aged 18–27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity. Results: Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001). Conclusions: Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and cisgender counterparts. PMID:27726496

  5. Delineation of motoneuron subgroups supplying individual eye muscles in the human oculomotor nucleus

    Directory of Open Access Journals (Sweden)

    Emmanuel eChe-Ngwa

    2014-02-01

    Full Text Available The oculomotor nucleus (nIII contains the motoneurons of medial, inferior and superior recti (MR, IR, SR, inferior oblique (IO and levator palpebrae (LP muscles. The delineation of motoneuron subgroups for each muscle is well-known in monkey, but not in human. We studied the transmitter inputs to human nIII and the trochlear nucleus (nIV, which innervates the superior oblique muscle (SO, to outline individual motoneuron subgroups. Parallel series of sections from human brainstems were immunostained for different markers: acetylcholine transferase (ChAT combined with glutamate decarboxylase (GAD, calretinin (CR or glycine receptor (GlyR. The cytoarchitecture was visualized with Cresyl violet, Gallyas staining and expression of non-phosphorylated neurofilaments (NP-NF. Apart from nIV, seven subgroups were delineated in nIII: the central caudal nucleus (CCN, a dorsolateral (DL, dorsomedial (DM, central (CEN, and ventral group (VEN, the nucleus of Perlia (NP and the non-preganglionic centrally projecting Edinger-Westphal nucleus (EWcp. DL, VEN, NP and EWcp were characterized by a strong supply of GAD-positive terminals, in contrast to DM, CEN and nIV. CR-positive terminals and fibres were confined to CCN, CEN and NP. Based on location and histochemistry of the motoneuron subgroups in monkey, CEN is considered as the SR and IO motoneurons, DL and VEN as the B- and A-group of MR motoneurons, respectively, and DM as IR motoneurons. A good correlation between monkey and man is seen for the CR input, which labels only motoneurons of eye muscles participating in upgaze (SR, IO and LP. The CCN contained LP motoneurons, and nIV those of SO. This study provides a map of the individual subgroups of motoneurons in human nIII for the first time, and suggests that NP may contain upgaze motoneurons. Surprisingly, a strong GABAergic input to human MR motoneurons was discovered, which is not seen in monkey and may indicate a functional oculomotor specialization.

  6. Parasitism, emergence, and development of Spalangia endius (Hymenoptera: Pteromalidae) in pupae of different ages of Bactrocera cucurbitae (Diptera: Tephritidae).

    Science.gov (United States)

    Tang, Liang-De; Ji, Xun-Cong; Han, Yun; Fu, Bu-Li; Liu, Kui

    2015-01-01

    The wasp Spalangia endius Walker (Hymenoptera: Pteromalidae) is a major parasitoid of the pupae of fruit flies, which are a common agricultural pest. An understanding of this intricate host-parasitoid interaction could provide basic information necessary for the sustainable integrated biological control of fruit flies. In this study, we investigated the effect of S. endius on different-aged pupae of the melon fly Bactrocera cucurbitae Coquillett by using choice and nonchoice tests under laboratory conditions. We showed that S. endius females oviposited, and their progeny successfully developed, in different-aged pupae of B. cucurbitae regardless of the method of exposure. There was an oviposition preference for 3-5-d-old pupa. The highest mean percentage parasitism occurred on 4- and 5-d-old hosts, followed by 2- and 3-d-old hosts. The average development time for both males and females was significantly longer in 6-7-d-old hosts than in the younger host stages. Adult females that developed from younger host pupae (2-5-d old) were significantly heavier than those from older host pupae (6-7-d old), and they also lived longer. The sex ratio (proportion of females) of the parasite progeny decreased with an increase in host age. Host mortality also decreased gradually as the pupal age increased. The differences in development time, body weight, and longevity between females and males were significant. These results suggest that S. endius is a good candidate for the biological control of B. cucurbitae. © The Author 2015. Published by Oxford University Press on behalf of the Entomological Society of America.

  7. Does the impact of biodiversity differ between emerging and endemic pathogens? The need to separate the concepts of hazard and risk.

    Science.gov (United States)

    Hosseini, Parviez R; Mills, James N; Prieur-Richard, Anne-Hélène; Ezenwa, Vanessa O; Bailly, Xavier; Rizzoli, Annapaola; Suzán, Gerardo; Vittecoq, Marion; García-Peña, Gabriel E; Daszak, Peter; Guégan, Jean-François; Roche, Benjamin

    2017-06-05

    Biodiversity is of critical value to human societies, but recent evidence that biodiversity may mitigate infectious-disease risk has sparked controversy among researchers. The majority of work on this topic has focused on direct assessments of the relationship between biodiversity and endemic-pathogen prevalence, without disentangling intervening mechanisms; thus study outcomes often differ, fuelling more debate. Here, we suggest two critical changes to the approach researchers take to understanding relationships between infectious disease, both endemic and emerging, and biodiversity that may help clarify sources of controversy. First, the distinct concepts of hazards versus risks need to be separated to determine how biodiversity and its drivers may act differently on each. This distinction is particularly important since it illustrates that disease emergence drivers in humans could be quite different to the general relationship between biodiversity and transmission of endemic pathogens. Second, the interactive relationship among biodiversity, anthropogenic change and zoonotic disease risk, including both direct and indirect effects, needs to be recognized and accounted for. By carefully disentangling these interactions between humans' activities and pathogen circulation in wildlife, we suggest that conservation efforts could mitigate disease risks and hazards in novel ways that complement more typical disease control efforts.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Author(s).

  8. An exploration of familial associations of two movement pattern-derived subgroups of chronic disabling low back pain; a cross-sectional cohort study.

    Science.gov (United States)

    Caneiro, Joao Paulo; Labie, Céline; Sulley, Emma; Briggs, Andrew M; Straker, Leon M; Burnett, Angus F; O'Sullivan, Peter B

    2016-04-01

    Altered movement patterns with pain have been demonstrated in children, adolescents and adults with chronic disabling low back pain (CDLBP). A previously developed classification system has identified different subgroups including active extension and multidirectional patterns in patients with CDLBP. While familial associations have been identified for certain spinal postures in standing, it is unknown whether a familial relationship might exist between movement pattern-derived subgroups in families with CDLBP. This study explored whether familial associations in movement pattern-derived subgroups within and between members of families with CDLBP existed. Cross-sectional cohort study. 33 parents and 28 children with CDLBP were classified into two subgroups based on clinical analysis of video footage of postures and functional movements, combined with aggravating factors obtained from Oswestry Disability Questionnaire. Prevalence of subgroups within family members was determined, associations between parent and child's subgroup membership was evaluated using Fisher's exact test, and spearman's correlation coefficient was used to determine the strength of association between familial dyads. The majority of parents were classified as active extenders, sons predominately multidirectional and daughters were evenly distributed between the two subgroups. No significant association was found when comparing subgroups in nine parent-child relationships. The exploration of a small cohort of family dyads in this study demonstrated that children's movement pattern-derived subgroups could not be explained by their parents' subgroup membership. These results cannot be generalised to the CLBP population due to this study's small sample. Larger sample studies are needed to further elucidate this issue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The prevalence of risk factors for general recidivism in female adolescent sexual offenders: A comparison of three subgroups

    NARCIS (Netherlands)

    van der Put, C.E.

    2013-01-01

    To our knowledge, there are no former studies in which subgroups of female adolescent sexual offenders are studied. Therefore, we examined differences in risk factors for general recidivism between female adolescents who have committed a felony sexual offense against a younger child (CSO, n = 25),

  10. Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes.

    Science.gov (United States)

    Khanbhai, Yasmin; Smith, David; Battersby, Malcolm

    2017-03-01

    Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.

  11. Use of a fragment of the tuf gene for phytoplasma 16Sr group/subgroup differentiation

    DEFF Research Database (Denmark)

    Contaldo, Nicoletta; Canel, Alessandro; Makarova, Olga

    2011-01-01

    The usefulness of RFLP analyses on a 435 bp fragment of the tuf gene for preliminary identification of phytoplasmas from a number of phytoplasma ribosomal groups and/or 'Candidatus. Phytoplasma' was verified. The strains employed belong to thirteen 16Sr DNA groups and 22 different subgroups and w...

  12. Identification of Subgroups of Women with Carpal Tunnel Syndrome with Central Sensitization.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Fernández-Muñoz, Juan J; Navarro-Pardo, Esperanza; da-Silva-Pocinho, Ricardo F; Ambite-Quesada, Silvia; Pareja, Juan A

    2016-09-01

    Identification of subjects with different sensitization mechanisms can help to identify better therapeutic strategies for carpal tunnel syndrome (CTS). The aim of the current study was to identify subgroups of women with CTS with different levels of sensitization. A total of 223 women with CTS were recruited. Self-reported variables included pain intensity, function, disability, and depression. Pressure pain thresholds (PPT) were assessed bilaterally over median, ulnar, and radial nerves, C5-C6 joint, carpal tunnel, and tibialis anterior to assess widespread pressure pain hyperalgesia. Heat (HPT) and cold (CPT) pain thresholds were also bilaterally assessed over the carpal tunnel and the thenar eminence to determine thermal pain hyperalgesia. Pinch grip force between the thumb and the remaining fingers was calculated to determine motor assessment. Subgroups were determined according to the status on a previous clinical prediction rule: PPT over the affected C5-C6 joint 66 points. The ANOVA showed that women within group 1 (positive rule, n = 60) exhibited bilateral widespread pressure hyperalgesia (P < 0.001) and bilateral thermal thresholds (P < 0.001) than those within group 2 (negative rule, n = 162). Women in group 1 also exhibited higher depression than those in group 2 (P = 0.023). No differences in self-reported variables were observed. This study showed that a clinical prediction rule originally developed for identifying women with CTS who are likely to respond favorably to manual physical therapy was able to identify women exhibiting higher widespread pressure hyper-sensitivity and thermal hyperalgesia. This subgroup of women with CTS exhibiting higher sensitization may need specific therapeutic programs. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Taxonomic boundaries, phylogenetic relationships and biogeography of the Drosophila willistoni subgroup (Diptera: Drosophilidae).

    Science.gov (United States)

    Robe, L J; Cordeiro, J; Loreto, E L S; Valente, V L S

    2010-06-01

    The Drosophila willistoni subgroup represents a complex with varying taxonomic levels. It encompasses D. willistoni and its five sibling species: D. equinoxialis, D. insularis, D. paulistorum, D. pavlovskiana and D. tropicalis. Of these, D. equinoxialis, D. tropicalis and D. willistoni present differentiation at subspecific level, whereas D. paulistorum represents a superspecies, formed by six semispecies. Despite this taxonomic and evolutionary complexity, many of these semi and subspecific taxa have not yet had their phylogenetic status tested in an explicitly molecular study. Aiming to contribute to the understanding of the evolution of this challenging group, we analyzed nucleotide sequences from two mitochondrial and four nuclear datasets, both individually and simultaneously, through different phylogenetic methods. High levels of incongruence were detected among partitions, especially concerning the mitochondrial sequences. As this incongruence was found to be statistically significant and robust to the use of different models and approaches, and basically restricted to mitochondrial loci, we suggest that it may stem mainly from hybridization-mediated asymmetrical introgression. Despite this, our nuclear data finally led to a phylogenetic hypothesis which further refines several aspects related to the willistoni subgroup phylogeny. In this respect, D. insularis, D. tropicalis, D. willistoni and D. equinoxialis successively branched off from the willistoni subgroup main stem, which recently subdivided to produce D. paulistorum and D. pavlovskiana. As regards the semispecies evolution, we found evidence of a recent diversification, which highly influenced the obtained results due to the associated small levels of genetic differentiation, further worsened by the possibly associated incompletely sorted ancestral polymorphisms and by the possibility of introgression. This study also raises the question of whether these semispecies are monophyletic at all. This

  14. Comparison of throughput times for limited English proficiency patient visits in the emergency department between different interpreter modalities.

    Science.gov (United States)

    Grover, Amy; Deakyne, Sara; Bajaj, Lalit; Roosevelt, Genie E

    2012-08-01

    Appropriate interpretation is imperative for families with limited English proficiency (LEP). We compared throughput times for ED visits involving families with LEP based on type of interpretation provided: in-person interpretation, remote telephonic interpretation or bilingual providers. This study is a secondary analysis of a prospective study of caretaker satisfaction with different interpreter modalities. We queried the medical record for event time stamps, clinical factors and disposition. The in-person cohort (116 min) had a significantly shorter total throughput time than telephonic (141 min) and bilingual provider (153 min) cohorts (P interpretation when controlling for potential confounders such as admission rate (P = 0.006). In-person interpretation significantly decreased ED throughput times and may be an important consideration in the choice of interpreter modality.

  15. Two subgroups of antipsychotic-naive, first-episode schizophrenia patients identified with a Gaussian mixture model on cognition and electrophysiology.

    Science.gov (United States)

    Bak, N; Ebdrup, B H; Oranje, B; Fagerlund, B; Jensen, M H; Düring, S W; Nielsen, M Ø; Glenthøj, B Y; Hansen, L K

    2017-04-11

    Deficits in information processing and cognition are among the most robust findings in schizophrenia patients. Previous efforts to translate group-level deficits into clinically relevant and individualized information have, however, been non-successful, which is possibly explained by biologically different disease subgroups. We applied machine learning algorithms on measures of electrophysiology and cognition to identify potential subgroups of schizophrenia. Next, we explored subgroup differences regarding treatment response. Sixty-six antipsychotic-naive first-episode schizophrenia patients and sixty-five healthy controls underwent extensive electrophysiological and neurocognitive test batteries. Patients were assessed on the Positive and Negative Syndrome Scale (PANSS) before and after 6 weeks of monotherapy with the relatively selective D 2 receptor antagonist, amisulpride (280.3±159 mg per day). A reduced principal component space based on 19 electrophysiological variables and 26 cognitive variables was used as input for a Gaussian mixture model to identify subgroups of patients. With support vector machines, we explored the relation between PANSS subscores and the identified subgroups. We identified two statistically distinct subgroups of patients. We found no significant baseline psychopathological differences between these subgroups, but the effect of treatment in the groups was predicted with an accuracy of 74.3% (P=0.003). In conclusion, electrophysiology and cognition data may be used to classify subgroups of schizophrenia patients. The two distinct subgroups, which we identified, were psychopathologically inseparable before treatment, yet their response to dopaminergic blockade was predicted with significant accuracy. This proof of principle encourages further endeavors to apply data-driven, multivariate and multimodal models to facilitate progress from symptom-based psychiatry toward individualized treatment regimens.

  16. Distinctive subgroups derived by cluster analysis based on pain and psychological symptoms in Swedish older adults with chronic pain - a population study (PainS65+).

