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Sample records for survival studies showed

  1. Adjusting for treatment switching in the METRIC study shows further improved overall survival with trametinib compared with chemotherapy.

    Science.gov (United States)

    Latimer, Nicholas R; Bell, Helen; Abrams, Keith R; Amonkar, Mayur M; Casey, Michelle

    2016-05-01

    Trametinib, a selective inhibitor of mitogen-activated protein kinase kinase 1 (MEK1) and MEK2, significantly improves progression-free survival compared with chemotherapy in patients with BRAF V600E/K mutation-positive advanced or metastatic melanoma (MM). However, the pivotal clinical trial permitted randomized chemotherapy control group patients to switch to trametinib after disease progression, which confounded estimates of the overall survival (OS) advantage of trametinib. Our purpose was to estimate the switching-adjusted treatment effect of trametinib for OS and assess the suitability of each adjustment method in the primary efficacy population. Of the patients randomized to chemotherapy, 67.4% switched to trametinib. We applied the rank-preserving structural failure time model, inverse probability of censoring weights, and a two-stage accelerated failure time model to obtain estimates of the relative treatment effect adjusted for switching. The intent-to-treat (ITT) analysis estimated a 28% reduction in the hazard of death with trametinib treatment (hazard ratio [HR], 0.72; 95% CI, 0.52-0.98) for patients in the primary efficacy population (data cut May 20, 2013). Adjustment analyses deemed plausible provided OS HR point estimates ranging from 0.48 to 0.53. Similar reductions in the HR were estimated for the first-line metastatic subgroup. Treatment with trametinib, compared with chemotherapy, significantly reduced the risk of death and risk of disease progression in patients with BRAF V600E/K mutation-positive advanced melanoma or MM. Adjusting for switching resulted in lower HRs than those obtained from standard ITT analyses. However, CI are wide and results are sensitive to the assumptions associated with each adjustment method. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Analyses adjusting for selective crossover show improved overall survival with adjuvant letrozole compared with tamoxifen in the BIG 1-98 study.

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    Colleoni, Marco; Giobbie-Hurder, Anita; Regan, Meredith M; Thürlimann, Beat; Mouridsen, Henning; Mauriac, Louis; Forbes, John F; Paridaens, Robert; Láng, István; Smith, Ian; Chirgwin, Jacquie; Pienkowski, Tadeusz; Wardley, Andrew; Price, Karen N; Gelber, Richard D; Coates, Alan S; Goldhirsch, Aron

    2011-03-20

    Among postmenopausal women with endocrine-responsive breast cancer, the aromatase inhibitor letrozole, when compared with tamoxifen, has been shown to significantly improve disease-free survival (DFS) and time to distant recurrence (TDR). We investigated whether letrozole monotherapy prolonged overall survival (OS) compared with tamoxifen monotherapy. Of 8,010 postmenopausal women with hormone receptor-positive, early breast cancer enrolled on the Breast International Group (BIG) 1-98 study, 4,922 were randomly assigned to 5 years of continuous adjuvant therapy with either letrozole or tamoxifen. Of 2,459 patients enrolled in the tamoxifen treatment arm, 619 (25.2%) selectively crossed over to either adjuvant or extended letrozole after initial trial results were presented in January 2005. To gain better estimates of relative treatment effects in the presence of selective crossover, we used inverse probability of censoring weighted (IPCW) modeling. Weighted Cox models, by using IPCW, estimated a statistically significant, 18% reduction in the hazard of an OS event with letrozole treatment (hazard ratio [HR], 0.82; 95% CI, 0.70 to 0.95). Estimates of 5-year OS on the basis of IPCW were 91.8% and 90.4% for letrozole and tamoxifen, respectively. The HRs of DFS and TDR events by using IPCW modeling were 0.83 (95% CI, 0.74 to 0.94) and 0.80 (95% CI, 0.67 to 0.94), respectively (P < .05 for DFS, OS, and TDR). Median follow-up was 74 months. Adjuvant treatment with letrozole, compared with tamoxifen, significantly reduces the risk of death, the risk of recurrent disease, and the risk of recurrence at distant sites in postmenopausal women with hormone receptor-positive breast cancer.

  3. Analyses adjusting for selective crossover show improved overall survival with adjuvant letrozole compared with tamoxifen in the BIG 1-98 study

    DEFF Research Database (Denmark)

    Colleoni, Marco; Giobbie-Hurder, Anita; Regan, Meredith M

    2011-01-01

    Among postmenopausal women with endocrine-responsive breast cancer, the aromatase inhibitor letrozole, when compared with tamoxifen, has been shown to significantly improve disease-free survival (DFS) and time to distant recurrence (TDR). We investigated whether letrozole monotherapy prolonged...

  4. Men and women show similar survival rates after breast cancer.

    Science.gov (United States)

    Bender, Paulo Franscisco Mascarenhas; de Oliveira, Letícia Lima; Costa, Célia Regina; de Aguiar, Suzana Sales; Bergmann, Anke; Thuler, Luiz Claudio Santos

    2017-04-01

    To compare the disease-free survival (DFS) and overall survival (OS) rates of men and women undergoing treatment for breast cancer. A retrospective cohort study of patients with breast cancer diagnosed and treated at the Cancer Hospital III of the National Cancer Institute of Brazil, Rio de Janeiro, Brazil, between 1999 and 2013. Male breast cancer cases were matched for age, year of diagnosis, and clinical staging to three female cases (1:3). Patient characteristics were abstracted from hospital records and medical charts. Cases were analyzed using descriptive statistics, and comparisons between the genders were performed using Kaplan-Meier curves and Cox regression analysis with 95% confidence intervals. The study population comprised 98 men and 294 women. There were significant differences (p breast surgery, neoadjuvant chemotherapy, adjuvant radiotherapy, and use of palliative bisphosphonate therapy. Five- and 10-year DFS rates were, respectively, 80.0 and 51.4% for men and 71.4 and 63.5% for women (p = 0.245), and 5- and 10-year OS rates were, respectively, 65.0 and 47.5% for men and 56.5 and 41.4% for women (p = 0.221). There was no significant difference in prognosis (DFS and OS rates) between the genders, but significant differences in sociodemographic and clinical characteristics were detected between male and female breast cancer cases.

  5. It isn't like this on TV: Revisiting CPR survival rates depicted on popular TV shows.

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    Portanova, Jaclyn; Irvine, Krystle; Yi, Jae Yoon; Enguidanos, Susan

    2015-11-01

    Public perceptions of cardiopulmonary resuscitation (CPR) can be influenced by the media. Nearly two decades ago, a study found that the rates of survival following CPR were far higher in popular TV shows than actual rates. In recent years, major strides toward enhanced education and communication around life sustaining interventions have been made. This study aimed to reassess the accuracy of CPR portrayed by popular medical TV shows. Additionally, we sought to determine whether these shows depicted discussions of care preferences and referenced advance directives. Three trained research assistants independently coded two leading medical dramas airing between 2010 and 2011, Grey's Anatomy and House. Patient characteristics, CPR survival rates, and goals of care discussions were recorded. CPR was depicted 46 times in the 91 episodes, with a survival rate of 69.6%. Among those immediately surviving following CPR, the majority (71.9%) survived to hospital discharge and 15.6% died before discharge. Advance directive discussions only occurred for two patients, and preferences regarding code status (8.7%), intubation (6.5%) and feeding (4.3%) rarely occurred. Both popular TV shows portrayed CPR as more effective than actual rates. Overall, the shows portrayed an immediate survival rate nearly twice that of actual survival rates. Inaccurate TV portrayal of CPR survival rates may misinform viewers and influence care decisions made during serious illness and at end of life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Immediate postmastectomy breast reconstruction showed limited advantage in patient survival after stratifying by family income.

    Science.gov (United States)

    Jiang, Yi-Zhou; Liu, Yi-Rong; Yu, Ke-Da; Zuo, Wen-Jia; Shao, Zhi-Ming

    2013-01-01

    Postmastectomy breast reconstruction is widely used in breast cancer patients for its aesthetic effect. Although several studies have casted suspicion upon the oncological safety of immediate breast reconstruction after mastectomy, the potential impact of different reconstruction methods on patient survival remains unclear. We identified 35,126 female patients diagnosed with breast cancer from January 1, 1998 to December 31, 2002 in the Surveillance, Epidemiology, and End Results database. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared among patients who underwent mastectomy with or without immediate breast reconstruction (autologous reconstruction or implant reconstruction) using Cox proportional hazard regression models. In multivariate analysis unadjusted for family income, patients undergoing immediate postmastectomy reconstruction exhibited improved BCSS [POOLED reconstruction (any types of reconstruction): hazard ratio (HR)  =  0.87, 95% confidence interval (CI) 0.80-0.95, P = 0.001] and OS (pooled reconstruction: HR = 0.70, 95% CI 0.65-0.75, Padvantage in BCSS and OS compared with those undergoing mastectomy alone. When comparing between the two reconstruction methods, no significant differences were observed in either BCSS (implant versus autologous reconstruction: HR = 1.11, 95%CI 0.90-1.35, P = 0.330) or OS (implant versus autologous reconstruction: HR = 1.07, 95% 0.90-1.28, P = 0.424). Compared to mastectomy alone, immediate postmastectomy reconstruction had limited advantage in survival after adjusting for confounding factor of family income. Our findings, if validated in other large databases, may help to illustrate the actual effect of immediate postmastectomy reconstruction on patient survival.

  7. Neoadjuvant Chemoradiation Shows No Survival Advantage to Chemotherapy Alone in Stage IIIA Patients.

    Science.gov (United States)

    Krantz, Seth B; Mitzman, Brian; Lutfi, Waseem; Kuchta, Kristine; Wang, Chi-Hsiung; Howington, John A; Kim, Ki Wan

    2018-02-13

    For operable patients with clinical stage IIIA non-small cell lung cancer, the optimum neoadjuvant treatment strategy remains unclear. Our aim was to compare perioperative and long-term outcomes for patients receiving neoadjuvant chemoradiotherapy (NCRT) versus neoadjuvant chemotherapy (NCT) alone. We queried the National Cancer Database to identify all patients with N2 and either T1-T2 non-small cell lung cancer who received either NCRT or NCT followed by lobectomy between 2006 and 2012. Patients with T3 tumors were excluded. A propensity match analysis was performed incorporating preoperative variables, and the incidence of postoperative complications, pathologic downstaging, and long-term survival were compared. In all, 1,936 patients met criteria, 745 NCT and 1,191 NCRT. The NCRT patients were younger, less likely to be treated at an academic medical center, and more likely to have adenocarcinoma. After propensity matching, patients in the NCT group showed lower 30-day mortality (1.3% versus 2.9%) and 90-day mortality (2.9% versus 6.0%), and were more likely to undergo a minimally invasive resection (25.7% versus 14.1%). The NCRT patients were more likely to have a pathologic complete response (14.2% versus 4.0%) and to be N0 at the time of resection (45.2% versus 38.7%). In the multivariable analysis, NCRT patients were at a greater risk of mortality than NCT patients (hazard ratio 1.18, 95% confidence interval: 1.03 to 1.36). In our cohort, combined neoadjuvant chemotherapy and radiation therapy was associated with improved pathologic downstaging but showed increased perioperative mortality with no improvement in long-term overall survival. For stage IIIA patients with smaller tumors without local invasion, chemotherapy alone may be the preferred neoadjuvant treatment. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Transgenic poplars with reduced lignin show impaired xylem conductivity, growth efficiency and survival.

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    Voelker, Steven L; Lachenbruch, Barbara; Meinzer, Frederick C; Kitin, Peter; Strauss, Steven H

    2011-04-01

    We studied xylem anatomy and hydraulic architecture in 14 transgenic insertion events and a control line of hybrid poplar (Populus spp.) that varied in lignin content. Transgenic events had different levels of down-regulation of two genes encoding 4-coumarate:coenzyme A ligase (4CL). Two-year-old trees were characterized after growing either as free-standing trees in the field or as supported by stakes in a greenhouse. In free-standing trees, a 20 to 40% reduction in lignin content was associated with increased xylem vulnerability to embolism, shoot dieback and mortality. In staked trees, the decreased biomechanical demands on the xylem was associated with increases in the leaf area to sapwood area ratio and wood specific conductivity (k(s)), and with decreased leaf-specific conductivity (k(l)). These shifts in hydraulic architecture suggest that the bending stresses perceived during growth can affect traits important for xylem water transport. Severe 4CL-downregulation resulted in the patchy formation of discoloured, brown wood with irregular vessels in which water transport was strongly impeded. These severely 4CL-downregulated trees had significantly lower growth efficiency (biomass/leaf area). These results underscore the necessity of adequate lignification for mechanical support of the stem, water transport, tree growth and survival. © 2011 Blackwell Publishing Ltd.

  9. Genomic prediction of survival time in a population of brown laying hens showing cannibalistic behavior

    NARCIS (Netherlands)

    Alemu, Setegn W.; Calus, Mario P.L.; Muir, William M.; Peeters, Katrijn; Vereijken, Addie; Bijma, Piter

    2016-01-01

    Background: Mortality due to cannibalism causes both economic and welfare problems in laying hens. To limit mortality due to cannibalism, laying hens are often beak-trimmed, which is undesirable for animal welfare reasons. Genetic selection is an alternative strategy to increase survival and is

  10. Thymidine kinase 1 deficient cells show increased survival rate after UV-induced DNA damage

    DEFF Research Database (Denmark)

    Skovgaard, T; Rasmussen, Lene Juel; Munch-Petersen, Birgitte

    2010-01-01

    Balanced deoxynucleotide pools are known to be important for correct DNA repair, and deficiency for some of the central enzymes in deoxynucleotide metabolism can cause imbalanced pools, which in turn can lead to mutagenesis and cell death. Here we show that cells deficient for the thymidine salvage...... enzyme thymidine kinase 1 (TK1) are more resistant to UV-induced DNA damage than TK1 positive cells although they have thymidine triphosphate (dTTP) levels of only half the size of control cells. Our results suggest that higher thymidine levels in the TK- cells caused by defect thymidine salvage to d...

  11. Transgenic poplars with reduced lignin show impaired xylem conductivity, growth efficiency and survival

    Science.gov (United States)

    Steven L. Voelker; Barbara Lachenbruch; Frederick C. Meinzer; Peter Kitin; Steven H. Strauss

    2011-01-01

    We studied xylem anatomy and hydraulic architecture in 14 transgenic insertion events and a control line of hybrid poplar (Populus spp.) that varied in lignin content. Transgenic events had different levels of down-regulation of two genes encoding 4-coumarate:coenzyme A ligase (4CL). Two-year-old trees were characterized after...

  12. Integrative Analyses of Colorectal Cancer Show Immunoscore Is a Stronger Predictor of Patient Survival Than Microsatellite Instability.

    Science.gov (United States)

    Mlecnik, Bernhard; Bindea, Gabriela; Angell, Helen K; Maby, Pauline; Angelova, Mihaela; Tougeron, David; Church, Sarah E; Lafontaine, Lucie; Fischer, Maria; Fredriksen, Tessa; Sasso, Maristella; Bilocq, Amélie M; Kirilovsky, Amos; Obenauf, Anna C; Hamieh, Mohamad; Berger, Anne; Bruneval, Patrick; Tuech, Jean-Jacques; Sabourin, Jean-Christophe; Le Pessot, Florence; Mauillon, Jacques; Rafii, Arash; Laurent-Puig, Pierre; Speicher, Michael R; Trajanoski, Zlatko; Michel, Pierre; Sesboüe, Richard; Frebourg, Thierry; Pagès, Franck; Valge-Archer, Viia; Latouche, Jean-Baptiste; Galon, Jérôme

    2016-03-15

    Microsatellite instability in colorectal cancer predicts favorable outcomes. However, the mechanistic relationship between microsatellite instability, tumor-infiltrating immune cells, Immunoscore, and their impact on patient survival remains to be elucidated. We found significant differences in mutational patterns, chromosomal instability, and gene expression that correlated with patient microsatellite instability status. A prominent immune gene expression was observed in microsatellite-instable (MSI) tumors, as well as in a subgroup of microsatellite-stable (MSS) tumors. MSI tumors had increased frameshift mutations, showed genetic evidence of immunoediting, had higher densities of Th1, effector-memory T cells, in situ proliferating T cells, and inhibitory PD1-PDL1 cells, had high Immunoscores, and were infiltrated with mutation-specific cytotoxic T cells. Multivariate analysis revealed that Immunoscore was superior to microsatellite instability in predicting patients' disease-specific recurrence and survival. These findings indicate that assessment of the immune status via Immunoscore provides a potent indicator of tumor recurrence beyond microsatellite-instability staging that could be an important guide for immunotherapy strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Prognostic and survival analysis of presbyopia: The healthy twin study

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    Lira, Adiyani; Sung, Joohon

    2015-12-01

    Presbyopia, a vision condition in which the eye loses its flexibility to focus on near objects, is part of ageing process which mostly perceptible in the early or mid 40s. It is well known that age is its major risk factor, while sex, alcohol, poor nutrition, ocular and systemic diseases are known as common risk factors. However, many other variables might influence the prognosis. Therefore in this paper we developed a prognostic model to estimate survival from presbyopia. 1645 participants which part of the Healthy Twin Study, a prospective cohort study that has recruited Korean adult twins and their family members based on a nation-wide registry at public health agencies since 2005, were collected and analyzed by univariate analysis as well as Cox proportional hazard model to reveal the prognostic factors for presbyopia while survival curves were calculated by Kaplan-Meier method. Besides age, sex, diabetes, and myopia; the proposed model shows that education level (especially engineering program) also contribute to the occurrence of presbyopia as well. Generally, at 47 years old, the chance of getting presbyopia becomes higher with the survival probability is less than 50%. Furthermore, our study shows that by stratifying the survival curve, MZ has shorter survival with average onset time about 45.8 compare to DZ and siblings with 47.5 years old. By providing factors that have more effects and mainly associate with presbyopia, we expect that we could help to design an intervention to control or delay its onset time.

  14. Meta-analyses of randomized controlled trials show suboptimal validity of surrogate outcomes for overall survival in advanced colorectal cancer.

    Science.gov (United States)

    Ciani, Oriana; Buyse, Marc; Garside, Ruth; Peters, Jaime; Saad, Everardo D; Stein, Ken; Taylor, Rod S

    2015-07-01

    To quantify and compare the treatment effects on three surrogate end points, progression-free survival (PFS), time to progression (TTP), and tumor response rate (TR) vs. overall survival (OS) based on a meta-analysis of randomized controlled trials (RCTs) of drug interventions in advanced colorectal cancer (aCRC). We systematically searched for RCTs of pharmacologic therapies in aCRC between 2003 and 2013. Trial characteristics, risk of bias, and outcomes were recorded based on a predefined form. Univariate and multivariate random-effects meta-analyses were used to estimate pooled summary treatment effects. The ratio of hazard ratios (HRs)/odds ratios (ORs) and difference in medians were used to quantify the degree of difference in treatment effects on the surrogate end points and OS. Spearman ρ, surrogate threshold effect (STE), and R(2) were also estimated across predefined trial-level covariates. We included 101 RCTs. In univariate and multivariate meta-analyses, we found larger treatment effects for the surrogates than for OS. Compared with OS, treatment effects were on average 13% higher when HRs were measured and 3% to 45% higher when ORs were considered; differences in median PFS/TTP were higher than on OS by an average of 0.5 month. Spearman ρ ranged from 0.39 to 0.80, mean R(2) from 0.06 to 0.65, and STE was 0.8 for HRPFS, 0.64 for HRTTP, or 0.28 for ORTR. The stratified analyses revealed high variability across all strata. None of the end points in this study were found to achieve the level of evidence (ie, mean R(2)trial > 0.60) that has been set to select high or excellent correlation levels by common surrogate evaluation tools. Previous surrogacy relationships observed between PFS and TTP vs. OS in selected settings may not apply across other classes or lines of therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Neonatal appendicitis: a survival case study

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    Izabela Linha Secco

    Full Text Available ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

  16. X-ray survival characteristics and genetic analysis for nine saccharomyces deletion mutants that show altered radiation sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Game, John C.; Williamson, Marsha S.; Baccari, Clelia

    2004-01-07

    The availability of a genome-wide set of Saccharomyces deletion mutants provides a chance to identify all the yeast genes involved in DNA repair. Using X-rays, we are screening these mutants to identify additional genes that show increased sensitivity to the lethal effects of ionizing radiation. For each mutant identified as sensitive, we are confirming that the sensitivity phenotype co-segregates with the deletion allele and are obtaining multipoint survival-versus-dose assays in at least two haploid and one homozygous diploid strains. We present data for deletion mutants involving the genes DOT1, MDM20, NAT3, SPT7, SPT20, GCN5, HFI1, DCC1 and VID21/EAF1, and discuss their potential roles in repair. Eight of these genes have a clear radiation-sensitive phenotype when deleted, but the ninth, GCN5, has at most a borderline phenotype. None of the deletions confer substantial sensitivity to ultra-violet radiation, although one or two may confer marginal sensitivity. The DOT1 gene is of interest because its only known function is to methylate one lysine residue in the core of the histone H3 protein. We find that histone H3 mutants (supplied by K. Struhl) in which this residue is replaced by other amino-acids are also X-ray sensitive, seeming to confirm that methylation of the lysine-79 residue is required for effective repair of radiation damage.

  17. Survival

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    U.S. Geological Survey, Department of the Interior — These data provide information on the survival of California red-legged frogs in a unique ecosystem to better conserve this threatened species while restoring...

  18. Directly Converted Human Fibroblasts Mature to Neurons and Show Long-Term Survival in Adult Rodent Hippocampus

    Directory of Open Access Journals (Sweden)

    Natalia Avaliani

    2017-01-01

    Full Text Available Direct conversion of human somatic cells to induced neurons (iNs, using lineage-specific transcription factors has opened new opportunities for cell therapy in a number of neurological diseases, including epilepsy. In most severe cases of epilepsy, seizures often originate in the hippocampus, where populations of inhibitory interneurons degenerate. Thus, iNs could be of potential use to replace these lost interneurons. It is not known, however, if iNs survive and maintain functional neuronal properties for prolonged time periods in in vivo. We transplanted human fibroblast-derived iNs into the adult rat hippocampus and observed a progressive morphological differentiation, with more developed dendritic arborisation at six months as compared to one month. This was accompanied by mature electrophysiological properties and fast high amplitude action potentials at six months after transplantation. This proof-of-principle study suggests that human iNs can be developed as a candidate source for cell replacement therapy in temporal lobe epilepsy.

  19. Escherichia coli K-12 survives anaerobic exposure at pH 2 without RpoS, Gad, or hydrogenases, but shows sensitivity to autoclaved broth products.

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    Daniel P Riggins

    Full Text Available Escherichia coli and other enteric bacteria survive exposure to extreme acid (pH 2 or lower in gastric fluid. Aerated cultures survive via regulons expressing glutamate decarboxylase (Gad, activated by RpoS, cyclopropane fatty acid synthase (Cfa and others. But extreme-acid survival is rarely tested under low oxygen, a condition found in the stomach and the intestinal tract. We observed survival of E. coli K-12 W3110 at pH 1.2-pH 2.0, conducting all manipulations (overnight culture at pH 5.5, extreme-acid exposure, dilution and plating in a glove box excluding oxygen (10% H2, 5% CO2, balance N2. With dissolved O2 concentrations maintained below 6 µM, survival at pH 2 required Cfa but did not require GadC, RpoS, or hydrogenases. Extreme-acid survival in broth (containing tryptone and yeast extract was diminished in media that had been autoclaved compared to media that had been filtered. The effect of autoclaved media on extreme-acid survival was most pronounced when oxygen was excluded. Exposure to H2O2 during extreme-acid treatment increased the death rate slightly for W3110 and to a greater extent for the rpoS deletion strain. Survival at pH 2 was increased in strains lacking the anaerobic regulator fnr. During anaerobic growth at pH 5.5, strains deleted for fnr showed enhanced transcription of acid-survival genes gadB, cfa, and hdeA, as well as catalase (katE. We show that E. coli cultured under oxygen exclusion (<6 µM O2 requires mechanisms different from those of aerated cultures. Extreme acid survival is more sensitive to autoclave products under oxygen exclusion.

  20. Estimation of total genetic effects for survival time in crossbred laying hens showing cannibalism, using pedigree or genomic information.

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    Brinker, T; Raymond, B; Bijma, P; Vereijken, A; Ellen, E D

    2017-02-01

    Mortality of laying hens due to cannibalism is a major problem in the egg-laying industry. Survival depends on two genetic effects: the direct genetic effect of the individual itself (DGE) and the indirect genetic effects of its group mates (IGE). For hens housed in sire-family groups, DGE and IGE cannot be estimated using pedigree information, but the combined effect of DGE and IGE is estimated in the total breeding value (TBV). Genomic information provides information on actual genetic relationships between individuals and might be a tool to improve TBV accuracy. We investigated whether genomic information of the sire increased TBV accuracy compared with pedigree information, and we estimated genetic parameters for survival time. A sire model with pedigree information (BLUP) and a sire model with genomic information (ssGBLUP) were used. We used survival time records of 7290 crossbred offspring with intact beaks from four crosses. Cross-validation was used to compare the models. Using ssGBLUP did not improve TBV accuracy compared with BLUP which is probably due to the limited number of sires available per cross (~50). Genetic parameter estimates were similar for BLUP and ssGBLUP. For both BLUP and ssGBLUP, total heritable variance (T(2) ), expressed as a proportion of phenotypic variance, ranged from 0.03 ± 0.04 to 0.25 ± 0.09. Further research is needed on breeding value estimation for socially affected traits measured on individuals kept in single-family groups. © 2016 The Authors. Journal of Animal Breeding and Genetics Published by Blackwell Verlag GmbH.

  1. Factors predicting survival in ALS: a multicenter Italian study.

    Science.gov (United States)

    Calvo, Andrea; Moglia, Cristina; Lunetta, Christian; Marinou, Kalliopi; Ticozzi, Nicola; Ferrante, Gianluca Drago; Scialo, Carlo; Sorarù, Gianni; Trojsi, Francesca; Conte, Amelia; Falzone, Yuri M; Tortelli, Rosanna; Russo, Massimo; Chiò, Adriano; Sansone, Valeria Ada; Mora, Gabriele; Silani, Vincenzo; Volanti, Paolo; Caponnetto, Claudia; Querin, Giorgia; Monsurrò, Maria Rosaria; Sabatelli, Mario; Riva, Nilo; Logroscino, Giancarlo; Messina, Sonia; Fini, Nicola; Mandrioli, Jessica

    2017-01-01

    The aim of this multicenter, retrospective study is to investigate the role of clinical characteristics and therapeutic intervention on ALS prognosis. The study included patients diagnosed from January 1, 2009 to December 31, 2013 in 13 Italian referral centers for ALS located in 10 Italian regions. Caring neurologists collected a detailed phenotypic profile and follow-up data until death into an electronic database. One center collected also data from a population-based registry for ALS. 2648 incident cases were collected. The median survival time from onset to death/tracheostomy was 44 months (SE 1.18, CI 42-46). According to univariate analysis, factors related to survival from onset to death/tracheostomy were: age at onset, diagnostic delay, site of onset, phenotype, degree of certainty at diagnosis according to revised El Escorial criteria (R-EEC), presence/absence of dementia, BMI at diagnosis, patients' provenance. In the multivariate analysis, age at onset, diagnostic delay, phenotypes but not site of onset, presence/absence of dementia, BMI, riluzole use, R-EEC criteria were independent prognostic factors of survival in ALS. We compared patients from an ALS Registry with patients from tertiary centers; the latter ones were younger, less frequently bulbar, but more frequently familial and definite at diagnosis. Our large, multicenter study demonstrated the role of some clinical and demographic factors on ALS survival, and showed some interesting differences between referral centers' patients and the general ALS population. These results can be helpful for clinical practice, in clinical trial design and to validate new tools to predict disease progression.

  2. Rainbow trout surviving infections of viral haemorrhagic septicemia virus (VHSV) show lasting antibodies to recombinant G protein fragments

    DEFF Research Database (Denmark)

    Encinas, P.; Gomez-Casado, E.; Grandes, Fregeneda

    2011-01-01

    sera from trout infected with the homologous VHSV isolate but also with the VHSV-DK-201433 heterologous isolate, which had 13 amino acid changes. Sera from healthy trout and/or from trout surviving infectious haematopoietic necrosis virus (IHNV) infection, were used to calculate cut-off absorbances...... refinements of the frg-ELISA could allow detection of anti-VHSV trout Abs in natural outbreaks caused by different heterologous VHSV isolates. The homologous frg-ELISA method could be useful to follow G immunization attempts during vaccine development and/or to best understand the fish Ab response during VHSV...... infections. The viral frgs approach might also be used with other fish species and/or viruses....

  3. Recombinant Tula hantavirus shows reduced fitness but is able to survive in the presence of a parental virus: analysis of consecutive passages in a cell culture

    Directory of Open Access Journals (Sweden)

    Plyusnin Alexander

    2005-02-01

    Full Text Available Abstract Tula hantavirus carrying recombinant S RNA segment (recTULV grew in a cell culture to the same titers as the original cell adapted variant but presented no real match to the parental virus. Our data showed that the lower competitiveness of recTULV could not be increased by pre-passaging in the cell culture. Nevertheless, the recombinant virus was able to survive in the presence of the parental virus during five consecutive passages. The observed survival time seems to be sufficient for transmission of newly formed recombinant hantaviruses in nature.

  4. Debate over Social Studies Shows Little Sign of Abating

    Science.gov (United States)

    Robelen, Erik W.

    2010-01-01

    The Texas board of education which consists of 15-member elected body drew national attention as a bloc of staunch conservatives largely succeeded in putting its stamp on a revised set of social studies standards. The debate was marked by tussles over such matters as the separation of church and state, the representation of minority figures and…

  5. Keeping Up with the Reality Show: A Ten-Years-Later Review of Surviving Teaching on the Internet

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    M. Louise Ripley

    2013-08-01

    Full Text Available A dozen years ago, I set out to teach my first Internet course at York University, a large urban Canadian university with 55,000+ students who are mainly commuters. Two years later I wrote an article titled, "Survivor!: When the Next Reality Show is You Teaching Your First Internet Course", in which I argued that there are ten major things you should not do when teaching on the Internet. Now ten years later, in this paper I revisit those recommendations to see if they still hold true, and to see if we need to add any new ones.

  6. Survival trends in metastatic bladder cancer in the United States: A population based study

    Directory of Open Access Journals (Sweden)

    Binay Kumar Shah

    2015-01-01

    Conclusions: This population-based study shows that decreases in 6-month and 12-month relative survival rates among patients with MBC in 2001-2010 compared to 1991-2000, specifically, more pronounced among CC men and Oth men.

  7. Assessment of Confounding in Studies of Delay and Survival

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Vedsted, Peter; Frydenberg, Morten

    BACKGROUND: Whether longer time to diagnosis (diagnostic delay) in patients with cancer symptoms is directly and independently associated with poor prognosis cannot be determined in randomised controlled trials. Analysis of observational data is therefore necessary. Many previous studies of the i...... of delay and cancer survival and enable us to make a more appropriate and reasonable choice of statistical models when analysing delay and survival data.......BACKGROUND: Whether longer time to diagnosis (diagnostic delay) in patients with cancer symptoms is directly and independently associated with poor prognosis cannot be determined in randomised controlled trials. Analysis of observational data is therefore necessary. Many previous studies...... of the influence of delay on survival have been subject to great uncertainties due to unmeasured confounding and measurement error. Systematic evaluation of confounding is needed. AIM: The purpose of this project is to assess confounding in studies of delay and survival in breast cancer patients. We aim to: 1...

  8. Survival after a psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study

    DEFF Research Database (Denmark)

    Boesen, Ellen H; Boesen, Sidsel H; Frederiksen, Kirsten

    2007-01-01

    The results of a randomized, intervention study done in 1993 of psychoeducation for patients with early-stage malignant melanoma showed a beneficial effect on recurrence and survival 6 years after the intervention. In the present study, we replicated the study with 258 Danish patients with malign...... with malignant melanoma. We also compared recurrence and survival among the participants in the randomized study with 137 patients who refused to participate....

  9. Emergency Locator Transmitter Survivability and Reliability Study

    Science.gov (United States)

    Stimson, Chad M.; Littell, Justin D.; Mazzuca, Lisa M.; Foster, Anthony W.; Theodorakos, George J.

    2017-01-01

    A comprehensive study of Emergency Locator Transmitter (ELT) performance was conducted over a three year period concluding in 2016 in support of the Search and Rescue (SAR) Mission Office at National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC). The study began with a review of reported performance cited in a collection of works published as early as 1980 as well as analysis of a focused set of contemporary aviation crash reports. Based on initial research findings, a series of subscale and fullscale system tests were performed at NASA Langley Research Center (LaRC) with the goals of investigating ELT system failure modes and developing recommended improvements to the Radio Technical Commission for Aeronautics (RTCA) Minimum Operational Performance Specification (MOPS) that will result in improved system performance. Enhanced performance of ELT systems in aviation accidents will reduce unnecessary loss of human life and make SAR operations safer and less costly by reducing the amount of time required to locate accident sites.

  10. Survival analysis for customer satisfaction: A case study

    Science.gov (United States)

    Hadiyat, M. A.; Wahyudi, R. D.; Sari, Y.

    2017-11-01

    Most customer satisfaction surveys are conducted periodically to track their dynamics. One of the goals of this survey was to evaluate the service design by recognizing the trend of satisfaction score. Many researchers recommended in redesigning the service when the satisfaction scores were decreasing, so that the service life cycle could be predicted qualitatively. However, these scores were usually set in Likert scale and had quantitative properties. Thus, they should also be analyzed in quantitative model so that the predicted service life cycle would be done by applying the survival analysis. This paper discussed a starting point for customer satisfaction survival analysis with a case study in healthcare service.

  11. A new approach to the "apparent survival" problem: estimating true survival rates from mark-recapture studies.

    Science.gov (United States)

    Gilroy, James J; Virzi, Thomas; Boulton, Rebecca L; Lockwood, Julie L

    2012-07-01

    Survival estimates generated from live capture-mark-recapture studies may be negatively biased due to the permanent emigration of marked individuals from the study area. In the absence of a robust analytical solution, researchers typically sidestep this problem by simply reporting estimates using the term "apparent survival." Here, we present a hierarchical Bayesian multistate model designed to estimate true survival by accounting for predicted rates of permanent emigration. Initially we use dispersal kernels to generate spatial projections of dispersal probability around each capture location. From these projections, we estimate emigration probability for each marked individual and use the resulting values to generate bias-adjusted survival estimates from individual capture histories. When tested using simulated data sets featuring variable detection probabilities, survival rates, and dispersal patterns, the model consistently eliminated negative biases shown by apparent survival estimates from standard models. When applied to a case study concerning juvenile survival in the endangered Cape Sable Seaside Sparrow (Ammodramus maritimus mirabilis), bias-adjusted survival estimates increased more than twofold above apparent survival estimates. Our approach is applicable to any capture-mark-recapture study design and should be particularly valuable for organisms with dispersive juvenile life stages.

  12. Estimating haplotype relative risks on human survival in population-based association studies.

    Science.gov (United States)

    Tan, Qihua; Christiansen, Lene; Bathum, Lise; Zhao, Jing Hua; Yashin, Anatoli I; Vaupel, James W; Christensen, Kaare; Kruse, Torben A

    2005-01-01

    Association-based linkage disequilibrium (LD) mapping is an increasingly important tool for localizing genes that show potential influence on human aging and longevity. As haplotypes contain more LD information than single markers, a haplotype-based LD approach can have increased power in detecting associations as well as increased robustness in statistical testing. In this paper, we develop a new statistical model to estimate haplotype relative risks (HRRs) on human survival using unphased multilocus genotype data from unrelated individuals in cross-sectional studies. Based on the proportional hazard assumption, the model can estimate haplotype risk and frequency parameters, incorporate observed covariates, assess interactions between haplotypes and the covariates, and investigate the modes of gene function. By introducing population survival information available from population statistics, we are able to develop a procedure that carries out the parameter estimation using a nonparametric baseline hazard function and estimates sex-specific HRRs to infer gene-sex interaction. We also evaluate the haplotype effects on human survival while taking into account individual heterogeneity in the unobserved genetic and nongenetic factors or frailty by introducing the gamma-distributed frailty into the survival function. After model validation by computer simulation, we apply our method to an empirical data set to measure haplotype effects on human survival and to estimate haplotype frequencies at birth and over the observed ages. Results from both simulation and model application indicate that our survival analysis model is an efficient method for inferring haplotype effects on human survival in population-based association studies.

  13. A Practice-based Study on the Survival of Restored Endodontically Treated Teeth

    NARCIS (Netherlands)

    Skupien, J.A.; Opdam, N.; Winnen, R.; Bronkhorst, E.; Kreulen, C.; Pereira-Cenci, T.; Huysmans, M.C.D.N.J.M.

    2013-01-01

    INTRODUCTION: This retrospective study evaluated the survival of endodontically treated teeth (ETTs) and investigated factors influencing restoration and tooth survival. METHODS: Data from 795 ETTs were recorded, and success (restoration still intact) and survival (restoration intact or

  14. Negative impact of rurality on lung cancer survival in a population-based study.

    Science.gov (United States)

    Westeel, Virginie; Pitard, Alexandre; Martin, Mael; Thaon, Isabelle; Depierre, Alain; Dalphin, Jean-Charles; Arveux, Patrick

    2007-07-01

    Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.

  15. High Content Analysis of Hippocampal Neuron-Astrocyte Co-cultures Shows a Positive Effect of Fortasyn Connect on Neuronal Survival and Postsynaptic Maturation

    Directory of Open Access Journals (Sweden)

    Anne-Lieke F. van Deijk

    2017-08-01

    Full Text Available Neuronal and synaptic membranes are composed of a phospholipid bilayer. Supplementation with dietary precursors for phospholipid synthesis –docosahexaenoic acid (DHA, uridine and choline– has been shown to increase neurite outgrowth and synaptogenesis both in vivo and in vitro. A role for multi-nutrient intervention with specific precursors and cofactors has recently emerged in early Alzheimer's disease, which is characterized by decreased synapse numbers in the hippocampus. Moreover, the medical food Souvenaid, containing the specific nutrient combination Fortasyn Connect (FC, improves memory performance in early Alzheimer's disease patients, possibly via maintaining brain connectivity. This suggests an effect of FC on synapses, but the underlying cellular mechanism is not fully understood. Therefore, we investigated the effect of FC (consisting of DHA, eicosapentaenoic acid (EPA, uridine, choline, phospholipids, folic acid, vitamins B12, B6, C and E, and selenium, on synaptogenesis by supplementing it to primary neuron-astrocyte co-cultures, a cellular model that mimics metabolic dependencies in the brain. We measured neuronal developmental processes using high content screening in an automated manner, including neuronal survival, neurite morphology, as well as the formation and maturation of synapses. Here, we show that FC supplementation resulted in increased numbers of neurons without affecting astrocyte number. Furthermore, FC increased postsynaptic PSD95 levels in both immature and mature synapses. These findings suggest that supplementation with FC to neuron-astrocyte co-cultures increased both neuronal survival and the maturation of postsynaptic terminals, which might aid the functional interpretation of FC-based intervention strategies in neurological diseases characterized by neuronal loss and impaired synaptic functioning.

  16. Factors Affecting the Survival of SMEs: A Study of Biotechnology Firms in South Korea

    Directory of Open Access Journals (Sweden)

    Kwangsoo Shin

    2017-01-01

    Full Text Available Past studies examining survival factors of biotechnology firms have focused on pioneer countries, such as the USA, the UK and Germany. However, as the biotechnology industry in Asia is reaching the take-off stage and showing a high growth rate, the research on survival factors in the context of Asian latecomers is needed. The present research investigates internal and external factors affecting the survival of SMEs (Small and Medium-sized Enterprises in the biotechnology industry in South Korea. The Cox hazard model was employed to perform a robust estimation in survival analysis. The analysis of internal factors showed that the origin of a firm (i.e., having prior experience or spin-offs and the business sub-sector (i.e., platform-based affect the hazard rates of biotechnology firms. In terms of external factors, unlike strategic alliances, government R&D funding lowered hazard rates for the firm’s survival. Additionally, considering that the reasons of firm exit can be divided into bankruptcy and M&A (Mergers and Acquisitions, the different effects of origins from other firms and strategic alliance for firm survival are confirmed. The results suggest that prior experience, platform-based and constant government R&D funding contribute to the sustainable development of SMEs in the biotechnology industry.

  17. Study of Hip Fracture Risk using Tree Structured Survival Analysis

    Directory of Open Access Journals (Sweden)

    Lu Y

    2003-01-01

    Survival Analysis (TSSA method to generate the subgroups based upon the cross-sectional data from 7,665 women enrolled in the Study of Osteoporotic Fractures (SOF. All of these women had forearm, os calcis, hip and spine bone mineral density (BMD measurements. Time to hip fracture since BMD measurement was also recorded for these women and was treated as the outcome variable. A random sample consisting of 75% (training data set of women from the 7,665 available was used to generate the prognostic subgroups while the other 25% (validation data set was used to validate the results. Based on the training data set, TSSA identified four subgroups for whom the risk of hip fracture for an average of 6.5 years of follow-up was 19%, 9%, 4% and 1%. The rules to generate the subgroups were based on BMD of Ward's triangle, BMD of the os calcis, and BMD of the femoral neck, and age. We reproduced these results using the validation data set, showing the usefulness of the classification rules in a clinical setting. In conclusion, TSSA provided a useful, powerful and reproducible procedure for identification of meaningful prognostic subgroups based upon an individual woman's age and BMD measurements.

  18. Injury elimination and survival: a cross-national study.

    Science.gov (United States)

    Rockett, I R

    1998-01-01

    Injury is potentially avoidable. In this study, nine industrialized countries were compared on the projected impact upon population survival of hypothetically eliminating injury mortality. Three principal research questions were addressed. Computer simulations were performed using a combination of single decrement, multiple decrement and cause-elimination life table techniques. Data pertained to 1992. French and American males exhibited the largest projected addition to life expectancy at birth of 2.1 y. They were followed by Canadian and Spanish males with gains of 1.6 y, respectively. Among females, the French were the leading beneficiaries with an added 1.1 y, followed by Americans with 0.8 y. Male gains typically were twice the female gains. Highlighted as relative injury problems were homicide for the US population, traffic fatalities for the Spanish population, and suicide for Japanese females. Among the hypothetically spared, American males registered the largest average projected benefit for either sex of any nationality with 31 additional years of life. At the other extreme were Dutch females with an extra 16 y. For persons exact age 15 of either sex, the greatest projected improvements in survival between ages 15 and 65 would occur for the French. French and US populations manifested the largest injury mortality burdens and British and Dutch the smallest. But survival benefits accruing from the injury mortality elimination varied considerably across nation and sex according to the nature of the life table analyses conducted.

  19. Survival Rate of Dental Implants in Patients with History of Periodontal Disease: A Retrospective Cohort Study.

    Science.gov (United States)

    Correia, Francisco; Gouveia, Sónia; Felino, António Campos; Costa, Ana Lemos; Almeida, Ricardo Faria

    To evaluate the differences between the survival rates of implants placed in patients with no history of periodontal disease (NP) and in patients with a history of chronic periodontal disease (CP). A retrospective cohort study was conducted in which all consenting patients treated with dental implants in a private clinic in Oporto, Portugal, from November 2, 2002 through February 11, 2011 were included. All patients were treated consecutively by the same experimental operator. This study aimed to analyze how the primary outcomes (presence of disease, time of placement, and time of loading) and the secondary outcomes (severity-generalized periodontitis, brand, implant length, prosthesis type, prosthesis metal-ceramic extension) influence the survival rate of dental implants. The survival analysis was performed through the Kaplan-Meier method, and the equality of survival distributions for all groups was tested with the log-rank test with a significance level of .05 for all comparisons. The sample consisted of 202 patients (47% NP and 53% CP) and 689 implants (31% NP and 69% CP). The survival rate in the NP and CP groups showed no statistically significant differences (95.8% versus 93.1%; P ≥ .05). Implants were lost before loading in 54.9% of the cases. The majority of the implants were lost in the first year and stabilized after the second year. Survival rates in the NP and CP patients showed no statistically significant differences when comparing the following factors: subclassification of the disease, implant brands, implant length (short/standard), type of prosthesis, extension of the prosthesis metal-ceramic, and time of placement and loading (P ≥ .05). This work disclosed no statistically significant differences in terms of survival rates when compared with the control group. Placing implants in patients with a history of periodontal disease appears to be viable and safe.

  20. Tree survival and maximum density of planted forests – Observations from South African spacing studies

    Directory of Open Access Journals (Sweden)

    Klaus v. Gadow

    2014-10-01

    Full Text Available Background Among the most important aspects of risk and hazard studies relating to forest ecosystems are maximum forest density and density-dependent tree survival. Methods Long-term observations about the maximum density of unthinned Pinus patula and P. elliottii field plots based on the Correlated Curve Trend (CCT spacing studies which were established almost 8 decades ago by O’Connor (Forest Research with Special Reference to Planting Distances and Thinning, 1935 in South Africa. Three specific approaches were introduced for analysing maximum density and tree survival, namely the ‘limiting line’, Nilson’s sparsity and tree survival with the Weibull function. Results The main results are: a Maximum densities differ greatly among the two species grown on the same site and within the same species grown on different sites; it is possible to relate these differences to site index in both species. b The relationship between the quadratic mean diameter and the minimum average spacing of surviving trees (known as Nilson’s Sparsity appears to be surprisingly similar in both species. c An analysis of tree survival in response to different initial planting espacements shows that the Weibull survival function parameters can be estimated if the initial planting density is known. This result is presented for each of the eight large experiments used in this study. Conclusions This study contributes to a better understanding of tree survival and maximum density which are the key factors required for estimating risk and uncertainty. The risk of tree mortality is not constant, but varies with tree species, planting density, tree age and growing site. For estimating that risk, therefore, continuous long-term observation on different sites and with varying planting densities, as provided by the unthinned CCT series, are essential.

  1. Survival Trends in Elderly Patients with Glioblastoma in the United States: a Population-based Study.

    Science.gov (United States)

    Shah, Binay Kumar; Bista, Amir; Sharma, Sandhya

    2016-09-01

    Concomitant and adjuvant temozolomide along with radiotherapy following surgery (the Stupp regimen) is the preferred therapy for young patients with glioblastoma as well as for elderly (>70 years) ones with favorable risk factors. This study investigated the survival trend since the introduction of the use of the Stupp regimen in elderly patients in a population-based setting. Surveillance, Epidemiology, and End Results 18 database was used to identify patients aged ≥70 years with glioblastoma as the first primary cancer diagnosed from 1999 to 2010. Chi-square test, Kaplan-Meier analysis with log-rank test and Cox proportional hazard method were used for analysis. A total of 5,575 patients were included in the survival analysis. Survival in Stupp era (year of diagnosis ≥2005) was significantly better compared to the pre-Stupp era with p<0.001 by log-rank test, with 1-, 2- and 3-year overall survival of 18.8% vs. 12.9%, 6.5% vs. 2.1% and 3.1% vs. 0.9% respectively, and hazard ratio for death in 3 years in the Stupp era was 0.87 (95% confidence interval=0.82-0.92; p<0.001) when compared with the pre-Stupp era. Factors such as younger age (<85 years), female sex, married status, Caucasian race and total resection favored better survival compared to their counterparts. This study shows that the survival of elderly patients with glioblastoma has improved since the introduction of the Stupp regimen. However, there are significant differences in survival rates among various cohorts. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter

    2010-01-01

    -based surveys is emphasized. For factors such as sex, and most cardiovascular risk factors further studies are necessary to clarify the relation to survival because studies disagree. Conclusions from studies of the relation between survival and alcohol intake are still debatable, mostly because of diverging...... definitions of the intensity of exposure. Smoking is uniformly associated with a poorer survival after stroke. Stroke unit treatment improves both short- and longterm survival regardless of stroke type, severity, age, and cardiovascular risk factor profile....

  3. Whole blood DNA aberrant methylation in pancreatic adenocarcinoma shows association with the course of the disease: a pilot study.

    Directory of Open Access Journals (Sweden)

    Albertas Dauksa

    Full Text Available Pancreatic tumors are usually diagnosed at an advanced stage in the progression of the disease, thus reducing the survival chances of the patients. Non-invasive early detection would greatly enhance therapy and survival rates. Toward this aim, we investigated in a pilot study the power of methylation changes in whole blood as predictive markers for the detection of pancreatic tumors. We investigated methylation levels at selected CpG sites in the CpG rich regions at the promoter regions of p16, RARbeta, TNFRSF10C, APC, ACIN1, DAPK1, 3OST2, BCL2 and CD44 in the blood of 30 pancreatic tumor patients and in the blood of 49 matching controls. In addition, we studied LINE-1 and Alu repeats using degenerate amplification approach as a surrogate marker for genome-wide methylation. The site-specific methylation measurements at selected CpG sites were done by the SIRPH method. Our results show that in the patient's blood, tumor suppressor genes were slightly but significantly higher methylated at several CpG sites, while repeats were slightly less methylated compared to control blood. This was found to be significantly associated with higher risk for pancreatic ductal adenocarcinoma. Additionally, high methylation levels at TNFRSCF10C were associated with positive perineural spread of tumor cells, while higher methylation levels of TNFRSF10C and ACIN1 were significantly associated with shorter survival. This pilot study shows that methylation changes in blood could provide a promising method for early detection of pancreatic tumors. However, larger studies must be carried out to explore the clinical usefulness of a whole blood methylation based test for non-invasive early detection of pancreatic tumors.

  4. Experimental methods for studying microbial survival in extraterrestrial environments.

    Science.gov (United States)

    Olsson-Francis, Karen; Cockell, Charles S

    2010-01-01

    Microorganisms can be used as model systems for studying biological responses to extraterrestrial conditions; however, the methods for studying their response are extremely challenging. Since the first high altitude microbiological experiment in 1935 a large number of facilities have been developed for short- and long-term microbial exposure experiments. Examples are the BIOPAN facility, used for short-term exposure, and the EXPOSE facility aboard the International Space Station, used for long-term exposure. Furthermore, simulation facilities have been developed to conduct microbiological experiments in the laboratory environment. A large number of microorganisms have been used for exposure experiments; these include pure cultures and microbial communities. Analyses of these experiments have involved both culture-dependent and independent methods. This review highlights and discusses the facilities available for microbiology experiments, both in space and in simulation environments. A description of the microorganisms and the techniques used to analyse survival is included. Finally we discuss the implications of microbiological studies for future missions and for space applications. Copyright 2009 Elsevier B.V. All rights reserved.

  5. Study of integrated heterogeneous data reveals prognostic power of gene expression for breast cancer survival.

    Directory of Open Access Journals (Sweden)

    Richard E Neapolitan

    Full Text Available Studies show that thousands of genes are associated with prognosis of breast cancer. Towards utilizing available genetic data, efforts have been made to predict outcomes using gene expression data, and a number of commercial products have been developed. These products have the following shortcomings: 1 They use the Cox model for prediction. However, the RSF model has been shown to significantly outperform the Cox model. 2 Testing was not done to see if a complete set of clinical predictors could predict as well as the gene expression signatures.We address these shortcomings. The METABRIC data set concerns 1981 breast cancer tumors. Features include 21 clinical features, expression levels for 16,384 genes, and survival. We compare the survival prediction performance of the Cox model and the RSF model using the clinical data and the gene expression data to their performance using only the clinical data. We obtain significantly better results when we used both clinical data and gene expression data for 5 year, 10 year, and 15 year survival prediction. When we replace the gene expression data by PAM50 subtype, our results are significant only for 5 year and 15 year prediction. We obtain significantly better results using the RSF model over the Cox model. Finally, our results indicate that gene expression data alone may predict long-term survival.Our results indicate that we can obtain improved survival prediction using clinical data and gene expression data compared to prediction using only clinical data. We further conclude that we can obtain improved survival prediction using the RSF model instead of the Cox model. These results are significant because by incorporating more gene expression data with clinical features and using the RSF model, we could develop decision support systems that better utilize heterogeneous information to improve outcome prediction and decision making.

  6. Impact of MELD allocation policy on survival outcomes after liver transplantation: a single-center study in northeast Brazil

    Directory of Open Access Journals (Sweden)

    Thales Paulo Batista

    2011-01-01

    Full Text Available OBJECTIVE: To analyze the impact of model for end-stage liver disease (MELD allocation policy on survival outcomes after liver transplantation (LT. INTRODUCTION: Considering that an ideal system of grafts allocation should also ensure improved survival after transplantation, changes in allocation policies need to be evaluated in different contexts as an evolutionary process. METHODS: A retrospective cohort study was carried out among patients who underwent LT at the University of Pernambuco. Two groups of patients transplanted before and after the MELD allocation policy implementation were identified and compared using early postoperative mortality and post-LT survival as end-points. RESULTS: Overall, early postoperative mortality did not significantly differ between cohorts (16.43% vs. 8.14%; p = 0.112. Although at 6 and 36-months the difference between pre-vs. post-MELD survival was only marginally significant (p = 0.066 and p = 0.063; respectively, better short, medium and long-term post-LT survival were observed in the post-MELD period. Subgroups analysis showed special benefits to patients categorized as nonhepatocellular carcinoma (non-HCC and moderate risk, as determined by MELD score (15-20. DISCUSSION: This study ensured a more robust estimate of how the MELD policy affected post-LT survival outcomes in Brazil and was the first to show significantly better survival after this new policy was implemented. Additionally, we explored some potential reasons for our divergent survival outcomes. CONCLUSION: Better survival outcomes were observed in this study after implementation of the MELD criterion, particularly amongst patients categorized as non-HCC and moderate risk by MELD scoring. Governmental involvement in organ transplantation was possibly the main reason for improved survival.

  7. Survival of immediately versus delayed loaded short implants: A prospective case series study

    Science.gov (United States)

    Alvira-González, Joaquin; Díaz-Campos, Erick; Sánchez-Garcés, Maria-Angeles

    2015-01-01

    Background To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. Material and Methods 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delayed loading. Failures, bone loss, probing depth and bleeding on probing were evaluated. Results 54 Mk III Shorty TiU and 15 Brånemark System®MK III TiU implants with a length longer than 7mm were included in the study. Twenty-eight implants were inserted following the immediate loading protocol and 26 according a two-stage procedure, depending on the torque value. The cumulative survival rate of short implants was 87% (n=54) after a mean time of 47.72 months (range 33-62 months), showing statistically significant differences related to loading protocol (p=0.047). Short implants immediately loaded had a higher long-term survival rate (96.4%) compared to the other study group (76.9%). Besides, short implants splinted to longer immediately loaded implants presented the highest survival rate (100%). Twenty-five (53.19%) short implants showed a bone loss of less than one millimeter after the follow-up period. Statistically significant differences were found between bleeding on probing, presence of plaque or suppuration and a higher bone loss in both loading protocols (p=0.001). Conclusions Immediate loading of short implants placed on free ends can be considered an option in the treatment protocol of patients with severe bone resorption especially if implants are splinted to others of greater length. Key words: Dental implants, short implants, immediate loading, prospective study, TiUnite surface. PMID:26034926

  8. A Combinatory Approach for Selecting Prognostic Genes in Microarray Studies of Tumour Survivals

    Directory of Open Access Journals (Sweden)

    Qihua Tan

    2009-01-01

    Full Text Available Different from significant gene expression analysis which looks for genes that are differentially regulated, feature selection in the microarray-based prognostic gene expression analysis aims at finding a subset of marker genes that are not only differentially expressed but also informative for prediction. Unfortunately feature selection in literature of microarray study is predominated by the simple heuristic univariate gene filter paradigm that selects differentially expressed genes according to their statistical significances. We introduce a combinatory feature selection strategy that integrates differential gene expression analysis with the Gram-Schmidt process to identify prognostic genes that are both statistically significant and highly informative for predicting tumour survival outcomes. Empirical application to leukemia and ovarian cancer survival data through-within- and cross-study validations shows that the feature space can be largely reduced while achieving improved testing performances.

  9. Gun shows and gun violence: fatally flawed study yields misleading results.

    Science.gov (United States)

    Wintemute, Garen J; Hemenway, David; Webster, Daniel; Pierce, Glenn; Braga, Anthony A

    2010-10-01

    A widely publicized but unpublished study of the relationship between gun shows and gun violence is being cited in debates about the regulation of gun shows and gun commerce. We believe the study is fatally flawed. A working paper entitled "The Effect of Gun Shows on Gun-Related Deaths: Evidence from California and Texas" outlined this study, which found no association between gun shows and gun-related deaths. We believe the study reflects a limited understanding of gun shows and gun markets and is not statistically powered to detect even an implausibly large effect of gun shows on gun violence. In addition, the research contains serious ascertainment and classification errors, produces results that are sensitive to minor specification changes in key variables and in some cases have no face validity, and is contradicted by 1 of its own authors' prior research. The study should not be used as evidence in formulating gun policy.

  10. Prediction of kidney survival in children with primary focal segmental glomerulosclerosis (a two-center study.

    Directory of Open Access Journals (Sweden)

    Alaleh Gheissari

    2007-07-01

    Full Text Available BACKGROUND: Focal segmental glomerulosclerosis (FSGS is one of the most common glomerulopathies in children leading to end stage renal disease (ESRD. Different values of median renal survival have been reported among different ethnicities and races. Many factors are assumed to be responsible for ESRD in these patients. In this study, we tried to determine median renal survival (MRS and also some clinical and histopathological features predisposing FSGS
    patients to ESRD in two referral hospitals in Tehran.
    METHODS: The study involved 103 FSGS patients (61 males and 42 females with a mean age of 7.08 ± 0.68 years. The diagnosis was made based on kidney biopsies. All kidney biopsies were studied by light and immunofluorescent microscopes. Ocular grids (counting squares were used as the standard method to calculate the percentage of cortical interstitial fibrosis (CIF. The percentage of glomerular sclerosis was presented as renal injury score. Glomerular filtration rate (GFR950 ml/min was considered as renal death or the end point. Patients were followed for 1 to 15 years, until occurrence of renal death.
    RESULTS: The MRS was 9.04 ± 1.8 yrs. The renal survival reached 72%, 47% and 17% after 5, 10 and 15 years, respectively. Univariate analysis showed significant reverse correlation (P<0.05 between renal survival and the following variables: hypertension, anemia, GFR at the time of first admission and also renal injury score >50%, peritubular fibrosis, periglomerular fibrosis, tubular atrophy and CIFC20%. However, multivariate analysis revealed only a reverse correlation between renal survival with CIFC20% and also hypertension (P<0.0001 and P<0.05, respectively.
    CONCLUSIONS: In our patients, FSGS showed a rapid course towards ESRD compared with patients of western countries. Perhaps some ethnic and genetic factors such as angiotensin converting enzyme genotypes

  11. Breast cancer in young Asian women: study on survival.

    Science.gov (United States)

    Foo, Chek Siang; Su, David; Chong, Chee Keong; Chng, Hong Chee; Tay, Khoon Hean; Low, Sze Chuan; Tan, Su Ming

    2005-07-01

    Breast cancer in young patients is often associated with a poorer prognosis, but there has been a paucity of published data in an Asian population. One hundred and six patients (12.6%) under the age of 40 years with breast cancer (group V) were compared with 737 patients with breast cancer aged 40 years or more (group W). Demographics, presentations, pathological profiles, treatment and survival measures were analysed. Median tumour size was similar in both groups. Group V had more patients with grade 3 tumours and nodal involvement compared to group W (51.5% vs 38.1%, P = 0.012 and 52.5% vs 41.8%, P = 0.045). The mean Nottingham prognostic index (NPI) score was significantly higher in group V compared to group W (4.75 vs 4.26, P < 0.001). The incidences of chemotherapy and radiotherapy in group V were higher than group W (69.2% vs 35.2%, P < 0.001 and 41.1% vs 24.4%, P = 0.002). There were no differences in overall survival and disease-free survival (local recurrence). Patients below 40 years with breast cancer have tumours with a poorer prognostic profile. However, this did not translate into a poorer overall survival, and this might be attributable to more aggressive adjuvant treatment of younger patients.

  12. Patients with high c-MYC-expressing squamous cell carcinomas of the tongue show better survival than those with low- and medium-expressing tumours.

    Science.gov (United States)

    Strindlund, Klas; Troiano, Giuseppe; Sgaramella, Nicola; Coates, Philip J; Gu, Xiaolian; Boldrup, Linda; Califano, Luigi; Fahraeus, Robin; Muzio, Lorenzo Lo; Ardito, Fatima; Colella, Giuseppe; Tartaro, Gianpaolo; Franco, Renato; Norberg-Spaak, Lena; Saadat, Mohammad; Nylander, Karin

    2017-11-01

    c-MYC is a potent oncoprotein with roles in a wide range of cellular processes such as differentiation, apoptosis and growth control. Deregulation of the MYC gene is commonly seen in human tumours resulting in overexpression of the protein. Here we studied expression of c-MYC in correlation to clinical outcome in patients with primary squamous cell carcinoma of the mobile tongue. Immunohistochemistry was used to identify c-MYC in a group of 104 tongue squamous cell carcinomas with an antibody directed against the N-terminal part of the protein. Staining was evaluated by multiplying the percentage of c-MYC-expressing cells with staining intensity, giving a quick score for each tumour. All 104 tumours expressed c-MYC at varying levels. Quantitation according to per cent of positive cells and staining intensity revealed that most (15/21; 71%) high-expressing tumours were seen in males. Within the group of high c-MYC-expressing tumours, the majority were alive 2 and 5 years after treatment. The present findings show that expression of c-MYC has prognostic value in squamous cell carcinoma of the tongue, and could be useful in choice of therapy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. In vitro study of cell survival following dynamic MLC intensity-modulated radiation therapy dose delivery.

    Science.gov (United States)

    Moiseenko, Vitali; Duzenli, Cheryl; Durand, Ralph E

    2007-04-01

    significantly different, p < 0.05, in three out of six cases. In contrast, when cell survival following IMRT was compared to that following IMRT with a break for MLC initialization the difference was always statistically insignificant. When projected to a 30 fraction treatment, dose deficit to bring cell survival to the same value as in POP was calculated as 4.1, 24.9, and 31.1 Gy for V79, WiDr, and SiHa cell lines, respectively. The dose deficit did not relate to the alpha/beta ratio obtained in this study for the three cell lines. Clinical data do not show reduction in local control following IMRT. Possible reasons for this are discussed. The obtained data set can serve as a test data set for models designed to explore the effect of dose delivery prolongation/fractionation in IMRT on radiation therapy outcome.

  14. Statistical Survival Analysis of Fish and Wildlife Tagging Studies; SURPH.1 Manual - Analysis of Release-Recapture Data for Survival Studies, 1994 Technical Manual.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.; Skalski, John R.; Schelechte, J. Warren [Univ. of Washington, Seattle, WA (United States). Center for Quantitative Science

    1994-12-01

    Program SURPH is the culmination of several years of research to develop a comprehensive computer program to analyze survival studies of fish and wildlife populations. Development of this software was motivated by the advent of the PIT-tag (Passive Integrated Transponder) technology that permits the detection of salmonid smolt as they pass through hydroelectric facilities on the Snake and Columbia Rivers in the Pacific Northwest. Repeated detections of individually tagged smolt and analysis of their capture-histories permits estimates of downriver survival probabilities. Eventual installation of detection facilities at adult fish ladders will also permit estimation of ocean survival and upstream survival of returning salmon using the statistical methods incorporated in SURPH.1. However, the utility of SURPH.1 far exceeds solely the analysis of salmonid tagging studies. Release-recapture and radiotelemetry studies from a wide range of terrestrial and aquatic species have been analyzed using SURPH.1 to estimate discrete time survival probabilities and investigate survival relationships. The interactive computing environment of SURPH.1 was specifically developed to allow researchers to investigate the relationship between survival and capture processes and environmental, experimental and individual-based covariates. Program SURPH.1 represents a significant advancement in the ability of ecologists to investigate the interplay between morphologic, genetic, environmental and anthropogenic factors on the survival of wild species. It is hoped that this better understanding of risk factors affecting survival will lead to greater appreciation of the intricacies of nature and to improvements in the management of wild resources. This technical report is an introduction to SURPH.1 and provides a user guide for both the UNIX and MS-Windows{reg_sign} applications of the SURPH software.

  15. Effect of VDRA on survival in incident hemodialysis patients: results of the FARO-2 observational study.

    Science.gov (United States)

    Messa, Piergiorgio; Cozzolino, Mario; Brancaccio, Diego; Cannella, Giuseppe; Malberti, Fabio; Costanzo, Anna Maria; di Luzio Paparatti, Umberto; Festa, Vincenzo; Gualberti, Giuliana; Mazzaferro, Sandro

    2015-02-06

    Mortality rate among patients with stage five chronic kidney disease (CKD) maintained on hemodialysis (HD) is high. Although evidence suggests that use of Vitamin D Receptor Activators (VDRA) in CKD patients increases survival, few studies have examined the effect of VDRA in incident HD patients. The FARO-2 study evaluated the clinical outcome of VDRA therapy on mortality in incident HD patients. FARO-2 was a longitudinal epidemiological study performed on 568 incident HD patients followed prospectively from 26 dialysis centers over a 3-year period. Data were collected every 6 months using a questionnaire, obtaining clinical, biochemical and therapeutic parameters. Kaplan-Meier curves and Cox proportional hazard regression models were used to determine cumulative probability of time-to-death and adjusted hazard ratios. 568 patients (68% male) with an average age of 65.5 years were followed up. Mean dialysis duration at study entry was 3 months. VDRA use increased from 46% at 6 months to 54.7% at 36 months of follow-up (p = 0.08). No difference was observed in the presence of comorbid diseases at baseline in patients with and without VDRA therapy. Cumulative probability of survival at 24 months was 74.5% (95% CI: 70.2-78.3). Patients receiving VDRA therapy showed a significant increase in survival at 24 months (80.7%; 95% CI: 75.7-84.8) compared to those without (63.3%; 95% CI: 54.8-70.7, p FARO-2 indicate that in incident HD patients VDRA therapy was associated with increased survival.

  16. Commonly studied polymorphisms in inflammatory cytokine genes show only minor effects on mortality and related risk factors in nonagenarians

    DEFF Research Database (Denmark)

    Dato, Serena; Krabbe, Karen S; Thinggaard, Mikael

    2010-01-01

    Systemic low-grade inflammation is consistently associated with functional status, cognitive functioning, multimorbidity, and survival in oldest olds. If inflammation is either a cause or a consequence of age-related pathology, genetic determinants of late-life survival can reside in cytokine genes....... Additionally, associations were investigated between inflammatory markers and major predictors of mortality as cognitive and functional status. Modest sex-specific associations were found with survival, cognitive functioning, and handgrip strength. Evaluation of combined genotypes indicated that......, in nonagenarian men, the balance of pro- and anti-inflammatory activity at IL18 and IL10 loci is protective against cognitive decline. In conclusion, in this large study with virtually complete follow-up, commonly studied polymorphisms in cytokine genes do not have a major impact on late-life survival...

  17. Three University Case Studies Show Varying Levels of Sophistication With All Systems GO For MIS

    Science.gov (United States)

    Kornfield, Leo

    1971-01-01

    Three university case studies - the University of Utah, Ohio State University and the University of Illinois - show varying levels of sophistication in their application, modification and practical use of management information systems. (Editor)

  18. Ethical Disputes and Public Service Televison. Case Study: Otvoreno Political Talk Show, Broadcasted on 21st of January, 2010

    Directory of Open Access Journals (Sweden)

    Gordana Škaljac Narančić

    2011-12-01

    Full Text Available Ratings of the television programs as well as commercial effects become crucial measures of the media success and journalists’ efficiency neglecting minimal ethical standards. The profit maximisation logic and mere survival in times of the economic crisis also has the impact on preserving the sensitive ethical standards. In this respect, the television, as the most influential medium, especially public television, has the biggest responsibility. Violation of the ethical norms on public television means that it does not fulfil its key role – the role of public service. In important cases of the violation of ethical rules, the lack of clear responses of the regulators is the other side of the problem. The case study in this text shows us how easy it is to turn to the contempt of the professional journalistic standards and, consequently, ethical norms. This leads us to think how difficult is today to remain professional and ethical in times of the tangible commercialism and sensationalism.

  19. The association of cancer survival with four socioeconomic indicators: a longitudinal study of the older population of England and Wales 1981–2000

    Directory of Open Access Journals (Sweden)

    Young Harriet

    2007-01-01

    Full Text Available Abstract Background Many studies have found socioeconomic differentials in cancer survival. Previous studies have generally demonstrated poorer cancer survival with decreasing socioeconomic status but mostly used only ecological measures of status and analytical methods estimating simple survival. This study investigate socio-economic differentials in cancer survival using four indicators of socioeconomic status; three individual and one ecological. It uses a relative survival method which gives a measure of excess mortality due to cancer. Methods This study uses prospective record linkage data from The Office for National Statistics Longitudinal Study for England and Wales. The participants are Longitudinal Study members, recorded at census in 1971 and 1981 and with a primary malignant cancer diagnosed at age 45 or above, between 1981 and 1997, with follow-up until end 2000. The outcome measure is relative survival/excess mortality, compared with age and sex adjusted survival of the general population. Relative survival and Poisson regression analyses are presented, giving models of relative excess mortality, adjusted for covariates. Results Different socioeconomic indicators detect survival differentials of varying magnitude and definition. For all cancers combined, the four indicators show similar effects. For individual cancers there are differences between indicators. Where there is an association, all indicators show poorer survival with lower socioeconomic status. Conclusion Cancer survival differs markedly by socio-economic status. The commonly used ecological measure, the Carstairs Index, is adequate at demonstrating socioeconomic differentials in survival for combined cancers and some individual cancers. A combination of car access and housing tenure is more sensitive than the ecological Carstairs measure at detecting socioeconomic effects on survival – confirming Carstairs effects where they occur but additionally identifying

  20. National database study of survival of pediatric congenital heart disease patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Shu-Jen Yeh

    2015-02-01

    Conclusion: This national database study revealed that the survival of children with simple CHD was still slightly lower than that of the general population and the survival of severe CHD patients, though only accounting for one-tenth of CHD cases, remained unsatisfactory. Such survival profiles are similar to those from Western reports and warrant a refined and dedicated medical care program for children with CHD.

  1. Prospective postmarket device studies versus returned product analysis as a predictor of system survival.

    Science.gov (United States)

    Pratt, T R; Pulling, C C; Stanton, M S

    2000-07-01

    Monitoring and reporting mechanisms are vital tools for clinicians to assess ICD system performance over time for optimal patient care. This article explores the various reporting mechanisms available to the clinician, both historical and current, and compares and contrasts two such methods. The lead survival rates obtained by return product analysis (RPA) are compared with those from an ongoing prospective chronic study that actively follows patients for clinical ICD system failures (Tachyarrhythmia Chronic Systems Study [TCSS]). Examination of available data shows that a prospective study such as the TCSS is capable of detecting clinically significant adverse events in 2.2% of the 3,958 leads followed. By comparison, RPA-based monitoring of the same leads detects "out of specification" events in 0.5% of the 78,571 leads followed. Statistical analyses of two separate families of leads (RV leads and SQ Patch leads) show that survival rates obtained by the two methods begin to differ at approximately 2 years of implant experience, with 95% confidence intervals no longer overlapping at 3 years. The authors conclude that prospective chronic device studies are a superior tool for the ongoing monitoring of implanted device performance compared to RPA-based reports.

  2. Annual survival estimation of migratory songbirds confounded by incomplete breeding site-fidelity: study designs that may help

    Directory of Open Access Journals (Sweden)

    Marshall, M. R.

    2004-06-01

    surrounding areas to minimize bias. Therefore, as an alternative protocol, we analyzed the data with subsets of three progressively larger areas surrounding the core. The data subsets provided four estimates of apparent survival that asymptotically approached true survival. This study design and analytical approach is likely to be logistically feasible in field settings and yields estimates of true survival unbiased (bias < 0.03 by incomplete breeding site–fidelity over a range of inter–annual territory movement patterns. The third approach we investigated used a robust design data collection and analysis approach. This approach resulted in estimates of survival that were unbiased (bias < 0.02, but were very imprecise and likely would not yield reliable estimates in field situations. The fourth approach utilized a fixed study area size, but modeled detection probability as a function of bird proximity to the study plot boundary (e.g., those birds closest to the edge are more likely to emigrate. This approach also resulted in estimates of survival that were unbiased (bias < 0.02, but because the individual covariates were normalized, the average capture probability was 0.50, and thus did not provide an accurate estimate of the true capture probability. Our results show that the core–area with surrounding resight–only can provide estimates of survival that are not biased by the effects of incomplete breeding site–fidelity.

  3. Efficacy, safety and drug survival of conventional agents in pediatric psoriasis: A multicenter, cohort study.

    Science.gov (United States)

    Ergun, Tulin; Seckin Gencosmanoglu, Dilek; Alpsoy, Erkan; Bulbul-Baskan, Emel; Saricam, Merve Hatun; Salman, Andac; Onsun, Nahide; Sarioz, Abdullah

    2017-06-01

    The data on long-term efficacy, safety and drug survival rates of conventional systemic therapeutics in pediatric psoriasis is lacking. The primary aim of this study is to investigate acitretin, methotrexate, cyclosporin efficacy, safety and drug survival rates in pediatric patients as well as predictors of drug survival. This is a multicenter study including 289 pediatric cases being treated with acitretin, methotrexate and cyclosporin in four academic referral centers. Efficacy, adverse events, reasons for discontinuation, 1, 2- and 3-year drug survival rates, and determinants of drug survival were analyzed. A 75% reduction of Psoriasis Area and Severity Index score or better response rate was obtained in 47.5%, 34.1% and 40% of the patients who were treated with acitretin, methotrexate and cyclosporin, respectively. One-year drug survival rates for acitretin, methotrexate and cyclosporin were 36.3%, 21.1% and 15.1%, respectively. The most significant determinant of drug survival, which diminished over time, was treatment response whereas arthritis, body mass index and sex had no influence. Although all three medications are effective and relatively safe in children, drug survival rates are low due to safety concerns at this age group. Effective disease control through their rational use can be expected to improve survival rates. © 2016 Japanese Dermatological Association.

  4. Effect of intended intraoperative cholangiography and early detection of bile duct injury on survival after cholecystectomy: population based cohort study

    Science.gov (United States)

    Strömberg, Cecilia; Persson, Gunnar; Nilsson, Magnus

    2012-01-01

    Objectives To determine whether the routine use of intraoperative cholangiography can improve survival from complications related to bile duct injuries. Design Population based cohort study. Setting Prospectively collected data from the Swedish national registry of gallstone surgery and endoscopic retrograde cholangiopancreatography, GallRiks. Multivariate analysis done by Cox regression. Population All cholecystectomies recorded in GallRiks between 1 May 2005 and 31 December 2010. Main outcome measures Evidence of bile duct injury, rate of intended use of intraoperative cholangiography, and rate of survival after cholecytectomy. Results During the study, 51 041 cholecystectomies were registered in GallRiks and 747 (1.5%) iatrogenic bile duct injuries identified. Patients with bile duct injuries had an impaired survival compared with those without injury (mortality at one year 3.9% v 1.1%). Kaplan-Meier analysis showed that early detection of a bile duct injury, during the primary operation, improved survival. The intention to use intraoperative cholangiography reduced the risk of death after cholecystectomy by 62% (hazard ratio 0.38 (95% confidence interval 0.31 to 0.46)). Conclusions The high incidence of bile duct injury recorded is probably from GallRiks’ ability to detect the entire range of injury severities, from minor ductal lesions to complete transections of major ducts. Patients with bile duct injury during cholecystectomy had impaired survival, and early detection of the injury improved survival. The intention to perform an intraoperative cholangiography reduced the risk of death after cholecystectomy. PMID:23060654

  5. Study of the cross-contamination and survival of Salmonella in fresh apples.

    Science.gov (United States)

    Perez-Rodriguez, F; Begum, M; Johannessen, G S

    2014-08-01

    The present work aimed at studying the cross contamination of apples by Salmonella during the processing of commercial fresh apples and its survival capacity on apple at room temperature. For the first study, the typical process of fresh apples was simulated at laboratory scale in which an apple that was artificially contaminated by Salmonella at different concentration levels (8, 6 and 5 log cfu/apple) was introduced in one batch and processed including a simulated transport/washing step and drying step using sponges to simulate the porous material used in the industry. Results indicated that at 8 log cfu/apple, 50% fresh apples were contaminated after processing, with all analysed environmental samples being positive for the pathogen, consisting of washing water and sponges. However, at lower inoculum levels (5-6 log cfu/apple) no cross contamination was detected in apples, and only environmental samples showed contamination by Salmonella after processing including both water and sponges. Experiments on the survival of Salmonella on apple showed that the pathogen was capable to survive for 12 days, only showing a significant drop at the end of the experiment. Finally, two-class attribute sampling plans were assessed as tool to detect Salmonella in different contamination scenarios in fresh apple. This analysis indicated that with the highest inoculum level, a total of 16 apples would be needed to reach 95% of detecting Salmonella (i.e. lot rejection). In turn, when low levels were assessed (5-6 log cfu/apple), a large number of apples (n=1021) would have to be sampled to obtain the same confidence level (95%). If the environment is sampled (i.e. water and sponges), a lower number of samples would be needed to detect the pathogen. However, the feasibility of environmental sampling has not been assessed from a practical point of view. Overall, the results in this study evidenced that cross contamination by Salmonella might occur during processing of fresh apples

  6. Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark--a nationwide study

    DEFF Research Database (Denmark)

    Frederiksen, Birgitte Lidegaard; Dalton, Susanne Oksbjerg; Osler, Merete

    2012-01-01

    Not all patients have benefited equally from the advances in non-Hodgkin lymphoma (NHL) survival. This study investigates several individual-level markers of socioeconomic position (SEP) in relation to NHL survival, and explores whether any social differences could be attributed to comorbidity...

  7. Survival of flexible, braided, bonded stainless steel lingual retainers : a historic cohort study

    NARCIS (Netherlands)

    Foek, D. J. Lie Sam; Ozcan, M.; Verkerke, G. J.; Sandham, John; Dijkstra, P. U.

    The objectives of this study were to retrospectively evaluate the clinical survival rate of flexible, braided, rectangular bonded stainless steel lingual retainers, and to investigate the influence of gender, age of the patient, and operator experience on survival after orthodontic treatment at the

  8. Studies on the survival of Ascaris suum eggs under laboratory and simulated field conditions

    NARCIS (Netherlands)

    Gaasenbeek, C.P.H.; Borgsteede, F.H.M.

    1998-01-01

    A series of four experiments was carried out to study the survival of Ascaris suum eggs: in a pig slurry unit on a farm, in the laboratory under anaerobic conditions and different relative humidities (rH), and under simulated field conditions. Survival of eggs in the pig slurry unit was 20% after

  9. Effect of team training on improving MRI study completion rates and no-show rates.

    Science.gov (United States)

    Norbash, Alexander; Yucel, Kent; Yuh, William; Doros, Gheorghe; Ajam, Amna; Lang, Elvira; Pauker, Stephen; Mayr, Nina

    2016-10-01

    Magnetic resonance imaging (MRI) is a high-cost imaging modality, and an optimized encounter ideally provides high-quality care, patient satisfaction, and capacity utilization. Our purpose was to assess the effectiveness of team training and its impact on patient show-up and completion rates for their MRI examinations. A total of 97,712 patient visits from three tertiary academic medical centers over 1-year intervals were evaluated, totaling 49,733 visits at baseline and 47,979 after training. Each center's MRI team received team training skill training including advanced communication and team training techniques training. This training included onsite instruction including case simulation with scenarios requiring appropriate behavioral and communicative interventions. Orientation and training also utilized customized online tools and proctoring. The study completion rate and patient show-up rate during consecutive year-long intervals before and after team training were compared to assess its effectiveness. Two-sided chi-square tests for proportions using were applied at a 0.05 significance level. Despite differing no-show rates (5-22.2%) and study incompletion rates (0.7-3.7%) at the three academic centers, the combined patients' data showed significant (P < 0.0001) improvement in the patients' no-show rates (combined decreases from 11.2% to 8.7%) and incompletion rates (combined decreases from 2.3% to 1.4%). Our preliminary results suggest training of the imaging team can improve the no-show and incompletion rates of the MRI service, positively affecting throughput and utilization. Team training can be readily implemented and may help address the needs of the current cost-conscious and consumer-sensitive healthcare environment. J. MAGN. RESON. IMAGING 2016;44:1040-1047. © 2016 International Society for Magnetic Resonance in Medicine.

  10. Exposure to magnetic fields and survival after diagnosis of childhood leukemia: a German cohort study

    DEFF Research Database (Denmark)

    Svendsen, Anne Louise; Weihkopf, Thomas; Kaatsch, Peter

    2007-01-01

    conducted between 1992 and 2001. A total of 595 ALL cases with 24-h magnetic field measurements are included in the analysis with a median follow-up of 9.5 years. We calculate the hazard ratios (HR) using the Cox proportional hazards model for overall survival, adjusted for age at diagnosis, calendar year......Inspired by a recent U.S. study showing poorer survival among children with acute lymphoblastic leukemia (ALL) exposed to magnetic fields above 0.3 microT, we examine this relationship in a German cohort of childhood leukemia cases derived from previous population-based case-control studies...... for prognostic risk group, the hazard for exposures above 0.2 microT increases to HR, 3.0 (95% CI, 0.9-9.8). In conclusion, this study is generally consistent with the previous finding; however, we report the excess risk at field levels lower than those in the U.S. study. In all, the evidence is still based...

  11. Lifestyle habits as prognostic factors in survival of laryngeal and hypopharyngeal cancer: a multicentric European study.

    Science.gov (United States)

    Dikshit, Rajesh P; Boffetta, Paolo; Bouchardy, Christine; Merletti, Franco; Crosignani, Paolo; Cuchi, Teresa; Ardanaz, Eva; Brennan, Paul

    2005-12-20

    Little information is available on the role of tobacco, alcohol and diet in the survival of upper aero digestive cancers. Our study analysed the survival of 931 laryngeal and hypopharyngeal cancer patients, enrolled in a population based case-control study conducted at 5 centres in southeast Europe during 1979-1982. Age at the time of diagnosis and site of origin of tumour were observed to be predictors of the survival. Cigarette smoking, and to a limited extent alcohol drinking, before the diagnosis of tumour seem to influence the overall survival whereas high intakes of vegetables and vitamin C were observed to favourably affect the prognosis. For mortality from upper aerodigestive cancer protective effects of high intakes of vegetables, fibres and vitamin C were observed. Our results support the hypothesis that there is a role for dietary intervention to improve survival of laryngeal and hypopharyngeal cancer patients. Copyright 2005 Wiley-Liss, Inc

  12. Complete hazard ranking to analyze right-censored data: An ALS survival study.

    Science.gov (United States)

    Huang, Zhengnan; Zhang, Hongjiu; Boss, Jonathan; Goutman, Stephen A; Mukherjee, Bhramar; Dinov, Ivo D; Guan, Yuanfang

    2017-12-01

    Survival analysis represents an important outcome measure in clinical research and clinical trials; further, survival ranking may offer additional advantages in clinical trials. In this study, we developed GuanRank, a non-parametric ranking-based technique to transform patients' survival data into a linear space of hazard ranks. The transformation enables the utilization of machine learning base-learners including Gaussian process regression, Lasso, and random forest on survival data. The method was submitted to the DREAM Amyotrophic Lateral Sclerosis (ALS) Stratification Challenge. Ranked first place, the model gave more accurate ranking predictions on the PRO-ACT ALS dataset in comparison to Cox proportional hazard model. By utilizing right-censored data in its training process, the method demonstrated its state-of-the-art predictive power in ALS survival ranking. Its feature selection identified multiple important factors, some of which conflicts with previous studies.

  13. Complete hazard ranking to analyze right-censored data: An ALS survival study.

    Directory of Open Access Journals (Sweden)

    Zhengnan Huang

    2017-12-01

    Full Text Available Survival analysis represents an important outcome measure in clinical research and clinical trials; further, survival ranking may offer additional advantages in clinical trials. In this study, we developed GuanRank, a non-parametric ranking-based technique to transform patients' survival data into a linear space of hazard ranks. The transformation enables the utilization of machine learning base-learners including Gaussian process regression, Lasso, and random forest on survival data. The method was submitted to the DREAM Amyotrophic Lateral Sclerosis (ALS Stratification Challenge. Ranked first place, the model gave more accurate ranking predictions on the PRO-ACT ALS dataset in comparison to Cox proportional hazard model. By utilizing right-censored data in its training process, the method demonstrated its state-of-the-art predictive power in ALS survival ranking. Its feature selection identified multiple important factors, some of which conflicts with previous studies.

  14. Executive functioning shows differential maturation from early to late adolescence: longitudinal findings from a TRAILS study.

    Science.gov (United States)

    Boelema, Sarai R; Harakeh, Zeena; Ormel, Johan; Hartman, Catharina A; Vollebergh, Wilma A M; van Zandvoort, Martine J E

    2014-03-01

    Maturation of executive functioning (EF) is topical, especially in relation to adolescence, yet longitudinal research covering early and late adolescence is lacking. This, however, is a prerequisite for drawing conclusions on normal cognitive development, and understanding deviant maturation. The aim of this study is to longitudinally investigate 6 subcomponents of EF in early (mean age 11) and late adolescence (mean age 19) and to investigate the influence of sex and socioeconomic status (SES). We used data of the TRacking Adolescents' Individual Lives Survey (TRAILS). A number of 2,217 participants carried out tasks of the Amsterdam Neuropsychological Tasks (ANT), measuring Focused Attention, Inhibition, Sustained Attention, Speed of Processing, Working Memory, and Shift Attention. Linear growth model with individual varying times of observation showed significant slopes for all 6 measures. Sex differences were found for the majority of the measures, where boys showed more maturation. Maturation was influenced by SES for Sustained Attention and Inhibition. Results show that significant maturation takes place for all the measured subcomponents over adolescence. Overall, girls show better baseline performance and smaller maturational rates, suggesting more mature skills in early adolescence. Maturation is only influenced by SES for Sustained Attention and Inhibition. Findings underline that for making statements about EF maturation in adolescence, it is essential to look at subcomponents. Furthermore, sex differences are an important factor when investing (ab)normal maturation of EF. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  15. Analysis of allergen immunotherapy studies shows increased clinical efficacy in highly symptomatic patients

    DEFF Research Database (Denmark)

    Howarth, P; Malling, Hans-Jørgen; Molimard, M

    2011-01-01

    To cite this article: Howarth P, Malling H-J, Molimard M, Devillier P. Analysis of allergen immunotherapy studies shows increased clinical efficacy in highly symptomatic patients. Allergy 2012; 67: 321-327. ABSTRACT: Background:  The assessment of allergen immunotherapy (AIT) efficacy...... them. Thus, clinical studies of AIT can neither establish baseline symptom levels nor limit the enrolment of patients to those with the most severe symptoms. Allergen immunotherapy treatment effects are therefore diluted by patients with low symptoms for a particular pollen season. The objective...... of this analysis was to assess the effect possible to achieve with AIT in the groups of patients presenting the most severe allergic symptoms. Methods:  Study centres were grouped into tertiles categorized according to symptom severity scores observed in the placebo patients in each centre (low, middle and high...