    Science.gov (United States)

    Larsson, Britt; Gerdle, Björn; Bernfort, Lars; Levin, Lars-Åke; Dragioti, Elena

    2017-09-02

    Improved knowledge based on clinical features of chronic pain in older adults would be valuable in terms of patient-orientated approaches and would provide support for health care systems in optimizing health care resources. This study identifies subgroups based on pain and psychological symptoms among Swedish older adults in the general population and compares derived subgroups with respect to socio-demographics, health aspects, and health care costs. This cross-sectional study uses data collected from four registers and one survey. The total sample comprised 2415 individuals ≥65 years old. A two-step cluster analysis was performed. Data on pain intensity, number of pain sites, anxiety, depression, and pain catastrophizing were used as classification variables. Differences in socio-demographics, quality of life, general health, insomnia, and health care costs among the clusters were investigated. Association of the clusters with the above parameters was further evaluated using multinomial logistic regression. Four major clusters were identified: Subgroup 1 (n = 325; 15%) - moderate pain and high psychological symptoms; Subgroup 2 (n = 516; 22%) - high pain and moderate psychological symptoms; Subgroup 3 (n = 686; 30%) - low pain and moderate psychological symptoms; and Subgroup 4 (n = 767; 33%) - low pain and low psychological symptoms. Significant differences were found between the four clusters with regard to age, sex, educational level, family status, quality of life, general health, insomnia, and health care costs. The multinomial logistic regression analysis revealed that Subgroups 1 and 2, compared to Subgroup 4, were significantly associated with decreased quality of life, decreased general health, and increased insomnia. Subgroup 3, compared to Subgroup 4, was associated with decreased general health and increased insomnia. In addition, compared to Subgroup 4, Subgroups 1 and 2 were significantly associated with higher health care costs. Two

  17. Discovery-based protein expression profiling identifies distinct subgroups and pathways in leiomyosarcomas

    DEFF Research Database (Denmark)

    Kirik, Ufuk; Hansson, Karin; Krogh, Morten

    2014-01-01

    subgroups within the leiomyosarcomas with distinct protein expression patterns. Pathways analysis indicates that key biologic nodes like apoptosis, cytoskeleton remodeling, and telomere regulation are differentially regulated among these subgroups. Finally, investigating the similarities between protein...

  18. An overview of statistical planning to address subgroups in confirmatory clinical trials.

    Science.gov (United States)

    Koch, Gary G; Schwartz, Todd A

    2014-01-01

    The effects of treatments within demographic and clinical subgroups of patients are of major interest in most confirmatory clinical trials. Potential factors for defining subgroups include gender, age, disease severity, and geographic region. A major statistical issue for the interpretation of treatment comparisons for subgroups is whether the role of a subgroup is inferential, supportive, or exploratory through respectively corresponding to a primary, key secondary, or hypothesis-generating assessment. This article discusses statistical planning to control type 1 error for the multiple comparisons that correspond to the scope of prespecified inferential subgroups, and it provides some suggestions for addressing the type 2 error that can pertain to prespecified supportive subgroups. Treatment comparisons for exploratory subgroups without a priori specification should always have a very cautious interpretation that accounts for how random variation can influence their pattern of results, although the suggested methods for supportive subgroups can be helpful in this light.

  19. Similarities and Differences of the Emerging Prison Problems in England and Wales vs. Kosovo: a Sociological and Criminological Perspective

    Directory of Open Access Journals (Sweden)

    MSc. Arben Lubach

    2015-06-01

    Full Text Available Prisons are probably the most debatable institutions within the Criminal Justice System in any given country and as such demand contemporary explanation and understanding. Despite the fact that prisons affect the life of many people, not only of those incarcerated but also of their families and friends, nevertheless they do not receive the necessary attention; instead they remain the most enigmatic and less interesting organizations amongst the Criminal Justice System in general. This paper, by using a literature review approach, looks into some of the most important debates, similarities and differences respectively, about prisons in England and Wales, and Kosovo. Whilst most of the problems both countries face are of similar nature, Kosovo nevertheless faces some additional problems which are not visible in the England and Wales prisons. The paper further examines the causes of these problems in the Kosovo prisons and the involvement of the international community and their efforts in assisting Kosovo in fixing the problems in the field of corrections as part of the Kosovo state-building process. The paper will show that both countries face difficulties with similar problem areas such as overcrowding, running costs, and so on. However, compared to England and Wales, the problems Kosovo prison system is facing are of a more serious and complicated nature which require serious involvement of the Kosovo government and policy makers as well as the international community which has been present in Kosovo since 1999.

  20. Emergence and early development of cupuassu seedlings grown on different substrates and under different conditions of shade =Emergência e desenvolvimento inicial de plântulas de cupuaçu cultivadas sob diferentes substratos e condições de sombreamento

    Directory of Open Access Journals (Sweden)

    Elias Ariel Moura

    2016-02-01

    Full Text Available O The cupuassu can be propagated either sexually or asexually, with seeds being the process most widely employed. Suitable environments for the production of seedlings can therefore provide better conditions for initial growth in the field, and contribute to an increase in the homogeneity and health, and to a reduction in the mortality of plants when planting, with factors such as light and type of substrate being important for germination and initial emergence. To this effect, the aim of the present study was to evaluate the effect of different substrates, and the influence of shading on emergence and initial growth in cupuassu seedlings. The experiment was carried out at Embrapa Roraima, using a completely randomised design in a 3 x 7 factorial scheme, comprising different environments (a plot with no covering, a plot with sombrite covering, giving 50% shade, and a plot with a clear-plastic, 100-micron covering combined with different substrates (sand, soil, vivatto®, sawdust, sand+soil, sand+soil+vivatto® and sand+soil+sawdust. Percentage emergence and emergence speed index (ESI were evaluated at five days after seeding, and shoot length, number of leaves, leaf area, root-system length, stem diameter, and shoot and root-system dry weight were evaluated at 50 days. It was found that the best values for percentage emergence, ESI and initial development of the cupuassu seedlings were obtained when using a substrate consisting of sand+soil+sawdust. The environment with 50% shade affords greater percentage emergence, ESI, stem diameter and root dry mass. = O cupuaçu pode ser propagado por via sexuada ou assexuada, sendo a via seminífera o processo mais utilizado. Dessa forma, ambientes apropriados para a produção de mudas propiciam melhores condições para o crescimento inicial em campo, colaborando para o aumento da homogeneidade, sanidade e redução da mortalidade de plantas no momento do plantio. Assim, fatores como luz e tipo de

  1. [Stable tachycardia with wide QRS complex in pre-hospital emergency medicine].

    Science.gov (United States)

    Ohlow, M-A; Beierlein, A; Müller, S; von Korn, H; Geller, J-C; Yu, J; Lauer, B

    2005-11-25

    Sustained, stable wide QRS-complex tachycardia (WCT) remains a diagnostic challenge, because the treatment of supra-ventricular tachycardia (SVT) with aberrant conduction differs considerably from that of a ventricular tachycardia (VT). A usual recommendation for treating a case of a stable WCT is to manage it as if it were VT, in accordance with the consideration of "first do no harm". The aim of this study was to determine whether Board-certified emergency-physicians are able to differentiate VT from SVT with aberrant conduction in a high percentage of cases (> 90%), thus to assure more precise prehospital treatment." Eight electrocardiograms with WCT (four with electrophysiologically proven VT or SVT, respectively) were evaluated in a blinded fashion by 64 Board-certified emergency-physicians (23 female, 41 male, mean age: 37,8 + 5,1 years). Initially, the diagnosis had to be made without any further information. Afterwards the same electrocardiograms were presented again, providing important additional information. 55% of the study population were able to establish the correct diagnosis merely by evaluating the electrocardiogram. Providing the above mentioned additional information, the number of correct diagnoses increased to 61%. These results were roughly similar in all subgroups, only the subgroup of cardiologists showed a trend to better results with correct diagnoses in 68% without and 73 % with additional information. None of the subgroups reached the pre-specified cut-off of > or = 90% correct diagnoses. Specialist status as well as experience in emergency medicine had no significant influence on the results, only the subgroup of emergency physicians with an experience of more than five years showed a trend towards a higher rate of correct diagnosis, compared with the subgroup with less than one year experience in emergency medicine. In cases of stable WCT the evaluation of the electrocardiogram without further information in prehospital emergency

  2. Analysis of efficacy and safety of treatment with collagenase Clostridium histolyticum among subgroups of patients with Dupuytren contracture.

    Science.gov (United States)

    Raven, Raymond B; Kushner, Harvey; Nguyen, Dat; Naam, Nash; Curtin, Catherine

    2014-09-01

    Collagenase Clostridium histolyticum (CCH) injection is a nonoperative treatment of hand contractures from Dupuytren disease. This study assessed the efficacy and safety of CCH in several subgroups of patients with increased surgical risk.Data were pooled from 3 randomized, placebo-controlled, double-blind trials. This analysis included 271 patients with metacarpophalangeal (n = 167) or proximal interphalangeal (n = 104) joint contractures greater than or equal to 20 degrees treated with CCH (0.58 mg collagenase per injection). Subgroups included age, sex, and diabetes status. End points included rate of clinical success (reduction in contracture to 0-5 degrees of normal) and percentage of adverse events.There was no significant difference in clinical success by age, diabetes status, or sex with 63% reaching the end point. There was no difference in adverse events among the subgroups, with peripheral edema, contusion, and injection-site hemorrhage being most common.High-risk subgroups do not demonstrate differences in efficacy or safety with CCH treatment of Dupuytren-related contractures.

  3. The Effectiveness of Mechanical Traction Among Subgroups of Patients With Low Back Pain and Leg Pain: A Randomized Trial.

    Science.gov (United States)

    Thackeray, Anne; Fritz, Julie M; Childs, John D; Brennan, Gerard P

    2016-03-01

    Randomized clinical trial. Background The recommended initial management strategy for patients with low back pain and signs of nerve root compression is conservative treatment, but there is little evidence to guide the most appropriate management strategy. Preliminary research suggests that a treatment protocol of mechanical traction and extension-oriented exercises may be effective, particularly in a specific subgroup of patients. To examine the effectiveness of mechanical traction in patients with lumbar nerve root compression and within a predefined subgroup. One hundred twenty patients with low back pain with nerve root compression were recruited from physical therapy clinics. Using predefined subgrouping criteria, patients were stratified at baseline and randomized to receive an extension-oriented treatment approach with or without the addition of mechanical traction. During a 6-week period, patients received up to 12 treatment visits. Primary outcomes of pain and disability were collected at 6 weeks, 6 months, and 1 year by assessors blinded to group allocation. Outcomes were examined using linear mixed-model analyses examining change over time by treatment and the interaction between treatment and subgrouping status. The mean ± SD age of participants was 41.1 ± 11.3 years, median duration of symptoms was 62 days, and 57% were male. No significant differences in disability or pain outcomes were noted between treatment groups at any time point, nor was any interaction found between subgroup status and treatment. Patients with lumbar nerve root compression presenting for physical therapy can expect significant changes in disability and pain over a 6-week treatment period. There is no evidence that mechanical lumbar traction in combination with an extension-oriented treatment is superior to extension-oriented exercises alone in the management of these patients or within a predefined subgroup of patients. The study protocol was registered with Clinical

  4. Differential impact of supported housing on selected subgroups of homeless veterans with substance abuse histories.

    Science.gov (United States)

    O'Connell, Maria J; Kasprow, Wesley J; Rosenheck, Robert A

    2012-12-01

    Studies have demonstrated that supported housing is an effective intervention for individuals who are homeless and have a mental illness or substance use disorder. This study examined data from an experimental trial of the U.S. Department of Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program to identify differences in the program's impact on subgroups defined by sociodemographic or clinical characteristics. Data were analyzed from 259 male homeless veterans with substance abuse problems who were randomly assigned to HUD-VASH (intensive case management [ICM] plus rent subsidy vouchers), ICM only, or treatment as usual between June 1992 and December 1995. Four subgroups were defined: African American versus Caucasian, younger versus older than 42.3 years, co-occurring diagnoses of mental illness versus diagnosis of a substance use disorder only, and active versus less active substance use upon program entry. Mixed models were used to identify significant interactions between HUD-VASH assignment and each subgroup. Compared with ICM alone, HUD-VASH was associated with more positive housing outcomes for Caucasians, veterans with co-occurring mental disorders, and veterans who were active substance users. HUD-VASH was associated with more positive socioclinical outcomes for African Americans. No differences were observed in housing or socioclinical outcomes as a function of age. Among homeless veterans with a substance use disorder, Caucasians and those with active substance use showed greater housing benefits than other veterans from HUD-VASH than from ICM alone. African Americans showed greater socioclinical benefit than Caucasians from HUD-VASH versus ICM. Interaction analysis deserves further study.

  5. Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and Fibromyalgia Syndrome.

    Science.gov (United States)

    Pfau, Doreen B; Rolke, Roman; Nickel, Ralf; Treede, Rolf-Detlef; Daublaender, Monika

    2009-12-15

    Some patients with myofascial pain from temporomandibular disorders (TMD) report pain in extra-trigeminal body regions. Our aim was to distinguish TMD as regional musculoskeletal pain syndrome (n=23) from a widespread pain syndrome (FMS; n=18) based on patients' tender point scores, pain drawings and quantitative sensory testing (QST) profiles. Referenced to 18 age- and gender-matched healthy subjects significant group differences for cold, pressure and pinprick pain thresholds, suprathreshold pinprick sensitivity and mechanical detection thresholds were found. Pain sensitivity in TMD patients ranged between those of FMS patients and healthy controls. The group of TMD patients was inhomogeneous with respect to their tender point count with an insensitive group (n=12) resembling healthy controls and a sensitive TMD group (n=9) resembling FMS patients. Nevertheless sensitive TMD patients did not fulfil diagnostic criteria for FMS in regard to widespread pain as shown by their pain drawings. TMD subgroups did not differ with respect to psychological parameters. The sensitive subgroup was more sensitive compared to healthy controls and to insensitive TMD patients in regard to their QST profile over all test areas as well as to their tenderness over orofacial muscles and trigeminal foramina. However, sensitive TMD patients had a short pain duration arguing against a transition from TMD to FMS over time. Data rather suggest an overlap in pathophysiology with FMS, e.g. a disturbance of central pain processing, in this subgroup of TMD patients. Those patients could be identified on the basis of their tender point count as an easy practicable screening tool.

  6. {sup 1}H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Hajek, Milan; Dezortova, Monika [Institute for Clinical and Experimental Medicine, MR Unit, Department of Diagnostic and Interventional Radiology, Prague (Czech Republic); Krsek, Pavel; Komarek, Vladimir [Charles University, Department of Pediatric Neurology, Prague 5 (Czech Republic); Marusic, Petr; Tomasek, Martin; Krijtova, Hana [Charles University, Department of Neurology, Prague (Czech Republic); Zamecnik, Josef [Charles University, Department of Pathology and Molecular Medicine, Prague (Czech Republic); Kyncl, Martin [Charles University, Department of Radiology, Prague (Czech Republic)

    2009-02-15

    The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy ({sup 1}H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal {sup 1}H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and {sup 1}H MRS 83%. MRI together with {sup 1}H MRS correctly lateralized 100% of patients. Nineteen subjects had 'classical' hippocampal sclerosis (HS), whereas the remaining 16 patients had 'mild' HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in {sup 1}H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that {sup 1}H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized {sup 1}H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral {sup 1}H MRS abnormality on post-surgical seizure outcome. (orig.)