  16. 20-year follow-up study of Danish HHT patients—survival and causes of death

    Directory of Open Access Journals (Sweden)

    Anette Kjeldsen

    2016-11-01

    Full Text Available Abstract Background Hereditary Haemorrhagic Telangiectasia (HHT is a dominantly inheritable disorder, with a wide variety of clinical manifestations due to presence of multiple arteriovenous manifestations. The most common mutations are found in HHT1 (ENG and HHT2 (ACVRL1 patients, causing alterations in the TGF-β pathway which is responsible for angiogenesis. Modulations of angiogenesis may influence cancer rates. The objective of the study was to evaluate 20-year survival according to HHT subtype, as well as to evaluate differences in causes of death comparing HHT patients and controls. We also wanted to investigate whether cancer morbidity among HHT patients differs from that among controls. Results We included all HHT patients in the County of Fyn, Denmark, prevalent as of January 1st 1995 in total 73 HHT patients. In addition three age- and sex- matched controls per HHT patient were evaluated, in total 218 controls (one was lost due to registration failure. The controls were defined at start of follow-up in 1995. Information on lifestyle factors was not available. A total of 32 (44% HHT patients and 97 (44% controls passed away during follow-up. The survival curves were evenly distributed showing similar survival rates in the two groups. Cancer diagnoses had been registered in the follow-up period in 4 (5% HHT patients and in 38 (17% controls. Conclusion The mortality was not increased among Danish HHT patients compared to controls. This study is based on a clinical unselected series of HHT patients with the whole spectrum of severity, independent of need for medical care. Our data also suggest that HHT patients to a lesser degree than the background population are affected by cancer.

  17. Young adolescents with autism show abnormal joint attention network: A gaze contingent fMRI study.

    Science.gov (United States)

    Oberwelland, E; Schilbach, L; Barisic, I; Krall, S C; Vogeley, K; Fink, G R; Herpertz-Dahlmann, B; Konrad, K; Schulte-Rüther, M

    2017-01-01

    Behavioral research has revealed deficits in the development of joint attention (JA) as one of the earliest signs of autism. While the neural basis of JA has been studied predominantly in adults, we recently demonstrated a protracted development of the brain networks supporting JA in typically developing children and adolescents. The present eye-tracking/fMRI study now extends these findings to adolescents with autism. Our results show that in adolescents with autism JA is subserved by abnormal activation patterns in brain areas related to social cognition abnormalities which are at the core of ASD including the STS and TPJ, despite behavioral maturation with no behavioral differences. Furthermore, in the autism group we observed increased neural activity in a network of social and emotional processing areas during interactions with their mother. Moreover, data indicated that less severely affected individuals with autism showed higher frontal activation associated with self-initiated interactions. Taken together, this study provides first-time data of JA in children/adolescents with autism incorporating the interactive character of JA, its reciprocity and motivational aspects. The observed functional differences in adolescents ASD suggest that persistent developmental differences in the neural processes underlying JA contribute to social interaction difficulties in ASD.

  18. Young adolescents with autism show abnormal joint attention network: A gaze contingent fMRI study

    Directory of Open Access Journals (Sweden)

    E. Oberwelland

    2017-01-01

    Full Text Available Behavioral research has revealed deficits in the development of joint attention (JA as one of the earliest signs of autism. While the neural basis of JA has been studied predominantly in adults, we recently demonstrated a protracted development of the brain networks supporting JA in typically developing children and adolescents. The present eye-tracking/fMRI study now extends these findings to adolescents with autism. Our results show that in adolescents with autism JA is subserved by abnormal activation patterns in brain areas related to social cognition abnormalities which are at the core of ASD including the STS and TPJ, despite behavioral maturation with no behavioral differences. Furthermore, in the autism group we observed increased neural activity in a network of social and emotional processing areas during interactions with their mother. Moreover, data indicated that less severely affected individuals with autism showed higher frontal activation associated with self-initiated interactions. Taken together, this study provides first-time data of JA in children/adolescents with autism incorporating the interactive character of JA, its reciprocity and motivational aspects. The observed functional differences in adolescents ASD suggest that persistent developmental differences in the neural processes underlying JA contribute to social interaction difficulties in ASD.

  19. Mycological study for a management plan of a neotropical show cave (Brazil

    Directory of Open Access Journals (Sweden)

    Erika Linzi Silva Taylor

    2013-09-01

    Full Text Available Caves are stable environments with characteristics favoring the development of microorganisms. The allocthonous input of organic matter and microbes into the warm Neotropical caves may favor the development of filamentous fungi, including pathogenic species. Histoplasma capsulatum is a pathogenic species commonly found in caves and associated with bat and bird guano. Many Brazilian caves have been historically visited due to scenic and religious tourism. The objective of this study was to perform a microbiology study for a management plan of a show cave in Brazil, focusing on the presence and distribution of pathogenic and opportunistic fungi in the cave. Statistic analysis was used to verify the influence of touristic activity on airborne fungi spore load. Fungi were isolated from air and guano in Lapa Nova Cave. Samples were obtained through serial dilution, direct and settle plate techniques. For H. capsulatum, samples were incubated in specific media and conditions. Airborne fungal spore load was compared prior and during visitation and statistically analyzed. A total of 2,575 isolates from the genera Aspergillus, Calcarisporium, Chaetomium, Cladosporium, Curvularia, Emericella, Eurotium, Fusarium, Geotrichum, Gliocladium, Mucor, Purpureocillium, Paecilomyces, Penicillium, Rhizopus and Trichoderma were identified. Histoplasma capsulatum was not isolated from the cave. Eleven opportunistic species were identified. Significant (p<0.05 variations on fungal richness in the air occurred due to cave visitation. Areas of potential microbiologic risks were indicated and management actions suggested. The results suggest a diverse community inhabiting the cave. Possible opportunistic species should be monitored in show caves and microbiota should always be included in the elaboration of cave management plans. This is the first detailed microbiologic study for a management plan of a show cave in the country. It provides relevant information for future

  20. Interpreting overall survival results when progression-free survival benefits exist in today's oncology landscape: a metastatic renal cell carcinoma case study

    Directory of Open Access Journals (Sweden)

    Tang Y

    2014-09-01

    Full Text Available Yiyun Tang,1 Paul Bycott,1 Örjan Åkerborg,2 Linus Jönsson,2 Sylvie Negrier,3 Connie Chen4 1Pfizer Global Research and Development, La Jolla, CA, USA; 2OptumInsight, Stockholm, Sweden; 3Medical Oncology Department, University of Lyon, Lyon, France; 4Pfizer Global Outcomes Research, New York, NY, USA Background: The debate surrounding the acceptance of progression-free survival (PFS as an intermediate endpoint to overall survival (OS has grown in recent years, due to the challenges in demonstrating an OS benefit within clinical trials today. PFS is generally a good predictor of OS for cases where survival post-progression (SPP is short, and less so when SPP is long. SPP depends on multiple factors, including residual effect from experimental treatment and effect from crossover or other subsequent therapies, posing unique challenges into the translation of PFS benefit into OS. Methods: The objective of this analysis was to conduct simulations investigating how increasing SPP impacts PFS translation to OS, utilizing data from the AXIS (axitinib versus sorafenib in advanced metastatic renal cell carcinoma trial. The underlying assumption was a treatment benefit in PFS (the PFS distribution parameters were chosen to be equal to median PFS in the AXIS trial but no treatment effect on SPP, implying that PFS improvement is directly reflected in OS improvement. Results: The probability of a statistically significant difference between arms for OS decreased from 54.7% to 6.1% when median SPP was increased from one to 20 months. The probability of the hazard ratio of OS being ≥0.9 was similarly increased from 24.3% to 72.6%, even though the hazard ratio for PFS was 0.69. Conclusion: The present study shows that when simulated SPP is added to trial PFS data, the existing PFS benefit is diluted. Knowing that the AXIS treatment arms are well balanced with respect to post-trial treatments, we conclude that the PFS to OS benefit translation is primarily

  1. Contesting the "Nature" Of Conformity: what Milgram and Zimbardo's studies really show.

    Science.gov (United States)

    Haslam, S Alexander; Reicher, Stephen D

    2012-01-01

    Understanding of the psychology of tyranny is dominated by classic studies from the 1960s and 1970s: Milgram's research on obedience to authority and Zimbardo's Stanford Prison Experiment. Supporting popular notions of the banality of evil, this research has been taken to show that people conform passively and unthinkingly to both the instructions and the roles that authorities provide, however malevolent these may be. Recently, though, this consensus has been challenged by empirical work informed by social identity theorizing. This suggests that individuals' willingness to follow authorities is conditional on identification with the authority in question and an associated belief that the authority is right.

  2. Contesting the "Nature" Of Conformity: what Milgram and Zimbardo's studies really show.

    Directory of Open Access Journals (Sweden)

    S Alexander Haslam

    Full Text Available Understanding of the psychology of tyranny is dominated by classic studies from the 1960s and 1970s: Milgram's research on obedience to authority and Zimbardo's Stanford Prison Experiment. Supporting popular notions of the banality of evil, this research has been taken to show that people conform passively and unthinkingly to both the instructions and the roles that authorities provide, however malevolent these may be. Recently, though, this consensus has been challenged by empirical work informed by social identity theorizing. This suggests that individuals' willingness to follow authorities is conditional on identification with the authority in question and an associated belief that the authority is right.

  3. Contesting the “Nature” Of Conformity: What Milgram and Zimbardo's Studies Really Show

    Science.gov (United States)

    Haslam, S. Alexander; Reicher, Stephen. D.

    2012-01-01

    Understanding of the psychology of tyranny is dominated by classic studies from the 1960s and 1970s: Milgram's research on obedience to authority and Zimbardo's Stanford Prison Experiment. Supporting popular notions of the banality of evil, this research has been taken to show that people conform passively and unthinkingly to both the instructions and the roles that authorities provide, however malevolent these may be. Recently, though, this consensus has been challenged by empirical work informed by social identity theorizing. This suggests that individuals' willingness to follow authorities is conditional on identification with the authority in question and an associated belief that the authority is right. PMID:23185132

  4. A Systematic Case Study of the Course, Offshore Survival Systems Training, To Improve the Practice of Marine Survival Training.

    Science.gov (United States)

    Zambon, Franco

    A major applied research project evaluated the effectiveness of a novel course, Offshore Survival Systems Training. The major course outcome that was evaluated was the increase in frequency with which offshore personnel correctly launched the covered powered survival craft on offshore drilling rigs. The evaluation methodology included the 628…

  5. Study of HeLa cells clone survival after X-ray irradiation in the presence of cisplatin

    Science.gov (United States)

    Baulin, A. A.; Sukhikh, E. S.; Vasilyev, S. A.; Sukhikh, L. G.; Sheino, I. N.

    2017-09-01

    Radiation therapy in the presence of heavy elements nuclei (Z > 53) is widely developed these days. The presence of such nuclei in cancer cells results in the local increase of energy release from primary photon beam thus increasing relative biological efficiency. In this paper we present the preliminary results of the cell survival study while irradiating cells by X-Ray photon beam in the presence of cisplatin (Pt, Z = 78). The preliminary results show the decrease of the cell survival in the presence of both radiation and cisplatin.

  6. Magnetic Nanoparticle Labeling of Human Platelets from Platelet Concentrates for Recovery and Survival Studies.

    Science.gov (United States)

    Aurich, Konstanze; Wesche, Jan; Palankar, Raghavendra; Schlüter, Rabea; Bakchoul, Tamam; Greinacher, Andreas

    2017-10-11

    Platelets are the smallest blood cells and important for hemostasis. Platelet concentrates (PC) are medicinal products transfused to prevent or treat bleeding. Typically, platelets in PCs are assessed by in vitro tests for their function. However, in vivo testing of these platelets is highly desirable. To distinguish transfused platelets from patients or probands own cells after PC transfusions within the scope of clinical studies, platelets need to be efficiently labeled with minimal preactivation prior to transfusion. Here we report on a method for improved cell uptake of ferucarbotran magnetic nanoparticles contained in Resovist, an FDA-approved MRI contrast agent, by modifying the nanoparticle shell with human serum albumin (HSA). Both HSA-ferucarbotran nanoparticles and magnetically labeled platelets were produced according to EU-GMP guidelines. Platelet function after labeling was evaluated by light transmission aggregometry and by determination of expression of CD62P as platelet activation marker. Magnetic labeling does not impair platelet function and platelets showed reasonable activation response to agonists. Platelet survival studies in NOD/SCID-mice resulted in comparable survival behavior of magnetically labeled and nonlabeled platelets. Additionally, labeled platelets can be recovered from whole blood by magnetic separation.

  7. Factors Affecting the Survival Rate of Dental Implants: A Retrospective Study.

    Science.gov (United States)

    Raikar, Sonal; Talukdar, Pratim; Kumari, Sarala; Panda, Sangram Kumar; Oommen, Vinni Mary; Prasad, Arvind

    2017-01-01

    Dental implants have emerged as new treatment modality for the majority of patients and are expected to play a significant role in oral rehabilitation in the future. The present study was conducted to assess various factors affecting the survival rate of dental implants. The present retrospective study was conducted in the Department of Prosthodontics. In this study, 5200 patients with dental implants which were placed during June 2008-April 2015 were included. Exclusion criteria were patients with hormonal imbalance, patients with chronic infectious disease, patients receiving immunosuppressive therapy, pregnant women, drug and alcohol addicts, and patients with severe periodontal diseases. Parameters such as name, age, gender, length of implant, diameter of implant, location of implant, and bone quality were recorded. Data were tabulated and statistically evaluated with IBM SPSS Statistics for Windows, Version 20.0., IBM Corp., Armonk, NY, USA. Out of 5200 patients, 2800 were males and 2400 females. Maximum implants failures (55) were seen in age group above 60 years of age (males - 550, females -700). Age group 11.5 mm (40/700) followed by implants with 4.5 mm (16/1600) and implants with diameter 3.75-4.5 mm (50/2600). The Chi-square test showed significant results ( P < 0.05). Mandibular posterior showed 3.3% implants failure, maxillary posterior revealed 2.2%, maxillary anterior showed 2.1%, and mandibular anterior showed 1% failure rate; this difference was significant ( P < 0.05). Type I bone showed 0.3% implant failure, Type II showed 1.95%, Type III showed 3%, and Type IV revealed 0.8% failure rate; this difference was significant ( P < 0.05). Age, length of implant, diameter of implant, bone quality, and region of implant are factors determining the survival rate of implants. We found that implant above 11.5 mm length, and with diameter <3.75 mm, placed in the mandibular posterior region, in Type III bone showed maximum failures.

  8. A combinatory approach for selecting prognostic genes in microarray studies of tumour survivals

    DEFF Research Database (Denmark)

    Tan, Qihua; Thomassen, Mads; Jochumsen, Kirsten M

    2009-01-01

    differential gene expression analysis with the Gram-Schmidt process to identify prognostic genes that are both statistically significant and highly informative for predicting tumour survival outcomes. Empirical application to leukemia and ovarian cancer survival data through-within- and cross-study validations...... for prediction. Unfortunately feature selection in literature of microarray study is predominated by the simple heuristic univariate gene filter paradigm that selects differentially expressed genes according to their statistical significances. We introduce a combinatory feature selection strategy that integrates...

  9. Experimental study of the survival of metastatic cancer cells in corneal organ culture.

    Science.gov (United States)

    Deb-Joardar, Nilanjana; Thuret, Gilles; Dumollard, Jean-Marc; Absi, Lena; Campos-Guyotat, Lydia; Peoc'h, Michel; Garraud, Olivier; Gain, Philippe

    2006-04-01

    Transmission of donor malignancy to the recipient could be one of the most disastrous complications of corneal grafting. Because of the scarcity of donor tissue and the lack of sufficient scientific evidence, the harvest of donor tissues from deaths due to systemic malignancy is permitted. This study was conducted to investigate the possible transmission of donor metastatic disease via corneal tissue preserved in organ culture (OC) conditions. The viability of four frequent human cancer cell lines (lung, breast, skin, and colon) was studied in OC. Various inoculums of cancer cells labeled with the membrane marker PKH67 were seeded on donor corneas and preserved in OC, followed by cell-tracking studies, histopathology, and immunohistochemistry. HLA matching of the dissected Descemet's membrane (DM) of preserved corneas was conducted, to demonstrate cell adherence. Primary cell culture was performed to confirm the viability of adherent tumor cells. Viability tests showed a poor but persistent survival of cancer cells after 2 weeks in OC. Cell tracking, histopathology, and immunohistochemistry demonstrated cancer cell adherence to donor endothelium. HLA typing of the DM of preserved corneas revealed the presence of cancer cell alleles. Primary culture of the DM showed cell proliferation that was identical with the original cancer cell line, according to HLA studies. The findings demonstrate that under laboratory conditions, metastatic cancer cells adhere to donor corneal tissue, survive, and retain proliferative capacity during storage in OC. Cell lines differ in their viability potential, as well as the pattern of adherence to donor endothelium. Further in vivo experimentation in laboratory animals is need to determine the safety of such harvests.

  10. Comparison of survival outcomes after recurrence detected by cancer antigen 125 elevation versus imaging study in epithelial ovarian cancer.

    Science.gov (United States)

    Paik, E Sun; Kim, Tae Joong; Lee, Yoo Young; Choi, Chel Hun; Lee, Jeong Won; Kim, Byoung Gie; Bae, Duk Soo

    2016-09-01

    The aim of this study was to compare survival outcomes in two groups of patients with recurrent epithelial ovarian cancer (EOC) with initial recurrence detection by cancer antigen 125 (CA-125) elevation or imaging, and underwent secondary cytoreductive surgery (SCS). A retrospective review of the medical records was performed on 99 recurrent EOC patients who underwent SCS at the Samsung Medical Center between January 2002 and December 2013. For follow-up after primary treatment, patients were routinely assessed by CA-125 levels every 3 months and computed tomography (CT) scan (or magnetic resonance imaging [MRI]) every 6 months for first 3 years, and by CA-125 every 6 months and CT scan (or MRI) every 12 months thereafter. The first recurrence was initially identified by either CA-125 elevation (n=41, 41.4%) or by imaging study (n=58, 58.6%). None of the patients showed the symptoms as initial sign of recurrence. There were higher percentages of extra-pelvic recurrence (87.8%) and multiple recurrences (78.0%) in the group diagnosed by CA-125 elevation. The proportion of no residual disease after SCS was comparably lower in the CA-125 group (22.0% vs. 72.4%). There were 19 cancer-associated deaths (19.2%) within a median follow-up period of 67 months. The group diagnosed by imaging had better overall survival from initial diagnosis (OS1), overall survival after SCS (OS2), progression-free survival after the initial treatment (PFS1) and progression-free survival after SCS compared to those of the CA-125 group (PFS2). EOC patients with recurrence initially detected by imaging study showed better survival outcomes than patients diagnosed by CA-125 elevation.

  11. Survival analysis of gastric cancer patients using Cox model: a five year study

    Directory of Open Access Journals (Sweden)

    Biglarian A

    2009-08-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gastric cancer is the second most common cancer and known as the second cause of death due to cancers worldwide. Adenocarcinoma is the most fatal cancer in Iran and a patient with this kind of cancer, has a lower lifetime than others. In this research, the survival of patients with gastric carcinoma who were registered at Taleghani Hospital, were studied."n"nMethods: 291 patients with Gastric carcinoma who had received care, chemotherapy or chemoradiotherapy, at Taleghani Hospital in Tehran from 2002 to 2007 were studied as a historical cohort. Their survival rates and its relationship with 12 risk factors were assessed."n"nResults: Of the 291 patients with Gastric carcinoma, 70.1 percent were men and others (29.9% were women. The mean age of men was 62.26 years and of women was 59.32 years at the time of diagnosis. Most of patients (93.91% were advanced stage and metastasis. The Cox proportional hazards model showed that age at diagnosis, tumor stage and histology type with survival time had significant relationships (p=0.039, p=0.042 and p=0.032 respectively."n"n Conclusion: The five-year survival rate and median lifetime of gastric cancer patients who underwent chemotherapy or chemoradiotherapy are very

  12. How does culture show? A case study of an international and interprofessional course in palliative care.

    Science.gov (United States)

    Pahor, Majda; Rasmussen, Birgit H

    2009-09-01

    Research shows slow improvement of the care of dying persons and their significant others. One of the reasons for that is the lack of palliative care education as an integral part of health professionals' undergraduate education. The paper discusses an attempt to develop innovative forms of palliative care education: an international, interprofessional and IT-supported undergraduate course for Swedish and Slovenian students of nursing, medicine, occupational therapy, physiotherapy, psychology and social work, which has been developed jointly by the two authors. One of the aims of the course has been to address differences in professional and national cultures relevant to quality in palliative care. The development and pilot implementation phases of the course were analysed qualitatively, using evaluation materials from students and teachers and from an external evaluation study. The results show that the interprofessional approach in the course enabled students to get to know other professions, as well as enabling them to work together as a team and resolve conflicts. Cultural differences between Sweden and Slovenia were not very pronounced, yet they came to the fore regarding teamwork and relationships between professions, as well as in respect of the "right thing" to do in relation to patient' problems.

  13. A qualitative study showing women's participation and empowerment in instrumental vaginal births.

    Science.gov (United States)

    Sjödin, Marie; Rådestad, Ingela; Zwedberg, Sofia

    2017-09-21

    An instrumental birth with a ventouse or forceps is a complicated birth, possibly resulting in fear of childbirth which could influence the entire birth experience negatively. Patients who are actively involved in their care have a stronger sense of satisfaction and a sense of participation can contribute to shorter hospital stays. To describe the experience of participation for women involved in an instrumental delivery with ventouse or forceps. Qualitative semi-structured interviews with 16 women who gave birth aided by a ventouse or forceps. Their answers were analyzed through qualitative content analysis. In addition the women were asked to evaluate their experience during the delivery. Using a numerical scale (NRS) the birth experience was graded by choosing a number between 0 (worst possible experience) and 10 (best conceivable experience). Two themes were extracted from the data: To be part of a team and To feel empowered. Five categories were identified from the women's descriptions of the experience of involvement during the instrumental delivery: to cooperate; to understand; to have contact; to participate, and to not be involved. Those women who rated their experience as low grade, described a lack of involvement in their childbirth compared to those women who rated their experience as high. This study shows how cooperation and empowerment of the woman are two key factors in order for the women to have a positive experience of their instrumental vaginal births. The study also shows that empowerment is created when the woman is actively engaged and participates in the birth process which gives her the feeling of being part of the team, creating an environment based on mutual understanding. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. Transcolonic Perirectal NOTES Access (PNA): A feasibility study with survival in swine model.

    Science.gov (United States)

    Oliveira, André L A; Zorron, Ricardo; Oliveira, Flavio M M DE; Santos, Marcelo B Dos; Scheffer, Jussara P; Rios, Marcelo; Antunes, Fernanda

    2017-05-01

    Transrectal access still has some unsolved issues such as spatial orientation, infection, access and site closure. This study presents a simple technique to perform transcolonic access with survival in a swine model series. A new technique for NOTES perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique. The specimens were extracted transanally. The flexible endoscope was inserted through a posterior transmural incision and the retrorectal space. Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days. Rectal site was closed using non-absorbable sutures. There was no bowel cleansing, nor preoperative fasting. The procedures were performed in 6 pigs through transcolonic natural orifice access using available endoscopic flexible instruments. All animals survived 14 days without complications, and cultures were negative. Histopathologic examination of the rectal closure site showed adequate healing of suture line and no micro abscesses. The results of feasibility and safety of experimental Transcolonic NOTES potentially brings new frontiers and future wider applications for minimally invasive surgery. The treatment of colorectal, abdominal and retroperitoneal diseases through a flexible Perirectal NOTES Access (PNA) is a promising new approach.

  15. Effects of blood transfusion on the immune responsiveness and survival of cancer patients: a prospective study.

    Science.gov (United States)

    Quintiliani, L; Buzzonetti, A; DiGirolamo, M; Iudicone, P; Guglielmetti, M; Martini, F; Scocchera, R; Terlizzi, F; Lapponi, P; Giuliani, E

    1991-10-01

    To evaluate whether blood transfusion exerts an adverse influence on cancer evolution, a prospective clinical and immunologic investigation was carried out on 58 surgical patients with gastric or colorectal adenocarcinoma. None had had previous transfusion; 35 received perioperative transfusion. Among preoperative variables, only red cell count and hemoglobin concentration were significantly reduced in the patients transfused at operation. Other clinical characteristics and immunologic functions (except interferon-gamma release) did not differ significantly from those of untransfused patients. The survival rate of transfused patients, although shorter, was not significantly different from that of untransfused patients. Immunologic tests done after surgery on 30 patients (17 transfused and 13 untransfused) did not show significant differences in the two groups. Significant increases in interleukin-2-stimulated production and immunoglobulin M synthesis were observed in transfused patients after surgery. Patients transfused perioperatively with more than 3 units of blood had some evidence of decreased immune function, but differences were not significant. While shorter survival and some immunologic changes may correlate with the number of transfusions, more patients must be studied to determine whether this relationship will be confirmed.

  16. Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Tone Bull Enger

    Full Text Available To assess long-term survival and mortality in adult cardiac surgery patients.8,564 consecutive patients undergoing cardiac surgery in Trondheim, Norway from 2000 until censoring 31.12.2014 were prospectively followed. Observed long-term mortality following surgery was compared to the expected mortality in the Norwegian population, matched on gender, age and calendar year. This enabled assessment of relative survival (observed/expected survival rates and relative mortality (observed/expected deaths. Long-term mortality was compared across gender, age and surgical procedure. Predictors of reduced survival were assessed with multivariate analyses of observed and relative mortality.During follow-up (median 6.4 years, 2,044 patients (23.9% died. The observed 30-day, 1-, 3- and 5-year mortality rates were 2.2%, 4.4%, 8.2% and 13.8%, respectively, and remained constant throughout the study period. Comparing observed mortality to that expected in a matched sample from the general population, patients undergoing cardiac surgery showed excellent survival throughout the first seven years of follow-up (relative survival ≥ 1. Subsequently, survival decreased, which was more pronounced in females and patients undergoing other procedures than isolated coronary artery bypass grafting (CABG. Relative mortality was higher in younger age groups, females and patients undergoing aortic valve replacement (AVR. The female survival advantage in the general population was obliterated (relative mortality ratio (RMR 1.35 (1.19-1.54, p<0.001. Increasing observed long-term mortality seen with ageing was due to population risk, and younger age was independently associated with increased relative mortality (RMR per 5 years 0.81 (0.79-0.84, p<0.001.Cardiac surgery patients showed comparable survival to that expected in the general Norwegian population, underlining the benefits of cardiac surgery in appropriately selected patients. The beneficial effect lasted shorter in

  17. Aviation occupant survival factors: an empirical study of the SQ006 accident.

    Science.gov (United States)

    Chang, Yu-Hern; Yang, Hui-Hua

    2010-03-01

    We present an empirical study of Singapore Airline (SIA) flight SQ006 to illustrate the critical factors that influence airplane occupant survivability. The Fuzzy Delphi Method was used to identify and rank the survival factors that may reduce injury and fatality in potentially survivable accidents. This is the first attempt by a group from both the public and private sectors in Taiwan to focus on cabin-safety issues related to survival factors. We designed a comprehensive survey based on our discussions with aviation safety experts. We next designed an array of important cabin-safety dimensions and then investigated and selected the critical survival factors for each dimension. Our findings reveal important cabin safety and survivability information that should provide a valuable reference for developing and evaluating aviation safety programs. We also believe that the results will be practical for designing cabin-safety education material for air travelers. Finally, the major contribution of this research is that it has identified 47 critical factors that influence accident survivability; therefore, it may encourage improvements that will promote more successful cabin-safety management. Copyright 2009 Elsevier Ltd. All rights reserved.

  18. Material rhetoric: spreading stones and showing bones in the study of prehistory.

    Science.gov (United States)

    Van Reybrouck, David; de Bont, Raf; Rock, Jan

    2009-06-01

    Since the linguistic turn, the role of rhetoric in the circulation and the popular representation of knowledge has been widely accepted in science studies. This article aims to analyze not a textual form of scientific rhetoric, but the crucial role of materiality in scientific debates. It introduces the concept of material rhetoric to understand the promotional regimes in which material objects play an essential argumentative role. It analyzes the phenomenon by looking at two students of prehistory from nineteenth-century Belgium. In the study of human prehistory and evolution, material data are either fairly abundant stone tools or very scarce fossil bones. These two types of material data stand for two different strategies in material rhetoric. In this article, the first strategy is exemplified by Aimé Rutot, who gathered great masses of eoliths (crudely chipped stones which he believed to be prehistoric tools). The second strategy is typified by the example of Julien Fraipont, who based his scientific career on only two Neanderthal skeletons. Rutot sent his "artifacts" to a very wide audience, while Fraipont showed his skeletons to only a few selected scholars. Unlike Rutot, however, Fraipont was able to monitor his audience's interpretation of the finds by means of personal contacts. What an archaeologist gains in reach, he or she apparently loses in control. In this article we argue that only those scholars who find the right balance between the extremes of reach and control will prove to be successful.

  19. Extracorporeal life support with left ventricular decompression-improved survival in severe cardiogenic shock: results from a retrospective study.

    Science.gov (United States)

    Schmack, Bastian; Seppelt, Philipp; Weymann, Alexander; Alt, Christina; Farag, Mina; Arif, Rawa; Doesch, Andreas O; Raake, Philip W; Kallenbach, Klaus; Mansur, Ashham; Popov, Aron-Frederik; Karck, Matthias; Ruhparwar, Arjang

    2017-01-01

    Extracorporeal life support (ECLS) is a life-saving procedure used in the treatment of severe cardiogenic shock. Within this retrospective single centre study, we examined our experience in this critically ill patient cohort to assess outcomes and clinical parameters by comparison of ECLS with or without selective left ventricular decompression. Between 2004 and 2014 we evaluated 48 adult patients with INTERMACS level 1 heart failure (age 49.7 ± 19.5 years), who received either central ECLS with (n = 20, 41.7%) or ECLS without (n = 28, 58.3%, including 10 peripheral ECLS) integrated left ventricular vent in our retrospective single centre trial. Follow up was 100% with a mean of 0.83 ± 1.85 years. Bridge to ventricular assist device was feasible in 29.2% (n = 14), bridge to transplant in 10.4% (n = 5) and bridge to recovery in 8.3% (n = 4). Overall 30-day survival was 37.5%, 6-month survival 27.1% and 1-year survival 25.0%. ECLS support with left ventricular decompression showed favourable 30-day survival compared to ECLS without left ventricular decompression (p = 0.034). Thirty-day as well as long-term survival did not differ between the subgroups (central ECLS with vent, ECLS without vent and peripheral ECLS without vent). Multivariate logistic regression adjusted for age and gender revealed ECLS without vent as independent factor influencing 30-day survival. ECLS is an established therapy for patients in severe cardiogenic shock. Independent of the ECLS approach, 30-day mortality is still high but with superior 30-day survival for patients with ECLS and left ventricular venting. Moreover, by unloading the ventricle, left ventricular decompression may provide an important time window for recovery or further treatment, such as bridge to bridge or bridge to transplant.

  20. Kinetic studies of Candida parapsilosis phagocytosis by macrophages and detection of intracellular survival mechanisms

    Directory of Open Access Journals (Sweden)

    Renata eToth

    2014-11-01

    Full Text Available Even though the number of Candida infections due to non-albicans species like C. parapsilosis has been increasing, little is known about their pathomechanisms. Certain aspects of C. parapsilosis and host interactions have already been investigated; however we lack information about the innate cellular responses towards this species. The aim of our project was to dissect and compare the phagocytosis of C. parapsilosis to C. albicans and to another Candida species C. glabrata by murine and human macrophages by live cell video microscopy. We broke down the phagocytic process into three stages: macrophage migration, engulfment of fungal cells and host cell killing after the uptake. Our results showed increased macrophage migration towards C. parapsilosis and we observed differences during the engulfment processes when comparing the three species. The engulfment time of C. parapsilosis was comparable to that of C. albicans regardless of the pseudohypha length and spatial orientation relative to phagocytes, while the rate of host cell killing and the overall uptake regarding C. parapsilosis showed similarities mainly with C. glabrata. Furthermore, we observed difference between human and murine phagocytes in the uptake of C. parapsilosis. UV-treatment of fungal cells had varied effects on phagocytosis dependent upon which Candida strain was used. Besides statistical analysis, live cell imaging videos showed that this species similarly to the other two also has the ability to survive in host cells via the following mechanisms: yeast replication, and pseudohypha growth inside of phagocytes, exocytosis of fungal cells and also abortion of host cell mitosis following the uptake. According to our knowledge this is the first study that provides a thorough examination of C. parapsilosis phagocytosis and reports intracellular survival mechanisms associated with this species.

  1. Comparative study on growth and survival of larval and juvenile ...

    African Journals Online (AJOL)

    In the present study, two experiments were carried out, the first one at age from 4th to 24th days post hatching (dph) which include Dicentrarchus labrax larvae rearing on rotifer and Artemia enriched with four types of algae as follows: Chlorella salina, Dunaleilla salina, Nannochloropsis salina and Tetraselmis chuii (ch1, D1, ...

  2. A Relational Approach to the Study of Religious Survival Units

    DEFF Research Database (Denmark)

    Reeh, Niels

    2012-01-01

    , a religion can be defined and studied as the result of complex set of dynamic relations, where a central tenet of a religion is that it relates to the significant religious other. As such religion is not a stable phenomenon but embedded in a dynamic historical process, which can explain the difficulties...

  3. SUCCESSION PLANNING AND ORGANIZATIONAL SURVIVAL: EMPIRICAL STUDY ON NIGERIAN PRIVATE TERTIARY INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Osibanjo Omotayo Adewale

    2011-11-01

    Full Text Available Organizational survival has been argued to be a primary goal or objective every organizationshould have. This paper proposes a conceptual framework of succession planning consisting of sixvariables (talent retention, turnover rate, career development, supervisor’ support, organizationalconflicts and nepotism and to explain the relationship among these variables regarding survival oforganizations. The sample consists of three private tertiary institutions in Ogun-State, SouthwestNigeria. The results indicate that Talent retention, organizational conflict and nepotism positive andsignificantly correlated with organizational survival. On the other hand variables such as TurnoverRate, Career Development and Supervisor’ Supervision are insignificantly correlated withorganizational survival. The results are supposed to inform the leadership (management team withessential insight into the relationship among the study variables (independent and dependent.

  4. Canada-USA Salmon Shelf Survival Study, 2007-2008 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Trudel, Marc; Tucker, Strahan; Morris, John

    2009-03-09

    Historically, salmon stocks from the Columbia River and Snake River formed one of the most valuable fisheries on the west coast of North America. However, salmon and steelhead returns sharply declined during the 1980s and 1990s to reach nearly 1 million fish. Although several factors may be responsible for the decline of Columbia River salmon and steelhead, there is increasing evidence that these drastic declines were primarily attributable to persistently unfavorable ocean conditions. Hence, an understanding of the effects of ocean conditions on salmon production is required to forecast the return of salmon to the Columbia River basin and to assess the efficacy of mitigation measures such as flow regulation on salmon resources in this system. The Canadian Program on High Seas Salmon has been collecting juvenile salmon and oceanographic data off the west coast of British Columbia and Southeast Alaska since 1998 to assess the effects of ocean conditions on the distribution, migration, growth, and survival of Pacific salmon. Here, we present a summary of the work conducted as part of the Canada-USA Salmon Shelf Survival Study during the 2008 fiscal year and compare these results with those obtained from previous years. The working hypothesis of this research is that fast growth enhances the marine survival of salmon, either because fast growing fish quickly reach a size that is sufficient to successfully avoid predators, or because they accumulate enough energy reserves to better survive their first winter at sea, a period generally considered critical in the life cycle of salmon. Sea surface temperature decreased from FY05 to FY08, whereas, the summer biomass of phytoplankton increased steadily off the west coast of Vancouver Island from FY05 to FY08. As in FY07, zooplankton biomass was generally above average off the west coast of Vancouver Island in FY08. Interestingly, phytoplankton and zooplankton biomass were higher in FY08 than was expected from the observed

  5. Trend analysis and survival of primary gallbladder cancer in the United States: a 1973-2009 population-based study.

    Science.gov (United States)

    Rahman, Rubayat; Simoes, Eduardo J; Schmaltz, Chester; Jackson, Christian S; Ibdah, Jamal A

    2017-04-01

    Primary gallbladder cancer is an aggressive and uncommon cancer with poor outcomes. Our study examines epidemiology, trend, and survival of gallbladder cancer in the United States from 1973 to 2009. We utilized the Surveillance Epidemiology and End Results database (SEER). Frequency and rate analyses on demographics, stage, and survival were compared among non-Hispanic whites, Hispanics, African American, and Asian/Pacific Islanders. A total of 18,124 cases were reported in SEER from 1973 to 2009 comprising 1.4% of all reported gastrointestinal cancers. Gallbladder cancer was more common in females than males (71 vs. 29%, respectively). The age-adjusted incidence rate was 1.4 per 100,000, significantly higher in females than males (1.7 vs. 1.0). Trend analysis showed that the incidence rate has been decreasing over the last three decades for males. However, among females, the incidence rate had decreased from 1973 to mid-90s but has remained stable since then. Trend analysis for stage at diagnosis showed that the proportion of late-stage cases has been increasing significantly since 2001 after a decreasing pattern since 1973. Survival has improved considerably over time, and survival is better in females than males and in Asian/Pacific Islanders than other racial groups. The highest survival was in patients who received both surgery and radiation. Trend analysis revealed a recent increase of the incidence of late-stage gallbladder cancer. Highest survival was associated with receiving both surgery and radiation. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  6. Mitochondrial DNA studies show asymmetrical Amerindian admixture in Afro-Colombian and Mestizo populations.

    Science.gov (United States)

    Rodas, Clemencia; Gelvez, Nancy; Keyeux, Genoveva

    2003-02-01

    The origin of the African populations that arrived on the Colombian coasts at the time of the Spanish conquest and their subsequent settlement throughout the country and interaction with Amerindian and Spanish populations are features that can be analyzed through the study of mitochondrial DNA (mtDNA) markers. For this purpose, the present study investigates the admixture between these populations by analyzing the markers defining the main (A, B, C, D) and minor (X) founder haplogroups in Native Americans, the principal African haplogroup (L), and additional generic markers present in Caucasian (I, J, K, H, T, U, V, W) and minor African lineages (L3). As part of an interdisciplinary research program (the Expedición Humana, furthered by the Universidad Javeriana and directed by J.E. Bernal V.), 159 Afro-Colombians from five populations in which they are the majority and 91 urban Mestizos were studied. No Amerindian haplogroups (A-D, X) were detected in 81% of the Afro-Colombians. In those samples with Amerindian lineages (average 18.8%, with a range from 10% to 43%), haplogroup B predominated. When analyzed for the presence of African haplotypes, Afro-Colombians showed an overall frequency of 35.8% for haplogroup L mtDNAs, although with broad differences between populations. A few Afro-Colombian samples (1.9%) had mutations that have not been described before, and might therefore be considered as previously unsampled African variants or as new mutations arising in the American continent. Conversely, in Mestizos less than 22% of their mtDNAs belonged to non-Amerindian lineages, of which most were likely to be West Eurasian in origin. Haplogroup L mtDNAs were found in only one Mestizo (1.1%), indicating that, if present, admixture with African women would bring in other, rarer African lineages. On the other hand, in an accompanying paper (Keyeux et al. 2002) we have shown that Amerindians from Colombia have experienced little or no matrilineal admixture with

  7. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    Kemal Özgür Demiralp

    2015-01-01

    Full Text Available Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P<0.05. Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P<0.05. Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials.

  8. Trends in incidence and survival of cutaneous malignant melanoma in Estonia: a population-based study.

    Science.gov (United States)

    Padrik, Peeter; Valter, Ann; Valter, Epp; Baburin, Aleksei; Innos, Kaire

    2017-01-01

    Previous studies have shown an increase in the incidence of cutaneous melanoma (CM) in Estonia, but also poor survival in international comparisons, with a significant survival gap between the sexes. The aim of this study was to analyze the time trends in CM incidence and relative survival by age, TNM stage and anatomical subsite among men and women in Estonia. Data from the Estonian Cancer Registry were used to calculate age-standardized (World) and age-specific incidence of CM in 1995-2013, and five-year relative survival ratios (RSR) for cases diagnosed in 1995-2012 and followed through in 2014. Period hybrid analysis was used to calculate the most recent survival estimates for 2010-2014. Between 1995 and 2013, the age-standardized incidence of CM increased significantly in Estonia among both sexes, at a rate of around 4% per year. Among women, the proportion of trunk melanomas increased from 26% in 1995-1999 to 39% in 2010-2012 and became the most common site. The proportion of stage I cases and T1 tumors increased considerably. Women had more favorable stage distribution and thinner tumors than men. The age-adjusted five-year RSR increased significantly, from 64% in 1995-1999 to 81% in 2010-2014. The latest age-adjusted RSRs were 76% among men and 84% among women. Survival gains were the largest in patients below 50 years, those with head and neck or trunk melanomas, and stage III cancer. The proportion of stage I and T1 cases is lower in Estonia compared with the Scandinavian data and is likely a major contributor to the persisting overall survival deficit in Estonia. The apparent deficit in stage II survival also warrants further investigation. A public health program is necessary in Estonia to raise awareness of CM and to significantly increase early stage diagnosis.

  9. Unique biophysical studies with diatomic deuterium beams. [Survival studies with V79 Chinese hamster cells

    Energy Technology Data Exchange (ETDEWEB)

    Rohrig, N.; Bird, R.P.; Colvett, R.D.; Rossi, H.H.; Marino, S.A.

    1978-01-01

    By irradiating cells attached to thin Mylar foils with diatomic deuteron beams, the role of interaction distance in radiobiology can be investigated in a unique manner. The molecule breaks up into two separate ions which diverge from each other because of the multiple scattering process in the foil and in the cellular material. A distribution of separation distances results whose characteristic separation depends on the Mylar foil thickness. An experimental facility to use diatomic beams is described. Cell survival results for V79 Chinese hamster cells synchronized in late S phase show that damage does result from tracks separated by as much as 250 nm. However, damage also results from interaction at nanometer dimensions.

  10. Complement activation in leprosy: a retrospective study shows elevated circulating terminal complement complex in reactional leprosy.

    Science.gov (United States)

    Bahia El Idrissi, N; Hakobyan, S; Ramaglia, V; Geluk, A; Morgan, B Paul; Das, P Kumar; Baas, F

    2016-06-01

    Mycobacterium leprae infection gives rise to the immunologically and histopathologically classified spectrum of leprosy. At present, several tools for the stratification of patients are based on acquired immunity markers. However, the role of innate immunity, particularly the complement system, is largely unexplored. The present retrospective study was undertaken to explore whether the systemic levels of complement activation components and regulators can stratify leprosy patients, particularly in reference to the reactional state of the disease. Serum samples from two cohorts were analysed. The cohort from Bangladesh included multi-bacillary (MB) patients with (n = 12) or without (n = 46) reaction (R) at intake and endemic controls (n = 20). The cohort from Ethiopia included pauci-bacillary (PB) (n = 7) and MB (n = 23) patients without reaction and MB (n = 15) patients with reaction. The results showed that the activation products terminal complement complex (TCC) (P ≤ 0·01), C4d (P ≤ 0·05) and iC3b (P ≤ 0·05) were specifically elevated in Bangladeshi patients with reaction at intake compared to endemic controls. In addition, levels of the regulator clusterin (P ≤ 0·001 without R; P < 0·05 with R) were also elevated in MB patients, irrespective of a reaction. Similar analysis of the Ethiopian cohort confirmed that, irrespective of a reaction, serum TCC levels were increased significantly in patients with reactions compared to patients without reactions (P ≤ 0·05). Our findings suggests that serum TCC levels may prove to be a valuable tool in diagnosing patients at risk of developing reactions. © 2016 British Society for Immunology.

  11. [The epidemiology of helicobacteriosis in humans; studies of the survival capacity of the microbe in food].

    Science.gov (United States)

    Böhmler, G; Gerwert, J; Scupin, E; Sinell, H J

    1996-10-01

    In man suffering from diseases of the stomach and the duodenum (gastritis, ulcus, enteritis, neoplasms), Helicobacter pylori (H..pylori) is frequently detected in the mucous membrane of the stomach. Up to now the spread of this agent is not quite clear. Since the direct transmission in humans can be taken for granted, the following study was to find out whether and for how long the agent mentioned above is able to survive in selected food and whether an infection of the consumer by these contaminated food is possible. 376 samples of secretions from the udder of healthy cows and those with mastitis where tested for the presence of H. pylori along with 100 stomachs of chicken from different flocks. In no case H. pylori could be detected. H. pylori was inoculated in high concentrations into milk and some milk-products. From cooled milk samples the agent could still be reisolated after six days in a density up to 10(3) CFU/ml of milk. At room-temperature or 37 degrees C resp. the pathogen could be detected in milk for three to four days only. In yoghurt the agent kept viable for three hours only, whereas in kefir for 24 hours. Mean survival time of then hours was found in pH-neutral curd cheese. The incubation of H.pylori in sterile drip from chicken and in physiologic saline resulted in maximal survival time of at least 48 hours at room temperature. But in H.pylori-broth the number of microorganisms had dropped below the limit of detectability only after 72 hours. At refrigerator-temperature (7 degrees C) H. pylori could still be detected within these three media after 72 hours in high concentrations. In drip from chicken kept at-20 degrees C before thawing H. pylori showed a considerable survival time. After four weeks its number had only dropped by one to two log cycles, whereas in saline and in broth the agent could not be detected anymore after one week at the most. Experiments concerning tenacity showed: On culture-media with different pH-values the growth

  12. Survival prediction from clinico-genomic models--a comparative study.

    Science.gov (United States)

    Bøvelstad, Hege M; Nygård, Ståle; Borgan, Ornulf

    2009-12-13

    Survival prediction from high-dimensional genomic data is an active field in today's medical research. Most of the proposed prediction methods make use of genomic data alone without considering established clinical covariates that often are available and known to have predictive value. Recent studies suggest that combining clinical and genomic information may improve predictions, but there is a lack of systematic studies on the topic. Also, for the widely used Cox regression model, it is not obvious how to handle such combined models. We propose a way to combine classical clinical covariates with genomic data in a clinico-genomic prediction model based on the Cox regression model. The prediction model is obtained by a simultaneous use of both types of covariates, but applying dimension reduction only to the high-dimensional genomic variables. We describe how this can be done for seven well-known prediction methods: variable selection, unsupervised and supervised principal components regression and partial least squares regression, ridge regression, and the lasso. We further perform a systematic comparison of the performance of prediction models using clinical covariates only, genomic data only, or a combination of the two. The comparison is done using three survival data sets containing both clinical information and microarray gene expression data. Matlab code for the clinico-genomic prediction methods is available at http://www.med.uio.no/imb/stat/bmms/software/clinico-genomic/. Based on our three data sets, the comparison shows that established clinical covariates will often lead to better predictions than what can be obtained from genomic data alone. In the cases where the genomic models are better than the clinical, ridge regression is used for dimension reduction. We also find that the clinico-genomic models tend to outperform the models based on only genomic data. Further, clinico-genomic models and the use of ridge regression gives for all three data sets

  13. Survival of flexible, braided, bonded stainless steel lingual retainers: a historic cohort study.

    Science.gov (United States)

    Lie Sam Foek, D J; Ozcan, M; Verkerke, G J; Sandham, A; Dijkstra, P U

    2008-04-01

    The objectives of this study were to retrospectively evaluate the clinical survival rate of flexible, braided, rectangular bonded stainless steel lingual retainers, and to investigate the influence of gender, age of the patient, and operator experience on survival after orthodontic treatment at the Department of Orthodontics, University of Groningen, between the years 2002 and 2006. The study group comprised of 277 patients [162 females: median age 14.8 years, interquartile range (IQR) 13.6-16.5 years and 115 males: median age 15.3 years, IQR 14.2-16.7 years]. After acid etching the lingual surfaces of each tooth, an adhesive resin was applied and retainers were bonded using a flowable resin composite. Data concerning, failures, gender, age of the patient, and operator experience were retrieved from the patient files that were updated by chart entries every 6 months or when failure was reported by the patient. The maximum follow-up period was 41.7 months. All 277 patients received flexible, braided, bonded mandibular canine-to-canine retainers. Eighteen failures were observed in the maxilla. A failure was recorded when there was debonding, fracture, or both, occurring in one arch. Only first failures were used for statistical analysis. When failures occurred in both jaws, these were considered as two separate incidences. Ninety-nine debonding (35.7 per cent), two fractures (0.7 per cent), and four debonding and fracture (1.4 per cent) events were observed. No significant effect (P > 0.05) of gender (females: 41 per cent, males: 32 per cent) or patient age ( or =16 years 38.7 per cent) was observed. The failure rate did not differ due to operator experience (n = 15; less experienced: 38.0 per cent; moderately experienced: 28.9 per cent, professional: 46.7 per cent; P > 0.05; chi-square test). Kaplan-Meier survival curves showed a 63 per cent success rate for the bonded lingual retainers over a 41.7 month period.

  14. Sauerbraten, Rotkappchen und Goethe: The Quiz Show as an Introduction to German Studies.

    Science.gov (United States)

    White, Diane

    1980-01-01

    Proposes an adaptation of the quiz-show format for classroom use, discussing a set of rules and sample questions designed for beginning and intermediate German students. Presents questions based on German life and culture which are especially selected to encourage participation from students majoring in subjects other than German. (MES)

  15. Studying the Effect of a Competitive Game Show in a Learning by Teaching Environment

    Science.gov (United States)

    Matsuda, Noboru; Yarzebinski, Evelyn; Keiser, Victoria; Raizada, Rohan; Stylianides, Gabriel J.; Koedinger, Kenneth R.

    2013-01-01

    In this paper we investigate how competition among tutees in the context of learning by teaching affects tutors' engagement as well as tutor learning. We conducted this investigation by incorporating a competitive Game Show feature into an online learning environment where students learn to solve algebraic equations by teaching a synthetic…

  16. Micro ecosystems from feed industry surfaces: a survival and biofilm study of Salmonella versus host resident flora strains.

    Science.gov (United States)

    Habimana, Olivier; Møretrø, Trond; Langsrud, Solveig; Vestby, Lene K; Nesse, Live L; Heir, Even

    2010-11-02

    The presence of Salmonella enterica serovars in feed ingredients, products and processing facilities is a well recognized problem worldwide. In Norwegian feed factories, strict control measures are implemented to avoid establishment and spreading of Salmonella throughout the processing chain. There is limited knowledge on the presence and survival of the resident microflora in feed production plants. Information on interactions between Salmonella and other bacteria in feed production plants and how they affect survival and biofilm formation of Salmonella is also limited. The aim of this study was to identify resident microbiota found in feed production environments, and to compare the survival of resident flora strains and Salmonella to stress factors typically found in feed processing environments. Moreover, the role of dominant resident flora strains in the biofilm development of Salmonella was determined. Surface microflora characterization from two feed productions plants, by means of 16 S rDNA sequencing, revealed a wide diversity of bacteria. Survival, disinfection and biofilm formation experiments were conducted on selected dominant resident flora strains and Salmonella. Results showed higher survival properties by resident flora isolates for desiccation, and disinfection compared to Salmonella isolates. Dual-species biofilms favored Salmonella growth compared to Salmonella in mono-species biofilms, with biovolume increases of 2.8-fold and 3.2-fold in the presence of Staphylococcus and Pseudomonas, respectively. These results offer an overview of the microflora composition found in feed industry processing environments, their survival under relevant stresses and their potential effect on biofilm formation in the presence of Salmonella. Eliminating the establishment of resident flora isolates in feed industry surfaces is therefore of interest for impeding conditions for Salmonella colonization and growth on feed industry surfaces. In-depth investigations are

  17. Micro ecosystems from feed industry surfaces: a survival and biofilm study of Salmonella versus host resident flora strains

    Directory of Open Access Journals (Sweden)

    Vestby Lene K

    2010-11-01

    Full Text Available Abstract Background The presence of Salmonella enterica serovars in feed ingredients, products and processing facilities is a well recognized problem worldwide. In Norwegian feed factories, strict control measures are implemented to avoid establishment and spreading of Salmonella throughout the processing chain. There is limited knowledge on the presence and survival of the resident microflora in feed production plants. Information on interactions between Salmonella and other bacteria in feed production plants and how they affect survival and biofilm formation of Salmonella is also limited. The aim of this study was to identify resident microbiota found in feed production environments, and to compare the survival of resident flora strains and Salmonella to stress factors typically found in feed processing environments. Moreover, the role of dominant resident flora strains in the biofilm development of Salmonella was determined. Results Surface microflora characterization from two feed productions plants, by means of 16 S rDNA sequencing, revealed a wide diversity of bacteria. Survival, disinfection and biofilm formation experiments were conducted on selected dominant resident flora strains and Salmonella. Results showed higher survival properties by resident flora isolates for desiccation, and disinfection compared to Salmonella isolates. Dual-species biofilms favored Salmonella growth compared to Salmonella in mono-species biofilms, with biovolume increases of 2.8-fold and 3.2-fold in the presence of Staphylococcus and Pseudomonas, respectively. Conclusions These results offer an overview of the microflora composition found in feed industry processing environments, their survival under relevant stresses and their potential effect on biofilm formation in the presence of Salmonella. Eliminating the establishment of resident flora isolates in feed industry surfaces is therefore of interest for impeding conditions for Salmonella colonization and

  18. Acoustic Telemetry Studies of Juvenile Chinook Salmon Survival at the Lower Columbia Projects in 2006

    Energy Technology Data Exchange (ETDEWEB)

    Ploskey, Gene R.; Weiland, Mark A.; Hughes, James S.; Zimmerman, Shon A.; Durham, Robin E.; Fischer, Eric S.; Kim, Jina; Townsend, Richard L.; Skalski, John R.; McComas, Roy L.

    2008-02-01

    The Portland District of the U.S. Army Corps of Engineers contracted with the Pacific Northwest National Laboratory (PNNL) to conduct three studies using acoustic telemetry to estimate detection probabilities and survival of juvenile Chinook salmon at three hydropower projects on the lower Columbia River. The primary goals were to estimate detection and survival probabilities based on sampling with JSATS equipment, assess the feasibility of using JSATS for survival studies, and estimate sample sizes needed to obtain a desired level of precision in future studies. The 2006 JSATS arrays usually performed as well or better than radio telemetry arrays in the JDA and TDA tailwaters, and underperformed radio arrays in the BON tailwater, particularly in spring. Most of the probabilities of detection on at least one of all arrays in a tailwater exceeded 80% for each method, which was sufficient to provide confidence in survival estimates. The probability of detection on one of three arrays includes survival and detection probabilities because fish may die or pass all three arrays undetected but alive.

  19. Breast cancer survival in the US and Europe: a CONCORD high-resolution study

    Science.gov (United States)

    Allemani, Claudia; Sant, Milena; Weir, Hannah K; Richardson, Lisa C; Baili, Paolo; Storm, Hans; Siesling, Sabine; Torrella-Ramos, Ana; Voogd, Adri C; Aareleid, Tiiu; Ardanaz, Eva; Berrino, Franco; Bielska-Lasota, Magdalena; Bolick, Susan; Cirilli, Claudia; Colonna, Marc; Contiero, Paolo; Cress, Rosemary; Crocetti, Emanuele; Fulton, John P; Grosclaude, Pascale; Hakulinen, Timo; Izarzugaza, M Isabel; Malmström, Per; Peignaux, Karin; Primic-Žakelj, Maja; Rachtan, Jadwiga; Diba, Chakameh Safaei; Sánchez, Maria-José; Schymura, Maria J; Shen, Tiefu; Traina, Adele; Tryggvadottir, Laufey; Tumino, Rosario; Velten, Michel; Vercelli, Marina; Wolf, Holly J; Woronoff, Anne-Sophie; Wu, Xiaocheng; Coleman, Michel P

    2015-01-01

    Breast cancer survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardised survival. The aim of this study is to explain these survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with breast cancer aged 15–99 years during 1996–98 in 7 US states and 12 European countries. Age-standardised net survival and the excess hazard of death up to five years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumours were more frequent in the US (39%) than in Europe (32%), while locally advanced tumours were twice as frequent in Europe (8%), and metastatic tumours of similar frequency (5–6%). Net survival in Northern, Western and Southern Europe (82–85%) was similar to that in the US (84%), but lower in Eastern Europe (72%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70–99 years, and mainly confined to women with locally advanced or metastatic tumours. Differences in breast cancer survival between Europe and the US in the late 1990s were mainly explained by lower survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment. PMID:22815141

  20. Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates

    NARCIS (Netherlands)

    Flint, R.B.; Halbmeijer, N.; Meesters, N.; Rosmalen, J. van; Reiss, I.; Dijk, M.; Simons, S.

    2017-01-01

    AIM: Using doxapram to treat neonates with apnoea of prematurity might avoid the need for endotracheal intubation and invasive ventilation. We studied whether doxapram prevented the need for intubation and identified the predictors of the success. METHODS: This was a retrospective study of preterm

  1. Excessive users of violent video games do not show emotional desensitization: an fMRI study.

    Science.gov (United States)

    Szycik, Gregor R; Mohammadi, Bahram; Hake, Maria; Kneer, Jonas; Samii, Amir; Münte, Thomas F; Te Wildt, Bert T

    2017-06-01

    Playing violent video games have been linked to long-term emotional desensitization. We hypothesized that desensitization effects in excessive users of violent video games should lead to decreased brain activations to highly salient emotional pictures in emotional sensitivity brain regions. Twenty-eight male adult subjects showing excessive long-term use of violent video games and age and education matched control participants were examined in two experiments using standardized emotional pictures of positive, negative and neutral valence. No group differences were revealed even at reduced statistical thresholds which speaks against desensitization of emotion sensitive brain regions as a result of excessive use of violent video games.

  2. Survival with sildenafil and inhaled iloprost in a cohort with pulmonary hypertension: An observational study

    NARCIS (Netherlands)

    H. Gall (Henning); N. Sommer (Natascha); K. Milger (Katrin); M.J. Richter (Manuel); R. Voswinckel (Robert); D. Bandorski (Dirk); W. Seeger (Werner); F. Grimminger (Friedrich); H.A. Ghofrani

    2016-01-01

    textabstractBackground: Combination therapy is frequently used to treat patients with pulmonary hypertension but few studies have compared treatment regimens. This study examined the long-term effect of different combination regimens of inhaled iloprost and oral sildenafil on survival and disease

  3. Survival of participating and nonparticipating limb amputees in prospective study : Consequences for research

    NARCIS (Netherlands)

    Bosmans, J.C.; Geertzen, J.H.B.; Hoekstra, H.J.; Dijkstra, P.U.

    2010-01-01

    This study quantified selection by analyzing the survival rate of the participants and nonparticipants in a 4-year prospective, multicenter cohort study. In addition, the differences between these groups were analyzed. Surgeons of six hospitals in the northern Netherlands referred, in total, 225

  4. A Study on the Factors Influencing the Growth and Survival of ...

    African Journals Online (AJOL)

    The aim of the present study was to investigate the influence environmental factors such as salinity and temperature and biological factors such as stocking density and feed type on the growth and survival of juvenile sea cucumbers Holothuria atra. The study was conducted from mid-October 2006 to end of January 2007 ...

  5. The "Hawthorne effect"--what did the original Hawthorne studies actually show?

    Science.gov (United States)

    Wickström, G; Bendix, T

    2000-08-01

    The "Hawthorne effect" is often mentioned as a possible explanation for positive results in intervention studies. It is used to cover many phenomena, not only unwitting confounding of variables under study by the study itself, but also behavioral change due to an awareness of being observed, active compliance with the supposed wishes of researchers because of special attention received, or positive response to the stimulus being introduced. At times, the term seems to be used as a social equivalent to "placebo effect". In social research, there is much critical literature indicating that, in general, the term "Hawthorne effect" should be avoided. Instead of referring to the ambiguous and disputable Hawthorne effect when evaluating intervention effectiveness, researchers should introduce specific psychological and social variables that may have affected the outcome under study but were not monitored during the project, along with the possible effect on the observed results.

  6. A population-based study of retinoblastoma incidence and survival in Argentine children.

    Science.gov (United States)

    Moreno, Florencia; Sinaki, Banafsheh; Fandiño, Adriana; Dussel, Verónica; Orellana, Liliana; Chantada, Guillermo

    2014-09-01

    An increased incidence of retinoblastoma in some developing countries has been reported but no conclusive data are available from population-based studies at national level. To report the incidence and survival of retinoblastoma in Argentina from the National Pediatric Cancer Registry (ROHA) and the influence of socio-economical indicators on outcome. Cases reported to the ROHA (2000-2009) were analyzed. Incidence rates were calculated using National Vital Statistics and survival was estimated. The extended human development index (EHDI) was used as a socio-economical indicator. With 438 patients reported, an incidence of 5.0 cases per million children 0-14 years old (95% CI 3.5-6.4) was calculated. Median age at diagnosis was significantly higher for children from provinces with lower EHDI; (24 vs. 35 months for unilateral, (P = 0.003) and 9 versus 11.5 months for bilateral retinoblastoma (P = 0.027). The 3-year probability of survival was 0.87 and 0.94 for unilateral and bilateral retinoblastoma, respectively. Residents in provinces with higher EHDI had a better 3-year survival (0.93 vs. 0.77 for lower EHDI, P < 0.0001). Probability of survival was higher for patients treated at tertiary level institutions (P = 0.0015). The combination of low EHDI residence province with no treatment at a tertiary institution was associated with the worst survival outcome. For both, unilateral and bilateral disease, children who died were in average diagnosed at older age. The incidence of retinoblastoma in Argentina is comparable to that of developed countries. Retinoblastoma is diagnosed later and survival is lower in the less developed areas of the country. © 2014 Wiley Periodicals, Inc.

  7. Ecological and toxicological responses in a multistressor scenario: Are monitoring programs showing the stressors or just showing stress? A case study in Brazil.

    Science.gov (United States)

    López-Doval, Julio C; Meirelles, Sergio Tadeu; Cardoso-Silva, Sheila; Moschini-Carlos, Viviane; Pompêo, Marcelo

    2016-01-01

    The Metropolitan Region of São Paulo (MRSP) is located in the Brazilian State of São Paulo and reservoirs in this region are vital for water supply and energy production. Changes in economic, social, and demographic trends produced pollution of water bodies, decreasing water quality for human uses and affecting freshwater populations. The presence of emerging pollutants, classical priority substances, nutrient excess and the interaction with tropical-climate conditions require periodic reviews of water policies and monitoring programs in order to detect and manage these threats in a global change scenario. The objective of this work is to determine whether the monitoring program of the São Paulo's Environmental Agency, is sufficient to explain the toxicological and biological responses observed in organisms in reservoirs of the MRSP, and whether it can identify the possible agents causing these responses. For that, we used publicly available data on water quality compiled by this agency in their routine monitoring program. A general overview of these data and a chemometric approach to analyze the responses of biotic indexes and toxicological bioassays, as a function of the physical and chemical parameters monitored, were performed. Data compiled showed temporal and geographical information gaps on variables measured. Toxicological responses have been observed in the reservoirs of the MRSP, together with a high incidence of impairments of the zooplankton community. This demonstrates the presence of stressors that affect the viability of organisms and populations. The statistical approach showed that the data compiled by the environmental agency are insufficient to identify and explain the factors causing the observed ecotoxicological responses and impairments in the zooplankton community, and are therefore insufficient to identify clear cause-effect relationships. Stressors different from those analyzed could be responsible for the observed responses. Copyright

  8. Affiliation, joint venture or PSO? Case studies show why provider strategies differ.

    Science.gov (United States)

    1998-03-01

    Joint venture, affiliation or PSO? Here are three case studies of providers who chose different paths under Medicare risk, plus some key questions you'll want to ask of your own provider organization. Learn from these examples so you'll make the best contracting decisions.

  9. Material Rhetoric: Spreading Stones and Showing Bones in the Study of Prehistory

    NARCIS (Netherlands)

    Van Reybrouck, D.; de Bont, R.; Rock, J.

    2009-01-01

    Since the linguistic turn, the role of rhetoric in the circulation and the popular representation of knowledge has been widely accepted in science studies. This article aims to analyze not a textual form of scientific rhetoric, but the crucial role of materiality in scientific debates. It introduces

  10. Study of medication-free children with Tourette syndrome do not show imaging abnormalities

    DEFF Research Database (Denmark)

    Jeppesen, Signe Søndergaard; Debes, Nanette Mol; Simonsen, Helle Juhl

    2014-01-01

    BACKGROUND: Imaging studies of patients with Tourette's syndrome (TS) across different cohorts have shown alterations in gray and white matter in areas associated with the cortico-striato-thalamic-cortical (CSTC) pathways; however, no consistent findings have subsequently established a clear...

  11. Show Me the Money! Why Higher Ed Should Help K-12 Do Economic Impact Studies

    Science.gov (United States)

    Alam, Nadia

    2010-01-01

    In education, economic impact studies have been largely the product of higher education institutions. Colleges and universities have recognized that they can cultivate public, political and financial support by effectively demonstrating their high return-on-investment value. For more than a decade, all types of higher education institutions have…

  12. Ganas of Showing the Way: A Grounded Theory Study of Hispanic Presidents in Higher Education

    Science.gov (United States)

    Barrios Gutierrez, Eugenio

    2010-01-01

    In this dissertation, based on classical grounded theory (Glaser & Strauss, 1967, 1971; Glaser, 1978, 1992, 1993, 1994a, 1994b, 1996, 1998, 2001, 2003, 2004), second generation Hispanic presidents and chancellors in higher education were studied to discover how they continually try to resolve second culture-coping challenges, the…

  13. A Case Study Showing Parameters Affecting the Quality of Education: Faculty Perspective

    Science.gov (United States)

    Kumari, Neeraj

    2014-01-01

    The study aims to examine the faculty members' perspective (age Wise, Gender Wise and Work Experience wise) of parameters affecting the quality of education in an affiliated Undergraduate Engineering Institution in Haryana. It is a descriptive type of research. The data has been collected with the help of 'Questionnaire Based Survey'. The sample…

  14. Taking the Show on the Road in Holding Academic Classes in Community Agencies: Exploratory Study Findings

    Science.gov (United States)

    Katz, Ellen; Serbinski, Sarah; Mishna, Faye

    2017-01-01

    Social work educators often teach students clinical knowledge within a university classroom, whereas students tend to learn clinical practice through their practicum experiences. This article describes data from a cross-sectional, mixed-method study on one way to effectively bridge the gap between teaching clinical knowledge and practice to…

  15. Prognostic factors of overall survival and cancer-specific survival in patients with resected early-stage rectal adenocarcinoma: a SEER-based study.

    Science.gov (United States)

    Lee, Ko-Chao; Chung, Kuan-Chih; Chen, Hong-Hwa; Liu, Chia-Cheng; Lu, Chien-Chang

    2017-12-01

    The benefits of radiotherapy for colorectal cancer are well documented, but the impact of adjuvant radiotherapy on early-stage rectal adenocarcinoma remains unclear. This study aimed to identify predictors of overall survival (OS) and cancer-specific survival (CSS) in patients with stage II rectal adenocarcinoma treated with preoperative or postoperative radiation therapy. Patients with early-stage rectal adenocarcinoma in the postoperative state were identified using the Surveillance, Epidemiology, and End Results database. The primary endpoints were OS and overall CSS. Stage IIA patients without radiotherapy had significantly lower OS and CSS compared with those who received radiation before or after surgery. Stage IIB patients with radiotherapy before surgery had significantly higher OS and CSS compared with patients in the postoperative or no radiotherapy groups. Patients with signet ring cell carcinoma had the poorest OS among all the groups. Multivariable analysis showed that ethnicity (HR, 0.388, p=0.006) and radiation before surgery (HR, 0.614, p=0.006) were favorable prognostic factors for OS, while age (HR, 1.064, pstage IIB (HR, 3.011, p=0.011), and more than one tumor deposit (TD) (HR, 2.300, p=0.001) were unfavorable prognostic factors for OS. Old age (HR, 1.047, pstage IIB (HR, 8.619, p=0.005), circumferential resection margin between 0.1 mm and 10 mm (HR, 1.529, p=0.039), and more than one TD (HR, 2.688, p=0.001) were unfavorable prognostic factors for CSS. This population-based study identified predictors of OS and CSS in patients with early-stage resected rectal adenocarcinoma, which may help to guide future management of this patient population. © American Federation for Medical Research (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. On differences in radiosensitivity estimation: TCP experiments versus survival curves. A theoretical study.

    Science.gov (United States)

    Stavrev, Pavel; Stavreva, Nadejda; Ruggieri, Ruggero; Nahum, Alan

    2015-08-07

    We have compared two methods of estimating the cellular radiosensitivity of a heterogeneous tumour, namely, via cell-survival and via tumour control probability (TCP) pseudo-experiments. It is assumed that there exists intra-tumour variability in radiosensitivity and that the tumour consists predominantly of radiosensitive cells and a small number of radio-resistant cells.Using a multi-component, linear-quadratic (LQ) model of cell kill, a pseudo-experimental cell-survival versus dose curve is derived. This curve is then fitted with a mono-component LQ model describing the response of a homogeneous cell population. For the assumed variation in radiosensitivity it is shown that the composite pseudo-experimental survival curve is well approximated by the survival curve of cells with uniform radiosensitivity.For the same initial cell radiosensitivity distribution several pseudo-experimental TCP curves are simulated corresponding to different fractionation regimes. The TCP model used accounts for clonogen proliferation during a fractionated treatment. The set of simulated TCP curves is then fitted with a mono-component TCP model. As in the cell survival experiment the fit with a mono-component model assuming uniform radiosensitivity is shown to be highly acceptable.However, the best-fit values of cellular radiosensitivity produced via the two methods are very different. The cell-survival pseudo-experiment yields a high radiosensitivity value, while the TCP pseudo-experiment shows that the dose-response is dominated by the most resistant sub-population in the tumour, even when this is just a small fraction of the total.

  17. Kemampuan Menulis Melalui Show Not Tell Dalam Pendekatan Quantum Learning (Studi pada Madrasah Ibtidaiyah Kartoharjo Madiun

    Directory of Open Access Journals (Sweden)

    Elen Inderasari

    2016-12-01

    Full Text Available This research serves an analysis for depicting: 1 the writing skill onexperiences can be developed through quantum learning approach for thestudents of fifth grade, Madrasah Ibtidaiyah, Kartoharjo, Madiun, 2 theimpacts of the implementation of quantum learning approach for thestudents of fifth grade, Islamic State Elementary School, Kartoharjo,Municipality of Madiun, 3 the efforts of teachers in developing students’writing skill on experiences in learning Bahasa Indonesia. This researchmakes use of Classroom Action Research under the collaboration of theresearcher, the teachers and the students. The analysis brings aboutconclusions that quantum learning approach has a significant influence onthe development of students’ writing skill and learning activity for thestudents of fifth grade of State Elementary School 03 Kanigoro, Kartoharjo,Municipality of Madiun. The reflection through indicators shows that: 1students make development in their learning activity, 2 under quantumlearning approach, teachers are capable of generating students’ learningmotivation, 3 teachers are comfortable in implementing quantum learningapproach, 4 teachers are capable of managing the class well, and 5 studentsgrades up writing skill scores through report, by 65.2 in pretest, 71.9 in testand 75.6 in posttest in average.

  18. Impact of scalp location on survival in head and neck melanoma: A retrospective cohort study.

    Science.gov (United States)

    Xie, Charles; Pan, Yan; McLean, Catriona; Mar, Victoria; Wolfe, Rory; Kelly, John

    2017-03-01

    Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere. We sought to describe the survival of patients with scalp melanoma versus other cutaneous head and neck melanoma (CHNM), and explore a possible independent negative impact of scalp location on CHNM survival. A retrospective cohort study was performed of all invasive primary CHNM cases seen at a tertiary referral center over a 20-year period. Melanoma-specific survival (MSS) was compared between scalp melanoma and other invasive CHNM. Multivariable Cox proportional hazards regression was performed to determine associations with survival. On univariate analysis, patients with scalp melanoma had worse MSS than other CHNM (hazard ratio 2.22, 95% confidence interval 1.59-3.11). Scalp location was not associated with MSS in CHNM on multivariable analysis (hazard ratio 1.11, 95% confidence interval 0.77-1.61) for all tumors together, but remained independently associated with MSS for the 0.76- to 1.50-mm thickness stratum (hazard ratio 5.51, 95% confidence interval 1.55-19.59). Disease recurrence was not assessed because of unavailable data. The poorer survival of scalp melanoma is largely explained by greater Breslow thickness and a higher proportion of male patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  19. National database study of survival of pediatric congenital heart disease patients in Taiwan.

    Science.gov (United States)

    Yeh, Shu-Jen; Chen, Hui-Chi; Lu, Chun-Wei; Wang, Jou-Kou; Huang, Li-Min; Huang, Shin-Chung; Huang, San-Kuei; Wu, Mei-Hwan

    2015-02-01

    The incidence of congenital heart disease (CHD) and severe CHD is 13.08 and 1.51/1000 live births, respectively, in Taiwan, which has had national health insurance since 1995 and child health indices similar to those in the US. This study sought to further elucidate the fatality of CHD patients and their survival from a national database. From the national health insurance database 2000-2010, we retrieved data from CHD patients who were diagnosed at age pediatric CHD patients were identified. The overall prevalence of CHD was 1288 per 100 000 live-births. Severe CHD (tetralogy of Fallot (4.4%), transposition of the great arteries (1.6%) and double outlet right ventricle (1.1%)) accounted for 11.5% of all cases. The 1-month/5-year survival in simple and severe CHD was 99.1%/97.5% and 90.2%/76.4%, respectively (p heart syndrome (19.7%), followed by transposition of the great arteries (66.7%), double outlet right ventricle (69.0%), and common ventricle (66.0%). The 5-year survival of the birth cohort in the same study period was 99.3%. This national database study revealed that the survival of children with simple CHD was still slightly lower than that of the general population and the survival of severe CHD patients, though only accounting for one-tenth of CHD cases, remained unsatisfactory. Such survival profiles are similar to those from Western reports and warrant a refined and dedicated medical care program for children with CHD. Copyright © 2012. Published by Elsevier B.V.

  20. Additive survival least square support vector machines: A simulation study and its application to cervical cancer prediction

    Science.gov (United States)

    Khotimah, Chusnul; Purnami, Santi Wulan; Prastyo, Dedy Dwi; Chosuvivatwong, Virasakdi; Sriplung, Hutcha

    2017-11-01

    Support Vector Machines (SVMs) has been widely applied for prediction in many fields. Recently, SVM is also developed for survival analysis. In this study, Additive Survival Least Square SVM (A-SURLSSVM) approach is used to analyze cervical cancer dataset and its performance is compared with the Cox model as a benchmark. The comparison is evaluated based on the prognostic index produced: concordance index (c-index), log rank, and hazard ratio. The higher prognostic index represents the better performance of the corresponding methods. This work also applied feature selection to choose important features using backward elimination technique based on the c-index criterion. The cervical cancer dataset consists of 172 patients. The empirical results show that nine out of the twelve features: age at marriage, age of first getting menstruation, age, parity, type of treatment, history of family planning, stadium, long-time of menstruation, and anemia status are selected as relevant features that affect the survival time of cervical cancer patients. In addition, the performance of the proposed method is evaluated through a simulation study with the different number of features and censoring percentages. Two out of three performance measures (c-index and hazard ratio) obtained from A-SURLSSVM consistently yield better results than the ones obtained from Cox model when it is applied on both simulated and cervical cancer data. Moreover, the simulation study showed that A-SURLSSVM performs better when the percentage of censoring data is small.

  1. "Show me the money": a fair criticism of economic studies on inhaled bronchodilators for COPD.

    Science.gov (United States)

    Kostikas, Konstantinos; Bouros, Demosthenes

    2010-09-15

    Chronic obstructive pulmonary disease (COPD) represents a significant burden for healthcare systems that is expected to grow further in the future. Inhaled long-acting bronchodilators, including tiotropium, represent the cornerstone of management of COPD patients. Economic studies evaluating the cost-effectiveness ratio of inhaled bronchodilators have to take into account several parameters, including the reduction of COPD exacerbations and related hospitalizations, as well as disease modification and improvement in quality of life and mortality. At an era when the healthcare resources are unlikely to grow as quickly as demand, economic analyses remain the cornerstone for the justification of the broad use of medication with an acceptable cost-effectiveness ratio. The greatest importance of such studies in COPD is the identification of subgroups of patients that will have the most benefit with an acceptable cost-effectiveness ratio for the healthcare providers. The development of models that will incorporate a global evaluation of the different aspects of this multi-component disease, in order to provide the best available care to each individual patient is urgently needed.

  2. Survival after radical prostatectomy for clinically localised prostate cancer: a population-based study

    DEFF Research Database (Denmark)

    Røder, MA; Brasso, K; Christensen, IJ

    2014-01-01

    hazard of all-cause and prostate cancer-specific mortality after 10 years was 15.4% (95% confide3nce interval [CI] 13.2-17.7) and 6.6% (95% CI 4.9-8.2) respectively. CONCLUSIONS: We present the first survival analysis of a complete, nationwide cohort of men undergoing RP for localised prostate cancer......OBJECTIVES: To describe survival and cause of death in a nationwide cohort of Danish patients with prostate cancer undergoing radical prostatectomy (RP). To describe risk factors associated with prostate cancer mortality. PATIENTS AND METHODS: Observational study of 6489 men with localised prostate...... cancer treated with RP at six different hospitals in Denmark between 1995 and 2011. Survival was described using Kaplan-Meier estimates. Causes of death were obtained from the national registry and cross-checked with patient files. Cumulative incidence of death, any cause and prostate cancer...

  3. Excellent survival after liver transplantation for isolated polycystic liver disease: an European Liver Transplant Registry study

    DEFF Research Database (Denmark)

    van Keimpema, Loes; Nevens, Frederik; Adam, René

    2011-01-01

    Patients with end-stage isolated polycystic liver disease (PCLD) suffer from incapacitating symptoms because of very large liver volumes. Liver transplantation (LT) is the only curative option. This study assesses the feasibility of LT in PCLD. We used the European Liver Transplant Registry (ELTR......) database to extract demographics and outcomes of 58 PCLD patients. We used Kaplan-Meier survival analysis for survival rates. Severe abdominal pain (75%) was the most prominent symptom, while portal hypertension (35%) was the most common complication in PCLD. The explantation of the polycystic liver...

  4. Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study.

    Directory of Open Access Journals (Sweden)

    Daria Gotti

    Full Text Available OBJECTIVES: We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC or non-AIDS-defining cancer (NADC diagnosis in the modern cART era. METHODS: Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model. RESULTS: Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51% were ADCs and 431 (49% were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017. Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001. Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14% than lung cancer (1-year survival: 28%±8.7%, liver cancer (5-year survival: 31.9%±6.4% or Hodgkin lymphoma (10-year survival: 24.8%±11.2%. Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs. CONCLUSIONS: cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group.

  5. Showing Where To Go by Maps or Pictures: An Empirical Case Study at Subway Exits

    Science.gov (United States)

    Ishikawa, Toru; Yamazaki, Tetsuo

    This study empirically examined the effectiveness of different methods of presenting route information on a mobile navigation sysyem, for accurate and effortless orientation at subway exits. Specifically, it compared participants’ spatial orientation performance with pictures and maps, in relation to the levels of their spatial ability. Participants identified the directions toward the goals after coming onto the ground faster when viewing pictures than when viewing maps. Spatial orientation with maps was more difficult than that with pictures at exits where body rotation was necessary, especially for people with low mental-rotation ability. In contrast, pictures were equally effective for people with low and high mental-rotation ability. Reasons for the effectiveness of pictures and possibilities of using other presentation formats are discussed.

  6. Mindful Yoga Pilot Study Shows Modulation of Abnormal Pain Processing in Fibromyalgia Patients.

    Science.gov (United States)

    Carson, James W; Carson, Kimberly M; Jones, Kim D; Lancaster, Lindsay; Mist, Scott D

    2016-01-01

    Published findings from a randomized controlled trial have shown that Mindful Yoga training improves symptoms, functional deficits, and coping abilities in individuals with fibromyalgia and that these benefits are replicable and can be maintained 3 months post-treatment. The aim of this study was to collect pilot data in female fibromyalgia patients (n = 7) to determine if initial evidence indicates that Mindful Yoga also modulates the abnormal pain processing that characterizes fibromyalgia. Pre- and post-treatment data were obtained on quantitative sensory tests and measures of symptoms, functional deficits, and coping abilities. Separation test analyses indicated significant improvements in heat pain tolerance, pressure pain threshold, and heat pain after-sensations at post-treatment. Fibromyalgia symptoms and functional deficits also improved significantly, including physical tests of strength and balance, and pain coping strategies. These findings indicate that further investigation is warranted into the effect of Mindful Yoga on neurobiological pain processing.

  7. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    Science.gov (United States)

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given the likelihood of long-term survival.

  8. A Feasibility Study Showing [(68)Ga]Citrate PET Detects Prostate Cancer.

    Science.gov (United States)

    Behr, Spencer C; Aggarwal, Rahul; Seo, Youngho; Aparici, Carina M; Chang, Emily; Gao, Kenneth T; Tao, Dora H; Small, Eric J; Evans, Michael J

    2016-12-01

    The management of advanced or recurrent prostate cancer is limited in part by the lack of effective imaging agents. Metabolic changes in prostate cancer have previously been exploited for imaging, culminating in the recent US FDA approval of [(11)C]choline for the detection of subclinical recurrent disease after definitive local therapy. Despite this milestone, production of [(11)C]choline requires an on-site cyclotron, limiting the scope of medical centers at which this scan can be offered. In this pilot study, we tested whether prostate cancer could be imaged with positron emission tomography (PET) using [(68)Ga]citrate, a radiotracer that targets iron metabolism but is produced without a cyclotron. Eight patients with castrate-resistant prostate cancer were enrolled in this single-center feasibility study. All patients had evidence of metastatic disease by standard of care imaging [X-ray computed tomography (CT), bone scan, or magnetic resonance imaging (MRI)] prior to PET with [(68)Ga]citrate. Patients were intravenously injected with increasing doses of [(68)Ga]citrate (136.9 to a maximum of 259 MBq). Uptake time was steadily increased from 1 h to approximately 3.5 h for the final 4 patients, and all patients were imaged with a PET/MRI. Qualitative and semi-quantitative (maximum standardized uptake value (SUVmax)) assessment of the metastatic lesions was performed and compared to the standard of care imaging. At 1- and 2-h imaging times post injection, there were no detectable lesions with [(68)Ga]citrate PET. At 3- to 4-h uptake time, there were a total of 71 [(68)Ga]citrate-positive lesions (67 osseous, 1 liver, and 3 lymph node). Of these, 65 lesions were visible on the standard of care imaging (CT and/or bone scan). One PET-avid osseous vertebral body metastasis was not apparent on either CT or bone scan. Twenty-five lesions were not PET-avid but seen on CT and bone scan (17 bone, 6 lymph node, 1 pleural, and 1 liver). The average of the maximum SUVs

  9. Melia azedarach plants show tolerance properties to water shortage treatment: an ecophysiological study.

    Science.gov (United States)

    Dias, Maria Celeste; Azevedo, Carla; Costa, Maria; Pinto, Glória; Santos, Conceição

    2014-02-01

    Candidate species for reforestation of areas prone to drought must combine water stress (WS) tolerance and economic or medicinal interest. Melia azedarach produces high quality timber and has insecticidal and medicinal properties. However, the impact of WS on M. azedarach has not yet been studied. Two-month old M. azedarach plants were exposed to WS during 20 days. After this period, plant's growth, water potential, photosynthetic performance and antioxidant capacity were evaluated. WS did not affect plants' growth, but induced stomatal closure, reduced net CO₂ assimilation rate (A) and the intercellular CO₂ availability in mesophyll (C(i)). WS also reduced the photosynthetic efficiency of PSII but not the pigment levels. WS up-regulated the antioxidant enzymes and stimulated the production of antioxidant metabolites, preventing lipid peroxidation. Therefore, despite some repression of photosynthetic parameters by WS, they did not compromise plant growth, and plants increased their antioxidant capacity. Our data demonstrate that M. azedarach juvenile plants have the potential to acclimate to water shortage conditions, opening new perspectives to the use of this species in reforestation/afforestation programs of drought prone areas. Copyright © 2014. Published by Elsevier Masson SAS.

  10. Patients with bipolar disorder show differential executive dysfunctions: A case-control study.

    Science.gov (United States)

    Leung, Meranda M W; Lui, Simon S Y; Wang, Ya; Tsui, Chi F; Au, Angie C W; Yeung, Hera K H; Yang, Tian-Xiao; Li, Zhi; Cheng, Chi-Wai; Cheung, Eric F C; Chan, Raymond C K

    2016-04-30

    Executive deficits in euthymic bipolar I disorder were examined in a fractionated manner based on the "Supervisory Attentional System" (SAS) model, and the relationship between the degree of executive impairment and the demographic and clinical characteristics of bipolar I participants was explored. A battery of neurocognitive tests capturing specific components of executive function was administered on 30 patients with bipolar I disorder in euthymic state, and compared with 30 healthy controls who were matched by age, gender and IQ. A differential impairment in executive function was demonstrated in euthymic bipolar I participants by using a fractionated approach of the SAS. Euthymic bipolar I patients were found to have significantly poorer performance in immediate and delayed visual memory; and in the executive domains of "initiation", "sustained attention", and "attention allocation and planning". Those with a greater number of executive impairments had lower IQ and higher negative sub-scores on PANSS. These findings might provide a the basis for further studies on identifying the executive components that are associated with particular disease characteristics of bipolar disorder, and those with poorer functional outcome, so that rehabilitation can be focused on the selective domains concerned. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Beyond Survival to Thrival: A Narrative Study of an Urban Teacher's Career Journey

    Science.gov (United States)

    Valtierra, Kristina M.