  7. Mobilidade e persistência de herbicidas aplicados em pré-emergência em diferentes solos Mobility and persistence of herbicides applied in pre-emergence on different soils

    Directory of Open Access Journals (Sweden)

    P.A. Monquero

    2008-06-01

    Full Text Available O objetivo deste ensaio foi verificar a mobilidade e persistência de herbicidas aplicados em pré-emergência em diferentes solos e quantidades de palha de cana-de-açúcar. Os herbicidas ametryn + clomazone (1.500 + 1.000 g i.a. ha-1, isoxaflutole (187,5 g i.a. ha-1 e diuron + hexazinone (1.170 + 330 g i.a. ha-1 foram aplicados em solo com textura argilosa e média nas seguintes condições: aplicação sobre 10 e 15 t ha-1 de palha com posterior simulação de chuva; simulação de chuva sobre o solo seguida da aplicação dos herbicidas, sendo coberto posteriormente com palha seca (10 t ha-1; aplicação dos herbicidas no solo sem palha; e testemunha. Aos 10, 20, 40 e 60 dias após aplicação dos herbicidas (DAA, foram semeados como bioindicadores sorgo e pepino, que foram avaliados com relação à fitotoxicidade aos 21 dias após emergência. A mistura ametryn + clomazone aplicada diretamente no solo controlou o bioindicador até 40 DAA, entretanto, após esse período, o efeito residual foi menor. A palha de cana-de-açúcar afetou negativamente o desempenho deste produto. O herbicida isoxaflutole aplicado diretamente no solo apresentou efeito residual até 60 DAA, com 82,5 e 77,5% de controle do bioindicador, em solos com textura argilosa e média, respectivamente; a presença de 10 e 15 t ha-1 de palha não alterou sua eficácia até 20 DAA. Para diuron + hexazinone aplicados no solo sem a presença de palha, verificou-se persistência até 60 DAA, principalmente em solo com textura argilosa; a deposição de 15 t ha-1 de palha reduziu a eficácia desta mistura.The objective of this work was to verify the mobility and persistence of herbicides applied in pre-emergence on different soils and amounts of sugarcane straw. The herbicides ametryn + clomazone (1,500 + 1,000 g i.a. ha-1, isoxaflutole (187,5 g.i.a. ha-1 and diuron + hexazinone (1,170 + 330 g i.a. ha-1 were applied in soil with clayey and medium texture under the following

  8. Number of patients needed to discriminate between subgroups in patient reported outcome measures

    DEFF Research Database (Denmark)

    Paulsen, Aksel

    2011-01-01

    Background: Patient reported outcome-measures (PROs) are increasingly used in orthopedics. Information on number of patients needed in different settings is warranted. Aim: To assess the number of patients needed for different PROs to discriminate between subgroups of age, gender, and diagnosis...... with sample size calculations or by power calculations and simulated ANOVA F tests, depending on the number of groups. Results: To discriminate between gender, the least number needed to find a statistically significant difference in mean sum score in each group was 298 (OHS) while HOOS QoL required the most....... Methods: 5777 primary THA patients, operated 1‐2, 5‐6, and 10‐11 years ago. SF‐12 Health Survey (SF-12), EQ-5D, Oxford 12‐item Hip Score (OHS), and Hip dysfunction and Osteoarthritis Outcome Score (HOOS) were included. The different PRO subscales abilities to discriminate between groups were studied using...

  9. Diferenças regionais de conhecimento, opinião e uso de contraceptivo de emergência entre universitários brasileiros de cursos da área de saúde Regional differences in knowledge, attitudes, and practice in emergency contraceptive use among health sciences university students in Brazil

    Directory of Open Access Journals (Sweden)

    Flávia Calanca da Silva

    2010-09-01

    Full Text Available O objetivo deste estudo foi avaliar as diferenças regionais de conhecimento, opinião e uso de anticoncepção de emergência entre universitários brasileiros. Questionário semi-estruturado abordando conhecimento, opinião, experiência com anticoncepção de emergência e comportamento sexual foi aplicado a adolescentes de universidades brasileiras. Para análise estatística utilizou-se o teste exato de Fisher e ANOVA. Diferenças foram significantes quando o valor de p The aim of this study was to evaluate regional differences in knowledge, attitudes, and practice in emergency contraception use among Brazilian university students. A sample of university students answered a semi-structured questionnaire on knowledge, attitudes, and practice related to emergency contraception and sexual behavior. Fisher's exact test and ANOVA were used for statistical analysis. Statistical significance was set at p < 0.05. Ninety-six percent (n = 588 of the students had heard of emergency contraception, and 19% (n = 111 knew all the situations in which emergency contraception is indicated, with statistical differences between regions of the country. Forty-two percent of sexually active women in the sample had already used emergency contraception; 35% (n = 207 of students equated emergency contraception with abortion; and 81% (n = 473 thought emergency contraception involves health risks. No significant difference was observed between regions of the country regarding use and attitudes towards emergency contraception. Inter-regional differences in knowledge had no impact on students' attitudes and practice in emergency contraception. National awareness-raising campaigns are needed to improve knowledge on emergency contraception.

  10. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing ...

  11. Differences between attendance in emergency care of male and female victims of traffic accidents in Porto alegre, Rio Grande do Sul state, Brazil

    Directory of Open Access Journals (Sweden)

    Raquel Forgiarini Saldanha

    2014-09-01

    Full Text Available Driving under the influence of alcohol/ drugs (DUI is a well-established risk factor for traffic accidents, and men and women have different consumption patterns. The scope of this paper is to analyze differences in alcohol and drug consumption, as well as on behavior associated with traffic accidents among men and women. A cross-sectional study was conducted with 609 sequential traffic accident victims attended in emergency care from Porto Alegre. Subjects gave a structured interview, were breathalyzed and had a saliva test for alcohol/drug screening. Results showed that women were mainly passengers or pedestrians (p < 0.001. There was no significant difference in positive blood alcohol concentration. However, men reported more binge drinking and THC use, while women had more benzodiazepine in their saliva (p<0.05. This is the first Brazilian study to compare alcohol and drug use among men and women who were the victims of traffic accidents. Results point to differences in the pattern of substance abuse, as well on risk behavior. Data may be useful for specific prevention strategies that take gender differences into consideration.

  12. Ophthalmic emergencies.

    Science.gov (United States)

    Mandell, Deborah C; Holt, Elaine

    2005-03-01

    Ophthalmic emergencies are common presenting complaints in an emergency room. Most ophthalmic emergencies can be treated and stabilized until an ophthalmologist can be consulted. Most ocular emergencies involve loss of vision, compromised globe integrity, or severe ocular pain. Delay in treating true emergencies may result ina blind eye or loss of an eye. This article discusses the clinical signs,diagnosis, and treatment as well as the prognosis of some of the more common ophthalmic emergencies.

  13. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

  14. Three subgroups of pain profiles identified in 227 women with arthritis: a latent class analysis.

    Science.gov (United States)

    de Luca, Katie; Parkinson, Lynne; Downie, Aron; Blyth, Fiona; Byles, Julie

    2017-03-01

    The objectives were to identify subgroups of women with arthritis based upon the multi-dimensional nature of their pain experience and to compare health and socio-demographic variables between subgroups. A latent class analysis of 227 women with self-reported arthritis was used to identify clusters of women based upon the sensory, affective, and cognitive dimensions of the pain experience. Multivariate multinomial logistic regression analysis was used to determine the relationship between cluster membership and health and sociodemographic characteristics. A three-class cluster model was most parsimonious. 39.5 % of women had a unidimensional pain profile; 38.6 % of women had moderate multidimensional pain profile that included additional pain symptomatology such as sensory qualities and pain catastrophizing; and 21.9 % of women had severe multidimensional pain profile that included prominent pain symptomatology such as sensory and affective qualities of pain, pain catastrophizing, and neuropathic pain. Women with severe multidimensional pain profile have a 30.5 % higher risk of poorer quality of life and a 7.3 % higher risk of suffering depression, and women with moderate multidimensional pain profile have a 6.4 % higher risk of poorer quality of life when compared to women with unidimensional pain. This study identified three distinct subgroups of pain profiles in older women with arthritis. Women had very different experiences of pain, and cluster membership impacted significantly on health-related quality of life. These preliminary findings provide a stronger understanding of profiles of pain and may contribute to the development of tailored treatment options in arthritis.

  15. [Emergency contraception: efficacy difference between levonorgestrel and ulipristal acetate depending on the follicular size at the time of an unprotected sexual intercourse].

    Science.gov (United States)

    Jamin, C

    2015-03-01

    The most used treatment in the world for emergency contraception is the levonorgestrel (LNG) pill. However, its efficacy decreases if it is administered 3 days after unprotected sexual intercourse, whereas the ulipristal acetate (UPA) pill is effective up until 5 days afterwards. Pooled clinical data show that UPA is more effective than LNG when taken very shortly after intercourse (within 24h) or, conversely, between 72 and 120 h after intercourse. UPA is also more effective than LNG in inhibiting follicular rupture when administered near the time of ovulation. We show here why overall UPA is more effective than LNG in reducing the rate of unwanted pregnancies by demonstrating the effect of each product depending on the follicular size at the time of an unprotected sexual intercourse We also explain the difference between UPA and LNG in the maximum time to administration simply by the shift in ovulation and the fact that UPA has an effect on larger follicles than LNG does (18 mm vs. 14 mm), without postulating a hypothetical endometrial effect. We also explain why UPA and LNG remain emergency contraceptives and should not be used for daily contraception. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Perceived differences in the management of mental health patients in remote and rural australia and strategies for improvement: findings from a national qualitative study of emergency clinicians.

    Science.gov (United States)

    Jelinek, G A; Weiland, T J; Mackinlay, C; Hill, N; Gerdtz, M F

    2011-01-01

    Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved. Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian emergency departments (EDs), stratified to represent states and territories and rural or metropolitan location. Content analysis of responses developed themes and sub-themes. Results. Of 39 doctors and 32 nurses responding to email invitation, 20 doctors and 16 nurses were interviewed. Major themes were resources/environment, staff and patient issues. Clinicians noted lack of access in rural areas to psychiatric support services, especially alcohol and drug services, limited referral options, and a lack of knowledge, understanding and acceptance of mental health issues. The clinicians suggested resource, education and guideline improvements, wanting better access to mental health experts in rural areas, better support networks and visiting specialist coverage, and educational courses tailored to the needs of rural clinicians. Conclusion. Clinicians managing mental health patients in rural and remote Australian EDs lack resources, support services and referral capacity, and access to appropriate education and training. Improvements would better enable access to support and referral services, and educational opportunities.

  17. Perceived Differences in the Management of Mental Health Patients in Remote and Rural Australia and Strategies for Improvement: Findings from a National Qualitative Study of Emergency Clinicians

    Directory of Open Access Journals (Sweden)

    G. A. Jelinek

    2011-01-01

    Full Text Available Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved. Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian emergency departments (EDs, stratified to represent states and territories and rural or metropolitan location. Content analysis of responses developed themes and sub-themes. Results. Of 39 doctors and 32 nurses responding to email invitation, 20 doctors and 16 nurses were interviewed. Major themes were resources/environment, staff and patient issues. Clinicians noted lack of access in rural areas to psychiatric support services, especially alcohol and drug services, limited referral options, and a lack of knowledge, understanding and acceptance of mental health issues. The clinicians suggested resource, education and guideline improvements, wanting better access to mental health experts in rural areas, better support networks and visiting specialist coverage, and educational courses tailored to the needs of rural clinicians. Conclusion. Clinicians managing mental health patients in rural and remote Australian EDs lack resources, support services and referral capacity, and access to appropriate education and training. Improvements would better enable access to support and referral services, and educational opportunities.

  18. An observation on inappropriate probiotic subgroup classifications in the meta-analysis by Lau and Chamberlain

    Directory of Open Access Journals (Sweden)

    McFarl

    2016-09-01

    Full Text Available Lynne V McFarland Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA I read with great interest the systematic review of meta-analysis assessing probiotics for the prevention of Clostridium difficile-associated diarrhea (CDAD published in the International Journal of General Medicine. These authors pooled 26 randomized controlled trials (RCTs and concluded that Lactobacilli, mixtures, and Saccharomyces probiotics were effective in preventing CDAD. However, the meta-analysis by Lau and Chamberlain is flawed due to improper classification by the types of probiotics. It is important to recognize that the efficacy of probiotics for various diseases has been shown to be strain specific for each probiotic product, and thus the data should only be pooled for probiotics that are of the identical type. In their analysis of probiotic subgroups by various species, the authors have inappropriately merged different types of Lactobacilli into one subgroup “Lactobacilli” and different types of mixtures into one group classified as “Mix”.View the original paper by Lau and Chamberlain. 

  19. Depressed serum IgM levels in SLE are restricted to defined subgroups.

    Science.gov (United States)

    Grönwall, Caroline; Hardt, Uta; Gustafsson, Johanna T; Elvin, Kerstin; Jensen-Urstad, Kerstin; Kvarnström, Marika; Grosso, Giorgia; Rönnelid, Johan; Padykov, Leonid; Gunnarsson, Iva; Silverman, Gregg J; Svenungsson, Elisabet

    2017-09-15

    Natural IgM autoantibodies have been proposed to convey protection from autoimmune pathogenesis. Herein, we investigated the IgM responses in 396 systemic lupus erythematosus (SLE) patients, divided into subgroups based on distinct autoantibody profiles. Depressed IgM levels were more common in SLE than in matched population controls. Strikingly, an autoreactivity profile defined by IgG anti-Ro/La was associated with reduced levels of specific natural IgM targeting phosphorylcholine (PC) antigens and malondialdehyde (MDA) modified-protein, as well as total IgM, while no differences were detected in SLE patients with an autoreactivity profile defined by anti-cardiolipin/β2glycoprotein-I. We also observed an association of reduced IgM levels with the HLA-DRB1*03 allelic variant among SLE patients and controls. Associations of low IgM anti-PC with cardiovascular disease were primarily found in patients without antiphospholipid antibodies. These studies further highlight the clinical relevance of depressed IgM. Our results suggest that low IgM levels in SLE patients reflect immunological and genetic differences between SLE subgroups. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The Effect of Parkinson's Disease Subgroups on Verbal and Nonverbal Fluency

    Science.gov (United States)

    Jaywant, Abhishek; Musto, Giovanni; Neargarder, Sandy; Gilbert, Karina Stavitsky; Cronin-Golomb, Alice

    2014-01-01

    Background Parkinson's disease (PD) leads to deficits in executive function, including verbal and nonverbal fluency, as a result of compromised fronto-striatal circuits. It is unknown whether deficits in verbal and nonverbal fluency in PD are driven by certain subgroups of patients, or how strategy use may facilitate performance. Participants Sixty-five non-demented individuals with PD, including 36 with right-body onset (RPD; 20 with tremor as their initial symptom, 16 non-tremor) and 29 with left-body onset (LPD; 14 with tremor as their initial symptom, 15 non-tremor), and 52 normal control participants (NC). Measurements Verbal fluency was assessed using the FAS and Animals tests. Nonverbal fluency was assessed using the Ruff Figural Fluency Test. Results Both RPD and LPD were impaired in generating words and in using clustering and switching strategies on phonemic verbal fluency, whereas different patterns of impairment were found on nonverbal fluency depending on the interaction of side of onset and initial motor symptom (tremor vs. non-tremor). Strategy use correlated with number of correct responses on verbal fluency in LPD, RPD, and NC. By contrast, on nonverbal fluency, strategy use correlated with correct responses for RPD and LPD, but not for NC. Conclusion Our findings demonstrate the importance of considering subgroups in PD and analyzing subcomponents of verbal and nonverbal fluency (correct responses, errors, and strategies), which may depend differently on the integrity of dorsolateral prefrontal cortex, inferior frontal cortex, and anterior cingulate cortex. PMID:24533593

  1. The Colony meteorite and the possible existence of a new chemical subgroup of CO3 chondrites

    Science.gov (United States)

    Rubin, A. E.; James, J. A.; Keck, B. D.; Weeks, K. S.; Sears, D. W. G.

    1984-01-01

    The Colony meteorite, found in Oklahoma around 1975, has an unrecrystallized texture and contains heterogeneous olivine and low Ca pyroxene, kamacite with low Ni and Co and high Cr, amoeboid inclusions with low FeO and MnO, and numerous small chondrules with clear pink glass. These characteristics are shared by members of the least metamorphosed subgroup of CO3 chondrites. Colony contains a fine grained matrix that has higher FeO and K2O and lower MgO and Na2O than normal CO3 matrices. Allan Hills A77307 is another unmetamorphosed meteorite that has many petrologic similarities to normal CO chondrites, including matrix abundance, mineral compositions and chondrule size. However, it differs from them in its abundance of magnetite and presence of iron carbides. The olivine and low Ca pyroxene compositional distributions of Colony and A77307 are very similar. The shapes of the thermoluminescence glow curves of Colony and A77307 are very similar, but differ significantly from those of normal CO chondrites. It is suggested that Colony and A77307 represent a distinct chemical subgroup of CO3 chondrites, characterized by low Ni, Co, S, Ca, Mg, Mn and, possibly, high Cd.

  2. Nucleotide sequence analyses of genomic RNAs of peanut stunt virus Mi, the type strain representative of a novel PSV subgroup from China

    OpenAIRE

    L. Yan; Xu, Z.; Goldbach, R.W.; Chen, Y. K.; Prins, M.W.

    2005-01-01

    The complete nucleotide sequence of Peanut stunt virus strain Mi (PSV-Mi) from China was determined and compared to other viruses of the genus Cucumovirus. The tripartite genome of PSV-Mi encoded five open reading frames (ORFs) typical of cucumoviruses. Distance analyses of four ORFs indicated that PSV-Mi differed sufficiently in nucleotide sequence from other PSV strains of subgroups I and II to warrant establishment of a third subgroup of PSV

  3. Nucleotide sequence analyses of genomic RNAs of Peanut stunt virus Mi, the type strain representative of a novel PSV subgroup from China.

    Science.gov (United States)

    Yan, L Y; Xu, Z Y; Goldbach, R; Kunrong, C; Prins, M

    2005-06-01

    The complete nucleotide sequence of Peanut stunt virus strain Mi (PSV-Mi) from China was determined and compared to other viruses of the genus Cucumovirus. The tripartite genome of PSV-Mi encoded five open reading frames (ORFs) typical of cucumoviruses. Distance analyses of four ORFs indicated that PSV-Mi differed sufficiently in nucleotide sequence from other PSV strains of subgroups I and II to warrant establishment of a third subgroup of PSV.

  4. Emerging Jets

    CERN Document Server

    Schwaller, Pedro; Weiler, Andreas

    2015-01-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilit...

  5. Integrating causal reasoning at different levels of abstraction. [in problem-solving system functioning as pilot assistant in commercial air transport emergencies

    Science.gov (United States)

    Hudlicka, Eva; Corker, Kevin

    1988-01-01

    In this paper, a problem-solving system which uses a multilevel causal model of its domain is described. The system functions in the role of a pilot's assistant in the domain of commercial air transport emergencies. The model represents causal relationships among the aircraft subsystems, the effectors (engines, control surfaces), the forces that act on an aircraft in flight (thrust, lift), and the aircraft's flight profile (speed, altitude, etc.). The causal relationships are represented at three levels of abstraction: Boolean, qualitative, and quantitative, and reasoning about causes and effects can take place at each of these levels. Since processing at each level has different characteristics with respect to speed, the type of data required, and the specificity of the results, the problem-solving system can adapt to a wide variety of situations. The system is currently being implemented in the KEE(TM) development environment on a Symbolics Lisp machine.

  6. Topography and Volcanology of the Huangtsuishan Volcano Subgroup, Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Ming Lai

    2010-01-01

    Full Text Available Combining the shaded relief topography model and the slope map from the Digital Terrain Model (DTM images, toporaphical map, field occurrences and petrography, the volcanic sequences of the Huangtsuishan Volcano Subgroup (HVS can be constructed. Two types of volcanic centers can be identified in this area. One is the Tachienhou volcanic dome, which may be located in the center of an older caldera. The other is the Huangtsui composite volcano, which is composed of interbedding lava flows and pyroclastic deposits with a volcanic crater named the Huangtsui pond at the summit. Eight lava plateaus radiated from Mts. Huangtsui and Tachienhou to the north and the east can be distinguished based on the DTM images. The volcanic deposits are comprised of four lithofacies, the lava flows, pyroclastic breccias, tuffs and lahars on the base of field occurrences. At least thirteen layers of lava flow, named the H1 to H13 can be recognized in the HVS and can be reconstructed and categorized into four stages. An old and large volcano erupted lava flows to form the products of stages one and two, then collapsed to form a caldera with a dome for the third stage. The latest stage of lava flow was poured out from the Huangtsui volcano, which formed a crater at the summit.

  7. Evidence of separate subgroups of juvenile southern bluefin tuna.

    Science.gov (United States)

    Chambers, Mark S; Sidhu, Leesa A; O'Neill, Ben; Sibanda, Nokuthaba

    2017-11-01

    Archival tagging studies of southern bluefin tuna (SBT , Thunnus maccoyii) have revealed that juveniles residing in the Great Australian Bight (GAB) over the austral summer undertake seasonal cyclic migrations to the southeast Indian Ocean and the Tasman Sea during winter. However, there remains disagreement about the extent of mixing between juvenile SBT regularly caught by longline fleets south of Africa and those observed in the GAB. Some researchers have argued that archival tag recoveries indicate most juveniles reside in the GAB over the austral summer. Others have suggested that recoveries of conventional and archival tags are better explained by a juvenile population consisting of separate groups on the eastern and western sides of the Indian Ocean with limited intermixing. We present analyses of catch and tag recovery data and re-examine archival tagging studies. The evidence provided strongly favors the hypothesis of separate juvenile subgroups, or contingents, with limited intermixing. We draw some tentative conclusions about the nature of the putative contingents and discuss some implications of these findings for the interpretation of existing datasets and future research priorities. We also provide the first evidence that the migration choices of juveniles that summer in the GAB are influenced by fidelity to winter feeding grounds and suggest this helps explain the collapse of the surface fishery off New South Wales in the 1980s.

  8. Resonance Elastic Scattering and Interference Effects Treatments in Subgroup Method

    Directory of Open Access Journals (Sweden)

    Yunzhao Li

    2016-04-01

    Full Text Available Based on the resonance integral (RI tables produced by the NJOY program, the conventional subgroup method usually ignores both the resonance elastic scattering and the resonance interference effects. In this paper, on one hand, to correct the resonance elastic scattering effect, RI tables are regenerated by using the Monte Carlo code, OpenMC, which employs the Doppler broadening rejection correction method for the resonance elastic scattering. On the other hand, a fast resonance interference factor method is proposed to efficiently handle the resonance interference effect. Encouraging conclusions have been indicated by the numerical results. (1 For a hot full power pressurized water reactor fuel pin-cell, an error of about +200 percent mille could be introduced by neglecting the resonance elastic scattering effect. By contrast, the approach employed in this paper can eliminate the error. (2 The fast resonance interference factor method possesses higher precision and higher efficiency than the conventional Bondarenko iteration method. Correspondingly, if the fast resonance interference factor method proposed in this paper is employed, the kinf can be improved by ∼100 percent mille with a speedup of about 4.56.

  9. Matching mice to malignancy: molecular subgroups and models of medulloblastoma

    Science.gov (United States)

    Lau, Jasmine; Schmidt, Christin; Markant, Shirley L.; Taylor, Michael D.; Wechsler-Reya, Robert J.

    2012-01-01

    Introduction Medulloblastoma, the largest group of embryonal brain tumors, has historically been classified into five variants based on histopathology. More recently, epigenetic and transcriptional analyses of primary tumors have sub-classified medulloblastoma into four to six subgroups, most of which are incongruous with histopathological classification. Discussion Improved stratification is required for prognosis and development of targeted treatment strategies, to maximize cure and minimize adverse effects. Several mouse models of medulloblastoma have contributed both to an improved understanding of progression and to developmental therapeutics. In this review, we summarize the classification of human medulloblastoma subtypes based on histopathology and molecular features. We describe existing genetically engineered mouse models, compare these to human disease, and discuss the utility of mouse models for developmental therapeutics. Just as accurate knowledge of the correct molecular subtype of medulloblastoma is critical to the development of targeted therapy in patients, we propose that accurate modeling of each subtype of medulloblastoma in mice will be necessary for preclinical evaluation and optimization of those targeted therapies. PMID:22315164

  10. Using a psychosocial subgroup assignment to predict sickness absence in a working population with neck and back pain

    Directory of Open Access Journals (Sweden)

    Jensen Irene

    2011-04-01

    Full Text Available Abstract Background The overall objective was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the MPI, the MPI-S, among gainfully employed workers with neck pain (NP and/or low back pain (LBP during a follow-up period of 18 and 36 months. Methods This is a prospective cohort study that is part of a larger longitudinal multi-centre study entitled Work and Health in the Process and Engineering Industries (AHA. The attempt was to classify individuals at risk for developing chronic disabling NP and LBP. This is the first study using the MPI-questionnaire in a working population with NP and LBP. Results Dysfunctional individuals (DYS demonstrated more statistically significant sickness absence compared to adaptive copers (AC after 36 months. DYS also had a threefold increase in the risk ratio of long-term sickness absence at 18 months. Interpersonally distressed (ID subgroup showed overall more sickness absence compared to the AC subgroup at the 36-month follow-up and had a twofold increase in the risk ratio of long-term sickness absence at 18 months. There was a significant difference in bodily pain, mental and physical health for ID and DYS subgroups compared to the AC group at both follow-ups. Conclusions The present study shows that this multidimensional approach to the classification of individuals based on psychological and psychosocial characteristics can distinguish different groups in gainfully employed working population with NP/LBP. The results in this study confirm the predictive validity of the MPI-S subgroup classification system.

  11. Using a psychosocial subgroup assignment to predict sickness absence in a working population with neck and back pain

    Science.gov (United States)

    2011-01-01

    Background The overall objective was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the MPI, the MPI-S, among gainfully employed workers with neck pain (NP) and/or low back pain (LBP) during a follow-up period of 18 and 36 months. Methods This is a prospective cohort study that is part of a larger longitudinal multi-centre study entitled Work and Health in the Process and Engineering Industries (AHA). The attempt was to classify individuals at risk for developing chronic disabling NP and LBP. This is the first study using the MPI-questionnaire in a working population with NP and LBP. Results Dysfunctional individuals (DYS) demonstrated more statistically significant sickness absence compared to adaptive copers (AC) after 36 months. DYS also had a threefold increase in the risk ratio of long-term sickness absence at 18 months. Interpersonally distressed (ID) subgroup showed overall more sickness absence compared to the AC subgroup at the 36-month follow-up and had a twofold increase in the risk ratio of long-term sickness absence at 18 months. There was a significant difference in bodily pain, mental and physical health for ID and DYS subgroups compared to the AC group at both follow-ups. Conclusions The present study shows that this multidimensional approach to the classification of individuals based on psychological and psychosocial characteristics can distinguish different groups in gainfully employed working population with NP/LBP. The results in this study confirm the predictive validity of the MPI-S subgroup classification system. PMID:21521502

  12. Characterization of courtship sounds of species of the subgroup fasciola (Diptera, Drosophilidae, Drosophila repleta group: interspecific and interpopulational analyses

    Directory of Open Access Journals (Sweden)

    C. T. A. COSTA

    Full Text Available The aim of this work was to characterize the male courtship song pattern of various species of the fasciola subgroup and to determine the level of variation both within and among species. The parameters analyzed were intrapulse interval (PI, interpulse interval (IPI, and intrapulse frequency (IF. Six different species were analyzed: D. coroica (three populations, D. ellisoni, D. fascioloides, D. moju, D. onca, and D. rosinae (one population each. There were significant differences among the six species for these three courtship song parameters. The IPI was the most variable parameter among these species, suggesting that this parameter is important for female discrimination. Four different hypotheses could explain this variation: 1. different selection pressures with absence of flow gene; 2. intraspecific sexual selection; 3. sympatric effects on song evolution; and 4. genetic drift. The PI was the only parameter that was significantly different among the three population of D. coroica. Low variability among populations within the same species was already observed for other subgroups and could be explained by the following hypotheses: strong selection acting on the song parameters, gene flow, or recent colonization from a common source. Additional studies of the courtship song of other species of the fasciola subgroup, as well as for other subgroups of the repleta group, and studies, using molecular makers, that focus on the genetic basis of the differences among these species in courtship song would allow us to evaluate the association of courtship song and sexual isolation in these species, and would also help us to understand the evolution of these behavioural differences.

  13. Detection of emamectin benzoate tolerance emergence in different life stages of sea lice, Lepeophtheirus salmonis, on farmed Atlantic salmon, Salmo salar L.

    Science.gov (United States)

    Jones, P G; Hammell, K L; Gettinby, G; Revie, C W

    2013-03-01

    Emamectin benzoate has been used to treat sea lice, Lepeophtheirus salmonis, infestations on farmed Atlantic salmon, Salmo salar. Recent evidence suggests a reduction in effectiveness in some locations. A major challenge in the detection of tolerance emergence can be the typically low proportion of resistant individuals in a population during the early phases. The objectives of this study were to develop a method for determining differences in temporal development of tolerance between sea lice life stages and to explore how these differences might be used to improve the monitoring of treatment effectiveness in a clinical setting. This study examined two data sets based on records of sea lice abundance following emamectin benzoate treatments from the west coast of Scotland (2002-2006) and from New Brunswick, Canada (2004-2008). Life stages were categorized into two groups (adult females and the remaining mobile stages) to examine the trends in mean abundance and treatment effectiveness. Differences in emamectin benzoate effectiveness were found between the two groups by year and location, suggesting that an important part of monitoring drug resistance development in aquatic ectoparasites may be the need to focus on key life stages. © 2013 Blackwell Publishing Ltd.