    2013-01-01

    Teacher burn out contributes to the epidemic of early career exit. At least half of all new K-12 teachers leave the profession by the time they reach their fifth year of teaching. Conversely, there are urban teachers who survive burn out and thrive as career-long educators. This qualitative study is an in-depth look into one 40-year veteran…

  12. Specialized care and survival of ovarian cancer patients in The Netherlands: Nationwide cohort study

    NARCIS (Netherlands)

    F. Vernooij (Flora); A.P.M. Heintz (Peter); P.O. Witteveen (Petronella); M. van der Heiden-Van der Loo (Margriet); J.W.W. Coebergh (Jan Willem); Y. van der Graaf (Yolanda)

    2008-01-01

    textabstractBackground: There is much debate on the necessity of regionalization of ovarian cancer care. We investigated the association between hospital type and survival of patients with ovarian cancer in The Netherlands. Methods: A retrospective, population-based cohort study was performed on all

  13. Changing Survival Rate of Infants Born Before 26 Gestational Weeks; Single-centre study

    Directory of Open Access Journals (Sweden)

    Asad Rahman

    2015-08-01

    Full Text Available Objectives: This study aimed to evaluate the changing survival rate and morbidities among infants born before 26 gestational weeks at the Sultan Qaboos University Hospital (SQUH in Muscat, Oman. Methods: This retrospective study assessed the mortality and morbidities of all premature infants born alive at 23–26 gestational weeks at SQUH between June 2006 and May 2013. Infants referred to SQUH within 72 hours of birth during this period were also included. Electronic records were reviewed for gestational age, gender, birth weight, maternal age, mode and place of delivery, antenatal steroid administration, morbidity and outcome. The survival rate was calculated and findings were then compared with those of a previous study conducted in the same hospital from 1991 to 1998. Rates of major morbidities were also calculated. Results: A total of 81 infants between 23–26 gestational weeks were admitted to the neonatal unit during the study period. Of these, 58.0% were male and 42.0% were female. Median gestational age was 25 weeks and mean birth weight was 770 ± 150 g. Of the 81 infants, 49 survived. The overall survival rate was 60.5% compared to 41% reported in the previous study. Respiratory distress syndrome (100.0%, retinopathy of prematurity (51.9%, bronchopulmonary dysplasia (34.6%, intraventricular haemorrhage (30.9% and patent ductus arteriosus (28.4% were the most common morbidities. Conclusion: The overall survival rate of infants between 23–26 gestational weeks during the study period had significantly improved in comparison to that found at the same hospital from 1991 to 1998. There is a need for the long-term neurodevelopmental follow-up of premature infants.

  14. Analyzing age-specific genetic effects on human extreme age survival in cohort-based longitudinal studies

    DEFF Research Database (Denmark)

    Tan, Qihua; Jacobsen, Rune; Sørensen, Mette

    2013-01-01

    The analysis of age-specific genetic effects on human survival over extreme ages is confronted with a deceleration pattern in mortality that deviates from traditional survival models and sparse genetic data available. As human late life is a distinct phase of life history, exploring the genetic...... effects on extreme age survival can be of special interest to evolutionary biology and health science. We introduce a non-parametric survival analysis approach that combines population survival information with individual genotype data in assessing the genetic effects in cohort-based longitudinal studies...

  15. Factors driving inequality in prostate cancer survival: a population based study.

    Directory of Open Access Journals (Sweden)

    Richéal M Burns

    Full Text Available PURPOSE: As cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s i.e. private versus public status. METHODS: Data were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998-2009 (N = 26,183. A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality. RESULTS: Older individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors. CONCLUSION: The role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation.

  16. Impact of Sodium Chloride and Heat on Survival Time of Linguatula Serrata Nymphs in vitro: An Experimental Study

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    B. Hajimohammadi

    2012-07-01

    Full Text Available Introduction: Linguatula serrata is a zoonotic parasite, belonging to the class Pentastomida. The major aim of this study was to evaluate the impact of sodium chloride (NaCl and heat on survival time of Linguatula serrata nymphs. Materials & Methods: Thirty nymphs (10 in triplicate were separately transferred to plastic tubes, containing different concentrations of NaCl solution (2%, 5% and 10%. Meanwhile, 30 nymphs in tubes containing Phosphate Buffer Saline (PBS were separately treated by +50°C, +60°C and +72°C. As control group, thirty nymphs were stored in PBS at +4°C. The effects of different conditions on survival time of the nymphs were evaluated by observing their motility in different periods of time. Results: The survival time of the nymphs stored in 10% NaCl solution was too short and all of them were dead after 3 hours. But the other ones maintained in 2% NaCl solution were significantly more resistant (p<0.05 and were survived for 2 days. All the nymphs pertaining to each +60°C and +72°C treatments were found dead after first 5-minute storage interval; the nymphs stored at +50°C died totally after 20 minutes. The nymphs maintained in PBS at +4°C (control group showed the longest survival time (p<0.05; all of them were alive until day 4 and the last ones died on day 34. Conclusion: It is concluded that salting and heating have significant parasiticidal effects on L. serrata nymphs and could be used as disinfecting methods in processing of meat products especially liver. However, refrigeration at +4°C increases the resistance of the nymphs in meat products and therefore might endanger the food safety.

  17. The survival time of chocolates on hospital wards: covert observational study.

    Science.gov (United States)

    Gajendragadkar, Parag R; Moualed, Daniel J; Nicolson, Phillip L R; Adjei, Felicia D; Cakebread, Holly E; Duehmke, Rudolf M; Martin, Claire A

    2013-12-14

    To quantify the consumption of chocolates in a hospital ward environment. Multicentre, prospective, covert observational study. Four wards at three hospitals (where the authors worked) within the United Kingdom. Boxes of Quality Street (Nestlé) and Roses (Cadbury) on the ward and anyone eating these chocolates. Observers covertly placed two 350 g boxes of Quality Street and Roses chocolates on each ward (eight boxes were used in the study containing a total of 258 individual chocolates). These boxes were kept under continuous covert surveillance, with the time recorded when each chocolate was eaten. Median survival time of a chocolate. 191 out of 258 (74%) chocolates were observed being eaten. The mean total observation period was 254 minutes (95% confidence interval 179 to 329). The median survival time of a chocolate was 51 minutes (39 to 63). The model of chocolate consumption was non-linear, with an initial rapid rate of consumption that slowed with time. An exponential decay model best fitted these findings (model R(2)=0.844, Pchocolates to be eaten) of 99 minutes. The mean time taken to open a box of chocolates from first appearance on the ward was 12 minutes (95% confidence interval 0 to 24). Quality Street chocolates survived longer than Roses chocolates (hazard ratio for survival of Roses v Quality Street 0.70, 95% confidence interval 0.53 to 0.93, P=0.014). The highest percentages of chocolates were consumed by healthcare assistants (28%) and nurses (28%), followed by doctors (15%). From our observational study, chocolate survival in a hospital ward was relatively short, and was modelled well by an exponential decay model. Roses chocolates were preferentially consumed to Quality Street chocolates in a ward setting. Chocolates were consumed primarily by healthcare assistants and nurses, followed by doctors. Further practical studies are needed.

  18. Incident Atrial Fibrillation and Disability-Free Survival in the Cardiovascular Health Study.

    Science.gov (United States)

    Wallace, Erin R; Siscovick, David S; Sitlani, Colleen M; Dublin, Sascha; Mitchell, Pamela H; Odden, Michelle C; Hirsch, Calvin H; Thielke, Stephen; Heckbert, Susan R

    2016-04-01

    To assess the associations between incident atrial fibrillation (AF) and disability-free survival and risk of disability. Prospective cohort study. Cardiovascular Health Study. Individuals aged 65 and older and enrolled in fee-for-service Medicare followed between 1991 and 2009 (MN = 4,046). Individuals with prevalent AF, activity of daily living (ADL) disability, or a history of stroke or heart failure at baseline were excluded. Incident AF was identified according to annual study electrocardiogram, hospital discharge diagnosis, or Medicare claims. Disability-free survival was defined as survival free of ADL disability (any difficulty or inability in bathing, dressing, eating, using the toilet, walking around the home, or getting out of a bed or chair). ADLs were assessed at annual study visits or in a telephone interview. Association between incident AF and disability-free survival or risk of disability was estimated using Cox proportional hazards models. Over an average of 7.0 years of follow-up, 660 individuals (16.3%) developed incident AF, and 3,112 (77%) became disabled or died. Incident AF was associated with shorter disability-free survival (hazard ratio (HR) for death or ADL disability = 1.71, 95% confidence interval (CI) = 1.55-1.90) and a higher risk of ADL disability (HR = 1.36, 95% CI = 1.18-1.58) than in individuals with no history of AF. This association persisted after adjustment for interim stroke and heart failure. These results suggest that AF is a risk factor for shorter functional longevity in older adults, independent of other risk factors and comorbid conditions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  19. Effects of Rosmarinus officinalis on the survivability of random-patterned skin flaps: an experimental study.

    Science.gov (United States)

    Ince, Bilsev; Yildirim, Alpagan Mustafa; Okur, Mehmet Ihsan; Dadaci, Mehmet; Yoruk, Ebru

    2015-04-01

    Improving survival of skin flaps used in soft-tissue reconstruction is clinically an important goal, and several systemic and local agents have been used for this purpose. However, a substance that prevents the flap necrosis has not yet been defined. This study aimed to investigate whether a Rosmarinus officinalis extract could improve the skin flap survival. In this study, 21 Wistar albino rats were divided into three groups. Rectangular 8 × 2 cm random-pattern flaps were elevated from the back of the rats. Group I was considered the control group. In Group II, a 0.5-cc of Rosmarinus officinalis oil was applied with an ear bud to the flap area 30 minutes before the flap elevation. After suturing the flaps to their location, the oil was administered twice a day for a week. In Group III, 0.5 cc of the oil was applied twice a day to the area that was elevated for a week until surgery. At the end of the week, the flaps were sutured to their location, and wiped postoperatively twice a day for a week with the oil. Mean percentage of these areas was found to be 29.81%, 58.99%, and 67.68% in Group I, Group II, and Group III, respectively. The mean percentage of the flap survival areas and vessel diameters were significantly greater in the Groups II and III than in the control group (p Rosmarinus officinalis extract can increase the flap survivability.

  20. A retrospective study on related factors affecting the survival rate of dental implants

    Science.gov (United States)

    Kang, Jeong-Kyung; Lee, Ki; Lee, Yong-Sang; Park, Pil-Kyoo

    2011-01-01

    PURPOSE The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 ± 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P.05). CONCLUSION Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival. PMID:22259704

  1. Extracorporeal life support with left ventricular decompression—improved survival in severe cardiogenic shock: results from a retrospective study

    Directory of Open Access Journals (Sweden)

    Bastian Schmack

    2017-09-01

    Full Text Available Objective Extracorporeal life support (ECLS is a life-saving procedure used in the treatment of severe cardiogenic shock. Within this retrospective single centre study, we examined our experience in this critically ill patient cohort to assess outcomes and clinical parameters by comparison of ECLS with or without selective left ventricular decompression. Methods Between 2004 and 2014 we evaluated 48 adult patients with INTERMACS level 1 heart failure (age 49.7 ± 19.5 years, who received either central ECLS with (n = 20, 41.7% or ECLS without (n = 28, 58.3%, including 10 peripheral ECLS integrated left ventricular vent in our retrospective single centre trial. Results Follow up was 100% with a mean of 0.83 ± 1.85 years. Bridge to ventricular assist device was feasible in 29.2% (n = 14, bridge to transplant in 10.4% (n = 5 and bridge to recovery in 8.3% (n = 4. Overall 30-day survival was 37.5%, 6-month survival 27.1% and 1-year survival 25.0%. ECLS support with left ventricular decompression showed favourable 30-day survival compared to ECLS without left ventricular decompression (p = 0.034. Thirty-day as well as long-term survival did not differ between the subgroups (central ECLS with vent, ECLS without vent and peripheral ECLS without vent. Multivariate logistic regression adjusted for age and gender revealed ECLS without vent as independent factor influencing 30-day survival. Conclusion ECLS is an established therapy for patients in severe cardiogenic shock. Independent of the ECLS approach, 30-day mortality is still high but with superior 30-day survival for patients with ECLS and left ventricular venting. Moreover, by unloading the ventricle, left ventricular decompression may provide an important time window for recovery or further treatment, such as bridge to bridge or bridge to transplant.

  2. A synthesis of tagging studies examining the behaviour and survival of anadromous salmonids in marine environments.

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    S Matthew Drenner

    Full Text Available This paper synthesizes tagging studies to highlight the current state of knowledge concerning the behaviour and survival of anadromous salmonids in the marine environment. Scientific literature was reviewed to quantify the number and type of studies that have investigated behaviour and survival of anadromous forms of Pacific salmon (Oncorhynchus spp., Atlantic salmon (Salmo salar, brown trout (Salmo trutta, steelhead (Oncorhynchus mykiss, and cutthroat trout (Oncorhynchus clarkii. We examined three categories of tags including electronic (e.g. acoustic, radio, archival, passive (e.g. external marks, Carlin, coded wire, passive integrated transponder [PIT], and biological (e.g. otolith, genetic, scale, parasites. Based on 207 papers, survival rates and behaviour in marine environments were found to be extremely variable spatially and temporally, with some of the most influential factors being temperature, population, physiological state, and fish size. Salmonids at all life stages were consistently found to swim at an average speed of approximately one body length per second, which likely corresponds with the speed at which transport costs are minimal. We found that there is relatively little research conducted on open-ocean migrating salmonids, and some species (e.g. masu [O. masou] and amago [O. rhodurus] are underrepresented in the literature. The most common forms of tagging used across life stages were various forms of external tags, coded wire tags, and acoustic tags, however, the majority of studies did not measure tagging/handling effects on the fish, tag loss/failure, or tag detection probabilities when estimating survival. Through the interdisciplinary application of existing and novel technologies, future research examining the behaviour and survival of anadromous salmonids could incorporate important drivers such as oceanography, tagging/handling effects, predation, and physiology.

  3. Effect of diagnostic delay on survival in patients with colorectal cancer: a retrospective cohort study.

    Science.gov (United States)

    Pita-Fernández, Salvador; González-Sáez, Luis; López-Calviño, Beatriz; Seoane-Pillado, Teresa; Rodríguez-Camacho, Elena; Pazos-Sierra, Alejandro; González-Santamaría, Paloma; Pértega-Díaz, Sonia

    2016-08-22

    Disparate and contradictory results make studies necessary to investigate in more depth the relationship between diagnostic delay and survival in colorectal cancer (CRC) patients. The aim of this study is to analyse the relationship between the interval from first symptom to diagnosis (SDI) and survival in CRC. Retrospective study of n = 942 CRC patients. SDI was calculated as the time from the diagnosis of cancer and the first symptoms of CRC. Cox regression was used to estimate five-year mortality hazard ratios as a function of SDI, adjusting for age and gender. SDI was modelled according to SDI quartiles and as a continuous variable using penalized splines. Median SDI was 3.4 months. SDI was not associated with stage at diagnosis (Stage I = 3.6 months, Stage II-III = 3.4, Stage IV = 3.2; p = 0.728). Shorter SDIs corresponded to patients with abdominal pain (2.8 months), and longer SDIs to patients with muchorrhage (5.2 months) and rectal tenesmus (4.4 months). Adjusting for age and gender, in rectum cancers, patients within the first SDI quartile had lower survival (p = 0.003), while in colon cancer no significant differences were found (p = 0.282). These results do not change after adjusting for TNM stage. The splines regression analysis revealed that, for rectum cancer, 5-year mortality progressively increases for SDIs lower than the median (3.7 months) and decreases as the delay increases until approximately 8 months. In colon cancer, no significant relationship was found between SDI and survival. Short diagnostic intervals are significantly associated with higher mortality in rectal but not in colon cancers, even though a borderline significant effect is also observed in colon cancer. Longer diagnostic intervals seemed not to be associated with poorer survival. Other factors than diagnostic delay should be taken into account to explain this "waiting-time paradox".

  4. Trends in treatment and survival for advanced laryngeal cancer: A 20-year population-based study in The Netherlands.

    Science.gov (United States)

    Timmermans, Adriana J; van Dijk, Boukje A C; Overbeek, Lucy I H; van Velthuysen, Marie-Louise F; van Tinteren, Harm; Hilgers, Frans J M; van den Brekel, Michiel W M

    2016-04-01

    The purpose of this study was to determine time trends for primary treatment modalities in advanced laryngeal cancer, overall survival (OS), and laryngectomy-free interval (LFI) over the last 2 decades in The Netherlands. We conducted an analysis of T3 to T4 laryngeal cancer data from 2 combined national (population-based and pathology-based) cancer registries. A total of 2072 T3 cases (14.7%) and 1722 T4 cases (12.2%) were identified. Total laryngectomy as primary treatment modality decreased, whereas radiotherapy (RT) increased. For T3 disease, 5-year OS after primary total laryngectomy (+/- adjuvant RT), RT, and chemoradiotherapy (CRT) was 49%, 47%, and 45%, respectively. For T4 disease, this was 48%, 34%, and 42% (overall p < .0001), respectively. Five-year LFI for T3 disease was 81% (RT) and 77% (CRT), and for T4 disease it was 81% and 87%, respectively. From 1991 to 2010 total laryngectomy as primary treatment modality for advanced laryngeal cancer decreased and RT increased. T3 disease showed similar survival rates for all primary treatment modalities. For T4 disease, total laryngectomy (+ adjuvant RT) showed the best survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1247-E1255, 2016. © 2015 Wiley Periodicals, Inc.

  5. Pre- and post-diagnostic β-blocker use and lung cancer survival: A population-based cohort study.

    Science.gov (United States)

    Weberpals, Janick; Jansen, Lina; Haefeli, Walter E; Hoffmeister, Michael; Wolkewitz, Martin; Herk-Sukel, Myrthe P P van; Vissers, Pauline A J; Brenner, Hermann

    2017-06-06

    Beta-blockers have been associated with decreased cancer mortality. However, evidence for lung cancer is sparse and reported beneficial effects might be based on biased analyses. In this so far largest study we investigated the association between β-blocker use and lung cancer survival. Therefore, patients with a lung cancer diagnosis between April 1998 and December 2011 were selected from a database linkage of the Netherlands Cancer Registry and the PHARMO Database Network. After matching eligible patients on the propensity score, adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were calculated using Cox proportional hazards regression to investigate the association between pre-diagnostic and time-dependent β-blocker use and overall survival. Duration and dose-response analyses and stratified analyses by β-blocker type, histological subgroups and stage were conducted. Of 3,340 eligible lung cancer patients, 1437 (43%) took β-blockers four months prior to diagnosis. Pre-diagnostic β-blocker use was not associated with overall survival (HR 1.00 (0.92-1.08)) in the adjusted model. Time-dependent post-diagnostic analysis showed similar results with a HR of 1.03 (0.94-1.11). Trend analyses showed no association for cumulative dose (HR 0.99 (0.97-1.02)) and cumulative duration (HR 1.00 (0.96-1.05)). In conclusion, β-blocker use is not associated with reduced mortality among lung cancer patients.

  6. Sex differences in cancer survival in Estonia: a population-based study.

    Science.gov (United States)

    Innos, Kaire; Padrik, Peeter; Valvere, Vahur; Aareleid, Tiiu

    2015-02-19

    In Estonia, women have much longer life expectancy than men. The aim of this study was to examine sex differences in cancer survival in Estonia and to explore the role of age at diagnosis, stage at diagnosis and tumour subsite. Using data from the population-based Estonian Cancer Registry, we examined the relative survival of adult patients diagnosed with nine common cancers in Estonia in 1995-2006 and followed up through 2011. Excess hazard ratios (EHR) of death associated with female gender adjusted for age, stage at diagnosis and tumour subsite were estimated. A total of 20 828 male and 13 166 female cases were analysed. The main data quality indicators were similar between men and women. Women had more cases with unknown extent of disease at diagnosis. Overall, the age-adjusted 5-year relative survival ratio was higher among women than men for all studied sites, but the difference was significant for cancers of mouth and pharynx (22% units), lung (5% units), skin melanoma (17% units) and kidney (8% units). The increase in survival over time was larger for women than men for cancers of mouth and pharynx, colon, rectum, kidney and skin melanoma. In multivariate analysis, women had a significantly lower EHR of death within five years after diagnosis for five of the nine cancers studied (cancers of mouth and pharynx, stomach, lung, skin melanoma and kidney). Adjustment for stage and subsite explained some, but not all of the women's advantage. We found a significant female survival advantage in Estonia for cancers of mouth and pharynx, stomach, lung, kidney and skin melanoma. The differences in favour of women tended to increase over time as from the 1990s to the 2000s, survival improved more among women than among men. A large part of the women's advantage is likely attributable to biological factors, but other factors, such as co-morbidities, treatment compliance or health behaviour, are also probable contributors to gender survival disparities in Estonia and

  7. Survival Comparison of Patients With Cystic Fibrosis in Canada and the United States: A Population-Based Cohort Study.

    Science.gov (United States)

    Stephenson, Anne L; Sykes, Jenna; Stanojevic, Sanja; Quon, Bradley S; Marshall, Bruce C; Petren, Kristofer; Ostrenga, Josh; Fink, Aliza K; Elbert, Alexander; Goss, Christopher H

    2017-04-18

    In 2011, the median age of survival of patients with cystic fibrosis reported in the United States was 36.8 years, compared with 48.5 years in Canada. Direct comparison of survival estimates between national registries is challenging because of inherent differences in methodologies used, data processing techniques, and ascertainment bias. To use a standardized approach to calculate cystic fibrosis survival estimates and to explore differences between Canada and the United States. Population-based study. 42 Canadian cystic fibrosis clinics and 110 U.S. cystic fibrosis care centers. Patients followed in the Canadian Cystic Fibrosis Registry (CCFR) and U.S. Cystic Fibrosis Foundation Patient Registry (CFFPR) between 1990 and 2013. Cox proportional hazards models were used to compare survival between patients followed in the CCFR (n = 5941) and those in the CFFPR (n = 45 448). Multivariable models were used to adjust for factors known to be associated with survival. Median age of survival in patients with cystic fibrosis increased in both countries between 1990 and 2013; however, in 1995 and 2005, survival in Canada increased at a faster rate than in the United States (P cystic fibrosis survival between Canada and the United States persisted after adjustment for risk factors associated with survival, except for private-insurance status among U.S. patients. Differential access to transplantation, increased posttransplant survival, and differences in health care systems may, in part, explain the Canadian survival advantage. U.S. Cystic Fibrosis Foundation.

  8. Type 2 Diabetes Mellitus and Glioblastoma Multiforme-Assessing Risk and Survival: Results of a Large Retrospective Study and Systematic Review of the Literature.

    Science.gov (United States)

    Barami, Kaveh; Lyon, Liisa; Conell, Carol

    2017-10-01

    Despite studies showing a positive correlation between type 2 diabetes mellitus (DM2), a modifiable risk factor, and various cancer types, the link remains controversial in the setting of glioblastoma multiforme (GBM). In this study, we assessed whether DM2 and DM2-associated factors were associated with a higher risk of developing GBM and also determined if DM2 affected the survival of patients with GBM. A cross-sectional case-control study of 1144 GBM cases diagnosed between 2000 and 2013 of which 969 patients matched for age and sex was performed to assess the association between DM2, hyperlipidemia, and obesity with the incidence of GBM. A longitudinal study of the patients with GBM was also performed to assess the association between the effect of DM2 and GBM survival. No association was seen between DM2, hyperlipidemia, obesity, and GBM. DM2 was associated with poorer survival in univariate testing yet not in multivariate testing. Diabetic patients with GBM had good glycemic control. Older patients had poorer survival and overall survival improved over years of study. DM2, hyperlipidemia, and obesity were not associated with increased risk of developing GBM, and DM2 itself does not seem to influence survival among these patients. This finding might be related to good glycemic control in this cohort. Survey of the literature consistently shows that hyperglycemia is associated with poorer survival. Our findings suggest that rather than the presence or absence of DM2, glycemic control seems to be more important in the survival of patients with GBM, which warrants future investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Survival in 76 cats with epilepsy of unknown cause: a retrospective study.

    Science.gov (United States)

    Szelecsenyi, Arlette Cornelia; Giger, Urs; Golini, Lorenzo; Mothersill, Ian; Torgerson, Paul R; Steffen, Frank

    2017-11-01

    Survival of cats with epilepsy of unknown cause (EUC) has not been reported. Seizure semiology and its relationship to treatment outcome and survival was studied in a population of 76 cats. A questionnaire for seizure semiology was developed based on experimental data. Seizure semiology was characterised by owner interviews at least one year after discharge. Seizures were classified as (1) primary generalised and (2) focal without and (3) with secondary generalisation. Median age at seizure onset was four (range 0.3-18) years. One-third of cats with EUC presented with primary generalised seizures and 78 per cent of those with initially focal seizures progressed to secondary generalised seizures. Clinical signs of generalised seizures included sudden onset of loss of consciousness and tonic-clonic seizures, while cats with focal seizures had unilateral signs. Antiepileptic drug (AED) therapy was initiated in 62 cats. Complete remission rate was 42 per cent and the median survival time was 3.2 (range 1-11) years with or without AED, and 91 per cent were still alive at the time of interview. Neither semiology nor seizure type predicted survival, response to treatment and outcome in cats with EUC. A seizure-free status of more than 12 months was observed in 79 per cent of cats without AED. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. A prospective study of phobic anxiety, risk of ovarian cancer, and survival among patients.

    Science.gov (United States)

    Poole, Elizabeth M; Kubzansky, Laura D; Sood, Anil K; Okereke, Olivia I; Tworoger, Shelley S

    2016-05-01

    In ovarian cancer patients and mouse models, psychosocial stress is associated with higher circulating markers of angiogenesis and cell migration, impaired immune response, and increasing tumor burden and aggressiveness. In the Nurses' Health Studies (NHS/NHSII), we assessed whether phobic anxiety, a marker of chronic distress, was associated with risk of incident ovarian cancer as well as survival among ovarian cancer patients. We used Cox proportional hazards regression to model the relative risks (RRs) and 95 % confidence intervals (CI) of ovarian cancer incidence and survival by categories of the Crown-Crisp phobic anxiety index (CCI). We identified 779 cases of ovarian cancer during 2,497,892 person-years of follow-up. For baseline CCI (NHS: 1988; NHSII: 1993), we observed a statistically nonsignificant increased risk of epithelial ovarian cancer (RR for CCI ≥ 4 vs. 0 or 1: 1.14; 95 % CI 0.96-1.36). However, when we updated CCI (NHS: 2004; NHSII: 2005), the associations were attenuated. Pre-diagnosis CCI was not associated with ovarian cancer survival (RR for ≥4 vs. 0 or 1: 1.00; 95 % CI 0.77-1.31); results were similar for post-diagnosis CCI. Distress, as measured by phobic anxiety symptoms, was not associated with ovarian cancer risk, although we cannot rule out a modest association. Future research should explore the role of phobic anxiety and other forms of psychological distress and ovarian cancer risk and survival.

  11. Survival in 76 cats with epilepsy of unknown cause: a retrospective study

    Science.gov (United States)

    Szelecsenyi, A.; Giger, U.; Golini, L.; Mothersill, I.; Torgerson, P. R.; Steffen, F.

    2017-01-01

    Survival of cats with epilepsy of unknown cause (EUC) has not been reported. Seizure semiology and its relationship to treatment outcome and survival was studied in a population of 76 cats. A questionnaire for seizure semiology was developed based upon experimental data. Seizure semiology was characterized by owner interviews at least one year after discharge. Seizures were classified as: (1) primary generalized and (2) focal without and (3) with secondary generalization. Median age at seizure onset was four (range 0.3 to 18) years. One third of cats with EUC presented with primary generalized seizures and 78% of those with initially focal seizures progressed to secondary generalized seizures. Clinical signs of generalized seizures included sudden onset of loss of consciousness and tonic-clonic seizures, while cats with focal seizures had unilateral signs. Antiepileptic drug (AED) therapy was initiated in 62 cats. Complete remission rate was 42% and median survival time was 3.2 (range 1 to 11) years with or without AED, and 91% were still alive at the time of interview. Neither semiology nor seizure type predicted survival, response to treatment, and outcome in cats with EUC. A seizure-free status of >12 months was observed in 79% of cats without AED. PMID:29097567

  12. Retrospective Study of the Survival Rates of Indirect Pulp Therapy Versus Different Pulpotomy Medicaments.

    Science.gov (United States)

    Wunsch, Patrice Barsamian; Kuhnen, Marissa M; Best, Al M; Brickhouse, Tegwyn H

    2016-10-15

    The purposes of this retrospective chart review were to determine: (1) how primary molars in need of vital pulp therapy (VPT) have been treated over a period of four years at a university-based pediatric dental practice (UBP); and which treatments-indirect pulp therapy (IPT), formocresol pulpotomy (FCP), and ferric sulfate pulpotomy (FSP)-have been successful. Electronic patient records (axiUm) that contained the procedure codes D3120 (pulp cap-indirect) or D3220 (therapeutic pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures (i.e., extractions [D7140] or pulpectomy [D3221/D3240]). A total of 2,001 primary molar teeth were included in the study. Success was compared using a Kaplan-Meier analysis. At the three-year follow-up, IPT had a 96.2 percent survival rate, FCP had a 65.8 percent survival rate, and FSP had a 62.9 percent survival rate (P<.0001). Over a four-year period of time, IPT became the more commonly used vital pulp therapy treatment at a university-based pediatric dental practice and had a significantly better survival rate than FCP or FSP.

  13. Breast cancer during pregnancy: a retrospective study on obstetrical problems and survival.

    Science.gov (United States)

    Framarino-Dei-Malatesta, Marialuisa; Piccioni, Maria Grazia; Brunelli, Roberto; Iannini, Isabella; Cascialli, Gianluca; Sammartino, Paolo

    2014-02-01

    Breast cancer is one of the most common cancers occurring in pregnancy. Data on survival of these patients and their obstetrical complications are still limited. We conducted a case-control, retrospective study to evaluate the overall survival (OS) of 22 patients with breast cancer in pregnancy (BCP) and 45 non-pregnant women with breast cancer (BC) matched for age, stage and hormonal status. Survival of BCP and BC patients using Kaplan-Meier analysis was similar (86.4% in cases and 80% in controls p=0.392) and BCP patients had survival consistent with the stage of the disease, providing that the treatment had been in agreement with the recommended protocols. The overall incidence of premature delivery was 54.6% and complications were observed in three newborns out of 23 (13%). Preterm labor induction without any obstetrical indication following woman's request to continue chemotherapy outside pregnancy can be reduced by explaining the risks of early delivery and the lack of effects of many chemotherapeutic regimens on the fetus. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Drug survival of fumaric acid esters for psoriasis: a retrospective study.

    Science.gov (United States)

    Ismail, N; Collins, P; Rogers, S; Kirby, B; Lally, A

    2014-08-01

    Fumaric acid esters (FAEs) have been used for over 30 years in the management of psoriasis. To determine drug survival of FAEs in patients with psoriasis, treatment-limiting adverse drug events and the range of effective drug doses. A retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012. Demographic data, length of treatment, reasons for discontinuation of FAEs, side-effects and range of doses were recorded. Two hundred and forty-nine patients [160 (64%) male] were included. The mean age at which FAEs were commenced was 44·5 years (range 17-82 years). The mean length of treatment was 28 months (range 1 week to 106 months). In patients who were commenced on FAEs ≥ 4 years before inclusion in this study, the 4-year drug survival was 60% (64/107). FAEs were discontinued in 146/249 patients (59%); this was due to lack of efficacy in 59/146 (40%) and gastrointestinal upset in 39/146 (27%). A very low dose of FAEs (psoriasis in 26 (10%) patients. The mean treatment duration of these patients was 64 months (range 32-106 months). Fumaric acid esters have a 4-year drug survival rate of 60%, which compares favourably with reported 4-year survival rates of 40% for etanercept and adalimumab and 70% for infliximab. Longer drug survival is more likely in the significant subgroup of patients in whom a very low dose of FAEs is sufficient to control disease. The reasons for this are unclear. © 2014 British Association of Dermatologists.

  15. Concomitant active tuberculosis prolongs survival in non-small cell lung cancer: a study in a tuberculosis-endemic country.

    Directory of Open Access Journals (Sweden)

    Chih-Hsi Kuo

    Full Text Available BACKGROUND: Adjuvant tumor cell vaccine with chemotherapy against non-small cell lung cancer (NSCLC shows limited clinical response. Whether it provokes effective cellular immunity in tumor microenvironment is questionable. Concomitant active tuberculosis in NSCLC (TBLC resembles locoregional immunotherapy of tumor cell vaccine; thus, maximally enriches effective anti-tumor immunity. This study compares the survival and immunological cell profile in TBLC over NSCLC alone. METHODS: Retrospective review of NSCLC patients within 1-year-period of 2007 and follow-up till 2010. RESULTS: A total 276 NSCLC patients were included. The median survival of TBLC is longer than those of NSCLC alone (11.6 vs. 8.8 month, p<0.01. Active tuberculosis is an independent predictor of better survival with HR of 0.68 (95% CI, 0.48 ~ 0.97. Squamous cell carcinoma (SCC (55.8 vs. 31.7%, p<0.01 is a significant risk factor for NSCLC with active TB. The median survival of SCC with active tuberculosis is significantly longer than adenocarcinoma or undetermined NSCLC with TB (14.2 vs. 6.6 and 2.8 months, p<0.05. Active tuberculosis in SCC increases the expression of CD3 (46.4 ± 24.8 vs. 24.0 ± 16.0, p<0.05, CXCR3 (35.1 ± 16.4 vs. 19.2 ± 13.3, p<0.01 and IP-10 (63.5 ± 21.9 vs. 35.5 ± 21.0, p<0.01, while expression of FOXP3 is decreased (3.5 ± 0.5 vs. 13.3 ± 3.7 p<0.05, p<0.05. Survival of SCC with high expression of CD3 (12.1 vs. 3.6 month, p<0.05 and CXCR3 (12.1 vs. 4.4 month, p<0.05 is longer than that with low expression. CONCLUSIONS: Active tuberculosis in NSCLC shows better survival outcome. The effective T lymphocyte infiltration in tumor possibly underlies the mechanism. Locoregional immunotherapy of tumor cell vaccine may deserve further researches.

  16. Factors relating to poor survival rates of aged cervical cancer patients: a population-based study with the relative survival model in Osaka, Japan.

    Science.gov (United States)

    Ioka, Akiko; Ito, Yuri; Tsukuma, Hideaki

    2009-01-01

    Poor survival of older cervical cancer patients has been reported; however, related factors, such as the extent of disease and the competitive risk by aging have not been well evaluated. We applied the relative survival model developed by Dickman et al to resolve this issue. Study subjects were cervical cancer patients retrieved from the Osaka Cancer Registry. They were limited to the 10,048 reported cases diagnosed from 1975 to 1999, based on the quality of data collection on vital status. Age at diagnosis was categorized into or = 65 years. The impact of prognostic factors on 5-year survival was evaluated with the relative survival model, incorporating patients' expected survival in multivariate analysis. The age-specific relative excess risk (RER) of death was significantly higher for older groups as compared with women aged 30-54 years (RER, 1.58 at 55-64 and 2.51 at > or = 65 years). The RER was decreased by 64.8% among the 55-64 year olds as an effect of cancer stage at diagnosis, and by 43.4% among those 65 years old and over. After adding adjustment for treatment modalities, the RER was no longer significantly higher among 55-64 year olds; however, it was still higher among 65 year olds and over. Advanced stage at diagnosis was the main determinant of poor survival among the aged cervical cancer patients, although other factors such as limitations on the combination of treatment were also suggested to have an influence in those aged 65 years and over.

  17. One-Month to 10-Year Survival in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2011-01-01

    year; SSS, age, sex, previous stroke, other complicating diseases, diabetes, smoking, and atrial fibrillation at 5 years; and SSS, age, sex, other complicating diseases, and diabetes at 10 years. Our data suggest that stroke severity is significantly associated with short-term and long-term survival......We studied the association of stroke severity with survival from 1 month to 10 years after stroke and explored how stroke severity interacts with other prognostic indicators with time. The study is based on 999 stroke patients from the community-based Copenhagen Stroke Study (mean age, 74.3 ± 11.......0 years; 56% women; mean Scandinavian Stroke Scale [SSS], 38.0 ± 17.4). Evaluation included stroke severity (based on the SSS), computed tomography scan, and a cardiovascular risk profile. Using logistic regression models, we examined the relevance of the SSS on mortality at 1 month and 1, 5, and 10 years...

  18. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.

    2009-01-01

    -stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset......Background and Purpose: Only few have studied long-term survival after stroke. Such knowledge is essential for the evaluation of the current and future burden of stroke. The present study presents up to 30 years of follow-up of patients after a first-ever stroke. Methods: Participants...... died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression...

  19. Robust prediction of t-year survival with data from multiple studies

    DEFF Research Database (Denmark)

    Cai, T; Gerds, Thomas Alexander; Zheng, Y

    2011-01-01

    of parameters of interest. In this article, we are interested in developing robust prognostic rules for the prediction of t-year survival based on multiple studies. We propose to construct a composite score for prediction by fitting a stratified semiparametric transformation model that allows the studies......Summary Recently meta-analysis has been widely utilized to combine information across multiple studies to evaluate a common effect. Integrating data from similar studies is particularly useful in genomic studies where the individual study sample sizes are not large relative to the number...

  20. Network ties and survival

    DEFF Research Database (Denmark)

    Acheampong, George; Narteh, Bedman; Rand, John

    2017-01-01

    Poultry farming has been touted as one of the major ways by which poverty can be reduced in low-income economies like Ghana. Yet, anecdotally there is a high failure rate among these poultry farms. This current study seeks to understand the relationship between network ties and survival chances...... of small commercial poultry farms (SCPFs). We utilize data from a 2-year network survey of SCPFs in rural Ghana. The survival of these poultry farms are modelled using a lagged probit model of farms that persisted from 2014 into 2015. We find that network ties are important to the survival chances...... but this probability reduces as the number of industry ties increases but moderation with dynamic capability of the firm reverses this trend. Our findings show that not all network ties aid survival and therefore small commercial poultry farmers need to be circumspect in the network ties they cultivate and develop....

  1. Education level and survival after oesophageal cancer surgery: a prospective population-based cohort study.

    Science.gov (United States)

    Brusselaers, Nele; Ljung, Rickard; Mattsson, Fredrik; Johar, Asif; Wikman, Anna; Lagergren, Pernilla; Lagergren, Jesper

    2013-12-03

    This study aimed to investigate whether a higher education level is associated with an improved long-term survival after oesophagectomy for cancer. A prospective, population-based cohort study. Sweden-nationwide. 90% of all patients with oesophageal and cardia cancer who underwent a resection in Sweden in 2001-2005 were enrolled in this study (N=600; 80.3% male) and followed up until death or the end of the study period (2012). The study exposure was level of education, defined as compulsory (≤9 years), moderate (10-12 years) or high (≥13 years). The main outcome measure was overall 5-year survival after oesophagectomy. Cox regression was used to estimate the associations between education level and mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume. The patient group with highest education was used as the reference category. Among the 600 included patients, 281 (46.8%) had compulsory education, 238 (39.7%) had moderate education and 81 (13.5%) had high education. The overall 5-year survival rate was 23.1%, 24.4% and 32.1% among patients with compulsory, moderate and high education, respectively. After adjustment for confounders, a slightly higher, yet not statistically significantly increased point HR was found among the compulsory educated patients (HR 1.08, 95% CI 0.80 to 1.47). In patients with tumour stage IV, increased adjusted HRs were found for compulsory (HR 2.88, 95% CI 1.07 to 7.73) and moderately (HR 2.83, 95% CI 1.15 to 6.95) educated patients. No statistically significant associations were found for the other tumour stages. This study provides limited evidence of an association between lower education and worse long-term survival after oesophagectomy for cancer.

  2. Yttrium-90 Radioembolization for Unresectable Standard-chemorefractory Intrahepatic Cholangiocarcinoma: Survival, Efficacy, and Safety Study

    Energy Technology Data Exchange (ETDEWEB)

    Rafi, Shoaib; Piduru, Sarat M. [Emory University School of Medicine, Division of Interventional Radiology and Image Guided Medicine, Department of Radiology (United States); El-Rayes, Bassel; Kauh, John S. [Emory University School of Medicine, Department of Hematology and Medical Oncology (United States); Kooby, David A.; Sarmiento, Juan M. [Emory University School of Medicine, Department of Surgical Oncology in Surgery (United States); Kim, Hyun S., E-mail: kevin.kim@emory.edu [Emory University School of Medicine, Division of Interventional Radiology and Image Guided Medicine, Department of Radiology (United States)

    2013-04-15

    To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC). Patients with unresectable standard-chemorefractory ICC treated with Y90 were studied. Survival was calculated from the date of first Y90 procedure. Tumor response was assessed with the Response Evaluation Criteria in Solid Tumors criteria on follow-up computed tomography or magnetic resonance imaging scans. National Cancer Institute Common Terminology Criteria (NCI CTCAE), version 3, were used for complications. Statistical analysis was performed by the Kaplan-Meier estimator by the log rank test. Nineteen patients underwent a total of 24 resin-based Y90 treatments. Median survival from the time of diagnosis and first Y90 procedure was 752 {+-} 193 [95 % confidence interval (CI) 374-1130] and 345 {+-} 128 (95 % CI 95-595) days, respectively. Median survival with Eastern Cooperative Oncology Group (ECOG) performance status 1 (n = 15) and ECOG performance status 2 (n = 4) was 450 {+-} 190 (95 % CI 78-822) and 345 {+-} 227 (95 % CI 0-790) days, respectively (p = .214). Patients with extrahepatic metastasis (n = 11) had a median survival of 404 {+-} 309 (95 % CI 0-1010) days versus 345 {+-} 117 (95 % CI 115-575) days for patients without metastasis (n = 8) (p = .491). No mortality was reported within 30 days from first Y90 radioembolization. One patient developed grade 3 thrombocytopenia as assessed by NCI CTCAE. Fatigue and transient abdominal pain were observed in 4 (21 %) and 6 (32 %) patients, respectively. Y90 radioembolization is effective for unresectable standard-chemorefractory ICC.

  3. Colorectal Cancer Patient Characteristics, Treatment and Survival in Oman--a Single Center Study.

    Science.gov (United States)

    Kumar, Shiyam; Burney, Ikram A; Zahid, Khawaja Farhan; D Souza, Philomena Charlotte; Belushi, Muna A L; Mufti, Taha Dawood; Meki, Waeil A L; Furrukh, Muhammad; Moundhri, Mansour S A L

    2015-01-01

    Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of 2nd line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.

  4. Adjusting survival estimates for premature transmitter failure: A case study from the Sacramento-San Joaquin Delta

    Science.gov (United States)

    Holbrook, Christopher M.; Perry, Russell W.; Brandes, Patricia L.; Adams, Noah S.