  14. The influence of child gender role and maternal feedback to child stress on the emergence of the gender difference in depressive rumination in adolescence.

    Science.gov (United States)

    Cox, Stephanie J; Mezulis, Amy H; Hyde, Janet S

    2010-07-01

    Extensive research has linked a greater female tendency to ruminate about depressed feelings or mood to the gender difference in depression. However, the developmental origins of the gender difference in depressive rumination are not well understood. We hypothesized that girls and women may be more likely to ruminate because rumination represents a gender-stereotyped coping style that is associated with a more feminine gender role identity, maternal encouragement of emotion expression, and passive coping responses to stress. This study examined whether child self-reported gender role identity and observed maternal responses to child stress mediated the emergent gender difference in depressive rumination in adolescence. Maternal gender role attitudes were further hypothesized to moderate the relationship between child sex and mediating variables. Rumination and gender role identity were assessed in 316 youths and their mothers in a longitudinal study from age 11 to age 15; in addition, 153 mother-child dyads participated in an observational task at age 11 from which maternal responses to a child stressor were coded. Results indicated that greater feminine gender role identity among children and encouragement of emotion expression by mothers at age 11 significantly mediated the association between child sex and the development of depressive rumination at age 15, even after controlling for rumination at age 11. Maternal gender role attitudes significantly moderated the relationship between child sex and maternal encouragement of emotion expression, such that mothers who endorsed more traditional gender role attitudes themselves were particularly likely to encourage emotion expression in their daughters.

  15. Understanding Causal Distributional and Subgroup Effects with the Instrumental Propensity Score.

    Science.gov (United States)

    Cheng, Jing; Lin, Winston

    2017-08-17

    To address issues with measured and unmeasured confounding in observational studies, this paper develops a unified approach to using an instrumental variable in more flexible ways to evaluate treatment effects. The approach is based on an instrumental propensity score conditional on baseline variables, which can then be incorporated in matching, regression, subclassification or weighting along with various parametric, semiparametric or nonparametric methods for the assessment of treatment effects. Therefore, the application of the instrumental propensity score allows different methods for outcome effect evaluations in addition to standard two-stage least square models while controlling for unmeasured confounders. Several properties of the instrumental propensity score are discussed in the paper. The approach is then illustrated using subclassification along with a semiparametric density ratio model and empirical likelihood. This method allows us to evaluate distributional and subgroup treatment effects in addition to the overall average treatment effect. Simulation studies show that the method works well. We apply our method to a study of the effects of attending a Catholic school versus a public school and find that attending a Catholic school had significant beneficial effects on subsequent wages among a subgroup of subjects. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Dietary Patterns Derived Using Exploratory and Confirmatory Factor Analysis are Stable and Generalizable Across Race, Region, and Gender Subgroups in the REGARDS Study

    Science.gov (United States)

    Judd, Suzanne E.; Letter, Abraham J.; Shikany, James M.; Roth, David L.; Newby, P. K.

    2015-01-01

    Background: Examining diet as a whole using dietary patterns as exposures is a complementary method to using single food or nutrients in studies of diet and disease, but the generalizability of intake patterns across race, region, and gender in the United States has not been established. Objective: To employ rigorous statistical analysis to empirically derive dietary patterns in a large bi-racial, geographically diverse population and examine whether results are stable across population subgroups. Design: The present analysis utilized data from 21,636 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who completed the Block 98 food frequency questionnaire. We employed exploratory factor analysis and confirmatory factor analyses on 56 different food groups iteratively and examined differences by race, region, and sex to determine the optimal factor solution in our sample. Results: Five dietary patterns emerged: the “Convenience” pattern was characterized by mixed dishes; the “Plant-based” pattern by fruits, vegetables, and fish; the “Sweets/Fats” pattern by sweet snacks, desserts, and fats and oils; the “Southern” pattern by fried foods, organ meat, and sweetened beverages; and the “Alcohol/Salads” pattern by beer, wine, liquor, and salads. Differences were most pronounced in the Southern pattern with black participants, those residing in the Southeast, and participants not completing high school having the highest scores. Conclusion: Five meaningful dietary patterns emerged in the REGARDS study and showed strong congruence across race, sex, and region. Future research will examine associations between these patterns and health outcomes to better understand racial disparities in disease and inform prevention efforts. PMID:25988129

  17. Dietary Patterns Derived Using Exploratory and Confirmatory Factor Analysis are Stable and Generalizable Across Race, Region, and Gender Subgroups in the REGARDS Study.

    Science.gov (United States)

    Judd, Suzanne E; Letter, Abraham J; Shikany, James M; Roth, David L; Newby, P K

    2014-01-01

    Examining diet as a whole using dietary patterns as exposures is a complementary method to using single food or nutrients in studies of diet and disease, but the generalizability of intake patterns across race, region, and gender in the United States has not been established. To employ rigorous statistical analysis to empirically derive dietary patterns in a large bi-racial, geographically diverse population and examine whether results are stable across population subgroups. The present analysis utilized data from 21,636 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who completed the Block 98 food frequency questionnaire. We employed exploratory factor analysis and confirmatory factor analyses on 56 different food groups iteratively and examined differences by race, region, and sex to determine the optimal factor solution in our sample. Five dietary patterns emerged: the "Convenience" pattern was characterized by mixed dishes; the "Plant-based" pattern by fruits, vegetables, and fish; the "Sweets/Fats" pattern by sweet snacks, desserts, and fats and oils; the "Southern" pattern by fried foods, organ meat, and sweetened beverages; and the "Alcohol/Salads" pattern by beer, wine, liquor, and salads. Differences were most pronounced in the Southern pattern with black participants, those residing in the Southeast, and participants not completing high school having the highest scores. Five meaningful dietary patterns emerged in the REGARDS study and showed strong congruence across race, sex, and region. Future research will examine associations between these patterns and health outcomes to better understand racial disparities in disease and inform prevention efforts.

  18. Dietary patterns derived using exploratory and confirmatory factor analysis are stable and generalizable across race, region, and gender subgroups in the REGARDS study

    Directory of Open Access Journals (Sweden)

    Suzanne E Judd

    2015-01-01

    Full Text Available Background: Examining diet as a whole using dietary patterns as exposures is a complementary method to using single food or nutrients in studies of diet and disease, but the generalizability of patterns across race, region, and gender in the United States has not been established. Objective: To employ rigorous statistical analysis to empirically derive dietary patterns in a large bi-racial, geographically diverse population and examine whether results are stable across population subgroups.Design: The present analysis utilized data from 21,636 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS study who completed the Block98 food frequency questionnaire. We employed exploratory factor analysis and confirmatory factor analyses on 56 different food groups iteratively and examined differences by race, region, sex to determine the optimal factor solution in our sample. Results: Five dietary patterns emerged: the Convenience pattern was characterized by mixed dishes; the Plant-based pattern by fruits, vegetables, and fish; the Sweets/Fats pattern by sweet snacks, desserts, and fats and oils; the Southern pattern by fried foods, organ meat, and sweetened beverages; and the Alcohol/Salads pattern by beer, wine, liquor, and salads. Differences were most pronounced in the Southern pattern with black participants, those residing in the Southeast, and participants not completing high school having the highest scores. Conclusions: Five meaningful dietary patterns emerged in the REGARDS study and showed strong congruence across race, sex and region. Future research will examine associations between these patterns and health outcomes to better understand racial disparities in disease and inform prevention efforts.

  19. Subgroup analyses in cost-effectiveness analyses to support health technology assessments.

    Science.gov (United States)

    Fletcher, Christine; Chuang-Stein, Christy; Paget, Marie-Ange; Reid, Carol; Hawkins, Neil

    2014-01-01

    'Success' in drug development is bringing to patients a new medicine that has an acceptable benefit-risk profile and that is also cost-effective. Cost-effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision-makers in the determination of the cost-effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost-effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost-effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost-effectiveness analyses. In summary, we recommend planning subgroup analyses for cost-effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost-effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Stratification of randomization is not required for a pre-specified subgroup analysis.

    Science.gov (United States)

    Kaiser, Lee D

    2013-01-01

    Published literature and regulatory agency guidance documents provide conflicting recommendations as to whether a pre-specified subgroup analysis also requires for its validity that the study employ randomization that is stratified on subgroup membership. This is an important issue, as subgroup analyses are often required to demonstrate efficacy in the development of drugs with a companion diagnostic. Here, it is shown, for typical randomization methods, that the fraction of patients in the subgroup given experimental treatment matches, on average, the target fraction in the entire study. Also, mean covariate values are balanced, on average, between treatment arms in the subgroup, and it is argued that the variance in covariate imbalance between treatment arms in the subgroup is at worst only slightly increased versus a subgroup-stratified randomization method. Finally, in an analysis of variance setting, a least-squares treatment effect estimator within the subgroup is shown to be unbiased whether or not the randomization is stratified on subgroup membership. Thus, a requirement that a study be stratified on subgroup membership would place an artificial roadblock to innovation and the goals of personalized healthcare. Copyright © 2012 John Wiley & Sons, Ltd.

  1. Photodynamic therapy vs. topical imiquimod for treatment of superficial basal cell carcinoma: a subgroup analysis within a noninferiority randomized controlled trial.

    Science.gov (United States)

    Roozeboom, M H; Nelemans, P J; Mosterd, K; Steijlen, P M; Arits, A H M M; Kelleners-Smeets, N W J

    2015-03-01

    A recent noninferiority randomized controlled trial (RCT) indicated that imiquimod can be considered as superior to methylaminolevulinate photodynamic therapy (MAL-PDT) in the treatment of superficial basal cell carcinoma (sBCC). Knowledge of treatment effectiveness in subgroups of patients is of great value in clinical practice to select the most effective treatment for an individual patient with sBCC. To explore whether the relative treatment effect of MAL-PDT and imiquimod is consistent across subgroups defined by patient and tumour characteristics. Data were derived from a single-blinded, noninferiority, multicentre RCT comparing MAL-PDT, topical imiquimod and fluorouracil (ISRCTN79701845). Treatment success was defined as free of tumour recurrence at 12-month follow-up. Subgroup analyses were performed for subgroups defined by sex, age, tumour location and tumour size. Two hundred and two patients received MAL-PDT and 198 received imiquimod. The superiority of imiquimod vs. MAL-PDT was observed in subgroups of females, sBCC on the trunk and large tumours with risk differences in favour of imiquimod of 18·4% [95% confidence interval (CI) 7·8-29·0%], 21·0% (95% CI 10·9-31·1%) and 18·9% (95% CI 7·1-30·7%), respectively. Higher probability of treatment success for imiquimod vs. MAL-PDT was consistently found in all other subgroups with the exception of sBCC localized on the lower extremities in older patients. In the latter subgroup, the risk difference at the expense of imiquimod was -57·3% (95% CI -81·7% to -32·9%). Imiquimod remains the first-choice treatment for sBCC in terms of effectiveness. In older patients with sBCC on the lower extremities MAL-PDT might be preferred. Results should be interpreted carefully as subgroup analyses were exploratory and not driven by prior hypotheses. © 2014 British Association of Dermatologists.

  2. Variations in spatial patterns of soil-vegetation properties and the emergence of multiple resilience thresholds within different debris flow fan positions

    Science.gov (United States)

    Mohseni, Neda; Hosseinzadeh, Seyed Reza; Sepehr, Adel; Golzarian, Mahmood Reza; Shabani, Farzin

    2017-08-01

    Debris flow fans are non-equilibrium landforms resulting from the spatial variations of debris flows deposited on them. This geomorphic disturbance involving the asymmetric redistribution of water and sediment may create spatially heterogeneous patterns of soil-vegetation along landforms. In this research, founded on field-based observations, we characterized the spatial patterns of some soil (e.g., particle size distribution including fine and coarse covers, and infiltration capacity) and vegetation (e.g., plant distance, vegetation density, patch size, and average number of patches) properties within different debris flow fan positions (Upper, Middle, and Lower fan) located at the base of the Binaloud Mountain hillslope in northeastern Iran. Thereafter, using a mathematical model of dry land vegetation dynamics, we calculated response trends of the different positions to the same environmental harshness gradient. Field measurements of soil-vegetation properties and infiltration rates showed that the asymmetric redistribution of debris flow depositions can cause statistically significant differences (P fan plots. Conversely, an increase in infiltration rate was observed. The simulation results on the aerial images taken from different positions, illustrated that positions with a heterogeneous distribution of vegetation patterns were not desertified to the same degree of aridity. Thus, the Middle and Lower positions could survive under harsher aridity conditions, due to the emergence of more varied spatial vegetation patterns than at the Upper fan position. The findings, based on a combined field and modeling approach, highlighted that debris flow as a geomorphic process with the asymmetric distribution of depositions on the gentle slope of an alluvial fan, can incur multiple resilience thresholds with different degrees of self-organization under stressful conditions over the spatial heterogeneities of soil-dependent vegetation structures.

  3. Specific autoantibody profiles and disease subgroups correlate with circulating micro-RNA in systemic sclerosis.

    Science.gov (United States)

    Wuttge, Dirk M; Carlsen, Anting Liu; Teku, Gabriel; Steen, Samantha O; Wildt, Marie; Vihinen, Mauno; Hesselstrand, Roger; Heegaard, Niels H H

    2015-11-01

    To evaluate the expression profiles of cell-free plasma miRNAs in SSc and to characterize their correlation with disease subgroups (lcSSc and dcSSc) and with autoantibody profiles. Using quantitative RT-PCR, the abundance of 45 mature miRNAs in plasma was determined in 95 patients (lcSSc = 63; dcSSc = 32), representing the following autoantibody subgroups: ACA, anti-DNA topoisomerase I, anti-RNA polymerase III and anti-U1-ribonucleoprotein. MiRNA data were correlated with clinical and paraclinical data. Multiple regression was used to model membership of the lcSSc, dcSSc and autoantibody subgroups, based on miRNA expression profiles. Thirty-six miRNAs were measurable in all samples. Four (miRNA-223, -181b, -342-3p and -184) were differently expressed in lcSSc and dcSSc (false discovery rate < 0.05). Ten miRNAs exhibited statistically significantly different levels in one or more autoantibody groups, and five (miRNA-409, -184, -92a, -29a and -101) remained significant after correction for multiple comparisons. Multiple regression models accurately predicted ACA and anti-DNA topoisomerase I antibody-positive patients (area under the curve (AUC) = 0.97 and 0.93, respectively) as well as membership of the dcSSc and lcSSc groups (AUC = 0.88). Circulating miRNA profiles differ between lcSSc and dcSSc patients and between patients with different autoantibodies. This is the first time autoantibody profiles, disease phenotypes and plasma miRNA profiles have been shown to correlate in an autoimmune disease. The data support a pathobiological role of miRNAs because specific miRNAs associate with autoantibody profiles of known diagnostic and prognostic value. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Emergency medicine as a growing career in Iran: an Internet-based survey.

    Science.gov (United States)

    Farahmand, Shervin; Karimialavijeh, Ehsan; Vahedi, Hojjat Sheikh Mottahar; Jahanshir, Amirhossein

    2016-01-01

    In Iran, few studies have evaluated emergency medicine as a career option. In the present study, we aimed to find out how Iranian emergency-medicine specialists view their specialty as a career. Following a qualitative study, a Likert-scale questionnaire was developed. Iranian emergency physician specialists who had at least two years' job experience were contacted via email. A uniform link to a Web-based survey and a cover letter that explained the survey were sent to the recipients. We used the Kruskal-Wallis test and post hoc analysis to determine the differences between demographic subgroups. A total of 109 eligible responses were received, a response rate of 72.63%. Of the responders, 57.8% were 30-40 years of age, 86.2% were male, 86.2% were single, 84.4% were faculty members and 90.8% had fewer than 10 years' job experience. The main problems occurring during the career of Iranian emergency physicians were: insufficient income, inadequate recognition of the specialty by the community, inadequate union support, insecurity in the emergency wards, overcrowding, job stresses and night shifts. Despite insufficiency of income, Iranian emergency physicians (EPs) did not care about the financial benefits of patient care. Academic activity had positive effects on the perspectives of Iranian emergency physicians regarding their careers. Iranian emergency physicians and leaders in emergency medicine should struggle to improve the present situation, aiming at an ideal state.

  5. Subgroup report on hard x-ray microprobes

    Energy Technology Data Exchange (ETDEWEB)

    Ice, G.E. [Oak Ridge National Lab., TN (United States); Barbee, T.; Bionta, R. [Lawrence Livermore National Lab., CA (United States); Howells, M.; Thompson, A.C. [Lawrence Berkeley Lab., CA (United States); Yun, W. [Argonne National Lab., IL (United States)

    1994-09-01

    The increasing availability of synchrotron x-ray sources has stimulated the development of advanced hard x-ray (E{>=}5 keV) microprobes. New x-ray optics have been demonstrated which show promise for achieving intense submicron hard x-ray probes. These probes will be used for extraordinary elemental detection by x-ray fluorescence/absorption and for microdiffraction to identify phase and strain. The inherent elemental and crystallographic sensitivity of an x-ray microprobe and its inherently nondestructive and penetrating nature makes the development of an advanced hard x-ray microprobe an important national goal. In this workshop state-of-the-art hard x-ray microprobe optics were described and future directions were discussed. Gene Ice, Oak Ridge National Laboratory (ORNL), presented an overview of the current status of hard x-ray microprobe optics and described the use of crystal spectrometers to improve minimum detectable limits in fluorescent microprobe experiments. Al Thompson, Lawrence Berkeley Laboratory (LBL), described work at the Center for X-ray Optics to develop a hard x-ray microprobe based on Kirkpatrick-Baez (KB) optics. Al Thompson also showed the results of some experimental measurements with their KB optics. Malcolm Howells presented a method for bending elliptical mirrors and Troy Barbee commented on the use of graded d spacings to achieve highest efficiency in KB multilayer microfocusing. Richard Bionta, Lawrence Livermore National Laboratory (LLNL), described the development of the first hard x-ray zone plates and future promise of so called {open_quotes}jelly roll{close_quotes} or sputter slice zone plates. Wenbing Yun, Argonne National Laboratory (ANL), described characterization of jelly roll and lithographically produced zone plates and described the application of zone plates to focus extremely narrow bandwidths by nuclear resonance. This report summarizes the presentations of the workshop subgroup on hard x-ray microprobes.

  6. Could the clinical interpretability of subgroups detected using clustering methods be improved by using a novel two-stage approach?

    Science.gov (United States)

    Kent, Peter; Stochkendahl, Mette Jensen; Christensen, Henrik Wulff; Kongsted, Alice

    2015-01-01

    Recognition of homogeneous subgroups of patients can usefully improve prediction of their outcomes and the targeting of treatment. There are a number of research approaches that have been used to recognise homogeneity in such subgroups and to test their implications. One approach is to use statistical clustering techniques, such as Cluster Analysis or Latent Class Analysis, to detect latent relationships between patient characteristics. Influential patient characteristics can come from diverse domains of health, such as pain, activity limitation, physical impairment, social role participation, psychological factors, biomarkers and imaging. However, such 'whole person' research may result in data-driven subgroups that are complex, difficult to interpret and challenging to recognise clinically. This paper describes a novel approach to applying statistical clustering techniques that may improve the clinical interpretability of derived subgroups and reduce sample size requirements. This approach involves clustering in two sequential stages. The first stage involves clustering within health domains and therefore requires creating as many clustering models as there are health domains in the available data. This first stage produces scoring patterns within each domain. The second stage involves clustering using the scoring patterns from each health domain (from the first stage) to identify subgroups across all domains. We illustrate this using chest pain data from the baseline presentation of 580 patients. The new two-stage clustering resulted in two subgroups that approximated the classic textbook descriptions of musculoskeletal chest pain and atypical angina chest pain. The traditional single-stage clustering resulted in five clusters that were also clinically recognisable but displayed less distinct differences. In this paper, a new approach to using clustering techniques to identify clinically useful subgroups of patients is suggested. Research designs, statistical

  7. Associations between gastric sensorimotor function, depression, somatization, and symptom-based subgroups in functional gastroduodenal disorders: are all symptoms equal?

    Science.gov (United States)

    Clauwaert, N; Jones, M P; Holvoet, L; Vandenberghe, J; Vos, R; Tack, J; Van Oudenhove, L

    2012-12-01

    Previous work indicated that psychosocial factors (depression and somatization) are more strongly associated with symptom severity and weight loss in functional dyspepsia (FD) than gastric sensorimotor function. However, there is conflicting evidence regarding the association of these etiopathogenetic factors with Rome III symptom-based subgroups in FD [epigastric pain syndrome (EPS), postprandial distress syndrome (PDS)]. We aimed to test whether gastric sensitivity and emptying, depression, and somatization are differentially associated with empirically derived functional gastroduodenal disorders (FGD) symptom factors in one comprehensive model. In 259 tertiary care FD patients, we studied gastric sensorimotor function with barostat and gastric emptying breath test. Depression, somatization, and FGD symptoms were measured using self-report questionnaires. Confirmatory factor analysis (CFA) on 7 FGD symptoms was used to determine the fit of a latent variable structure based on Rome III symptom-based subgroups. Structural equation modeling (SEM) was used to test the putative relationships of the symptom factors with gastric sensorimotor function, depression, and somatization. The results of the CFA show a good fit [C(min) /DF = 1.54, CFI(comparative fit index) = 0.97] for the three-factor solution based on Rome III subgroups. The SEM also fitted the data well (C(min) /DF = 1.24, CFI = 0.98) and demonstrated that gastric sensitivity and depression are associated with PDS and nausea and vomiting. Gastric emptying is uniquely associated with EPS and somatization is strongly associated with all three symptom factors. Confirmatory factor analysis confirms the existence of three FGD symptom factors, corresponding to Rome III symptom-based subgroups. The SEM results suggest that different psychobiological mechanisms may play a role in these subgroups. © 2012 Blackwell Publishing Ltd.

  8. GPR99, a new G protein-coupled receptor with homology to a new subgroup of nucleotide receptors

    Directory of Open Access Journals (Sweden)

    Chica Schaller H

    2002-07-01

    Full Text Available Abstract Background Based on sequence similarity, the superfamily of G protein-coupled receptors (GPRs can be subdivided into several subfamilies, the members of which often share similar ligands. The sequence data provided by the human genome project allows us to identify new GPRs by in silico homology screening, and to predict their ligands. Results By searching the human genomic database with known nucleotide receptors we discovered the gene for GPR99, a new orphan GPR. The mRNA of GPR99 was found in kidney and placenta. Phylogenetic analysis groups GPR99 into the P2Y subfamily of GPRs. Based on the phylogenetic tree we propose a new classification of P2Y nucleotide receptors into two subgroups predicting a nucleotide ligand for GPR99. By assaying known nucleotide ligands on heterologously expressed GPR99, we could not identify specifically activating substances, indicating that either they are not agonists of GPR99 or that GPR99 was not expressed at the cell surface. Analysis of the chromosomal localization of all genes of the P2Y subfamily revealed that all members of subgroup "a" are encoded by less than 370 kb on chromosome 3q24, and that the genes of subgroup "b" are clustered on one hand to chromosome 11q13.5 and on the other on chromosome 3q24-25.1 close to the subgroup "a" position. Therefore, the P2Y subfamily is a striking example for local gene amplification. Conclusions We identified a new orphan receptor, GPR99, with homology to the family of G protein-coupled nucleotide receptors. Phylogenetic analysis separates this family into different subgroups predicting a nucleotide ligand for GPR99.

  9. Fitness components and natural selection: why are there different patterns on the emergence of drug resistance in Plasmodium falciparum and Plasmodium vivax?

    Directory of Open Access Journals (Sweden)

    Schneider Kristan A

    2013-01-01

    Full Text Available Abstract Background Considering the distinct biological characteristics of Plasmodium species is crucial for control and elimination efforts, in particular when facing the spread of drug resistance. Whereas the evolutionary fitness of all malarial species could be approximated by the probability of being taken by a mosquito and then infecting a new host, the actual steps in the malaria life cycle leading to a successful transmission event show differences among Plasmodium species. These “steps” are called fitness components. Differences in terms of fitness components may affect how selection imposed by interventions, e.g. drug treatments, differentially acts on each Plasmodium species. Thus, a successful malaria control or elimination programme should understand how differences in fitness components among different malaria species could affect adaptive evolution (e.g. the emergence of drug resistance. In this investigation, the interactions between some fitness components and natural selection are explored. Methods A population-genetic model is formulated that qualitatively explains how different fitness components (in particular gametocytogenesis and longevity of gametocytes affect selection acting on merozoites during the erythrocytic cycle. By comparing Plasmodium falciparum and Plasmodium vivax, the interplay of parasitaemia and gametocytaemia dynamics in determining fitness is modelled under circumstances that allow contrasting solely the differences between these two parasites in terms of their fitness components. Results By simulating fitness components, it is shown that selection acting on merozoites (e.g., on drug resistant mutations or malaria antigens is more efficient in P. falciparum than in P. vivax. These results could explain, at least in part, why resistance against drugs, such as chloroquine (CQ is highly prevalent in P. falciparum worldwide, while CQ is still a successful treatment for P. vivax despite its massive use

  10. Different factors associate with body image in adolescence than in emerging adulthood: A gender comparison in a follow-up study

    Directory of Open Access Journals (Sweden)

    Sunna Gestsdottir

    2017-11-01

    Full Text Available Background Body image dissatisfaction has been linked with a range of adverse psychosocial outcomes in both genders and has become an important public health issue. Across all ages, women have reported being more dissatisfied with their bodies than men. The aim of the current study was to examine if fitness and physical activity associate with body image satisfaction differently across gender and age, measured in the same participants. Participants and procedure Participants were measured initially at age 15 years (N = 385 and again at age 23 years (N = 201. Structural equation modelling was used to examine the association between body image satisfaction, fitness, and physical activity. Covariates included skinfold thickness, body mass index, socioeconomic status, anxiety, and depression. Results Fitness and physical activity declined during the study period, body mass index increased, but no changes were found in body image satisfaction, depression, anxiety, or skinfold thickness. For women at ages 15 and 23 years, self-reported fitness and depression were found to be related to body image satisfaction, including body mass index at the age of 23 years. For 15-year-old men, skinfold thickness and aerobic fitness related to body image satisfaction, whereas skinfold thickness, depression, body mass index, and self-reported fitness did so at age 23 years. Conclusions Results suggest that different approaches are needed across gender to improve body image in adolescence whereas more similar ones can be used in emerging adulthood.

  11. Ethnic Differences in Profiles of Mother-Child Interactions and Relations to Emerging School Readiness in African American and Latin American Children.

    Science.gov (United States)

    Dyer, Nazly; Owen, Margaret Tresch; Caughy, Margaret O'Brien

    2014-10-01

    This article examines ethnic similarities and differences in profiles of mother-child interaction qualities for low-income African American and Latin American mothers and associations with preschoolers' emerging school readiness. Videotaped mother-child interactions were collected at age 2.5 years from a sample of African American (n = 192) and Latin American (n = 210) families. Profiles of maternal behavior were identified in person-centered within-group analyses of five ratings of maternal behavior from the videotaped interactions. Mothering profile groups were examined for relations to child receptive language, behavior problems, and pre-academic school readiness measured at age 3.5 years. Latent class analyses yielded three similar profiles in the two ethnicities identified as Child-Oriented, Directive, and Harsh-Intrusive mothering, and a fourth profile of Withdrawn mothering only among the African American mothers. For African American children, Child-Oriented and Directive mothering were each associated with higher pre-academic school readiness and language scores than Harsh-Intrusive or Withdrawn mothering. For Latin American children, Child-Oriented mothering was associated with fewer child behavior problems than Harsh-Intrusive mothering, and higher school readiness scores than Directive mothering. Both similarities and differences were found between African American and Latin American families in observation- based mothering profiles and their linkages with preschoolers' school readiness.

  12. Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department.

    Science.gov (United States)

    Diggins, Emma; Kelley, Rachael; Cottrell, David; House, Allan; Owens, David

    2017-01-15

    Characteristics of self-harm differ across ages, but there is little work identifying age-related differences in younger people. Young people entering adolescence face emotionally and developmentally different challenges to those entering adulthood. This study investigates how Emergency Department (ED) presentations and management of self-harm differ through adolescence and early adulthood. 3782 consecutive self-harm episodes involving 2559 people aged 12-25 years were identified from an existing database of Leeds ED attendances from 2004 to 2007. Odds ratios for each of four age bands were compared to the remaining young people. The female to male ratio was 6.3:1 at 12-14 years old, decreasing with successive age groups to 1.2:1 at 22-25 years old. Self-poisoning was commoner in those under 18 years old. 18-25 year olds were more likely to self-poison with prescribed medications, mixed overdoses, alcohol or recreational drugs. 18-25 year olds more often required medical treatment for the effects of the self-harm. 12-14 year olds were more often seen urgently by ED medical staff and offered high intensity mental health aftercare. Repetition of self-harm was commonest in 12-14 year olds, although multiple repetition of self-harm was commonest in 22-25 year olds. Data were not collected on whether the aftercare offered was received. The study sample included hospital attenders only. The large excess of females over males in young people's self-harm is only true at the younger age range. Older adolescents present with more severe acts of self-harm, yet receive the lowest intensity of assessment and after care. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla for evaluation of hemodynamic characteristics of vascular malformations: description of distinct subgroups.