    2013-01-01

    In telemetry studies, premature tag failure causes negative bias in fish survival estimates because tag failure is interpreted as fish mortality. We used mark-recapture modeling to adjust estimates of fish survival for a previous study where premature tag failure was documented. High rates of tag failure occurred during the Vernalis Adaptive Management Plan’s (VAMP) 2008 study to estimate survival of fall-run Chinook salmon (Oncorhynchus tshawytscha) during migration through the San Joaquin River and Sacramento-San Joaquin Delta, California. Due to a high rate of tag failure, the observed travel time distribution was likely negatively biased, resulting in an underestimate of tag survival probability in this study. Consequently, the bias-adjustment method resulted in only a small increase in estimated fish survival when the observed travel time distribution was used to estimate the probability of tag survival. Since the bias-adjustment failed to remove bias, we used historical travel time data and conducted a sensitivity analysis to examine how fish survival might have varied across a range of tag survival probabilities. Our analysis suggested that fish survival estimates were low (95% confidence bounds range from 0.052 to 0.227) over a wide range of plausible tag survival probabilities (0.48–1.00), and this finding is consistent with other studies in this system. When tags fail at a high rate, available methods to adjust for the bias may perform poorly. Our example highlights the importance of evaluating the tag life assumption during survival studies, and presents a simple framework for evaluating adjusted survival estimates when auxiliary travel time data are available.

  5. Commonly studied polymorphisms in inflammatory cytokine genes show only minor effects on mortality and related risk factors in nonagenarians

    DEFF Research Database (Denmark)

    Dato, Serena; Krabbe, Karen S; Thinggaard, Mikael

    2010-01-01

    Systemic low-grade inflammation is consistently associated with functional status, cognitive functioning, multimorbidity, and survival in oldest olds. If inflammation is either a cause or a consequence of age-related pathology, genetic determinants of late-life survival can reside in cytokine genes...

  6. Incidence, prevalence, and survival of moyamoya disease in Korea: a nationwide, population-based study.

    Science.gov (United States)

    Ahn, Il Min; Park, Dong-Hyuk; Hann, Hoo Jae; Kim, Kyoung Hoon; Kim, Hyun Jung; Ahn, Hyeong Sik

    2014-04-01

    There is a scarcity of information on the epidemiology and natural course of moyamoya disease. The aim of this study was to investigate the nationwide epidemiological features of moyamoya disease in Korea, including incidence, prevalence, and survival. We used the data from nationwide, population-based Health Insurance Review and Assessment Service claims database and Rare Intractable Disease registration program, which includes physician-certified diagnoses based on uniform criteria for moyamoya disease from 2007 to 2011. Age-specific incidence and prevalence were calculated, and survival was examined using Kaplan-Meier method. The total number of patients with moyamoya disease was 8154 in 2011, with a female-to-male ratio of 1.8. The incidence from 2007 to 2011 was 1.7 to 2.3/10(5), and the prevalence in 2011 was 16.1/10(5). In total, 66.3% of patients aged 0 to 14 years underwent surgery, whereas only 21.5% in the older than 15 years age group underwent surgery. The 1- and 5-year survival rates of adult patients were 96.9% and 92.9%, respectively, and of child patients were 99.6% and 99.3%, respectively. The prevalence and incidence presented in this study are higher than those in previous studies. This study demonstrates that the burden of moyamoya disease in Korea is substantial.

  7. Increasing incidence and survival in oral cancer: a nationwide Danish study from 1980 to 2014

    DEFF Research Database (Denmark)

    Karnov, Kirstine Kim Schmidt; Grønhøj, Christian; Jensen, David Hebbelstrup

    2017-01-01

    regression analysis in relation to location, gender, age, and calendar year at diagnosis. Results: Altogether, 8299 patients with oral cancer were identified, 5062 (61%) of whom were males and 3237 (39%) were females. The median age at diagnosis was 63 years. The AAIR of patients with OC increased from 1......Background: Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980...... to 2014. Material and methods: This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980–2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox...

  8. Gene Expression-Based Survival Prediction in Lung Adenocarcinoma: A Multi-Site, Blinded Validation Study

    Science.gov (United States)

    Shedden, Kerby; Taylor, Jeremy M.G.; Enkemann, Steve A.; Tsao, Ming S.; Yeatman, Timothy J.; Gerald, William L.; Eschrich, Steve; Jurisica, Igor; Venkatraman, Seshan E.; Meyerson, Matthew; Kuick, Rork; Dobbin, Kevin K.; Lively, Tracy; Jacobson, James W.; Beer, David G.; Giordano, Thomas J.; Misek, David E.; Chang, Andrew C.; Zhu, Chang Qi; Strumpf, Dan; Hanash, Samir; Shepherd, Francis A.; Ding, Kuyue; Seymour, Lesley; Naoki, Katsuhiko; Pennell, Nathan; Weir, Barbara; Verhaak, Roel; Ladd-Acosta, Christine; Golub, Todd; Gruidl, Mike; Szoke, Janos; Zakowski, Maureen; Rusch, Valerie; Kris, Mark; Viale, Agnes; Motoi, Noriko; Travis, William; Sharma, Anupama

    2009-01-01

    Although prognostic gene expression signatures for survival in early stage lung cancer have been proposed, for clinical application it is critical to establish their performance across different subject populations and in different laboratories. Here we report a large, training-testing, multi-site blinded validation study to characterize the performance of several prognostic models based on gene expression for 442 lung adenocarcinomas. The hypotheses proposed examined whether microarray measurements of gene expression either alone or combined with basic clinical covariates (stage, age, sex) can be used to predict overall survival in lung cancer subjects. Several models examined produced risk scores that substantially correlated with actual subject outcome. Most methods performed better with clinical data, supporting the combined use of clinical and molecular information when building prognostic models for early stage lung cancer. This study also provides the largest available set of microarray data with extensive pathological and clinical annotation for lung adenocarcinomas. PMID:18641660

  9. Educational attainment and differences in relative survival after acute myocardial infarction in Norway: a registry-based population study.

    Science.gov (United States)

    Klitkou, Søren Toksvig; Wangen, Knut R

    2017-08-28

    Although there is a broad societal interest in socioeconomic differences in survival after an acute myocardial infarction, only a few studies have investigated how such differences relate to the survival in general population groups. We aimed to investigate education-specific survival after acute myocardial infarction and to compare this with the survival of corresponding groups in the general population. Our study included the entire population of Norwegian patients admitted to hospitals for acute myocardial infarction during 2008-2010, with a 6- year follow-up period. Patient survival was measured relative to the expected survival in the general population for three educational groups: primary, secondary and tertiary. Education, sex, age and calendar year-specific expected survival were obtained from population life tables and adjusted for the presence of infarction-related mortality. Six-year patient survivals were 56.3% (55.3-57.2) and 65.5% (65.6-69.3) for the primary and tertiary educational groups (95% CIs), respectively. Also 6-year relative survival was markedly lower for the primary educational group: 70.2% (68.6-71.8) versus 81.2% (77.4-84.4). Throughout the follow-up period, patient survival tended to remain lower than the survival in the general population with the same educational background. Both patient survival and relative survival after acute myocardial infarction are positively associated with educational level. Our findings may suggest that secondary prevention has been more effective for the highly educated. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Exploring survival rates of companies in the UK video-games industry: An empirical study

    OpenAIRE

    Cabras, I.; Goumagias, N. D.; Fernandes, K.; Cowling, P.; Li, F.; Kudenko, D.; Devlin, S.; Nucciarelli, A.

    2016-01-01

    The study presented in this paper investigates companies operating in the UK video-game industry with regard to their levels of survivability. Using a unique dataset of companies founded between 2009 and 2014, and combining elements and theories from the fields of Organisational Ecology and Industrial Organisation, the authors develop a set of hierarchical logistic regressions to explore and examine the effects of a range of variables such as industry concentration, market size and density on...

  11. A retrospective observational study of the relationship between family history and survival from colorectal cancer.

    Science.gov (United States)

    Morris, E J A; Penegar, S; Whitehouse, L E; Quirke, P; Finan, P; Bishop, D T; Wilkinson, J; Houlston, R S

    2013-04-16

    Although family history is well established to be a risk factor for developing colorectal cancer (CRC), much less is known about its impact on patient survival. This study aimed to link CRC patient data from the National Study of Colorectal Cancer Genetics (NSCCG) to the National Cancer Data Repository (NCDR) to examine the relationship between family history and the characteristics and outcomes of CRC. All eligible NSCCG patients underwent a matching process to the NCDR using combinations of their personal identifiers. The characteristics and survival of CRC patients with and without a family history of CRC were compared. Of the 10 937 NSCCG patients eligible to be matched into the NCDR, 10 782 (98.6%) could be fully linked. There were no significant differences between those with and without a family history of CRC (defined as having at least one affected first-degree relative) in terms of age, sex, tumour stage at diagnosis, presence of multiple cancers, mode of presentation to hospital and surgical management, although patients with familial CRC were more likely to have right-sided tumours (Phistory of CRC is associated with better survival after a diagnosis of CRC.

  12. Increasing incidence and survival in oral cancer: a nationwide Danish study from 1980 to 2014.

    Science.gov (United States)

    Karnov, Kirstine Kim Schmidt; Grønhøj, Christian; Jensen, David Hebbelstrup; Wessel, Irene; Charabi, Birgitte Wittenborg; Specht, Lena; Kjaer, Andreas; von Buchwald, Christian

    2017-09-01

    Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980 to 2014. This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980-2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox regression analysis in relation to location, gender, age, and calendar year at diagnosis. Altogether, 8299 patients with oral cancer were identified, 5062 (61%) of whom were males and 3237 (39%) were females. The median age at diagnosis was 63 years. The AAIR of patients with OC increased from 1.9 per 100,000 in 1980 to 3.5 per 100,000 in 2014, and we observed a significant increase in 5-year OS of 12% points (a relative increase of 38%) from the period 1980-1984 to 2005-2009. Women were found to have a better prognosis than men. We found an unexpected increase in the age-standardized incidence of OC during the last 30 years in Denmark, and also an improvement in survival. The 5-year OS was significantly better in recent years even when we adjusted the analysis for relevant covariates.

  13. Candida albicans survival, growth and biofilm formation are differently affected by mouthwashes: an in vitro study.

    Science.gov (United States)

    Paulone, Simona; Malavasi, Giulia; Ardizzoni, Andrea; Orsi, Carlotta Francesca; Peppoloni, Samuele; Neglia, Rachele Giovanna; Blasi, Elisabetta

    2017-01-01

    Candida albicans is the most common cause of oral mycoses. The aim of the present study was to investigate in vitro the susceptibility of C. albicans to mouthwashes, in terms of growth, survival and biofilm formation. Candida albicans, laboratory strain SC5314, and 7 commercial mouthwashes were employed: 3 with 0.2% chlorhexidine digluconate; 1 with 0.06% chlorhexidine digluconate and 250 ppm F- sodium fluoride; 3 with fluorine-containing molecules. None of the mouthwashes contained ethanol in their formulations. The anti-Candida effects of the mouthwashes were assessed by disk diffusion, crystal violet and XTT assays. By using five protocols combining different dilutions and contact times the mouthwashes were tested against: 1) C. albicans growth; 2) biofilm formation; 3) survival of fungal cells in early, developing and mature Candida biofilm. Chlorhexidine digluconate-containing mouthwashes consistently exhibited the highest anti-Candida activity, irrespective of the protocols employed. Fungal growth, biofilm formation and survival of Candida cells within biofilm were impaired, the effects strictly depending on both the dilution employed and the time of contact. These in vitro studies provide evidence that mouthwashes exert anti-Candida activity against both planktonic and biofilm fungal structures, but to a different extent depending on their composition. This suggests special caution in the choice of mouthwashes for oral hygiene, whether aimed at prevention or treatment of oral candidiasis.

  14. HIV and tuberculosis trends and survival of coinfection in a referral center in Tehran: A 12-year study

    Directory of Open Access Journals (Sweden)

    Parvaneh Baghaei

    2016-01-01

    Conclusion: Our retrospective review of coinfected TB-HIV patients hospitalized in Tehran showed that the management and monitoring of coinfection, pneumothorax and other adverse effects, as well as early initiation of ART, improved patient survival.

  15. Double-crown-retained removable dental prostheses: a retrospective study of survival and complications.

    Science.gov (United States)

    Schwindling, Franz Sebastian; Dittmann, Britta; Rammelsberg, Peter

    2014-09-01

    Research data are scarce on double-crown-retained removable dental prostheses. In double-crown-retained removable dental prostheses, crown-like copings are definitively cemented to the abutment teeth and serve as prosthesis attachments. The purpose of this study was to evaluate the survival of double-crown-retained removable dental prostheses in use for 7 years and to determine their most common complications. A retrospective analysis was conducted to investigate the clinical outcome of 117 prostheses in 86 patients with 385 abutment teeth. Thirty-two telescopic-crown-retained removable dental prostheses, 51 conical-crown-retained removable dental prostheses, and 34 resilient telescopic-crown-retained overdentures were clinically reexamined by 1 investigator. Prosthesis success was defined as survival without severe complications (abutment tooth extraction). Statistical analyses were performed with Kaplan-Meier modeling and Cox regression (α=.05). Minor complications, for example, the decementation of primary crowns (34.2%), failure of the veneer of secondary crowns (11.1%), fracture of the denture base (17.1%), and the need for relining (12%), were common. Cumulative prosthesis survival for all types of prostheses was 93.8% after 7 years. After the same period, prosthesis success was 90% for telescopic-crown-retained removable dental prostheses and 78.5% for conical-crown-retained removable dental prostheses and resilient telescopic-crown-retained overdentures. The medium-term double-crown-retained removable dental prosthesis survival found in this retrospective investigation appears acceptable. When bearing in mind the limits of this study, this kind of prosthesis might be a viable treatment option for patients with a reduced dentition. However, more laboratory and clinical research is necessary to reduce the incidence of minor complications and confirm the present in vivo results in larger patient groups. Copyright © 2014 Editorial Council for the Journal of

  16. Predictors of survival in children with methymalonic acidemia with homocystinuria in Beijing, China: a prospective cohort study.

    Science.gov (United States)

    Qiliang, Li; Wenqi, Song; Quan, Wang; Xinying, Yang; Jiuwei, Li; Qiang, Sun; Xiaoxia, Peng; Peichang, Wang

    2015-02-01

    (i) To determine whether clinical features and biochemical parameters help to predict survival of methylmalonic acidemia with homocystinuria; (ii) To find the cutoff values of biochemical parameters for predicting survival of methylmalonic acidemia with homocystinuria. A prospective cohort study. A pediatric tertiary hospital in Beijing; all patients were followed until death or June 2013. 45 pediatric patients diagnosed with methylmalonic acidemia with homocystinuria between 2006 and 2012. The data of clinical characteristics and pretreatment biochemical parameters were collected. The Cox regression analysis was performed to identify independent risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The best cutoff values for these independent factors were determined by the receiver characteristic curve. Newborn onset (OR=6.856, 95%CI=2.241-20.976, P=0.001), high level of methylmalonic acid in urine (OR=1.022, 95%CI=1.011-1.033, P<0.001), and high level of urea in serum (OR=1.083, 95%CI=1.027-1.141, P=0.003) were independent negative risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The cutoff values of maximum predictive accuracy of methylmalonic acid in urine and urea in serum were respectively 5.41 mmol/mmol creatinine and 7.80 mmol/L by receiver operating characteristic curve analysis. The patients of methylmalonic acidemia with homocystinuria tend to have an adverse outcome if they have newborn onsets. Elevated urea and urinary methylmalonic acid are predictors of adverse outcomes for the patients. They show similar effect for predicting severe adverse prognosis. The combination of methylmalonic acid in urine concentration and urea in serum concentration provided the most accurate predictive tool.

  17. Patients' perceptions of physicians: a pilot study of the influence of prime-time fictional medical shows.

    Science.gov (United States)

    Stinson, Mary Elizabeth; Heischmidt, Kenneth

    2012-01-01

    Much criticism has fallen onto prime-time crime shows for skewing the perception the public has on crime. Could the same criticism apply to prime-time medical dramas, which tend to be among the most watched television shows today, for skewing patients' expectations? In the past, physicians on prime-time fictional medical shows tended to be depicted in a positive manner. However, today's medical dramas often portray physicians in a less positive context. The results of this study showed that television exposure only negatively affect patients' perceptions of physicians in regards to physical attractiveness and character, but not to physician propriety, power, communication, sociability, extroversion, competence, and composure. In addition, this study showed that prime-time fictional shows affect patient-physician interactions.

  18. Survival rate and pressure ulcer prevalence in patients with and without dementia: a retrospective study.

    Science.gov (United States)

    Jaul, E; Rosenzweig, J P; Meiron, O

    2017-07-02

    This retrospective study aimed to investigate the prevalence of pressure ulcers (PUs) in older patients with advanced dementia versus older patients without dementia but with other comorbidities, such as diabetes, ischaemic heart disease and chronic renal failure. PUs were thought to be more prevalent and to present a higher risk of mortality in patients with dementia. PUs were assessed on admission using the European Pressure Ulcer Advisory Panel (EPUAP) staging system. Patients were classified as either with or without dementia according to Reisberg's functional assessment staging test (FAST). The prevalence of PUs and the survival rates were analysed and compared in both groups. The combined effect of PUs and dementia on survival was assessed using the Cox proportional hazard model. The median survival rate of patients with PUs and dementia was 63 days, significantly lower than in patients with PUs without dementia 117 days. Both groups had similar other comorbidities. These findings underscore the requirement for geriatricians and health professionals to be more vigilant in examining PUs as dementia progresses.

  19. Surviving space flight: case study on MELiSSA's CIII nitrifying compartment

    Science.gov (United States)

    Ilgrande, Chiara; Lasseur, Christophe; Mastroleo, Felice; Paille, Christel; Leys, Natalie; Morozova, Julia; Ilyin, Vyacheslav; Clauwaert, Peter; Christiaens, Marlies E. R.; Lindeboom, Ralph E. F.; Vlaeminck, Siegfried; Prat, Delphine; Arroyo, Jose M. C.; Conincx, Ilse; Van Hoey, Olivier; Roume, Hugo; Udert, Kai; Sas, Benedikt

    2016-07-01

    Space synthetic biology offers key opportunities for long-term space missions. Planets mining, terraformation, space medicine and Life Support technologies would all benefit from an integrative biological approach. However, space is a harsh environment for life: microgravity, temperature, UV and cosmic radiation can affect the health and functionality of microorganisms and plants, possibly preventing the optimal performance of the systems. The European Space Agency's Life Support System (MELiSSA) has been developed as a model for future long term Space missions and Space habitation. MELiSSA is a 5 compartment artificial ecosystem with microorganisms and higher, that aims at completely recycling gas, liquid and solid waste. In this study, the survival and functional activity after Lower Earth Orbit conditions of microbial nitrogen conversions, relevant for MELiSSA's CIII compartment, was tested. Synthetic communities containing Nitrosomonas europeae, Nitrosomonas ureae, Nitrobacter winogradskyi, Nitrospira moscoviensis and Cupriavidus pinatubonensis were exposed to the Lower Earth Orbit conditions of the International Space Station (ISS) for 7 days. Nitrosomonas europeae, Nitrobacter winogradskyi, Cupriavidus pinatubonensis, and three mixed communities (a urine nitrification sludge, a sludge containing aerobic ammonia oxidizing bacteria and anammox bacteria (OLAND), and an aquaculture sludge containing ammonia oxidizing archaea) were exposed to Lower Earth Orbit conditions for 44 days. Survival after both space flights was demonstrated because nitritation, nitratation, denitrification and anammox activity could be restored at a rate comparable to ground storage conditions. Our results validate the potential survival feasibility and suggest future space applications for N-related microorganisms.

  20. Predictors of survival from urachal cancer: a Mayo Clinic study of 49 cases.

    Science.gov (United States)

    Molina, Julian R; Quevedo, J Fernando; Furth, Alfred F; Richardson, Ronald L; Zincke, Horst; Burch, Patrick A

    2007-12-01

    Outcome results of a long-term analysis of urachal cancer using a new staging system are presented. The authors analyzed clinical outcomes from 49 patients with the diagnosis of urachal cancer who were seen at the Mayo Clinic, Rochester, Minnesota from 1950 to 2003. The TNM staging system was used to predict outcome after surgical resection. Among 49 study patients, 33 were men, 16 were women, and their median age at presentation was 57.5 years. The vast majority of tumors were adenocarcinomas (89%), 4% were sarcomas and transitional cell carcinomas, and the rest were high-grade mixed neoplasms. Among the adenocarcinomas, 63.6% were mucin-producing tumors. Partial cystectomy with or without pelvic lymph node dissection and removal of the urachus was performed in 41 (83%) cases. Overall survival for all stages was 62 months with 17 (34%) patients still alive more than 5 years after treatment. Applying the TNM staging system, the authors demonstrated a median survival time for stage I/II patients of 10.8 years (95% CI, 6.9 years to 12.0 years) compared with a median survival of 1.3 years (95% CI, 1.1 years to 1.9 years; log-rank Purachal cancer. Better systemic modality treatments are needed for advanced stages of this disease. Copyright (c) 2007 American Cancer Society.

  1. Radiation protection by an isoflavone, genistein: A study on the survivability of mice

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    Bhatia Lal Arvind

    2007-01-01

    Full Text Available The radioprotective effects of an acute administration of the isoflavone genistein (4¢, 5, 7-trihydroxyflavone, have been investigated in the present study. Male mice were administered with different doses (100, 200, 300, and 400 mg/kg body weight of genistein 24 hours prior to 8 Gy gamma irradiation and the 200 mg/kg dose of genistein was determined to offer the maximum survivability and was used as an optimum dose for further experimentation. The 0.5 ml dose of genistein (200 mg/kg was administered intraperitoneally to 2 different groups of mice, 15 minutes and 24 hours prior to gamma irradiation. In the mice treated with genistein with the optimum dose 24 hours before irradiation, a significant increase in 30 day survival has been recorded in contrast to the mice treated with genistein 15 minutes before the irradiation. The longer survivability (i. e. 20% for a period of more than 30 days has been observed in the 24 hour group as compared to that of 15 minutes (i. e. 20% for 22 days. Although the radioprotective effect of genistein was evident in both groups, it was of greater magnitude in the group with a longer interval, indicating thereby an efficacy with longer retention with the possible minimum toxicity, unlike hitherto known other radioprotective agents.

  2. Parturition, dystocia and foal survival: a retrospective study of 1047 births.

    Science.gov (United States)

    McCue, P M; Ferris, R A

    2012-02-01

    An understanding of the normal events of foaling, causes of dystocia and clinical outcomes is important for equine practitioners. The goals of the present study were to: 1) evaluate factors that influence gestation length; 2) report duration of Stage II labour; 3) determine the frequency of dystocia and premature placental separation; and 4) determine the relationship between problems at foaling and foal survival. Foaling records of 1047 mare births were evaluated. The average gestation length was 342.7 days [corrected] +/- 0.4 days, with no effect of mare age or breed observed. Mares carrying male fetuses had a longer gestation (P foaled at night between 2000 h and 0200 h when the facility was quiet. Dystocia occurred in 10.1% of all births and the incidence rate was higher in Thoroughbred mares than in Quarter Horse mares. The most common cause of dystocia was abnormalities of fetal posture. A delay in foal delivery beyond 40 min of Stage II of labour was associated with a significant increase in foal mortality. In addition, an increase in foal morbidity and mortality was noted when the interval from birth to standing or birth to nursing was prolonged. Early detection and rapid appropriate intervention are critical to foal survival in an equine dystocia. Equine veterinarians should counsel horse owners that early recognition of a foaling problem and rapid, appropriate intervention are critical to the survival of a foal.

  3. A pilot study of microsatellite instability and endometrial cancer survival in white and African American women.

    Science.gov (United States)

    Cote, Michele L; Kam, Audrey; Chang, Cherry Yin-Yi; Raskin, Leon; Reding, Kerryn W; Cho, Kathleen R; Gruber, Stephen B; Ali-Fehmi, Rouba

    2012-01-01

    Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States and can be classified on the basis of various pathologic, molecular, and genetic features, including microsatellite instability (MSI). As MSI is generally associated with a more favorable outcome in colorectal cancers, it is feasible that microsatellite instability may also influence endometrial cancer survival. We examined MSI and survival in 45 African American and 31 white women diagnosed with endometrial cancer at a large, urban cancer center. Fifty-five tumors were classified as type I and 21 tumors were classified as type II. Unconditional logistic regression models found that microsatellite stable tumors were more frequently observed in white women compared with African American women (odds ratio, 8.61; 95% confidence interval, 1.01-73.69). Type I tumors with MSI were not found to be significantly associated with smoking status, tumor stage, or age. Only one type II tumor was classified as MSI. Neither race nor MSI status was a predictor of death from all causes or only endometrial cancer-related deaths were considered in univariate and multivariate survival models. The potential significance of a larger proportion of MSI tumors found in African American women with type I endometrial cancer should be assessed in a larger prospective study.

  4. Improved survival with ursodeoxycholic acid prophylaxis in allogeneic stem cell transplantation: long-term follow-up of a randomized study.

    Science.gov (United States)

    Ruutu, Tapani; Juvonen, Eeva; Remberger, Mats; Remes, Kari; Volin, Liisa; Mattsson, Jonas; Nihtinen, Anne; Hägglund, Hans; Ringdén, Olle

    2014-01-01

    We report the long-term results of a prospective randomized study on the use of ursodeoxycholic acid (UDCA) for prevention of hepatic complications after allogeneic stem cell transplantation. Two hundred forty-two patients, 232 with malignant disease, were randomized to receive (n = 123) or not to receive (n = 119) UDCA from the beginning of the conditioning until 90 days post-transplantation. The results were reported after 1-year follow-up. UDCA administration reduced significantly the proportion of patients developing high serum bilirubin levels as well as the incidence of severe acute graft-versus-host disease (GVHD), liver GVHD, and intestinal GVHD. In the UDCA prophylaxis group, nonrelapse mortality (NRM) was lower and overall survival better than in the control group. After a 10-year follow-up, the difference in the survival and NRM in favor of the UDCA-treated group, seen at 1 year, was maintained (survival 48% versus 38%, P = .037; NRM 28% versus 41%, P = .01). A landmark analysis in patients surviving at 1 year post-transplantation showed no significant differences between the study groups in the long-term follow-up in chronic GVHD, relapse rate, NRM, disease-free survival, or overall survival. These long-term results continue to support the useful role of UDCA in the prevention of transplant-related complications in allogeneic transplantation. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  5. Improvement in survival of patients with oral cavity squamous cell carcinoma: An international collaborative study.

    Science.gov (United States)

    Amit, Moran; Yen, Tzu-Chen; Liao, Chun-Ta; Chaturvedi, Pankaj; Agarwal, Jai Prakash; Kowalski, Luiz P; Ebrahimi, Ardalan; Clark, Jonathan R; Kreppel, Matthias; Zöller, Joachim; Fridman, Eran; Bolzoni, Villaret A; Shah, Jatin P; Binenbaum, Yoav; Patel, Snehal G; Gil, Ziv

    2013-12-15

    An association between the survival of patients with oral cavity squamous cell carcinoma (OCSCC) and advancements in diagnosis and therapy has not been established. This was a retrospective, longitudinal, international, population-based study of 2738 patients who underwent resection of OCSCC during 2 different decades. Characteristics of patients from 7 international cancer centers who received treatment between 1990 and 2000 (group A; n = 735) were compared with patients who received treatment between 2001 and 2011 (group B; n = 2003). Patients in group B had more advanced tumors and tended to develop distant metastases more frequently than patients in group A (P = .005). More group B patients underwent selective neck dissection and received adjuvant radiotherapy (P < .001). Outcome analysis revealed a significant improvement in 5-year overall survival, from 59% for group A to 70% for group B (P < .001). There was also a significant improvement in disease-specific survival associated with operations performed before and after 2000 (from 69% to 81%, respectively; P < .001). Surgery after 2000, negative margins, adjuvant treatment, and early stage disease were independent predictors of a better outcome in multivariate analysis. The decade of treatment was an independent prognostic factor for cancer-specific mortality (hazard ratio, 0.42; 95% confidence interval, 0.3-0.6). The survival rate of patients with OCSCC improved significantly during the past 2 decades despite older age, more advanced disease stage, and a higher rate of distant metastases. The current results suggest that the prognosis for patients with OCSCC has improved over time, presumably because of advances in imaging and therapy. © 2013 American Cancer Society.

  6. A controlled study on gastrointestinal nematodes from two Swedish cattle farms showing field evidence of ivermectin resistance

    Science.gov (United States)

    2014-01-01

    in the calves inoculated with isolates A and B, whereas C also had 8% O. ostertagi. Conclusions Overall, this experiment showed that the animals were successfully treated according to the Faecal egg count reduction test (FECRT) standard (≥ 95% reduction). However, several adult worms of the dose-limiting species C. oncophora demonstrably survived the IVM treatment. PMID:24401545

  7. Cervical cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.

    Science.gov (United States)

    Benard, Vicki B; Watson, Meg; Saraiya, Mona; Harewood, Rhea; Townsend, Julie S; Stroup, Antoinette M; Weir, Hannah K; Allemani, Claudia

    2017-12-15

    Overall, cervical cancer survival in the United States has been reported to be among the highest in the world, despite slight decreases over the last decade. Objective of the current study was to describe cervical cancer survival trends among US women and examine differences by race and stage. This study used data from the CONCORD-2 study to compare survival among women (aged 15-99 years) diagnosed in 37 states covering 80% of the US population. Survival was adjusted for background mortality (net survival) with state- and race-specific life tables and was age-standardized with the International Cancer Survival Standard weights. Five-year survival was compared by race (all races, blacks, and whites). Two time periods, 2001-2003 and 2004-2009, were considered because of changes in how the staging variable was collected. From 2001 to 2009, 90,620 women were diagnosed with invasive cervical cancer. The proportion of cancers diagnosed at a regional or distant stage increased over time in most states. Overall, the 5-year survival was 63.5% in 2001-2003 and 62.8% in 2004-2009. The survival was lower for black women versus white women in both calendar periods and in most states; black women had a higher proportion of distant-stage cancers. The stability of the overall survival over time and the persistent differences in survival between white and black women in all US states suggest that there is a need for targeted interventions and improved access to screening, timely treatment, and follow-up care, especially among black women. Cancer 2017;123:5119-37. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  8. Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study.

    Science.gov (United States)

    Oza, Amar; Lu, Na; Schoenfeld, Sara R; Fisher, Mark C; Dubreuil, Maureen; Rai, Sharan K; Zhang, Yuqing; Choi, Hyon K

    2017-10-01

    Recent studies have shown an increase in both cardiovascular and all-cause mortality in ankylosing spondylitis (AS). We examined the potential survival benefit of statin use in AS within a general population context. We performed an incident user cohort study with time-stratified propensity score matching using a UK general population database between 1 January 2000 and 31 December 2014. To account for potential confounders, we compared propensity score-matched cohorts of statin initiators and non-initiators using 1-year cohort accrual blocks. The variables used to create the propensity score model included disease duration, body mass index, lifestyle factors, comorbidities and medication use. Using unmatched AS cohorts, statin initiators (n=1430) showed a 43% higher risk of mortality than non-initiators (n=1430) (HR=1.43; 95% CI 1.12 to 1.84). After propensity score matching, patients with AS who initiated statins (n=1108) had 96 deaths, and matched non-initiators (n=1108) had 134 deaths over a mean follow-up of 5.3 and 5.1 years, respectively. This corresponded to mortality rates of 16.5 and 23.8 per 1000 person-years (PY), respectively, resulting in an HR of 0.63 (95% CI 0.46 to 0.85) and an absolute mortality rate difference of 7.3 deaths per 1000 PY (95% CI 2.1 to 12.5). This general population-based cohort study suggests that statin initiation is associated with a substantially lower risk of mortality among patients with AS. The magnitude of the inverse association appears to be larger than that observed in randomised trials of the general population and in population-based cohort studies of patients with rheumatoid arthritis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Single-port unilateral transaxillary totally endoscopic thyroidectomy: A survival animal and cadaver feasibility study

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    Henrique Neubarth Phillips

    2016-01-01

    Full Text Available Background: Single-port unilateral axillary thyroidectomy has great potential to become a valid alternative technique for thyroid surgery. We tested the technique in a study on live animals and cadavers to evaluate the feasibility and reproducibility of the procedure. Materials and Methods: Institutional review board (IRB approval was obtained in our university by the Council of Ethics for the study in surviving animals and cadavers. Subtotal thyroidectomy using unilateral axillary single port was performed in five dogs and five cadavers. Performing incision in the axillary fossa, a disposable single port was inserted. The dissection progressed for creating a subcutaneous tunnel to the subplatysmal region; after opening the platysma muscle and separation of the strap muscles, the thyroid gland was identified. After key anatomical landmarks were identified, the dissection was started at the upper pole towards the bottom, and to the isthmus. Specimens were extracted intact through the tunnel. Clinical and laboratorial observations of the experimental study in a 15-day follow-up and intraoperative data were documented. Results: All surgeries were performed in five animals which survived 15 days without postoperative complications. In the surgeries successfully performed in five cadavers, anatomical landmarks were recognised and intraoperative dissection of recurrent nerves and parathyroid glands was performed. Mean operative time was 64 min (46-85 min in animals and 123 min (110-140 min in cadavers, with a good cosmetic outcome since the incision was situated in the axillary fold. Conclusion: The technique of single-port axillary unilateral thyroidectomy was feasible and reproducible in the cadavers and animal survival study, suggesting the procedure as an alternative to minimally invasive surgery of the neck.

  10. The effect of comorbidity on the use of adjuvant chemotherapy and survival from colon cancer: a retrospective cohort study

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    Purdie Gordon

    2009-04-01

    Full Text Available Abstract Background Comorbidity has a well documented detrimental effect on cancer survival. However it is difficult to disentangle the direct effects of comorbidity on survival from indirect effects via the influence of comorbidity on treatment choice. This study aimed to assess the impact of comorbidity on colon cancer patient survival, the effect of comorbidity on treatment choices for these patients, and the impact of this on survival among those with comorbidity. Methods This retrospective cohort study reviewed 589 New Zealanders diagnosed with colon cancer in 1996–2003, followed until the end of 2005. Clinical and outcome data were obtained from clinical records and the national mortality database. Cox proportional hazards and logistic regression models were used to assess the impact of comorbidity on cancer specific and all-cause survival, the effect of comorbidity on chemotherapy recommendations for stage III patients, and the impact of this on survival among those with comorbidity. Results After adjusting for age, sex, ethnicity, area deprivation, smoking, stage, grade and site of disease, higher Charlson comorbidity score was associated with poorer all-cause survival (HR = 2.63 95%CI:1.82–3.81 for Charlson score ≥ 3 compared with 0. Comorbidity count and several individual conditions were significantly related to poorer all-cause survival. A similar, but less marked effect was seen for cancer specific survival. Among patients with stage III colon cancer, those with a Charlson score ≥ 3 compared with 0 were less likely to be offered chemotherapy (19% compared with 84% despite such therapy being associated with around a 60% reduction in excess mortality for both all-cause and cancer specific survival in these patients. Conclusion Comorbidity impacts on colon cancer survival thorough both physiological burden of disease and its impact on treatment choices. Some patients with comorbidity may forego chemotherapy unnecessarily

  11. Virtual prototyping study shows increased ATPase activity of Hsp90 to be the key determinant of cancer phenotype.

    Science.gov (United States)

    Vali, Shireen; Pallavi, Rani; Kapoor, Shweta; Tatu, Utpal

    2010-03-01

    Hsp90 is an ATP-dependent molecular chaperone that regulates key signaling proteins and thereby impacts cell growth and development. Chaperone cycle of Hsp90 is regulated by ATP binding and hydrolysis through its intrinsic ATPase activities, which is in turn modulated by interaction with its co-chaperones. Hsp90 ATPase activity varies in different organisms and is known to be increased in tumor cells. In this study we have quantitatively analyzed the impact of increasing Hsp90 ATPase activity on the activities of its clients through a virtual prototyping technology, which comprises a dynamic model of Hsp90 interaction with clients involved in proliferation pathways. Our studies highlight the importance of increased ATPase activity of Hsp90 in cancer cells as the key modulator for increased proliferation and survival. A tenfold increase in ATPase activity of Hsp90 often seen in cancer cells increases the levels of active client proteins such as Akt-1, Raf-1 and Cyclin D1 amongst others to about 12-, 8- and 186-folds respectively. Additionally we studied the effect of a competitive inhibitor of Hsp90 activity on the reduction in the client protein levels. Virtual prototyping experiments corroborate with findings that the drug has almost 10- to 100-fold higher affinity as indicated by a lower IC(50) value (30-100 nM) in tumor cells with higher ATPase activity. The results also indicate a 15- to 25-fold higher efficacy of the inhibitor in reducing client levels in tumor cells. This analysis provides mechanistic insights into the links between increased Hsp90 ATPase activity, tumor phenotype and the hypersensitivity of tumor Hsp90 to inhibition by ATP analogs. The online version of this article (doi:10.1007/s11693-009-9046-3) contains supplementary material, which is available to authorized users.

  12. Applying Data Mining Techniques to Extract Hidden Patterns about Breast Cancer Survival in an Iranian Cohort Study.

    Science.gov (United States)

    Khalkhali, Hamid Reza; Lotfnezhad Afshar, Hadi; Esnaashari, Omid; Jabbari, Nasrollah

    2016-01-01

    Breast cancer survival has been analyzed by many standard data mining algorithms. A group of these algorithms belonged to the decision tree category. Ability of the decision tree algorithms in terms of visualizing and formulating of hidden patterns among study variables were main reasons to apply an algorithm from the decision tree category in the current study that has not studied already. The classification and regression trees (CART) was applied to a breast cancer database contained information on 569 patients in 2007-2010. The measurement of Gini impurity used for categorical target variables was utilized. The classification error that is a function of tree size was measured by 10-fold cross-validation experiments. The performance of created model was evaluated by the criteria as accuracy, sensitivity and specificity. The CART model produced a decision tree with 17 nodes, 9 of which were associated with a set of rules. The rules were meaningful clinically. They showed in the if-then format that Stage was the most important variable for predicting breast cancer survival. The scores of accuracy, sensitivity and specificity were: 80.3%, 93.5% and 53%, respectively. The current study model as the first one created by the CART was able to extract useful hidden rules from a relatively small size dataset.

  13. A change in the study evaluation paradigm reveals that larynx preservation compromises survival in T4 laryngeal cancer patients.

    Science.gov (United States)

    Dyckhoff, Gerhard; Plinkert, Peter K; Ramroth, Heribert

    2017-09-01

    Larynx preservation (LP) is recommended for up to low-volume T4 laryngeal cancer as an evidence-based treatment option that does not compromise survival. However, a reevaluation of the current literature raises questions regarding whether there is indeed reliable evidence to support larynx preservation for T4 tumor patients. In an observational cohort study of 810 laryngeal cancer patients, we evaluated the outcomes of all T4 tumor patients treated with primary chemo-radiotherapy (CRT) or primary radiotherapy alone (RT) compared with upfront total laryngectomy followed by adjuvant (chemo)radiotherapy (TL + a[C]RT). Additionally, we reevaluated the studies that form the evidence base for the recommendation of LP for patients with up to T4 tumors (Pfister et al., J Clin Oncol 24:3693-704, 2006). The evaluation of all 288 stage III and IV patients together did not show a significant difference in overall survival (OS) between CRT-LP and TL + a(C)RT (hazard ratio (HR) 1.23; 95% confidence interval (CI): 0.82-1.86; p = 0.31) using a multivariate proportional hazard model. However, a subgroup analysis of T4 tumor patients alone (N = 107; 13.9%) revealed significantly worse OS after CRT compared with TL + a(C)RT (HR 2.0; 95% CI: 1.04-3.7; p = 0.0369). A reevaluation of the subgroup of T4 patients in the 5 LP studies that led to the ASCO clinical practice guidelines revealed that only 21-45 T4 patients had differential data on survival outcome. These data, however, showed a markedly worse outcome for T4 patients after LP. T4 laryngeal cancer patients who reject TL as a treatment option should be informed that their chance of organ preservation with primary conservative treatment is likely to result in a significantly worse outcome in terms of OS. Significant loss of survival in T4 patients after LP is also confirmed in recent literature.

  14. Identification of prognostic factors in canine mammary malignant tumours: a multivariable survival study

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    Santos Andreia A

    2013-01-01

    Full Text Available Abstract Background Although several histopathological and clinical features of canine mammary gland tumours have been widely studied from a prognostic standpoint, considerable variations in tumour individual biologic behaviour difficult the definition of accurate prognostic factors. It has been suggested that the malignant behaviour of tumours is the end result of several alterations in cellular physiology that culminate in tumour growth and spread. Accordingly, the aim of this study was to determine, using a multivariable model, the independent prognostic value of several immunohistochemically detected tumour-associated molecules, such as MMP-9 and uPA in stromal cells and Ki-67, TIMP-2 and VEGF in cancer cells. Results Eighty-five female dogs affected by spontaneous malignant mammary neoplasias were followed up for a 2-year post-operative period. In univariate analysis, tumour characteristics such as size, mode of growth, regional lymph node metastases, tumour cell MIB-1 LI and MMP-9 and uPA expressions in tumour-adjacent fibroblasts, were associated with both survival and disease-free intervals. Histological type and grade were related with overall survival while VEGF and TIMP-2 were not significantly associated with none of the outcome parameters. In multivariable analysis, only a MIB-1 labelling index higher than 40% and a stromal expression of MMP-9 higher than 50% retained significant relationships with poor overall and disease-free survival. Conclusions The results of this study indicate that MMP-9 and Ki-67 are independent prognostic markers of canine malignant mammary tumours. Furthermore, the high stromal expressions of uPA and MMP-9 in aggressive tumours suggest that these molecules are potential therapeutic targets in the post-operative treatment of canine mammary cancer.

  15. Relative survival in dilated cardiomyopathy: a stratification study of long-term outcome to evaluate life insurance cover.

    Science.gov (United States)

    Barbati, Giulia; Merlo, Marco; Marocco, Patrizia; Gregori, Dario; Sabbadini, Gastone; Lattuada, Luca; Ginanneschi, Ugo; Sinagra, Gianfranco; Di Lenarda, Andrea

    2009-01-01

    The aim of this study was to compare mortality of dilated cardiomyopathy (DCM) patients with the mortality in the background Italian population, taking into account demographic characteristics and clinical stratification of long-term outcome, ie, "reverse remodelling" within the first 2 years of follow-up. DCM is a myocardial disease, characterized by left and/or right ventricular dilation and dysfunction and poor outcome. Evidence-based treatment with ACE inhibitors, beta-blockers and, in the last decade, implantable cardioverter defibrillators have been demonstrated to improve significantly heart failure symptoms and prognosis. At present, DCM patients are unlikely to be accepted for life insurance. A cohort of 577 DCM patients consecutively enrolled from 1988 to 2004 in the Heart Muscle Disease Registry of Trieste, Italy, was matched by sex, age and registry data entry with the mortality data of the Italian population. Relative survival has been estimated by means of Kaplan-Meier technique, and mortality ratios (MR) with corresponding 95% confidence intervals have been computed. DCM patients who showed a significant reverse remodelling within the first 2 years of treatment showed comparable survival with respect to the control population, and therefore could be taken into consideration for life insurance coverage, at least for a short or medium-term of years. The data illustrate that survival probability strongly depend on the individual treatment and evolution of the disease and could be easily measured within the first 2 years of follow-up. If this information is collected at the time of evaluation of an applicant for life cover, the insurance company could possibly improve its risk stratification.