    Science.gov (United States)

    Hammer, Simone; Uller, Wibke; Manger, Florentine; Fellner, Claudia; Zeman, Florian; Wohlgemuth, Walter A

    2017-01-01

    Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signalmax), time intervals between onset of arterial enhancement and lesion enhancement (tonset), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (tmax) were analyzed. All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signalmax 737 %, IQR [interquartile range] = 511 - 1182 %; median tonset 5 s, IQR = 5 - 10 s; median tmax 35 s, IQR = 26 - 40 s) and without AVFs (median signalmax 284 %, IQR = 177-432 %; median tonset 23 s, IQR = 15 - 30 s; median tmax 60 s, IQR = 55 - 75 s). Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. • Time-resolved MRA at 3.0 Tesla provides quantitative hemodynamic characterization of vascular malformations. • Malformations significantly differ in time courses of enhancement and signal intensity increase. • AVMs show a distinctive high-flow hemodynamic pattern. • Two significantly different types of VMs emerged: VMs with and without AVFs.

  14. Clinical and epidemiological features of acute infantile gastroenteritis associated with human rotavirus subgroups 1 and 2.

    OpenAIRE

    Uhnoo, I; Svensson, L

    1986-01-01

    During a prospective 1-year study rotavirus isolates from 169 children with gastroenteritis were investigated by polyacrylamide gel electrophoresis. A total of 118 (70%) of the strains analyzed contained sufficient viral nucleic acid to give visible electrophoretic patterns; 36% were identified as strains belonging to subgroup 1 (short patterns), and 64% were identified as strains belonging to subgroup 2 (long patterns). The two subgroups cocirculated at equal frequencies during the first 7 m...

  15. Subgroups of fibromyalgia patients using the 1990 American College of Rheumatology criteria and the modified 2010 preliminary diagnostic criteria: the al-Ándalus project.

    Science.gov (United States)

    Segura-Jiménez, Víctor; Soriano-Maldonado, Alberto; Álvarez-Gallardo, Inmaculada C; Estévez-López, Fernando; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel

    2016-01-01

    We aimed to investigate the symptom profiles in subsets of fibromyalgia patients according to the subgroups created from the satisfaction of the 1990 American College of Rheumatology (ACR) diagnostic criteria (1990c) and/or the modified 2010 ACR preliminary diagnostic criteria (m-2010c). A total of 913 (84 men) participants took part in this cross-sectional study. Participants were grouped as follows: i) 285 who did not fulfil any ACR diagnostic criteria (non-fibromyalgia); ii) 73 who fulfilled the 1990c only; iii) 96 who fulfilled the m-2010c only; iv) 459 who fulfilled both ACR diagnostic criteria. Experimental and clinical pain, chronic pain self-efficacy, pain catastrophising, fibromyalgia severity, fatigue, health-related quality of life, depression, state anxiety and physical fitness were assessed by means of several questionnaires and tests. Overall, the differences were consistent across all study outcomes (all, overall pfibromyalgia participants) had the most favourable results. Furthermore, the subgroup fulfilling the m-2010c only had a worse profile than the subgroup fulfilling the 1990c only, and presented similar but slightly better results than those fulfilling both diagnostic criteria. Our results reinforce the understanding of fibromyalgia as a heterogeneous condition. Subgrouping of fibromyalgia patients is highly recommendable, since these subgroups show diverse clinical pictures and therefore treatment options should be individually tailored to their specific profile. The combination of 1990c and the m-2010c is potentially useful to identify subgroups of fibromyalgia patients.

  16. Factor Structure of the TOEFL Internet-Based Test across Subgroups. TOEFL iBT Research Report. TOEFL iBT-07. ETS Research Report. RR-08-66

    Science.gov (United States)

    Stricker, Lawrence J.; Rock, Donald A.

    2008-01-01

    This study assessed the invariance in the factor structure of the "Test of English as a Foreign Language"™ Internet-based test (TOEFL® iBT) across subgroups of test takers who differed in native language and exposure to the English language. The subgroups were defined by (a) Indo-European and Non-Indo-European language family, (b)…

  17. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data: SPSS TwoStep Cluster analysis, Latent Gold and SNOB.

    Science.gov (United States)

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice

    2014-10-02

    indicated that all three clustering methods showed a near-perfect ability to detect known subgroups and correctly classify individuals into those subgroups. Our subjective judgement was that Latent Gold offered the best balance of sensitivity to subgroups, ease of use and presentation of results with these datasets but we recognise that different clustering methods may suit other types of data and clinical research questions.

  18. Developing the group mind through functional subgrouping: linking systems-centered training (SCT) and interpersonal neurobiology.

    Science.gov (United States)

    Gantt, Susan P; Agazarian, Yvonne M

    2010-10-01

    This article introduces the systems-centered concept of the "group mind" by linking systems-centered thinking and interpersonal neurobiology, building on Siegel's definition of mind as the process of regulating the flow of energy and information. Functional subgrouping, the systems-centered group method for resolving conflicts, discriminates and integrates the flow of energy and information within and between group members, subgroups, and the group-as-a-whole, thus potentiating survival, development, and transformation. This article uses the interpersonal neurobiological framework to discuss functional subgrouping as a tool for developing the group mind: considering how functional subgrouping facilitates emotional regulation, creates a secure relational context, and potentiates neural integration.

  19. Prehospital ultrasound in emergency medicine: incidence, feasibility, indications and diagnoses.

    Science.gov (United States)

    Hoyer, Hans Xaver; Vogl, Stefan; Schiemann, Uwe; Haug, Alexander; Stolpe, Erwin; Michalski, Thomas

    2010-10-01

    Sonography is an established diagnostic procedure in hospitals, but is not routinely used in prehospital emergency medicine. Several studies have addressed the use of ultrasound during helicopter flights and in emergency rooms, few in prehospital settings, but most focused on abdominal blunt trauma. Several case reports describe crucial decisions distinguished by ultrasound. In this study, four different handheld ultrasound systems in 4 helicopters and one emergency vehicle were used over a cumulative period of 3 years. Incidence, feasibility, indication, diagnoses and exploration time (in subgroups) were investigated in an overall profile of emergency patients, encompassing the area of internal medicine. On 971 missions ultrasound systems were available. In 17% of the cases ultrasound was considered valuable, in 144 patients (14.8%) sonographic studies were performed. Additional information could be given in 130 cases (90%). Compared with the available clinical data (return rate of 76%) there were no false-positive findings during this study, resulting in a specificity and positive predictive value of 100%, showing this technique to be reliable. Sensitivity was 85%, accuracy was 96% and negative predictive value was 95%. Ultrasound is the only imaging modality and a useful diagnostic tool in prehospital emergency medicine. Helpful information can be provided in at least one of six cases (or even more) in a trauma-dominated collective. Examination time is short; it will not significantly delay medical care. Ultrasound examination could improve triage in cases of more than one patient in disaster medicine, but further studies are necessary.

  20. Emergency Contraception

    Science.gov (United States)

    ... after unprotected sex. Often called the morning-after pill, emergency contraception pills (ECPs) are hormone pills that women ... Does It Cost? Depending on the types of pills, the emergency contraception pill costs between $10 and $80. An ...

  1. Emergency Checklist

    Science.gov (United States)

    ... Prevention Week National Prescription Drug Take-Back Day Emergency Checklist If someone may have been poisoned, call ... may save you from a visit to the emergency room. Below is a checklist to help you ...

  2. Characterizing emergency departments to improve understanding of emergency care systems.

    Science.gov (United States)

    Steptoe, Anne P; Corel, Blanka; Sullivan, Ashley F; Camargo, Carlos A

    2011-07-14

    International emergency medicine aims to understand different systems of emergency care across the globe. To date, however, international emergency medicine lacks common descriptors that can encompass the wide variety of emergency care systems in different countries. The frequent use of general, system-wide indicators (e.g. the status of emergency medicine as a medical specialty or the presence of emergency medicine training programs) does not account for the diverse methods that contribute to the delivery of emergency care both within and between countries. Such indicators suggest that a uniform approach to the development and structure of emergency care is both feasible and desirable. One solution to this complex problem is to shift the focus of international studies away from system-wide characteristics of emergency care. We propose such an alternative methodology, in which studies would examine emergency department-specific characteristics to inventory the various methods by which emergency care is delivered. Such characteristics include: emergency department location, layout, time period open to patients, and patient type served. There are many more ways to describe emergency departments, but these characteristics are particularly suited to describe with common terms a wide range of sites. When combined, these four characteristics give a concise but detailed picture of how emergency care is delivered at a specific emergency department. This approach embraces the diversity of emergency care as well as the variety of individual emergency departments that deliver it, while still allowing for the aggregation of broad similarities that might help characterize a system of emergency care.

  3. Gender differences in patient-described pain, stress, and anxiety among patients undergoing treatment for painful conditions in the emergency department.

    Science.gov (United States)

    Patel, Roma; Biros, Michelle H; Moore, Johanna; Miner, James R

    2014-12-01

    , anxiety, and satisfaction VAS scores, changes in pain related to male gender was no longer significant (coefficient = 0.034, p = 0.11). When asked about their satisfaction with the results of the pain treatment that had been provided, patients reported a median of 2 (out of 6, 1 = satisfied, 6 = dissatisfied; interquartile range = 1 to 2). There was no significant difference between sexes (p > 0.90). Patient-reported stress and anxiety were higher among female patients than male patients, but there was no significant difference in reported pain and satisfaction between sexes. Sex alone was not a significant predictor of change in pain for patients presenting to the emergency department with pain-related complaints. Anxiety and stress may potentially influence the pain-gender relationship. © 2014 by the Society for Academic Emergency Medicine.

  4. Sex based subgroup differences in randomized controlled trials: Empirical evidence from Cochrane meta-analyses

    NARCIS (Netherlands)

    Wallach, J.D. (Joshua D.); Sullivan, P.G. (Patrick G.); Trepanowski, J.F. (John F.); E.W. Steyerberg (Ewout); J.P.A. Ioannidis (John)

    2016-01-01

    textabstractObjective To evaluate the frequency, validity, and relevance of statistically significant (P<0.05) sex-treatment interactions in randomized controlled trials in Cochrane meta-analyses. Design Meta-epidemiological study. Data sources Cochrane Database of Systematic Reviews (CDSR) and

  5. Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses.

    Science.gov (United States)

    Wallach, Joshua D; Sullivan, Patrick G; Trepanowski, John F; Steyerberg, Ewout W; Ioannidis, John P A

    2016-11-24

     To evaluate the frequency, validity, and relevance of statistically significant (PUpToDate, an online physician-authored clinical decision support resource, suggested differential management of men and women for one of these sex-treatment interactions.  Statistically significant sex-treatment interactions are only slightly more frequent than what would be expected by chance and there is little evidence of subsequent corroboration or clinical relevance of sex-treatment interactions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. A Subgroup Analysis of Predictors to Certification Examination Success in Differing Principal Preparation Programs.

    Science.gov (United States)

    Wilmore, Elaine L.

    This study addresses the factors of Graduate Record Examination scores (GRE), race, gender, and undergraduate grade point average (GPA) as predictors of principal certification examination success at a large urban university. The university has three programs that lead to a masters degree and principal certification. The regular program consists…

  7. Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children with Mathematics Difficulties

    Science.gov (United States)

    Wong, Terry T.-Y.; Ho, Connie S.-H.; Tang, Joey

    2017-01-01

    Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests…

  8. iSubgraph: integrative genomics for subgroup discovery in hepatocellular carcinoma using graph mining and mixture models.

    Directory of Open Access Journals (Sweden)

    Bahadir Ozdemir

    Full Text Available The high tumor heterogeneity makes it very challenging to identify key tumorigenic pathways as therapeutic targets. The integration of multiple omics data is a promising approach to identify driving regulatory networks in patient subgroups. Here, we propose a novel conceptual framework to discover patterns of miRNA-gene networks, observed frequently up- or down-regulated in a group of patients and to use such networks for patient stratification in hepatocellular carcinoma (HCC. We developed an integrative subgraph mining approach, called iSubgraph, and identified altered regulatory networks frequently observed in HCC patients. The miRNA and gene expression profiles were jointly analyzed in a graph structure. We defined a method to transform microarray data into graph representation that encodes miRNA and gene expression levels and the interactions between them as well. The iSubgraph algorithm was capable to detect cooperative regulation of miRNAs and genes even if it occurred only in some patients. Next, the miRNA-mRNA modules were used in an unsupervised class prediction model to discover HCC subgroups via patient clustering by mixture models. The robustness analysis of the mixture model showed that the class predictions are highly stable. Moreover, the Kaplan-Meier survival analysis revealed that the HCC subgroups identified by the algorithm have different survival characteristics. The pathway analyses of the miRNA-mRNA co-modules identified by the algorithm demonstrate key roles of Myc, E2F1, let-7, TGFB1, TNF and EGFR in HCC subgroups. Thus, our method can integrate various omics data derived from different platforms and with different dynamic scales to better define molecular tumor subtypes. iSubgraph is available as MATLAB code at http://www.cs.umd.edu/~ozdemir/isubgraph/.

  9. Rapid, reliable, and reproducible molecular sub-grouping of clinical medulloblastoma samples.

    Science.gov (United States)

    Northcott, Paul A; Shih, David J H; Remke, Marc; Cho, Yoon-Jae; Kool, Marcel; Hawkins, Cynthia; Eberhart, Charles G; Dubuc, Adrian; Guettouche, Toumy; Cardentey, Yoslayma; Bouffet, Eric; Pomeroy, Scott L; Marra, Marco; Malkin, David; Rutka, James T; Korshunov, Andrey; Pfister, Stefan; Taylor, Michael D

    2012-04-01

    The diagnosis of medulloblastoma likely encompasses several distinct entities, with recent evidence for the existence of at least four unique molecular subgroups that exhibit distinct genetic, transcriptional, demographic, and clinical features. Assignment of molecular subgroup through routine profiling of high-quality RNA on expression microarrays is likely impractical in the clinical setting. The planning and execution of medulloblastoma clinical trials that stratify by subgroup, or which are targeted to a specific subgroup requires technologies that can be economically, rapidly, reliably, and reproducibly applied to formalin-fixed paraffin embedded (FFPE) specimens. In the current study, we have developed an assay that accurately measures the expression level of 22 medulloblastoma subgroup-specific signature genes (CodeSet) using nanoString nCounter Technology. Comparison of the nanoString assay with Affymetrix expression array data on a training series of 101 medulloblastomas of known subgroup demonstrated a high concordance (Pearson correlation r = 0.86). The assay was validated on a second set of 130 non-overlapping medulloblastomas of known subgroup, correctly assigning 98% (127/130) of tumors to the appropriate subgroup. Reproducibility was demonstrated by repeating the assay in three independent laboratories in Canada, the United States, and Switzerland. Finally, the nanoString assay could confidently predict subgroup in 88% of recent FFPE cases, of which 100% had accurate subgroup assignment. We present an assay based on nanoString technology that is capable of rapidly, reliably, and reproducibly assigning clinical FFPE medulloblastoma samples to their molecular subgroup, and which is highly suited for future medulloblastoma clinical trials.