  16. Impact of elevated temperature on the growth, survival and trophic dynamics of winter flounder larvae: a mesocosm study

    Energy Technology Data Exchange (ETDEWEB)

    Keller, A. A.; Klein-MacPhee, G. [Rhode Island Univ., Narragansett, RI (United States)

    2000-12-01

    The impact of increased temperature on the growth, survival and trophic dynamics of winter flounder larvae was studied in a land-based mesocosm, in order to gain a better understanding of the factors controlling the recruitment of winter flounder, the dominant commercial fish in Narragansett Bay, Rhode Island. The investigation was prompted by a number of recent studies suggesting that the declining flounder population observed over the past 14 years was in some manner related to warmer winter temperatures which cause to increase the mortality of flounder larvae as well as predator activity. The paper describes the impact of increasing water temperature by three degrees relative to control systems in six enclosed mesocosms over a diatom post-winter-spring bloom period. The study focused on the effects of the altered temperature on food availability, abundance of active predators and the growth and survival of winter flounder larvae. It was observed that cooler temperature tended to prolong the incubation period of the larvae, resulting in hatching at a larger size in the cool mesocosm relative to the warm. Daily instantaneous growth and mortality rates showed a significant inverse relationship. The cumulative impact of warmer temperatures resulted in a 10 to 16 per cent decline of larvae surviving to metamorphosis (about six weeks). Increased temperature-mediated egg predation effects were also observed. It was concluded that chronic over-exploitation is associated with a long-term decline in winter flounder stock abundance despite production of good year-classes. Incorporation of the effect of warmer temperatures into fishing management plans, e. g. reducing fishing pressure following periods of successive warm winters, might be the most likely way to arrest declining stocks of winter flounder in the affected area. 34 refs., 4 tabs., 10 figs.

  17. In-State and Interstate Associations Between Gun Shows and Firearm Deaths and Injuries: A Quasi-experimental Study.

    Science.gov (United States)

    Matthay, Ellicott C; Galin, Jessica; Rudolph, Kara E; Farkas, Kriszta; Wintemute, Garen J; Ahern, Jennifer

    2017-12-19

    Gun shows are an important source of firearms, but no adequately powered studies have examined whether they are associated with increases in firearm injuries. To determine whether gun shows are associated with short-term increases in local firearm injuries and whether this association differs by the state in which the gun show is held. Quasi-experimental. California. Persons in California within driving distance of gun shows. Gun shows in California and Nevada between 2005 and 2013 (n = 915 shows) and rates of firearm-related deaths, emergency department visits, and inpatient hospitalizations in California. Compared with the 2 weeks before, postshow firearm injury rates remained stable in regions near California gun shows but increased from 0.67 injuries (95% CI, 0.55 to 0.80 injuries) to 1.14 injuries (CI, 0.97 to 1.30 injuries) per 100 000 persons in regions near Nevada shows. After adjustment for seasonality and clustering, California shows were not associated with increases in local firearm injuries (rate ratio [RR], 0.99 [CI, 0.97 to 1.02]) but Nevada shows were associated with increased injuries in California (RR, 1.69 [CI, 1.16 to 2.45]). The pre-post difference was significantly higher for Nevada shows than California shows (ratio of RRs, 1.70 [CI, 1.17 to 2.47]). The Nevada association was driven by significant increases in firearm injuries from interpersonal violence (RR, 2.23 [CI, 1.01 to 4.89]) but corresponded to a small increase in absolute numbers. Nonfirearm injuries served as a negative control and were not associated with California or Nevada gun shows. Results were robust to sensitivity analyses. Firearm injuries were examined only in California, and gun show occurrence was not randomized. Gun shows in Nevada, but not California, were associated with local, short-term increases in firearm injuries in California. Differing associations for California versus Nevada gun shows may be due to California's stricter firearm regulations. National

  18. Population-based study of breast cancer in older women: prognostic factors of relative survival and predictors of treatment

    Directory of Open Access Journals (Sweden)

    Dialla Pegdwende

    2012-10-01

    Full Text Available Abstract Background A large proportion of women with breast cancer (BC are elderly. However, there is a lack of information regarding BC prognostic factors and care in this population. The aims of this study were to assess the prognostic factors of relative survival (RS among women with BC aged ≥ 75 years old and to identify the predictive factors of treatments administered to this population. Methods A population-based study was performed using data from the Cote d’Or breast and gynaecological cancer registry. Women aged 75 years and older with primary invasive BC and resident in Cote d’Or at the time of diagnosis made between January 1998 and December 2008 were retrospectively selected. Prognostic factors of RS were estimated in a generalized linear model with a Poisson error structure. RS rate for the whole population was given at 5 years. Logistic regression models were used to identify the predictors of the treatments administered. Results Six hundred and eighty-one women were included. Median age at diagnosis was 80. Comorbidities (p=0.02, pT stage (p=0.04, metastases (p= Conclusions Comorbid conditions adversely affect survival in older women with breast cancer. Moreover the results of this study showed that there are numerous predictors of the type of treatment administered, and that the most important were age and comorbidities.

  19. High survival and hatching rates following vitrification of embryos at blastocyst stage: a bovine model study.

    Science.gov (United States)

    Huang, Jack Y J; Chung, Jin-Tae; Tan, Seang Lin; Chian, Ri-Cheng

    2007-04-01

    Cryopreservation of embryos at the blastocyst stage may provide an effective method to increase the cumulative pregnancy rate for each treatment cycle of ovarian-stimulated IVF. The objective of this study was to evaluate the survival rate and hatching rate of bovine blastocysts following vitrification using a method designed for oocytes, with a view to introducing this methodology into human assisted reproduction technology and reproductive medicine. Bovine blastocysts were produced from abattoir materials subjected to in-vitro maturation and in-vitro fertilization. Survival rate of the bovine blastocysts was 100% (94/94) following vitrification using a method designed for oocyte cryopreservation. There was no difference in the hatching rate of the bovine blastocysts between control (62.5%: 60/96) and vitrified (61.7%: 58/94) groups. The number of dead cells in the blastocysts was not significantly different between control (5.0 +/- 2.9) and vitrified (9.5 +/- 4.0) groups. In conclusion, the results of this study indicate that bovine blastocysts can be vitrified successfully using a procedure designed for oocyte cryopreservation. It is possible that this method may also be successful for the cryopreservation of human embryos. A further study into this is currently being organized.

  20. The Antarctic nematode Plectus murrayi: an emerging model to study multiple stress survival.

    Science.gov (United States)

    Adhikari, Bishwo N; Tomasel, Cecilia M; Li, Grace; Wall, Diana H; Adams, Byron J

    2010-11-01

    The genus Plectus is one of the most widely distributed and common nematode taxa of freshwater and terrestrial habitats in the world, and is of particular interest because of its phylogenetic position relative to the origin of the Secernentean radiation. Plectus murrayi, a bacteria-feeding nematode, inhabits both semi-aquatic and terrestrial biotopes in the Antarctic McMurdo Dry Valleys (MCM), where its distribution is limited by organic carbon and soil moisture. Plectus nematodes from the MCM can survive extreme desiccation, freezing conditions, and other types of stress. Ongoing investigations of the physiological and molecular aspects of the stress biology of P. murrayi, along with the availability of genomic resources, will likely establish this nematode as an excellent invertebrate model system for studies of extreme environmental survival, and may provide a valuable source of genomic resources for comparative studies in other organisms. Moreover, because P. murrayi and Caenorhabditis elegans share a most recent common ancestor with the rest of the Secernentea, and given the ability of P. murrayi to be cultured at lower temperatures compared to C. elegans, P. murrayi could also be an emerging model system for the study of the evolution of environment-sensitive (stress response) alleles in nematodes.

  1. HER-3 overexpression is prognostic of reduced breast cancer survival: a study of 4046 patients.

    Science.gov (United States)

    Chiu, Connie G; Masoudi, Hamid; Leung, Samuel; Voduc, David K; Gilks, Blake; Huntsman, David G; Wiseman, Sam M

    2010-06-01

    Advances in molecular biology have led to the identification of potential markers of prognostic and therapeutic importance in human cancers. HER-2 testing and targeted therapy now represents a critical cornerstone in the management of breast cancer. The objectives of the current study were to determine the frequency and prognostic significance of HER-3 over-expression and HER-4 over-expression by invasive breast cancer. Tissue microarrays were constructed using clinically annotated formalin-fixed and paraffin-embedded tumor samples from 4046 patients diagnosed with invasive breast carcinoma with a median 12.5 years of follow-up. Type 1 growth factor receptor family members HER-1, HER-2, HER-3, and HER-4 expression levels were determined by immunohistochemistry, and HER-2 status was further resolved by fluorescent in-situ hybridization. The study cohort was randomly divided and analyzed as a core data set and a validation data set. HER-3 over-expression was identified in 10.0% of tumors and was a significant marker of reduced patient breast cancer-specific survival on univariate analysis (P = 1.32 x 10(-5)). Furthermore, in tumors with normal expression levels of HER-1 and HER-2, the overexpression of HER-3 had a significant negative prognostic effect on disease-specific survival (HR: 1.541, 95% CI: 1.166-2.036, P = 2.37 x 10(-3)) independent of patient age at diagnosis, Estrogen receptor status, tumor grade, tumor size, nodal status, and the presence of lymphatic or vascular invasion by cancer. HER-4 overexpression was identified in 78.2% of breast cancers and was not a significant marker of patient survival (P = 0.214). Results of all statistical tests were positively confirmed in the validation data set analysis. HER-3 status is an important prognostic marker of disease-specific survival in patients with invasive breast cancer. Accordingly, evaluation of the HER-3 expression level may identify a subset of patients with a poor disease prognosis, and who could

  2. Non-exercise physical activity and survival: English longitudinal study of ageing.

    Science.gov (United States)

    Hamer, Mark; de Oliveira, Cesar; Demakakos, Panayotes

    2014-10-01

    The activity patterns of older adults include more light/mild-intensity or "non-exercise" activity and less moderate- to vigorous-intensity activity. The health benefits of this type of activity pattern remain unclear. To examine dose-response associations between physical activity and survival using time-varying analysis to understand the importance of "non-exercise" activity for survival in older adults. Participants (N=10,426) were drawn from The English Longitudinal Study of Ageing, a representative sample of men and women aged ≥50 years living in England. Participant data were linked with death records from the National Health Service registries from 2002 to 2011. Analyses were conducted in 2013. Cox proportional hazards models were used to estimate the risk of death according to time-varying estimates of physical activity. Over an average follow-up of 7.8 years (median follow-up, 8.5 years), there were 1,896 deaths. In models adjusted for comorbidities, psychosocial factors, smoking, and obesity, there was a dose-response association between time-varying physical activity and mortality, with the greatest survival benefit in vigorously active participants. However, participating in mild ("non-exercise")-intensity physical activity was also associated with a lower risk of all-cause mortality (hazard ratio [HR]=0.76, 95% CI=0.69, 0.83); cardiovascular mortality (HR=0.74, 95% CI=0.64, 0.85); and death by other causes (HR=0.67, 95% CI=0.58, 0.78). Time-varying models produced stronger, more robust estimates than models using a single measurement of physical activity at baseline. Older adults gain health benefits from participating in regular "non-exercise" physical activity, although the greatest benefits are observed for more vigorous activity. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Survival after acute hemodialysis in Pennsylvania, 2005-2007: a retrospective cohort study.

    Science.gov (United States)

    Ramer, Sarah J; Cohen, Elan D; Chang, Chung-Chou H; Unruh, Mark L; Barnato, Amber E

    2014-01-01

    Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity. This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council. Exposure variable is acute hemodialysis; dependent variable is survival following acute hemodialysis. We used multivariable logistic regression to determine propensity to receive acute hemodialysis and then, for a Cox proportional hazards model, matched acute hemodialysis and non-acute hemodialysis patients 1∶5 on this propensity. In 2,131,248 admissions of adults without end-stage renal disease, there were 6,657 instances of acute hemodialysis. In analyses adjusted for predicted probability of death upon admission plus other covariates and stratified on age, being male, black, and insured were independent predictors of receipt of acute hemodialysis. One-year post-admission mortality was 43% for those receiving acute hemodialysis, compared to 13% among those not receiving acute hemodialysis. After matching on propensity to receive acute hemodialysis and adjusting for predicted probability of death upon admission, patients who received acute hemodialysis had a higher risk of death than patients who did not over at least 1 year of follow-up (hazard ratio 1·82, 95% confidence interval 1·68-1·97). In a populous US state, receipt of acute hemodialysis varied by age, sex, race, and insurance status even after adjustment for illness severity. In a comparison of patients with similar propensity to receive acute hemodialysis, those who did receive it were less likely to survive than those who did not. These findings raise questions about reasons for lack of benefit.

  4. Survival after acute hemodialysis in Pennsylvania, 2005-2007: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Ramer

    Full Text Available BACKGROUND: Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity. MATERIALS AND METHODS: This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council. Exposure variable is acute hemodialysis; dependent variable is survival following acute hemodialysis. We used multivariable logistic regression to determine propensity to receive acute hemodialysis and then, for a Cox proportional hazards model, matched acute hemodialysis and non-acute hemodialysis patients 1∶5 on this propensity. RESULTS: In 2,131,248 admissions of adults without end-stage renal disease, there were 6,657 instances of acute hemodialysis. In analyses adjusted for predicted probability of death upon admission plus other covariates and stratified on age, being male, black, and insured were independent predictors of receipt of acute hemodialysis. One-year post-admission mortality was 43% for those receiving acute hemodialysis, compared to 13% among those not receiving acute hemodialysis. After matching on propensity to receive acute hemodialysis and adjusting for predicted probability of death upon admission, patients who received acute hemodialysis had a higher risk of death than patients who did not over at least 1 year of follow-up (hazard ratio 1·82, 95% confidence interval 1·68-1·97. CONCLUSIONS: In a populous US state, receipt of acute hemodialysis varied by age, sex, race, and insurance status even after adjustment for illness severity. In a comparison of patients with similar propensity to receive acute hemodialysis, those who did receive it were less likely to survive than those who did not. These findings raise questions about reasons for lack of

  5. Total transvaginal endoscopic abdominal wall hernia repair: a NOTES survival study.

    Science.gov (United States)

    Lomanto, D; Dhir, U; So, J B Y; Cheah, W K; Moe, M A; Ho, K Y

    2009-08-01

    Natural orifice transluminal endoscopic surgery (NOTES) has gained widespread interest as a potentially less invasive alternative to laparoscopic surgery or, else, an evolution as the next-generation surgery. The main objective of this study was to assess the safety of transluminal abdominal wall hernia repair for potential human application by specifically investigating the feasibility and challenges of using a transvaginal approach. NOTES ventral hernia repair via a transvaginal approach. University Hospital (National University Health System, Singapore). The study utilized five female pigs (30-40 kg) between 5 and 7 months of age, which underwent abdominal wall hernia repair using a transvaginal approach. The procedures were performed using a double-channel endoscope under general endotracheal anesthesia. A mesh was placed and fixed to the abdominal wall using standard laparoscopic and endoscopic equipment. The animals survived for 2 weeks and were then euthanized and a necropsy performed. To assess the safety and feasibility of NOTES ventral hernia repair in a survival experimental model. All of the procedures could be safely performed using the standard equipment. At the necropsy, all meshes were well in place and mild adhesions were recorded in one animal with a small abscess in the subcutaneous area. This novel approach seems technically challenging but feasible using equipment and accessories currently available for conventional laparoscopic and interventional endoscopy with low intra-abdominal contamination and sepsis. New procedure-specific instruments and equipment need to be developed to allow the surgeon safer access and more degrees of instrument freedom.

  6. A Randomized Study on Postrelapse Disease-Free Survival with Adjuvant Mistletoe versus Oral Etoposide in Osteosarcoma Patients

    Directory of Open Access Journals (Sweden)

    Alessandra Longhi

    2014-01-01

    Full Text Available Background. Osteosarcoma is a highly malignant bone tumour. After the second relapse, the 12-month postrelapse disease-free survival (PRDFS rate decreases below 20%. Oral Etoposide is often used in clinical practice after surgery as an “adjuvant” outside any protocol and with only limited evidence of improved survival. Viscum album fermentatum Pini (Viscum is an extract of mistletoe plants grown on pine trees for subcutaneous (sc injection with immunomodulatory activity. Methods. Encouraged by preliminary findings, we conducted a study where osteosarcoma patients free from disease after second metastatic relapse were randomly assigned to Viscum sc or Oral Etoposide. Our goal was to compare 12-month PRDFS rates with an equivalent historical control group. Results. Twenty patients have been enrolled, with a median age of 34 years (range 11–65 and a median follow-up time of 38.5 months (3–73. The median PRDSF is currently 4 months (1–47 in the Etoposide and 39 months (2–73 in the Viscum group. Patients getting Viscum reported a higher quality of life due to lower toxicity. Conclusion. Viscum shows promise as adjuvant treatment in prolonging PRDFS after second relapse in osteosarcoma patients. A larger study is required to conclusively determine efficacy and immunomodulatory mechanisms of Viscum therapy in osteosarcoma patients.

  7. A Randomized Study on Postrelapse Disease-Free Survival with Adjuvant Mistletoe versus Oral Etoposide in Osteosarcoma Patients.

    Science.gov (United States)

    Longhi, Alessandra; Reif, Marcus; Mariani, Erminia; Ferrari, Stefano

    2014-01-01

    Background. Osteosarcoma is a highly malignant bone tumour. After the second relapse, the 12-month postrelapse disease-free survival (PRDFS) rate decreases below 20%. Oral Etoposide is often used in clinical practice after surgery as an "adjuvant" outside any protocol and with only limited evidence of improved survival. Viscum album fermentatum Pini (Viscum) is an extract of mistletoe plants grown on pine trees for subcutaneous (sc) injection with immunomodulatory activity. Methods. Encouraged by preliminary findings, we conducted a study where osteosarcoma patients free from disease after second metastatic relapse were randomly assigned to Viscum sc or Oral Etoposide. Our goal was to compare 12-month PRDFS rates with an equivalent historical control group. Results. Twenty patients have been enrolled, with a median age of 34 years (range 11-65) and a median follow-up time of 38.5 months (3-73). The median PRDSF is currently 4 months (1-47) in the Etoposide and 39 months (2-73) in the Viscum group. Patients getting Viscum reported a higher quality of life due to lower toxicity. Conclusion. Viscum shows promise as adjuvant treatment in prolonging PRDFS after second relapse in osteosarcoma patients. A larger study is required to conclusively determine efficacy and immunomodulatory mechanisms of Viscum therapy in osteosarcoma patients.

  8. Long-term integrated studies show complex and surprising effects of climate change in northern hardwood forests

    Science.gov (United States)

    Peter M. Groffman; Lindsey Rustad; Pamela H. Templer; John Campbell; Lynn M. Christenson; Nina K. Lany; Anne M. Socci; Matthew A. Vadeboncoeur; Paul Schaberg; Geoffrey F. Wilson; Charles T. Driscoll; Timothy J. Fahey; Melany C. Fisk; Christine L. Goodale; Mark B. Green; Steven P. Hamburg; Chris E. Johnson; Myron J. Mitchell; Jennifer L. Morse; Linda H. Pardo; Nicholas L. Rodenhouse

    2012-01-01

    Evaluations of the local effects of global change are often confounded by the interactions of natural and anthropogenic factors that overshadow the effects of climate changes on ecosystems. Long-term watershed and natural elevation gradient studies at the Hubbard Brook Experimental Forest and in the surrounding region show surprising results demonstrating the effects...

  9. Better survival in patients with metastasised kidney cancer after nephrectomy: a population-based study in the Netherlands

    NARCIS (Netherlands)

    Aben, K.K.H.; Heskamp, S.; Janssen-Heijnen, M.L.; Koldewijn, E.L.; Herpen, C.M. van; Kiemeney, L.A.L.M.; Oosterwijk, E.; Spronsen, D.J. van

    2011-01-01

    AIM: Cytoreductive nephrectomy is considered beneficial in patients with metastasised kidney cancer but only a minority of these patients undergo cytoreductive surgery. Factors associated with nephrectomy and the independent effect of nephrectomy on survival were evaluated in this study. METHODS:

  10. Study Proposal for Reproductive Success and Nestling Survival of White-faced Ibis in Relation to Habitat in Northwest Nevada

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The goal of this study is to determine nesting success, survival rate of nestlings, and recruitment of fledglings relative to habitat conditions within major nesting...

  11. The outcome and survival of palliative surgery in thoraco-lumbar spinal metastases: contemporary retrospective cohort study

    NARCIS (Netherlands)

    Nemelc, R.M.; Stadhouder, A.; van Royen, B.J.; Jiya, T.U.

    2014-01-01

    Purpose To evaluate outcome and survival and to identify prognostic variables for patients surgically treated for spinal metastases. Methods A retrospective study was performed on 86 patients, surgically treated for spinal metastases. Preoperative analyses of the ASIA and spinal instability

  12. Non-specific effects of vaccination on child survival: prospective cohort study in Burkina Faso.

    Science.gov (United States)

    Vaugelade, J; Pinchinat, S; Guiella, G; Elguero, E; Simondon, F

    2004-12-04

    To study the effect of vaccination on mortality before 2 years of age in a developing country. Prospective cohort study. Rural communities in Burkina Faso. 9085 children born in the study area between 1985 and 1993. Child death rate. Mortality before 2 years of age was lower in children who had been vaccinated: those vaccinated with BCG only had significantly lower mortality (risk ratio for vaccinated v unvaccinated children 0.37, 95% confidence interval 0.29 to 0.48) as did those vaccinated with diphtheria, tetanus, and pertussis only (0.24, 0.13 to 0.43). The second dose of diphtheria, tetanus, and pertussis was not associated with lower mortality (0.80, 0.58 to 1.12). Vaccination with diphtheria, tetanus, and pertussis as well as BCG is associated with better survival of children up to 2 years of age.

  13. Disparities in breast cancer survival in the United States (2001-2009): Findings from the CONCORD-2 study.

    Science.gov (United States)

    Miller, Jacqueline W; Smith, Judith Lee; Ryerson, A Blythe; Tucker, Thomas C; Allemani, Claudia

    2017-12-15

    Reducing breast cancer incidence and achieving equity in breast cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring breast cancer survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of cancer management and treatment. We analyzed breast cancer survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009). Overall, 5-year breast cancer net survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, survival was 89.6% for white females and 78.4% for black females. Breast cancer survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in breast cancer survival can highlight populations in need of improved cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  14. Survival of patients with Kaposi’s sarcoma in the South African antiretroviral treatment era: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    M M Sengayi

    2017-10-01

    Full Text Available Background. When South Africa (SA implemented its antiretroviral therapy (ART programme in 2004, the model for treating HIV-positive Kaposi’s sarcoma (KS patients shifted from symptomatic palliation to potential cure. Objective. To evaluate survival and changes over time in AIDS-KS patients treated at a tertiary academic hospital oncology unit (the Steve Biko Academic Hospital medical oncology unit in Pretoria, SA, in the context of ART availability in SA. Methods. We conducted a retrospective review of electronic and paper records of KS patients who accessed cancer care between May 2004 and September 2012. We used Kaplan-Meier survival functions to estimate 1- and 2-year survival, and Cox regression models to identify changes over time and prognostic factors. Results. Our study included 357 AIDS-KS patients, almost all of whom were black Africans (n=353, 98.9%; 224 (62.7% were men. The median age at cancer diagnosis was 37 (interquartile range (IQR 30 - 43 years, and the median baseline CD4+ count was 242 (IQR 130 - 403 cells/µL. Most patients received ART (n=332, 93.0% before or after KS diagnosis; 169 (47.3% were treated with chemotherapy and 209 (58.6% with radiation therapy. Mortality was 62.7% lower (adjusted hazard ratio (HR 0.37, 95% confidence interval (CI 0.19 - 0.73 in the late (2009 - 2012 than in the early (2004 - 2008 ART period. Receiving chemotherapy (adjusted HR 0.3, 95% CI 0.15 - 0.61 and poor-risk AIDS Clinical Trials Group KS stage (adjusted HR 2.88, 95% CI 1.36 - 6.09 predicted mortality. Conclusions. Our results show that large national ART roll-out programmes can successfully reduce KS-related mortality at the individual patient level. If ART coverage is extended, KS-associated morbidity and mortality are likely to drop.

  15. Predicting survival of de novo metastatic breast cancer in Asian women: systematic review and validation study.

    Science.gov (United States)

    Miao, Hui; Hartman, Mikael; Bhoo-Pathy, Nirmala; Lee, Soo-Chin; Taib, Nur Aishah; Tan, Ern-Yu; Chan, Patrick; Moons, Karel G M; Wong, Hoong-Seam; Goh, Jeremy; Rahim, Siti Mastura; Yip, Cheng-Har; Verkooijen, Helena M

    2014-01-01

    In Asia, up to 25% of breast cancer patients present with distant metastases at diagnosis. Given the heterogeneous survival probabilities of de novo metastatic breast cancer, individual outcome prediction is challenging. The aim of the study is to identify existing prognostic models for patients with de novo metastatic breast cancer and validate them in Asia. We performed a systematic review to identify prediction models for metastatic breast cancer. Models were validated in 642 women with de novo metastatic breast cancer registered between 2000 and 2010 in the Singapore Malaysia Hospital Based Breast Cancer Registry. Survival curves for low, intermediate and high-risk groups according to each prognostic score were compared by log-rank test and discrimination of the models was assessed by concordance statistic (C-statistic). We identified 16 prediction models, seven of which were for patients with brain metastases only. Performance status, estrogen receptor status, metastatic site(s) and disease-free interval were the most common predictors. We were able to validate nine prediction models. The capacity of the models to discriminate between poor and good survivors varied from poor to fair with C-statistics ranging from 0.50 (95% CI, 0.48-0.53) to 0.63 (95% CI, 0.60-0.66). The discriminatory performance of existing prediction models for de novo metastatic breast cancer in Asia is modest. Development of an Asian-specific prediction model is needed to improve prognostication and guide decision making.

  16. Social equity in perinatal survival: a case-control study at hospitals in Kigali, Rwanda.

    Science.gov (United States)

    Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Selling, Katarina Ekholm; Persson, Lars-Åke

    2015-12-01

    Rwanda has invested heavily in improving maternal and child health, but knowledge is limited regarding social equity in perinatal survival. We analysed whether perinatal mortality risks differed between social groups in hospitals in the country's capital. A case-control study was carried out on singleton births aged at least 22 weeks of gestation and born in district or tertiary referral hospitals in Kigali from July 2013 to May 2014. Perinatal deaths were recorded as they occurred, with the next two surviving neonates born in the same hospital selected as controls. Conditional logistic regression was used to determine social determinants of perinatal death after adjustments for potential confounders. We analysed 234 perinatal deaths and 468 controls. Rural residence was linked to an increased risk of perinatal death (OR = 3.31, 95% CI 1.43-7.61), but maternal education or household asset score levels were not. Having no health insurance (OR = 2.11, 95% CI 0.91-4.89) was associated with an increased risk of perinatal death, compared to having community health insurance. Living in a rural area and having no health insurance were associated with an increased risk of perinatal mortality rates in the Rwandan capital, but maternal education and household assets were not. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  17. Survival Potential and Photosynthetic Activity of Lichens Under Mars-Like Conditions: A Laboratory Study

    Science.gov (United States)

    de Vera, Jean-Pierre; Möhlmann, Diedrich; Butina, Frederike; Lorek, Andreas; Wernecke, Roland; Ott, Sieglinde

    2010-03-01

    Lichens were repetitively exposed over 22 days to thermophysical Mars-like conditions at low-and mid-latitudes. The simulated parameters and the experimental setup are described. Natural samples of the lichen Xanthoria elegans were used to investigate their ability to survive the applied Mars-like conditions. The effects of atmospheric pressure, CO2 concentration, low temperature, water availability, and light on Mars were also studied. The results of these experiments indicate that - no significant decrease in the vitality of the lichen occurred after exposure to simulated martian conditions, which was demonstrated by confocal laser scanning microscopy analysis, and - a 95% CO2 atmosphere with 100% humidity, low pressure (partial pressure of CO2 was 600 Pa), and low temperature has a balancing effect on photosynthetic activity as a function of temperature. This means a starting low photosynthetic activity at high CO2 concentrations with Earth-like pressure has a reduction of 60%. But, if the simulated atmospheric pressure is reduced to Mars-like conditions with the maintenance of the same Mars-like 95% CO2 concentration, the photosynthetic activity increases and again reaches similar values as those exhibited under terrestrial atmospheric pressure and concentration. Based on these results, we presume that, in any region on Mars where liquid water might be available, even for short periods of time, a eukaryotic symbiotic organism would have the ability to survive, at least over weeks, and to temporarily photosynthesize.

  18. SAMPLE SIZE DETERMINATION IN NON-RADOMIZED SURVIVAL STUDIES WITH NON-CENSORED AND CENSORED DATA

    Directory of Open Access Journals (Sweden)

    S FAGHIHZADEH

    2003-06-01

    Full Text Available Introduction: In survival analysis, determination of sufficient sample size to achieve suitable statistical power is important .In both parametric and non-parametric methods of classic statistics, randomn selection of samples is a basic condition. practically, in most clinical trials and health surveys randomn allocation is impossible. Fixed - effect multiple linear regression analysis covers this need and this feature could be extended to survival regression analysis. This paper is the result of sample size determination in non-randomnized surval analysis with censored and non -censored data. Methods: In non-randomnized survival studies, linear regression with fixed -effect variable could be used. In fact such a regression is conditional expectation of dependent variable, conditioned on independent variable. Likelihood fuction with exponential hazard constructed by considering binary variable for allocation of each subject to one of two comparing groups, stating the variance of coefficient of fixed - effect independent variable by determination coefficient , sample size determination formulas are obtained with both censored and non-cencored data. So estimation of sample size is not based on the relation of a single independent variable but it could be attain the required power for a test adjusted for effect of the other explanatory covariates. Since the asymptotic distribution of the likelihood estimator of parameter is normal, we obtained the variance of the regression coefficient estimator formula then by stating the variance of regression coefficient of fixed-effect variable, by determination coefficient we derived formulas for determination of sample size in both censored and non-censored data. Results: In no-randomnized survival analysis ,to compare hazard rates of two groups without censored data, we obtained an estimation of determination coefficient ,risk ratio and proportion of membership to each group and their variances from

  19. Tetranectin positive expression in tumour tissue leads to longer survival in Danish women with ovarian cancer. Results from the 'Malova' ovarian cancer study

    DEFF Research Database (Denmark)

    Heeran, Mel C; Rask, Lene; Høgdall, Claus K

    2015-01-01

    of the disease. Using tissue arrays we analysed the expression levels in tissues from 166 women with borderline ovarian tumours (BOTs) and 592 women with ovarian cancer (OC). A panel of three antibodies was used for immunohistochemistry: a polyclonal and two monoclonal antibodies. Serum TN was measured using......The primary objective of this study was to analyse Tetranectin (TN) expression in tumour tissues and TN serum concentration in 758 women with epithelial ovarian tumours. The second was to evaluate, whether TN tissue expression levels correlate with clinico-pathological parameters and prognosis...... the polyclonal antibody A-371. Univariate survival analyses stratified for chemotherapy showed that positive tissue TN as demonstrated by the polyclonal antibody indicated a significantly longer overall survival (OS) (p = 0.0001) as well as cancer specific survival (CSS) (p

  20. Comparison of Survival and Safety Requirements in European Union for Recreational Craft Inspections. A Spanish Case Study

    Directory of Open Access Journals (Sweden)

    J. Torralbo

    2014-03-01

    Full Text Available Statistical data shows that a large number of maritime accidents are related to recreational craft. For instance, in Spain, more than fifty percent of the emergencies are related to pleasure boats at sea. Recreational craft marketed in the EU must comply with harmonized technical safety and environmental requirements defined by Directive 94/25/EC, as amended in 2003. On 28 December 2013, the new recreational craft directive 2013/53/EU was published in the Official Journal of the European Union. EU Member States have until 18 January 2016 to amend their national legislation and transpose the new directive. The current directive 94/25/EC as amended by directive 2003/44/EC will be repealed on 18 January 2016, after the full application of the new text. Although this directive, there is not a clear coordination and equivalence among the EU countries according to the survival and safety equipment compulsory for recreational crafts. The main purpose of this paper is to analyze and compare the types of survey / inspections to be carried in pleasure craft (non-commercial use, periodicity and required safety equipment in some member states of the European Union. A case study of Spain is presented. From the results obtained, we can make clear that in the European Union there is a lack of coordination in this area and indicate the need to unify a common pattern in inspections and survival and safety requirements of recreational boats in the EU.

  1. Liver cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.

    Science.gov (United States)

    Momin, Behnoosh R; Pinheiro, Paulo S; Carreira, Helena; Li, Chunyu; Weir, Hannah K

    2017-12-15

    Worldwide, liver cancer is a leading cause of death for both men and women. The number of Americans who are diagnosed with and die of liver cancer has been rising slowly each year. Using data from the CONCORD-2 study, this study examined population-based survival by state, race, and stage at diagnosis. Data from 37 statewide registries, which covered 81% of the US population, for patients diagnosed during 2001-2009 were analyzed. Survival up to 5 years was adjusted for background mortality (net survival) with state- and race-specific life tables, and it was age-standardized with the International Cancer Survival Standard weights. Liver cancer was diagnosed overall more often at the localized stage, with blacks being more often diagnosed at distant and regional stages than whites. 5-year net survival was 12.2% in 2001-2003 and 14.8% in 2004-2009. Whites had higher survival than blacks in both calendar periods (11.7% vs 9.1% and 14.3% vs 11.4%, respectively). During 2004-2009, 5-year survival was 25.7% for localized-stage disease, 9.5% for regional-stage disease, and 3.5% for distant-stage disease. Some progress has occurred in survival for patients with liver cancer, but 5-year survival remains low, even for those diagnosed at the localized stage. Efforts directed at controlling well-established risk factors such as hepatitis B may have the greatest impact on reducing the burden of liver cancer in the United States. Cancer 2017;123:5059-78. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  2. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study.

    Science.gov (United States)

    Mattison, Julie A; Roth, George S; Beasley, T Mark; Tilmont, Edward M; Handy, April M; Herbert, Richard L; Longo, Dan L; Allison, David B; Young, Jennifer E; Bryant, Mark; Barnard, Dennis; Ward, Walter F; Qi, Wenbo; Ingram, Donald K; de Cabo, Rafael

    2012-09-13

    Calorie restriction (CR), a reduction of 10–40% in intake of a nutritious diet, is often reported as the most robust non-genetic mechanism to extend lifespan and healthspan. CR is frequently used as a tool to understand mechanisms behind ageing and age-associated diseases. In addition to and independently of increasing lifespan, CR has been reported to delay or prevent the occurrence of many chronic diseases in a variety of animals. Beneficial effects of CR on outcomes such as immune function, motor coordination and resistance to sarcopenia in rhesus monkeys have recently been reported. We report here that a CR regimen implemented in young and older age rhesus monkeys at the National Institute on Aging (NIA) has not improved survival outcomes. Our findings contrast with an ongoing study at the Wisconsin National Primate Research Center (WNPRC), which reported improved survival associated with 30% CR initiated in adult rhesus monkeys (7–14 years) and a preliminary report with a small number of CR monkeys. Over the years, both NIA and WNPRC have extensively documented beneficial health effects of CR in these two apparently parallel studies. The implications of the WNPRC findings were important as they extended CR findings beyond the laboratory rodent and to a long-lived primate. Our study suggests a separation between health effects, morbidity and mortality, and similar to what has been shown in rodents, study design, husbandry and diet composition may strongly affect the life-prolonging effect of CR in a long-lived nonhuman primate.

  3. Prediction of survival after out-of-hospital cardiac arrest: results of a community-based study in Vienna.

    Science.gov (United States)

    Gaul, G B; Gruska, M; Titscher, G; Blazek, G; Havelec, L; Marktl, W; Muellner, W; Kaff, A

    1996-10-01

    The objective of this study was the assessment of out-of-hospital cardiac arrest and the definition of possible predictive factors for final hospital discharge. Out of a database of 89,557 consecutive missions of the Vienna emergency medical system (EMS) during 1990, there were 623 missions due to a collapse of non-traumatic origin: in 374 cases (60.0%) the patients were declared dead without further attempts at resuscitation. The remaining 249 patients were analysed for predictive factors at site. Survival to hospital admission: 109 patients survived to hospital admission (43.7%); bystander support had a small impact (P < 0.05) on survival to hospital arrival whereas age and gender had no predictive power. Most patients with ventricular tachycardia/fibrillation (VT/VF) survived primarily (69 of 117, i.e. 59.0%). Survival to hospital discharge: 27 patients were discharged from hospital care (10.8%). ECG findings on arrival of the EMS physician at the site proved to be the only powerful predictor for survival: 24 of 117 patients with VT/VF survived compared with only one of 81 with primary asystole, two of 39 with severe bradycardia, and no patient with electromechanical dissociation.

  4. Survival Rates from Fracture of Endodontically Treated Premolars Restored with Full-coverage Crowns or Direct Resin Composite Restorations: A Retrospective Study.

    Science.gov (United States)

    Suksaphar, Warattama; Banomyong, Danuchit; Jirathanyanatt, Titalee; Ngoenwiwatkul, Yaowaluk

    2017-12-02

    The aim of the present study was to compare the survival rates against fracture of premolar endodontically treated teeth (ETT) restored with resin composite or crowns and to identify risk factors associated with the fracture. Data from dental records and radiographs of premolar ETT with postendodontic restorations (ie, resin composite or crowns) were collected between 2012 and 2016 and selected following selected inclusion and exclusion criteria. Tooth location, type of restoration, number of proximal contacts, and amount of tooth surface loss were recorded. The incidence and restorability of postendodontic fractures were identified. Survival rates against fracture of the 2 restoration types were calculated using Kaplan-Meier survival analysis. Any potential factors associated with fractures were identified using Cox proportional hazards models. The survival rate against fracture of ETT restored with crowns (95.1%) was higher than resin composite (77.0%). ETT restored with resin composite with 1 or 2 tooth surface losses and 2 proximal contacts had a high survival rate of 88.5% that was not significantly different from ETT with crowns. A higher incidence of restorability after fracture was observed in teeth restored with resin composite than crowns. The type of restoration and number of proximal contacts were identified as potential risk factors associated with fracture incidence. The survival rate against fracture of ETT restored with crowns was higher than resin composite. However, ETT with 1 or 2 tooth surface losses and 2 proximal contacts and restored with resin composite showed a high survival rate that was comparable with ETT restored with crowns. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

  6. A multicenter study on Leigh syndrome: disease course and predictors of survival.

    Science.gov (United States)

    Sofou, Kalliopi; De Coo, Irenaeus F M; Isohanni, Pirjo; Ostergaard, Elsebet; Naess, Karin; De Meirleir, Linda; Tzoulis, Charalampos; Uusimaa, Johanna; De Angst, Isabell B; Lönnqvist, Tuula; Pihko, Helena; Mankinen, Katariina; Bindoff, Laurence A; Tulinius, Már; Darin, Niklas

    2014-04-15

    Leigh syndrome is a progressive neurodegenerative disorder, associated with primary or secondary dysfunction of the mitochondrial oxidative phosphorylation. Despite the fact that Leigh syndrome is the most common phenotype of mitochondrial disorders in children, longitudinal natural history data is missing. This study was undertaken to assess the phenotypic and genotypic spectrum of patients with Leigh syndrome, characterise the clinical course and identify predictors of survival in a large cohort of patients. This is a retrospective study of patients with Leigh syndrome that have been followed at eight centers specialising in mitochondrial diseases in Europe; Gothenburg, Rotterdam, Helsinki, Copenhagen, Stockholm, Brussels, Bergen and Oulu. A total of 130 patients were included (78 males; 52 females), of whom 77 patients had identified pathogenic mutations. The median age of disease onset was 7 months, with 80.8% of patients presenting by the age of 2 years. The most common clinical features were abnormal motor findings, followed by abnormal ocular findings. Epileptic seizures were reported in 40% of patients. Approximately 44% of patients experienced acute exacerbations requiring hospitalisation during the previous year, mainly due to infections. The presence of pathological signs at birth and a history of epileptic seizures were associated with higher occurrence of acute exacerbations and/or relapses. Increased lactate in the cerebrospinal fluid was significantly correlated to a more severe disease course, characterised by early onset before 6 months of age, acute exacerbations and/or relapses, as well as brainstem involvement. 39% of patients had died by the age of 21 years, at a median age of 2.4 years. Disease onset before 6 months of age, failure to thrive, brainstem lesions on neuroimaging and intensive care treatment were significantly associated with poorer survival. This is a multicenter study performed in a large cohort of patients with Leigh syndrome

  7. Eleven-Year Retrospective Survival Study of 275 Veneered Lithium Disilicate Single Crowns.

    Science.gov (United States)

    Simeone, Piero; Gracis, Stefano

    2015-01-01

    The aim of the present clinical retrospective study was to evaluate the long-term survival and clinical performance of veneered lithium disilicate single restorations in anterior and posterior areas after up to 11 years. Following a rigid protocol, 275 lithium disilicate single crowns (35 IPS Empress II and 240 e.max Press) were cemented over 11 years, in 106 patients, using an adhesive technique; of these 106 were anterior (38.5%) and 169 posterior (61.5%) teeth. Teeth receiving endodontic therapy and composite reconstruction (50%) and teeth with preexisting metalceramic crowns, called prosthetic retreatments (PR; 65%), were included as well. Of the 106 patients enrolled in the study, 25 (23.5%) were diagnosed with bruxism habits, and 7 of these patients (6.6% of all patients) received full-mouth single lithium disilicate restorations (FMR). The exclusion criteria for this retrospective clinical study were: monolithic lithium disilicate crowns, teeth with cast post and cores, implant-supported all-ceramic crowns, active periodontitis, and/or poor oral hygiene. Clinical reevaluation was performed by the clinicians who prepared and luted them during maintenance appointments between January 2012 and October 2013. Number of restoration failures and characteristics of failures were recorded. Marginal adaptation and marginal discoloration were evaluated based on the Cvar-Ryge criteria. The overall cumulative survival rate was 98.2%. The failures recorded were the result of either mechanical failure or debonding. Five crowns failed mechanically-three because of chipping and two because of core fracture-and were replaced. None of the failed crowns was associated with the bruxers with FMR. A total of 15 crowns debonded (5.5% of all crowns); however, 11 belonged to the same patient who had endodontically treated and reconstructed abutments. In this retrospective clinical evaluation of up to 132 months, veneered lithium disilicate single crowns had a low failure rate.

  8. Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study.

    Science.gov (United States)

    Figueras, J; Jaurrieta, E; Valls, C; Benasco, C; Rafecas, A; Xiol, X; Fabregat, J; Casanovas, T; Torras, J; Baliellas, C; Ibañez, L; Moreno, P; Casais, L

    1997-06-01

    Cumulative recurrence after surgical resection for hepatocellular carcinoma (HCC) is very high. Several retrospective analyses have shown that liver transplantation was more effective than resection for patients with HCC at early tumor stages. Consequently, in January 1990, we decided to prospectively indicate orthotopic liver transplantation (OLT) as the first surgical treatment for small, localized HCC in cirrhotic patients without nodal involvement independently of the degree of liver function. The aim of this prospective cohort study was to analyze prognosis, recurrence rate, and survival after liver transplantation in patients in whom the main indication was HCC with cirrhosis. Thirty-eight patients in whom the main indication for liver transplantation was HCC and hepatic cirrhosis were compared with 136 transplantations because of cirrhosis without tumor, performed in our unit from January 1990 to December 1995. HCC arising in noncirrhotic livers and those incidently discovered after OLT were excluded from the study. Chemoembolization using doxorubicin, lipiodol, and Gelfoam was performed before OLT in 31 patients with good liver function. There were no differences in gender, but HCC patients were older (57 +/- 7 vs. 50 +/- 10 years [P < .001]). Liver function was better in HCC (Child-Pugh score: 6.9 +/- 2 vs. 8.6 +/- 1.8; P < .001), and hepatitis C virus antibody was positive in 31 (82%) vs. 51 (37%) (P < .007). Seven tumors had bilobar involvement (18%). Capsule was present in 22 (58%). The mean size of the tumor was 3.4 +/- 2 cm. Seventeen tumors (45%) were larger than 3 cm, and 4 (11%) were larger than 5 cm. The average number of nodules was 2 +/- 1. The tumor-node-metastasis stage of the tumors was pT1 in 6 patients (16%), 11 were pT2 (29%), 12 were pT3 (31%), and 9 were pT4 (24%). Seven patients were retransplanted in the HCC group (18%) and 19 (14%) in the nontumor group (not significant). Tumor recurrence was detected in three patients (8%). One, 3

  9. Preoperative Cholesterol Level Is Associated With Worse Pathological Outcomes and Postoperative Survival in Localized Renal Cell Carcinoma Patients: A Propensity Score-Matched Study.