  10. Sex-Based Differences in the Performance of the HEART Score in Patients Presenting to the Emergency Department With Acute Chest Pain.

    Science.gov (United States)

    Bank, Ingrid E M; de Hoog, Vince C; de Kleijn, Dominique P V; Pasterkamp, Gerard; Doevendans, Pieter A; den Ruijter, Hester M; Dalmeijer, Geertje; Wildbergh, Thierry X; Mosterd, Arend; Timmers, Leo

    2017-06-21

    Sex-based differences in clinical presentation, pathophysiology, and outcomes of patients with acute chest pain are increasingly being recognized, but are not implemented in guidelines and clinical prediction tools. We evaluated the performance of the HEART score in women versus men, because sex-based differences may exist among the algorithm's components: history, electrocardiogram, age, risk factors, and admission troponin level. The HEART score was retrospectively assessed in 831 women and 1084 men presenting to the emergency department with acute chest pain, assigning patients to the low-, intermediate-, or high-risk category for the occurrence of major adverse cardiac events (MACE) within 6 weeks. MACE, consisting of myocardial infarction, coronary revascularization, and all-cause death, also included events during index visit. Six-week MACE rates were 2 times lower in women than men (10.0% versus 20.8%; Prisk categories: 2.1% versus 6.5% (Prisk category, 12.7% versus 21.3% (Prisk category, and 53.1% versus 77.0% (P=0.02) in the high-risk category. The HEART score-adjusted risk ratio for men was 1.6 (1.3-2.0; Prisk in men across all HEART risk categories should be taken into account when using the HEART score to guide clinical decision making; early discharge with a low-risk HEART score appears less safe for men than women with acute chest pain. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  11. Sequence and analysis of a whole genome from Kuwaiti population subgroup of Persian ancestry.

    Science.gov (United States)

    Thareja, Gaurav; John, Sumi Elsa; Hebbar, Prashantha; Behbehani, Kazem; Thanaraj, Thangavel Alphonse; Alsmadi, Osama

    2015-02-18

    The 1000 Genome project paved the way for sequencing diverse human populations. New genome projects are being established to sequence underrepresented populations helping in understanding human genetic diversity. The Kuwait Genome Project an initiative to sequence individual genomes from the three subgroups of Kuwaiti population namely, Saudi Arabian tribe; "tent-dwelling" Bedouin; and Persian, attributing their ancestry to different regions in Arabian Peninsula and to modern-day Iran (West Asia). These subgroups were in line with settlement history and are confirmed by genetic studies. In this work, we report whole genome sequence of a Kuwaiti native from Persian subgroup at >37X coverage. We document 3,573,824 SNPs, 404,090 insertions/deletions, and 11,138 structural variations. Out of the reported SNPs and indels, 85,939 are novel. We identify 295 'loss-of-function' and 2,314 'deleterious' coding variants, some of which carry homozygous genotypes in the sequenced genome; the associated phenotypes include pharmacogenomic traits such as greater triglyceride lowering ability with fenofibrate treatment, and requirement of high warfarin dosage to elicit anticoagulation response. 6,328 non-coding SNPs associate with 811 phenotype traits: in congruence with medical history of the participant for Type 2 diabetes and β-Thalassemia, and of participant's family for migraine, 72 (of 159 known) Type 2 diabetes, 3 (of 4) β-Thalassemia, and 76 (of 169) migraine variants are seen in the genome. Intergenome comparisons based on shared disease-causing variants, positions the sequenced genome between Asian and European genomes in congruence with geographical location of the region. On comparison, bead arrays perform better than sequencing platforms in correctly calling genotypes in low-coverage sequenced genome regions however in the event of novel SNP or indel near genotype calling position can lead to false calls using bead arrays. We report, for the first time, reference

  12. Prevalence and distribution of Gardnerella vaginalis subgroups in women with and without bacterial vaginosis.

    Science.gov (United States)

    Janulaitiene, Migle; Paliulyte, Virginija; Grinceviciene, Svitrigaile; Zakareviciene, Jolita; Vladisauskiene, Alma; Marcinkute, Agne; Pleckaityte, Milda

    2017-06-05

    Bacterial vaginosis (BV) is one of the leading causes of vaginal complaints among women of childbearing age. The role of Gardnerella vaginalis remains controversial due to its presence in healthy and BV-type vaginal microflora. The phenotypic and genotypic heterogeneity of G. vaginalis suggested the existence of strain variants linked with different health conditions. We sought to analyze prevalence and distribution of G. vaginalis subgroups (clades) in BV-positive (n = 29), partial BV (n = 27), and BV-negative (n = 53) vaginal samples from Lithuanian women. Vaginal samples were characterized by Amsel criteria and the Nugent method. Bacterial signatures characteristic of BV and concomitant infections were identified by culture and PCR. Using singleplex PCR assays, G. vaginalis subgroups were identified in 109 noncultured vaginal specimens by targeting clade-specific genes. Isolated G. vaginalis clinical strains were subtyped and the presence of the sialidase coding gene was detected by PCR. Data analysis was performed using GraphPad Prism statistical software. G. vaginalis was found in 87% of women without BV. Clade 4 was most frequently detected (79.4%), followed by clade 1 (63.7%), clade 2 (42.2%), and clade 3 (15.7%). Multi-clade G. vaginalis communities showed a positive association with Nugent score (NS) ≥ 4 (OR 3.64; 95% CI 1.48-8.91; p = 0.005). Clade 1 and clade 2 were statistically significantly more common in samples with NS 7-10 (OR 4.69; 95% CI 1.38-15.88; p = 0.01 and OR 6.26; 95% CI 2.20-17.81; p ≤ 0.001, respectively). Clade 3 and clade 4 showed no association with high NS (OR 0.88; 95% CI 0.26-3.04; p = 1.00 and OR 1.31; 95% CI 0.39-4.41; p = 0.767, respectively). The gene coding for sialidase was detected in all isolates of clade 1 and clade 2, but not in clade 4 isolates. We showed an association between the microbial state of vaginal microflora and specific subgroups of G. vaginalis, the distribution of which may determine the clinical

  13. Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA)

    DEFF Research Database (Denmark)

    Holden, Melanie A; Burke, Danielle L; Runhaar, Jos

    2017-01-01

    INTRODUCTION: Knee and hip osteoarthritis (OA) is a leading cause of disability worldwide. Therapeutic exercise is a recommended core treatment for people with knee and hip OA, however, the observed effect sizes for reducing pain and improving physical function are small to moderate. This may...... be due to insufficient targeting of exercise to subgroups of people who are most likely to respond and/or suboptimal content of exercise programmes. This study aims to identify: (1) subgroups of people with knee and hip OA that do/do not respond to therapeutic exercise and to different types of exercise...... and (2) mediators of the effect of therapeutic exercise for reducing pain and improving physical function. This will enable optimal targeting and refining the content of future exercise interventions. METHODS AND ANALYSIS: Systematic review and individual participant data meta-analyses. A previous...

  14. Orienting Schools toward Equity: Subgroup Accountability Pressure and School-Level Responses

    Science.gov (United States)

    Garver, Rachel

    2017-01-01

    This article examines school-level responses to subgroup accountability pressure through an ethnographic case study of a school cited for failing to make adequate yearly progress for student subgroups. Concerns about the calculations and measures used to derive the citation and reservations about acting on accountability data delegitimized the…

  15. Level of evidence for promising subgroup findings in an overall non-significant trial

    NARCIS (Netherlands)

    Tanniou, Julien; van der Tweel, Ingeborg|info:eu-repo/dai/nl/262684438; Teerenstra, S.; Roes, Kit C.B.|info:eu-repo/dai/nl/115147020

    2016-01-01

    In drug development and drug licensing, it sometimes occurs that a new drug does not demonstrate effectiveness for the full study population, but there appears to be benefit in a relevant, pre-defined subgroup. This raises the question, how strong the evidence from such a subgroup is, and which

  16. Measuring English Language Workplace Proficiency across Subgroups: Using CFA Models to Validate Test Score Interpretation

    Science.gov (United States)

    Yoo, Hanwook; Manna, Venessa F.

    2017-01-01

    This study assessed the factor structure of the Test of English for International Communication (TOEIC®) Listening and Reading test, and its invariance across subgroups of test-takers. The subgroups were defined by (a) gender, (b) age, (c) employment status, (d) time spent studying English, and (e) having lived in a country where English is the…

  17. Caffeine for Apnea of Prematurity trial: benefits may vary in subgroups

    NARCIS (Netherlands)

    Davis, Peter G.; Schmidt, Barbara; Roberts, Robin S.; Doyle, Lex W.; Asztalos, Elizabeth; Haslam, Ross; Sinha, Sunil; Tin, Win; Schmidt, B.; D'Ilario, J.; Cairnie, J.; Dix, J.; Adams, B.; Faber, B.; Callanan, K.; Davis, N.; Duff, J.; Ford, G.; Golec, L.; Lacy, M.; Hohn, D.; Barnett, C.; Goodchildt, L.; Lontis, R.; Fraser, S.; Keng, J.; Saunders, K.; Opie, G.; Kelly, E.; Bairam, A.; Ferland, S.; Laperriere, L.; Bélanger, S.; St Amand, P.; Blayney, M.; Davis, D.; Frank, J.; Lemyre, L.; Solimano, A.; Singh, A.; Chalmers, M.; Ramsay, K.; Synnes, A.; Whitfield, M.; Rogers, M.; Tomlinson, J.; Offringa, M.; Nuytemans, D.; Vermeulen, E.; Kok, J.; van Wassenaer, A.; Arnon, S.; Chalaf, A.; Regev, R.; Netter, I.; Ohlsson, A.; Nesbitt, K.; O'Brien, K.; Hamilton, A. M.; Sankaran, K.; Morgan, S.; Proctor, P.; LaCorte, M.; LeBlanc, P.; Braithwaite, A.; Golan, A.; Barabi, T.; Goldstein, E.; Reynolds, G.; Dromgool, B.; Meskell, S.; McMillan, D.; Schaab, D.; Spellen, L.; Sauve, R.; Christianson, H.; Anseeuw-Deeks, D.; Alvaro, R.; Chiu, A.; Porter, C.; Turner, G.; Moddemann, D.; Granke, N.; Penner, K.; Mulder, T.; Ghys, A.; van der Hoeven, M.; Clarke, M.; Parfitt, J.; MacLean, H.; Nwaesei, C.; Kuhn, L.; Ryan, H.; Saunders, C.; Schulze, A.; Pudenz, P.; Muller, M.; Lagercrantz, H.; Bhiladvala, M.; Legneval, L.; Herlenius, E.; Matthew, D.; Amos, W.; Tulsiani, S.; Tan-Dy, C.; Turner, M.; Shinwell, E.; Levine, R.; Juster-Reicher, A.; Barrington, K.; Kokkotis, T.; Khairy, M.; Grier, P.; Vachon, J.; Tin, W.; Fritz, S.; Walti, H.; Royer, D.; Halliday, H.; Millar, D.; Berry, A.; Mayes, C.; Cummings, C.; Fahnenstich, H.; Philipp, K.; Tillmann, B.; Weber, P.; Canning, R.; Wariyar, U.; Embleton, N.; Bucher, H.-U.; Fauchere, J.-C.; Pfister, R.; Launoy, V.; Huppi, P.; Poets, C.; Urschitz-Duprat, P.; Davis, P.; Doyle, L. W.; Gent, M.; Fraser, W.; Hey, E.; Perlman, M.; Thorpe, K.; Gray, S.; Roberts, R. S.; Chambers, C.; Costantini, L.; McGean, L.; Scapinello, L.

    2010-01-01

    OBJECTIVE: To determine whether the benefits of caffeine vary in three subgroups of 2006 participants in the Caffeine for Apnea of Prematurity (CAP) trial. STUDY DESIGN: Post-hoc subgroup analyses were performed on the basis of: (1) indication for commencement of study drug: treat apnea, prevent

  18. Nilpotency and Theory of L-Subgroups of an L-Group

    Directory of Open Access Journals (Sweden)

    Naseem Ajmal

    2014-03-01

    Full Text Available In this paper, the notion of commutator is modified and extended to L-setting. Also, the notion of descending central series is introduced which is used to formulate the important notion of nilpotent L-subgroup of an L-group. Moreover, the level subset characterization for the notion of nilpotent L-subgroup is provided.

  19. Flux Emergence (Theory

    Directory of Open Access Journals (Sweden)

    Mark C. M. Cheung

    2014-07-01

    Full Text Available Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field in models impact the evolution of the emerging field and plasma.

  20. Is the performance of MRI in preoperative staging of breast cancer independent of clinical and histological factors? A subgroup analysis.

    Science.gov (United States)

    Carreira Gómez, C; Zamora Romero, J; Gil de Miguel, A; Chiva de Agustín, M; Plana Farrás, M N; Martínez González, J

    2015-01-01

    To determine whether preoperative breast MRI is more useful in patients according to their breast density, age, menopausal status, and biopsy findings of carcinoma in situ. We retrospectively studied 264 patients treated for breast cancer who had undergone mammography, ultrasonography, and MRI. We compared the size of the tumor on the three techniques and the sensitivity of the techniques for detecting additional lesions both in the overall group and in subgroups of patients classified according to their breast density, age, menopausal status, and histological findings of intraductal carcinoma. The definitive histological diagnosis was used as the gold standard. MRI was the technique that was most concordant with the histological findings for the size of the lesion, and it was also the technique that detected the most additional lesions. With MRI, we observed no differences in lesion size between the overall group and the subgroups in which MRI provided added value. Likewise, we observed no differences in the number of additional lesions detected in the overall group except for multicentric lesions, which was larger in older patients (P=.02). In the subgroup of patients in which MRI provided added value, the sensitivity for bilateral lesions was higher in patients with fatty breasts (P=.04). Multifocal lesions were detected significantly better in premenopausal patients (P=.03). MRI is better than mammography and better than ultrasonography for establishing the size of the tumor and for detecting additional lesions. Our results did not identify any subgroups in which the technique was more useful. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  1. Simple changes within dietary subgroups can rapidly improve the nutrient adequacy of the diet of French adults.

    Science.gov (United States)

    Verger, Eric O; Holmes, Bridget A; Huneau, Jean François; Mariotti, François

    2014-06-01

    Identifying the dietary changes with the greatest potential for improving diet quality is critical to designing efficient nutrition communication campaigns. Our objective was to simulate the effects of different types of dietary substitutions to improve diet quality at the individual level. Starting from the observed diets of 1330 adults participating in the national French Nutrition and Health Survey (Etude Nationale Nutrition Santé), we simulated the effects of 3 different types of food and beverage substitutions with graded implementation difficulty for the consumer in a stepwise dietary counseling model based on the improvement in the PANDiet index, which measures diet quality in terms of nutrient adequacy. In scenario 1, substitutions of a food or beverage for its "lighter" version resulted in a modest improvement in the PANDiet score (Δ = +3.3 ± 0.1) and