    Science.gov (United States)

    Lee, Hakmin; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe; Seo, Seong Il; Lee, Hyun Moo; Oh, Jong Jin; Lee, Sang Chul; Hong, Sung Kyu; Lee, Sang Eun; Byun, Seok-Soo

    2017-12-01

    Lipid metabolism has been suggested to be associated with clinical outcomes of renal cell carcinoma (RCC). In this study, we aimed to investigate the relationship between preoperative cholesterol level (PCL) and postoperative outcomes of patients with localized RCC. We retrospectively analyzed the data of 5022 patients surgically treated for nonmetastatic RCC. According to the receiver operating curve of PCL for cancer-specific mortality, we stratified the patients into 2 groups by using a cutoff value of 161 mg/dL. The propensity scores for having low PCL were calculated, and the low PCL group was matched with the high PCL group at a 1:2 ratio. The oncological profiles and postoperative survival of patients were compared. A low cholesterol level was significantly associated with adverse pathologic findings, such as higher pathologic stage (P cholesterol group showed significantly worse progression-free, cancer-specific, and overall survival (all P values cholesterol group. Multivariate analysis exhibited a higher PCL as an independent predictor of better progression-free (P < .001), cancer-specific (P = .018), and overall survival (P = .001) after matching. Subgroup analysis according to tumor histology revealed that PCL had a significant relationship with patients' survival in clear cell RCC, but not in non-clear cell RCC. Decreased PCL was significantly associated with worse pathologic outcomes and also inferior postoperative survival in patients with localized RCC; however, those relationships were significant only in clear cell subtypes. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. A Study of the Survival and Oxygen Deficiency at the Zebra Mussel (Dreissena polymorpha Treated with Zinc (Zn

    Directory of Open Access Journals (Sweden)

    Bogdan N. Nikolov

    2009-07-01

    Full Text Available The current paper studies the change of respiratory rate and survival of Dreissena polymorpha at short exposure to zinc under laboratory conditions. The experiment is lasted 96h and three different concentrations of ZnSO4.7H2O were used - 0.5mg/l, 1.5mg/l; 2,0 mg/l. Survival and intensity of breathing of Dreissena polymorpha decreases with the increasing concentration of zinc in the water.

  11. Residential road traffic noise exposure and colorectal cancer survival - A Danish cohort study

    DEFF Research Database (Denmark)

    Roswall, Nina; Bidstrup, Pernille Envold; Raaschou-Nielsen, Ole

    2017-01-01

    traffic noise at different time-windows, and overall and CRC-specific mortality. Furthermore, we investigated interaction with sex, age, prognostic factors, and comorbidity. Mortality Rate Ratios (MRR) were calculated in unadjusted models, and adjusted for railway noise, lifestyle factors......BACKGROUND: Residential traffic noise exposure may entail sleep disruption and compromised circadian functioning; two factors which have been associated with a poor colorectal cancer (CRC) prognosis. Hence, the aim of the present study was to investigate the association between residential road...... traffic noise and CRC survival. METHODS AND MATERIALS: Road traffic noise was calculated for all residential addresses from 1987 to February 2012 for incident CRC cases (n = 1,234) in a cohort of 57,053 Danes. We used Cox Proportional Hazard Models to investigate the association between residential road...

  12. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  13. Statin Use and Breast Cancer Survival: A Nationwide Cohort Study from Finland

    Science.gov (United States)

    Murtola, Teemu J.; Visvanathan, Kala; Artama, Miia; Vainio, Harri; Pukkala, Eero

    2014-01-01

    Recent studies have suggested that statins, an established drug group in the prevention of cardiovascular mortality, could delay or prevent breast cancer recurrence but the effect on disease-specific mortality remains unclear. We evaluated risk of breast cancer death among statin users in a population-based cohort of breast cancer patients. The study cohort included all newly diagnosed breast cancer patients in Finland during 1995–2003 (31,236 cases), identified from the Finnish Cancer Registry. Information on statin use before and after the diagnosis was obtained from a national prescription database. We used the Cox proportional hazards regression method to estimate mortality among statin users with statin use as time-dependent variable. A total of 4,151 participants had used statins. During the median follow-up of 3.25 years after the diagnosis (range 0.08–9.0 years) 6,011 participants died, of which 3,619 (60.2%) was due to breast cancer. After adjustment for age, tumor characteristics, and treatment selection, both post-diagnostic and pre-diagnostic statin use were associated with lowered risk of breast cancer death (HR 0.46, 95% CI 0.38–0.55 and HR 0.54, 95% CI 0.44–0.67, respectively). The risk decrease by post-diagnostic statin use was likely affected by healthy adherer bias; that is, the greater likelihood of dying cancer patients to discontinue statin use as the association was not clearly dose-dependent and observed already at low-dose/short-term use. The dose- and time-dependence of the survival benefit among pre-diagnostic statin users suggests a possible causal effect that should be evaluated further in a clinical trial testing statins’ effect on survival in breast cancer patients. PMID:25329299

  14. An Incident Cohort Study Comparing Survival on Home Hemodialysis and Peritoneal Dialysis (Australia and New Zealand Dialysis and Transplantation Registry)

    Science.gov (United States)

    Nadeau-Fredette, Annie-Claire; Hawley, Carmel M.; Pascoe, Elaine M.; Chan, Christopher T.; Clayton, Philip A.; Polkinghorne, Kevan R.; Boudville, Neil; Leblanc, Martine

    2015-01-01

    Background and objectives Home dialysis is often recognized as a first-choice therapy for patients initiating dialysis. However, studies comparing clinical outcomes between peritoneal dialysis and home hemodialysis have been very limited. Design, setting, participants, & measurements This Australia and New Zealand Dialysis and Transplantation Registry study assessed all Australian and New Zealand adult patients receiving home dialysis on day 90 after initiation of RRT between 2000 and 2012. The primary outcome was overall survival. The secondary outcomes were on-treatment survival, patient and technique survival, and death-censored technique survival. All results were adjusted with three prespecified models: multivariable Cox proportional hazards model (main model), propensity score quintile–stratified model, and propensity score–matched model. Results The study included 10,710 patients on incident peritoneal dialysis and 706 patients on incident home hemodialysis. Treatment with home hemodialysis was associated with better patient survival than treatment with peritoneal dialysis (5-year survival: 85% versus 44%, respectively; log-rank Pdialysis. PMID:26068181

  15. Multicenter Study of Planar Technetium 99m Pyrophosphate Cardiac Imaging: Predicting Survival for Patients With ATTR Cardiac Amyloidosis.

    Science.gov (United States)

    Castano, Adam; Haq, Muhammad; Narotsky, David L; Goldsmith, Jeff; Weinberg, Richard L; Morgenstern, Rachelle; Pozniakoff, Ted; Ruberg, Frederick L; Miller, Edward J; Berk, John L; Dispenzieri, Angela; Grogan, Martha; Johnson, Geoffrey; Bokhari, Sabahat; Maurer, Mathew S

    2016-11-01

    Transthyretin cardiac amyloidosis (also known as ATTR cardiac amyloidosis) is an increasingly recognized cause of heart failure with preserved ejection fraction. In single-center studies, technetium 99m pyrophosphate (Tc 99m PYP) cardiac imaging noninvasively detects ATTR cardiac amyloidosis, but the accuracy of this technique in a multicenter study and the association of Tc 99m PYP myocardial uptake with survival are unknown. To assess Tc 99m PYP cardiac imaging as a diagnostic tool for ATTR cardiac amyloidosis and its association with survival in a multicenter study. Retrospective cohort study performed at 3 academic specialty centers for cardiac amyloidosis in the United States in which 229 participants were evaluated for cardiac amyloidosis and also underwent Tc 99m PYP cardiac imaging. The date of analysis and final confirmation from the statistician was May 4, 2016. Tc 99m PYP cardiac imaging for detection of ATTR cardiac amyloidosis. Retention of Tc 99m PYP in the heart was assessed using both a semiquantitative visual score (range, 0 [no uptake] to 3 [uptake greater than bone]) and a quantitative heart to contralateral (H/CL) ratio. The H/CL ratio was calculated as total counts in a region of interest over the heart divided by background counts in an identical size region of interest over the contralateral chest. The outcome measured was time to death after Tc 99m PYP imaging. Tc 99m PYP imaging of 171 participants (121 with ATTR cardiac amyloidosis and 50 with non-ATTR cardiac amyloidosis [34 with AL amyloidosis and 16 with nonamyloid heart failure with preserved ejection fraction]; 86% male; median [IQR] age, 73 years [65-79 years]) demonstrated 91% sensitivity and 92% specificity for detecting ATTR cardiac amyloidosis with an area under the curve of 0.960 (95% CI, 0.930-0.981). Univariable and multivariable Cox proportional hazards regression analyses among participants with ATTR cardiac amyloidosis showed that an H/CL ratio of 1.6 or greater predicted

  16. Immuno-histochemical study of ovine cystic echinococcosis (Echinococcus granulosus) shows predominant T cell infiltration in established cysts.

    Science.gov (United States)

    Vismarra, A; Mangia, C; Passeri, B; Brundu, D; Masala, G; Ledda, S; Mariconti, M; Brindani, F; Kramer, L; Bacci, C

    2015-04-30

    Ovine hydatidosis (OH; Echinococcus granulosus) is endemic in several European countries surrounding the Mediterranean basin. There have been a limited number of studies aimed at evaluating the local immune response to established tissue cysts in the ovine host. In the present study, immunohistochemical analysis of lymphocyte populations surrounding established cysts showed a predominance of CD3+ T cells compared to CD79+ B cells. A percentage of infiltrating lymphocytes were also FoxP3+, suggesting that established ovine cysts may be protected from immune aggression through the suppressive action of T regulatory cells. The present study contributes to the understanding of local immune responses to ovine echinococcosis. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Full dates (day, month, year) should be used in population-based cancer survival studies.

    Science.gov (United States)

    Woods, Laura M; Rachet, Bernard; Ellis, Libby; Coleman, Michel P

    2012-10-01

    Accurate survival estimates are essential for monitoring cancer survival trends, for health care planning and for resource allocation. To obtain precise estimates of survival, full dates (day, month and year) rather than partial dates (month and year) are required. In some jurisdictions, however, cancer registries are constrained from providing full dates on the grounds of confidentiality. The bias resulting from the use of partial dates in the estimation and comparison of survival makes it impossible to determine precisely the differences in the risk of death from cancer between population groups or in successive calendar periods. Important operational arguments also exist against the use of incomplete dates for survival analysis, including increased workload for cancer registry staff and the introduction of avoidable complexity for quality control of survival data. Cancer survival is one of the most widely known outputs produced by population-based cancer registries, and it is a crucial metric for the comparative effectiveness of health services. The bodies that set data access guidelines must take a more balanced view of the risks and benefits of using full dates for the estimation of cancer survival. Copyright © 2012 UICC.

  18. The influence of genetic ancestry and ethnicity on breast cancer survival associated with genetic variation in the TGF-β-signaling pathway: The Breast Cancer Health Disparities Study.

    Science.gov (United States)

    Slattery, Martha L; Lundgreen, Abbie; Stern, Marianna C; Hines, Lisa; Wolff, Roger K; Giuliano, Anna R; Baumgartner, Kathy B; John, Esther M

    2014-03-01

    The TGF-β signaling pathway regulates cellular proliferation and differentiation. We evaluated genetic variation in this pathway, its association with breast cancer survival, and survival differences by genetic ancestry and self-reported ethnicity. The Breast Cancer Health Disparities Study includes participants from the 4-Corners Breast Cancer Study (n = 1,391 cases) and the San Francisco Bay Area Breast Cancer Study (n = 946 cases) who have been followed for survival. We evaluated 28 genes in the TGF-β signaling pathway using a tagSNP approach. Adaptive rank truncated product (ARTP) was used to test the gene and pathway significance by Native American (NA) ancestry and by self-reported ethnicity (non-Hispanic white (NHW) and Hispanic/NA). Genetic variation in the TGF-β signaling pathway was associated with overall breast cancer survival (P ARTP = 0.05), especially for women with low NA ancestry (P ARTP = 0.007) and NHW women (P ARTP = 0.006). BMP2, BMP4, RUNX1, and TGFBR3 were significantly associated with breast cancer survival overall (P ARTP = 0.04, 0.02, 0.002, and 0.04, respectively). Among women with low NA, ancestry associations were as follows: BMP4 (P ARTP = 0.007), BMP6 (P ARTP = 0.001), GDF10 (P ARTP = 0.05), RUNX1 (P ARTP = 0.002), SMAD1 (P ARTP = 0.05), and TGFBR2 (P ARTP = 0.02). A polygenic risk model showed that women with low NA ancestry and high numbers of at-risk alleles had twice the risk of dying from breast cancer as did women with high NA ancestry. Our data suggest that genetic variation in the TGF-β signaling pathway influences breast cancer survival. Associations were similar when the analyses were stratified by genetic ancestry or by self-reported ethnicity.

  19. Locally ablative treatment of breast cancer liver metastases: identification of factors influencing survival (the Mammary Cancer Microtherapy and Interventional Approaches (MAMMA MIA) study).

    Science.gov (United States)

    Seidensticker, Max; Garlipp, Benjamin; Scholz, Sophia; Mohnike, Konrad; Popp, Felix; Steffen, Ingo; Seidensticker, Ricarda; Stübs, Patrick; Pech, Maciej; PowerskI, Maciej; Hass, Peter; Costa, Serban-Dan; Amthauer, Holger; Bruns, Christiane; Ricke, Jens

    2015-07-14

    Liver metastases from breast cancer (LMBC) are typically considered to indicate systemic disease spread and patients are most often offered systemic palliative treatment only. However, retrospective studies suggest that some patients may have improved survival with local treatment of their liver metastases compared to systemic therapy alone. In the absence of randomized trials, it is important to identify patient characteristics indicating that benefit from local treatment can be expected. 59 patients undergoing radiofrequency ablation (RFA), interstitial brachytherapy (BT), or radioembolization (RE) of LMBC as a salvage treatment were studied. Potential factors influencing survival were analyzed in a multivariate Cox model. For factors identified to have an independent survival impact, Kaplan-Meier analysis and comparison of overall survival (OS) using the log-rank test was performed. Median OS following local interventional treatment was 21.9 months. Considering only factors evaluable at treatment initiation, maximum diameter of liver metastases (≥3.9 cm; HR: 3.1), liver volume (≥ 1376 mL; HR: 2.3), and history of prior chemotherapy (≥ 3 lines of treatment; HR: 2.5-2.6) showed an independent survival impact. When follow-up data were included in the analysis, significant factors were maximum diameter of liver metastases (≥ 3.9 cm; HR: 3.1), control of LMBC during follow-up (HR: 0.29), and objective response as best overall response (HR: 0.21). Neither the presence of any extrahepatic metastases nor presence of bone metastases only had a significant survival impact. Median OS was 38.7 vs. 16.1 months in patients with metastases history of systemic LMBC treatment are most likely to benefit from local approaches. Limited extrahepatic disease should not lead to exclusion from a randomized study and should not be a contraindication for local LMBC treatment as long as no randomized data are available.

  20. The McGill Brisbane Symptom Score in relation to survival in pancreatic adenocarcinoma: a validation study.

    Science.gov (United States)

    Doi, Suhail A R; Furuya-Kanamori, Luis; Engel, Jessica M; Jamal, Mohammad H; Stankowski, Rachel V; Barkun, Jeffrey; Onitilo, Adedayo A

    2016-07-01

    The McGill Brisbane Symptom Score (MBSS) is a clinical score for pancreatic cancer patients upon initial presentation that takes into account four variables (weight loss, abdominal pain, jaundice, and history of smoking) to stratify them into two MBSS intensity categories. Several studies have suggested that these categories are strongly associated with eventual survival in patients with resectable (rPCa) and unresectable (uPCa) pancreatic cancer. This study aimed to validate the MBSS in a cohort of patients with pancreatic cancer from a single institution. Survival time by resection status and MBSS intensity category were analyzed among 633 patients from our institution between 2001 and 2010. Hazard ratios for death using Cox proportional hazards models, with age as the timescale, adjustment for sex and year of diagnosis, and stratified by adjuvant chemotherapy status were estimated. Median survival time was the longest in patients with low-intensity MBSS and rPCa (817 days), whereas the shortest survival time was found among patients with uPCa regardless of MBSS status (144-147 days). After consideration of age and chemotherapy status, high-intensity MBSS was associated with poorer survival for both rPCa (HR 1.64; 95 % CI 1.07-2.52) and uPCa (HR 1.35; 95 % CI 1.06-1.72). Preoperative MBSS intensity is a useful prognostic indicator of survival in resectable as well as unresectable pancreatic cancer.

  1. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  2. Foodborne Pread of Hepatitis A: Recent Studies on Virus Survival, Transfer and Inactivation

    Directory of Open Access Journals (Sweden)

    Syed A Sattar

    2000-01-01

    Full Text Available Hepatitis A virus (HAV is responsible for considerable morbidity and economic losses worldwide, and is the only reportable, foodborne viral pathogen in Canada. Outbreaks caused by it occur more frequently in settings such as hospitals, daycare centres, schools, and in association with foods and food service establishments. In recent years, the incidence of hepatitis A has increased in Canada. Many factors, including changing lifestyles and demographics, faster and more frequent travel, and enhanced importation of foods from hepatitis A-endemic regions, may be behind this increase. Despite its increasing significance as a human pathogen, not much was known until recently about the survival and inactivation of HAV, and even less was understood about the effectiveness of measures to prevent and control its foodborne spread. Studies conducted in the past decade have shown that HAV can survive for several hours on human hands and for several days on environmental surfaces indoors. The virus can also retain its infectivity for several days on fruits and vegetables which are often consumed raw, and such imported items have already been incriminated in disease outbreaks. Casual contact between contaminated hands and clean food items can readily lead to a transfer of as much as 10% of the infectious virus. HAV is also relatively resistant to inactivation by heat, gamma irradiation and chemical germicides. In view of these findings, better approaches to prevent the contamination of foods with HAV and more effective methods for its inactivation in foods, on environmental surfaces and on the hands of food handlers are needed.

  3. Predicting survival of de novo metastatic breast cancer in Asian women: systematic review and validation study.

    Directory of Open Access Journals (Sweden)

    Hui Miao

    Full Text Available BACKGROUND: In Asia, up to 25% of breast cancer patients present with distant metastases at diagnosis. Given the heterogeneous survival probabilities of de novo metastatic breast cancer, individual outcome prediction is challenging. The aim of the study is to identify existing prognostic models for patients with de novo metastatic breast cancer and validate them in Asia. MATERIALS AND METHODS: We performed a systematic review to identify prediction models for metastatic breast cancer. Models were validated in 642 women with de novo metastatic breast cancer registered between 2000 and 2010 in the Singapore Malaysia Hospital Based Breast Cancer Registry. Survival curves for low, intermediate and high-risk groups according to each prognostic score were compared by log-rank test and discrimination of the models was assessed by concordance statistic (C-statistic. RESULTS: We identified 16 prediction models, seven of which were for patients with brain metastases only. Performance status, estrogen receptor status, metastatic site(s and disease-free interval were the most common predictors. We were able to validate nine prediction models. The capacity of the models to discriminate between poor and good survivors varied from poor to fair with C-statistics ranging from 0.50 (95% CI, 0.48-0.53 to 0.63 (95% CI, 0.60-0.66. CONCLUSION: The discriminatory performance of existing prediction models for de novo metastatic breast cancer in Asia is modest. Development of an Asian-specific prediction model is needed to improve prognostication and guide decision making.

  4. Individual social capital and survival: a population study with 5-year follow-up.

    Science.gov (United States)

    Ejlskov, Linda; Mortensen, Rikke N; Overgaard, Charlotte; Christensen, Line R B U; Vardinghus-Nielsen, Henrik; Kræmer, Stella R J; Wissenberg, Mads; Hansen, Steen M; Torp-Pedersen, Christian; Hansen, Claus D

    2014-10-02

    The concept of social capital has received increasing attention as a determinant of population survival, but its significance is uncertain. We examined the importance of social capital on survival in a population study while focusing on gender differences. We used data from a Danish regional health survey with a five-year follow-up period, 2007-2012 (n = 9288, 53.5% men, 46.5% women). We investigated the association between social capital and all-cause mortality, performing separate analyses on a composite measure as well as four specific dimensions of social capital while controlling for covariates. Analyses were performed with Cox proportional hazard models by which hazard ratios and 95% confidence intervals were calculated. For women, higher levels of social capital were associated with lower all-cause mortality regardless of age, socioeconomic status, health, and health behaviour (HR = 0.586, 95% CI = 0.421-0.816) while no such association was found for men (HR = 0.949, 95% CI = 0.816-1.104). Analysing the specific dimensions of social capital, higher levels of trust and social network were significantly associated with lower all-cause mortality in women (HR = 0.827, 95% CI = 0.750-0.913 and HR = 0.832, 95% CI = 0.729-0.949, respectively). For men, strong social networks were associated with a higher risk of all-cause mortality (HR = 1.132, 95% CI = 1.017-1.260). Civic engagement had a similar effect for both men (HR = 0.848, 95% CI = 0.722-0.997) and women (HR = 0.848, 95% CI = 0.630-1.140). We found differential effects of social capital in men compared to women. The predictive effects on all-cause mortality of four specific dimensions of social capital varied. Gender stratified analysis and the use of multiple indicators to measure social capital are thus warranted in future research.

  5. Survival and predictors of disability in Turkish MS patients. Turkish Multiple Sclerosis Study Group (TUMSSG).

    Science.gov (United States)

    Kantarci, O; Siva, A; Eraksoy, M; Karabudak, R; Sütlaş, N; Ağaoğlu, J; Turan, F; Ozmenoğlu, M; Toğrul, E; Demirkiran, M

    1998-09-01

    To examine the natural history, survival, and prognostic factors in a sample of Turkish MS patients. This multicenter study included 1,259 definite MS patients diagnosed according to the criteria of Poser et al. Actuarial analysis of selected disability levels of 3, 6, 8, and 10 achieved with the Expanded Disability Status Scale (EDSS); a multivariate Cox regression analysis for prognostic factors related to time to reach EDSS > or = 6; and Pearson's correlation coefficient for individual factors were performed. The survival (+/- SE) at 15 years from onset was 94.6 +/- 2.9%, and at 25 years was 89.0 +/- 5.8%. The disability reached by 15 years was EDSS > or = 3 in 66.4%, EDSS > or = 6 in 41.2%, EDSS > or = 8 in 10.5%, and EDSS = 10 in 5.4%. The most significant unfavorable prognostic factors were progressive course (relative risk [RR], 3.73; CI, 2.71 to 5.13) and sphincter symptoms at onset (RR, 1.86; CI, 1.23 to 2.82), followed by male sex, motor symptoms at onset, and a high attack frequency within the first 5 years. Primary progressive disease was correlated positively with male sex (r = 0.0895, p = 0.001), older age (r = 0.1807, p = 0.000), and motor (r = 0.1433, p = 0.000) or sphincter symptoms (r = 0.1001, p = 0.000) at onset, unlike relapsing-remitting and secondary progressive disease. Although a slightly better prognosis is observed in the Turkish MS population, early prognostic factors are similar to most of the previous Western series. Primary progressive disease, mostly seen in older men with motor and sphincter involvement at onset, has a worse prognosis and may represent a distinct behavioral variant of MS.

  6. Severe Obesity Impacts Recurrence-Free Survival of Women with High-Risk Endometrial Cancer: Results of a French Multicenter Study

    National Research Council Canada - National Science Library

    Canlorbe, Geoffroy; Bendifallah, Sofiane; Raimond, Emilie; Graesslin, Olivier; Hudry, Delphine; Coutant, Charles; Touboul, Cyril; Bleu, Géraldine; Collinet, Pierre; Darai, Emile; Ballester, Marcos

    2015-01-01

    Studies focusing on the impact of obesity on survival in endometrial cancer (EC) have reported controversial results and few data exist on the impact of obesity on recurrence rate and recurrence-free survival (RFS...

  7. Overall survival and final efficacy and safety results from a Japanese phase II study of axitinib in cytokine-refractory metastatic renal cell carcinoma

    Science.gov (United States)

    Eto, Masatoshi; Uemura, Hirotsugu; Tomita, Yoshihiko; Kanayama, Hiroomi; Shinohara, Nobuo; Kamei, Yoichi; Fujii, Yosuke; Umeyama, Yoshiko; Ozono, Seiichiro; Naito, Seiji; Akaza, Hideyuki

    2014-01-01

    In an open-label, multicenter phase II study of Japanese patients with cytokine-refractory metastatic renal cell carcinoma, axitinib showed substantial antitumor activity with an acceptable safety profile. Here, we report overall survival and updated efficacy and safety results. Sixty-four Japanese patients with metastatic renal cell carcinoma following prior therapy with cytokines were treated with axitinib at a starting dose of 5 mg b.i.d. Following median treatment duration of 14.2 months, median overall survival was 37.3 months (95% CI, 28.6–49.9). The objective response rate, the primary endpoint of the study, was 51.6% (95% CI, 38.7–64.2); the median duration of response, 11.1 months (95% CI, 8.2–13.7); and the median progression-free survival was 11.0 months (95% CI, 9.2–12.0), assessed by the independent review committee. Common treatment-related all-grade adverse events were hypertension (88%), hand-foot syndrome (75%), diarrhea (66%), proteinuria (63%), fatigue (55%) and dysphonia (53%). In an exploratory analysis, median overall survival was found to be significantly longer in patients who had greater decreases in plasma levels of soluble vascular endothelial growth factor receptor-2 during the first cycle of treatment. In conclusion, the present study showed axitinib to be effective, and toxicities with long-term treatment were generally controllable with axitinib dose modification and/or standard medications in these Japanese patients. Some frequently reported adverse events warrant close monitoring and management. Changes in the plasma levels of soluble vascular endothelial growth factor receptor-2 may be used as a prognostic factor for overall survival in metastatic renal cell carcinoma following axitinib treatment. This study is registered at http://ClinicalTrial.gov (identifier NCT00569946). PMID:25283266

  8. Nonlinear Analysis of Motor Activity Shows Differences between Schizophrenia and Depression: A Study Using Fourier Analysis and Sample Entropy

    Science.gov (United States)

    Hauge, Erik R.; Berle, Jan Øystein; Oedegaard, Ketil J.; Holsten, Fred; Fasmer, Ole Bernt

    2011-01-01

    The purpose of this study has been to describe motor activity data obtained by using wrist-worn actigraphs in patients with schizophrenia and major depression by the use of linear and non-linear methods of analysis. Different time frames were investigated, i.e., activity counts measured every minute for up to five hours and activity counts made hourly for up to two weeks. The results show that motor activity was lower in the schizophrenic patients and in patients with major depression, compared to controls. Using one minute intervals the depressed patients had a higher standard deviation (SD) compared to both the schizophrenic patients and the controls. The ratio between the root mean square successive differences (RMSSD) and SD was higher in the schizophrenic patients compared to controls. The Fourier analysis of the activity counts measured every minute showed that the relation between variance in the low and the high frequency range was lower in the schizophrenic patients compared to the controls. The sample entropy was higher in the schizophrenic patients compared to controls in the time series from the activity counts made every minute. The main conclusions of the study are that schizophrenic and depressive patients have distinctly different profiles of motor activity and that the results differ according to period length analysed. PMID:21297977

  9. Longitudinal study showed that the quality of life of Finnish adolescents with cerebral palsy continued to be relatively good.

    Science.gov (United States)

    Böling, Sanna; Varho, Tarja; Haataja, Leena

    2018-03-01

    This longitudinal study examined what perceptions paediatric patients with cerebral palsy (CP) and their caregivers had of the patient's quality of life (QoL). It examined changing trends as children with CP became adolescents and examined the feasibility of the Finnish version of the CP QOL-Teen questionnaire. Carried out in autumn 2015, this study formed part of the multi-centre Finnish national CP project and aimed to validate the CP QOL-Teen questionnaire, which was posted to 54 adolescents and their caregivers. They included 24 who had responded to CP QOL-Child questionnaire in 2013. The questionnaires were returned by 27 pairs of adolescents and caregivers and one extra caregiver also responded. Of these, 24 pairs had taken part in the 2013 survey. The internal consistencies of the sum variables were found to be acceptable in all cases. Overall QoL showed an average score of 81.8 on a scale from 0 to 100. Adolescents reported significantly higher QoL than their caregivers. There were no significant differences between the responses of the children and adolescents. We showed that QoL was relatively good in childhood and adolescence. The Finnish version of the CP QOL-Teen questionnaire was an appropriate clinical tool for assessing QoL. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. Nomogram prediction of survival in patients with brain metastases from hepatocellular carcinoma treated with whole-brain radiotherapy: a multicenter retrospective study.

    Science.gov (United States)

    Park, Younghee; Kim, Kyung Su; Kim, Kyubo; Chie, Eui Kyu; Kim, Jin Ho; Kim, Jae-Sung; Kim, Tae Hyun; Kim, Dae Yong; Jang, Won Il; Kim, Mi-Sook; Koo, Tae Ryool; Chang, Ah Ram

    2015-11-01

    The incidence of brain metastasis from hepatocellular carcinoma (HCC) is increasing because of the improved survival outcome of HCC patients, but the prognosis of these patients is extremely poor. HCC patients with brain metastasis were investigated to identify their prognostic factors for overall survival. Patients with brain metastasis from HCC who had been treated with whole-brain radiotherapy (WBRT) in five hospitals were enrolled in the study. The medical records of the patients were reviewed, and the clinical factors were analyzed to identify the prognostic factors for overall survival. Of the total of 97 patients who were enrolled in the study, 83 were male and the median age at the brain metastases was 56.6 years. Motor weakness (43.3 %) and headache (41.2 %) were common presenting symptoms. The median AFP level was 4180 ng/ml, and 81 patients were assessed as belonging to Child-Pugh classification A upon the diagnosis of brain metastasis. WBRT alone in 71 patients, surgery or radiosurgery combined with WBRT as the adjuvant setting in 18 patients, and WBRT as salvage treatment in 8 patients were performed. The median overall survival of the patients was 3.5 months. In the multivariate analysis, the ECOG performance status (PS), Child-Pugh classification, AFP, and treatment aim showed significant association with the overall survival of the patients. Based on these factors, a nomogram predicting the prognosis was developed. The concordance index of the nomogram was 0.74, and the prediction was well calibrated. In conclusion, the survival outcome of patients with brain metastasis from HCC can be predicted with the nomogram constructed from the ECOG PS, Child-Pugh classification, AFP, and treatment aim.

  11. Protective role of the apolipoprotein E2 allele in age-related disease traits and survival: Evidence from the Long Life Family Study

    Science.gov (United States)

    Kulminski, Alexander M.; Raghavachari, Nalini; Arbeev, Konstantin G.; Culminskaya, Irina; Arbeeva, Liubov; Wu, Deqing; Ukraintseva, Svetlana V.; Christensen, Kaare; Yashin, Anatoliy I.

    2016-01-01

    The apolipoprotein E (apoE) is a classic example of a gene exhibiting pleiotropism. We examine potential pleiotropic associations of the apoE2 allele in three biodemographic cohorts of long-living individuals, offspring, and spouses from the Long Life Family Study, and intermediate mechanisms, which can link this allele with age-related phenotypes. We focused on age-related macular degeneration, bronchitis, asthma, pneumonia, stroke, creatinine, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, diseases of heart (HD), cancer, and survival. Our analysis detected favorable associations of the ε2 allele with lower LDL-C levels, lower risks of HD, and better survival. The ε2 allele was associated with LDL-C in each gender and biodemographic cohort, including long-living individuals, offspring, and spouses, resulting in highly significant association in the entire sample (beta=-7.1, p=6.6×10-44). This allele was significantly associated with HD in long-living individuals and offspring (relative risk [RR]=0.60, p=3.1×10-6) but this association was not mediated by LDL-C. The protective effect on survival was specific for long-living women but it was not explained by LDL-C and HD in the adjusted model (RR=0.70, p=2.1×10-2). These results show that ε2 allele may favorably influence LDL-C, HD, and survival through three mechanisms. Two of them (HD- and survival-related) are pronounced in the long-living parents and their offspring; the survival-related mechanism is also sensitive to gender. The LDL-C-related mechanism appears to be independent of these factors. Insights into mechanisms linking ε2 allele with age-related phenotypes given biodemographic structure of the population studied may benefit translation of genetic discoveries to health care and personalized medicine. PMID:27447179

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Longitudinal study shows that addictive Internet use during adolescence was associated with heavy drinking and smoking cigarettes in early adulthood.

    Science.gov (United States)

    Lee, Bo Hye; Lee, Hae Kook

    2017-03-01

    Existing studies showing an association between substance use disorders and Internet addiction have been limited due their cross-sectional design. This longitudinal study investigated the association between addictive Internet use during adolescence and heavy drinking and cigarette smoking in early adulthood. We focused on middle school students from the Korea Youth Panel Study who were 15 in 2003:1804 who did not drink alcohol and 2277 who did not smoke. Multivariate logistic analysis investigated the relationships between Internet use at the age of 15, with regard to location, time spent and reason for use, and drinking and smoking at the age of 20. Using the Internet for chatting, games and adult websites at the age of 15 had a significant association with heavy drinking at the age of 20. The Internet café as the location for Internet use at the age of 15 was associated with smoking behaviour at the age of 20. This study confirmed significant associations between addictive use of the Internet at the age of 15 and heavy drinking and cigarette smoking at the age of 20. The findings demonstrated the negative effects of addictive Internet use, one of the biggest problems with adolescents. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Amyotrophic lateral sclerosis: impact of pulmonary follow-up and mechanical ventilation on survival. A study of 114 cases.

    Science.gov (United States)

    Sanjuán-López, Pilar; Valiño-López, Paz; Ricoy-Gabaldón, Jorge; Verea-Hernando, Héctor

    2014-12-01

    To study the impact of ventilatory management and treatment on the survival of patients with amyotrophic lateral sclerosis (ALS). Retrospective analysis of 114 consecutive patients admitted to a general hospital, evaluating demographic data, type of presentation, clinical management, treatment with mechanical ventilation and survival. descriptive and Kaplan-Meier estimator. Sixty four patients presented initial bulbar involvement. Overall mean survival after diagnosis was 28.0 months (95%CI, 21.1-34.8). Seventy patients were referred to the pulmonary specialist (61.4%) and 43 received non-invasive ventilation (NIV) at 12.7 months (median) after diagnosis. Thirty seven patients continued to receive NIV with no subsequent invasive ventilation. The mean survival of these patients was 23.3 months (95%CI, 16.7-28.8), higher in those without bulbar involvement, although below the range of significance. Survival in the 26 patients receiving programmed NIV was higher than in the 11 patients in whom this was indicated without prior pulmonary assessment (considered following diagnosis, P<.012, and in accordance with the start of ventilation, P<.004). A total of 7 patients were treated invasively; mean survival in this group was 72 months (95%CI, 14.36-129.6), median 49.6±17.5 (95%CI, 15.3-83.8), and despite the difficulties involved in home care, acceptance and tolerance was acceptable. Long-term mechanical ventilation prolongs survival in ALS. Programmed pulmonary assessment has a positive impact on survival of ALS patients and is key to the multidisciplinary management of this disease. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  15. Does Jatropha curcas L. show resistance to drought in the Sahelian zone of West Africa? A case study from Burkina Faso

    Science.gov (United States)

    Bayen, P.; Sop, T. K.; Lykke, A. M.; Thiombiano, A.

    2015-05-01

    Land degradation is an environmental problem which weakens agro-sylvo-pastoral productivity in sub-Saharan Africa. The most common manifestation of land degradation is the appearance of denuded land. We carried out an experiment to test the effect of three soil and water conservation techniques on survival and growth of Jatropha curcas seedlings transplanted onto two completely denuded lands in the Sahelian and Sudanian zones of Burkina Faso. We implemented an experimental design with three replicates per restoration technique. A total of 174 seedlings were planted in each study site. The results showed that the soil water content varied according to the restoration technique used (df = 2; F = 53.21; p curcas is unsuited to denuded land in the Sahelian zone. Most of the plants died in the Sahel between April and May, which is the peak of the dry season; this may be an indication that J. curcas may not be as drought-resistant as suggested by the prolific literature which has reported on diverse claims surrounding this plant.

  16. Further studies on the survival of non-proliferating human diploid fibroblasts irradiated with ultraviolet light

    Energy Technology Data Exchange (ETDEWEB)

    Chan, G.L.; Little, J.B. (Harvard Univ., Boston, MA (USA). School of Public Health)

    1982-04-01

    Labelling index data showed that in AG1518 cells, a diploid human fibroblast strain, there was a lag period of at least 14 hours between subculture from the density-inhibited plateau phase of growth and entry into DNA synthesis. Cells irradiated with 254nm wavelength U.V. light 8 hours after subculture did not exhibit the same degree of resistance as cells irradiated in plateau phase and subcultured immediately. When cells were arrested from proliferation by maintenance in an arginine and glutamine deficient medium for 72 hours, they were nearly as resistant to U.V. light as plateau phase cells although maintenance in this medium for 24 hours after irradiation supported further recovery only after low U.V. doses. One strain of Cockayne syndrome fibroblasts was found to be resistant to U.V. light in plateau phase while another strain was found to have the same survival response whether it was irradiated in the plateau or log phase of growth.

  17. Study of Survival Rate After Cardiopulmonary Resuscitation (CPR) in Hospitals of Kermanshah in 2013

    Science.gov (United States)

    Goodarzi, Afshin; Jalali, Amir; Almasi, Afshin; Naderipour, Arsalan; Kalhori, Reza Pourmirza; Khodadadi, Amineh

    2015-01-01

    Background: After CPR, the follow-up of survival rate and caused complications are the most important practices of the medical group. This study was performed aimed at determining the follow-up results after CPR in patients of university hospitals in Kermanshah in 2014. Methods: In this prospective study, 320 samples were examined. A purposive sampling method was used, and data was collected using a researcher-made information form with content and face validity and reliability of r= 0.79. Data was analyzed with STATA9 software and statistical tests, including calculation of the success rate, relative risk (RR), chi-square and Fisher at significance level of P < 0.05. Results: The initial success rate of cardiopulmonary resuscitation was equal to 15.3%, while the ultimate success rate (discharged alive from the hospital) was as 10.6%. The six-month success rate after resuscitation was 8.78% than those who were discharged alive. There were no significant statistical differences between different age groups regarding the initial success rate of resuscitation (P = 0.14), and the initial resuscitation success rate was higher in patients in morning shift (P = 0.02). Conclusion: By the results of study, it is recommended to increase the medical - nursing knowledge and techniques for personnel in the evening and night shifts. Also, an appropriate dissemination of health care staff in working shifts should be done to increase the success rate of CPR procedure. PMID:25560341

  18. Following Musical Shows: A Study with Focal Groups on Satisfaction of Musical Concerts Regular Visitors and Socialization between Them

    Directory of Open Access Journals (Sweden)

    Lúmia Massa Garcia Pires

    2017-06-01

    Full Text Available This article aimed to identify which attributes impact more significantly on the satisfaction of concerts’ regular visitors and socialization between them when inserted in these kinds of events. Thus, we used a qualitative methodology, performing focus groups. Among the main results of this study, we found, regarding satisfaction of concerts’ visitors, the attributes that most influence the public are related to services - especially for beverage supply, cleaning of bathrooms and lines formed inside the event - organization, show infrastructure and performance artists. Furthermore, considering the socialization of the visitors, we found that most respondents often go to concerts together with other people, but some did not exclude the possibility to attend the concerts alone when it comes to a familiar artist.

  19. Complex mixtures of dissolved pesticides show potential aquatic toxicity in a synoptic study of Midwestern U.S. streams

    Science.gov (United States)

    Nowell, Lisa H.; Moran, Patrick W.; Schmidt, Travis S.; Norman, Julia E.; Nakagaki, Naomi; Shoda, Megan E.; Mahler, Barbara J.; Van Metre, Peter C.; Stone, Wesley W.; Sandstrom, Mark W.; Hladik, Michelle L.

    2018-01-01

    Aquatic organisms in streams are exposed to pesticide mixtures that vary in composition over time in response to changes in flow conditions, pesticide inputs to the stream, and pesticide fate and degradation within the stream. To characterize mixtures of dissolved-phase pesticides and degradates in Midwestern streams, a synoptic study was conducted at 100 streams during May–August 2013. In weekly water samples, 94 pesticides and 89 degradates were detected, with a median of 25 compounds detected per sample and 54 detected per site. In a screening-level assessment using aquatic-life benchmarks and the Pesticide Toxicity Index (PTI), potential effects on fish were unlikely in most streams. For invertebrates, potential chronic toxicity was predicted in 53% of streams, punctuated in 12% of streams by acutely toxic exposures. For aquatic plants, acute but likely reversible effects on biomass were predicted in 75% of streams, with potential longer-term effects on plant communities in 9% of streams. Relatively few pesticides in water—atrazine, acetochlor, metolachlor, imidacloprid, fipronil, organophosphate insecticides, and carbendazim—were predicted to be major contributors to potential toxicity. Agricultural streams had the highest potential for effects on plants, especially in May–June, corresponding to high spring-flush herbicide concentrations. Urban streams had higher detection frequencies and concentrations of insecticides and most fungicides than in agricultural streams, and higher potential for invertebrate toxicity, which peaked during July–August. Toxicity-screening predictions for invertebrates were supported by quantile regressions showing significant associations for the Benthic Invertebrate-PTI and imidacloprid concentrations with invertebrate community metrics for MSQA streams, and by mesocosm toxicity testing with imidacloprid showing effects on invertebrate communities at environmentally relevant concentrations. This study documents the most

  20. [Physical activity and cancer survival].

    Science.gov (United States)

    Romieu, Isabelle; Touillaud, Marina; Ferrari, Pietro; Bignon, Yves-Jean; Antoun, Sami; Berthouze-Aranda, Sophie; Bachmann, Patrick; Duclos, Martine; Ninot, Grégory; Romieu, Gilles; Sénesse, Pierre; Behrendt, Jan; Balosso, Jacques; Pavic, Michel; Kerbrat, Pierre; Serin, Daniel; Trédan, Olivier; Fervers, Béatrice

    2012-10-01

    Physical activity has been shown in large cohort studies to positively impact survival in cancer survivors. Existing randomized controlled trials showed a beneficial effect of physical activity on physical fitness, quality of life, anxiety and self-esteem; however, the small sample size, the short follow-up and the lack of standardization of physical activity intervention across studies impaired definite conclusion in terms of survival. Physical activity reduces adiposity and circulating estrogen levels and increases insulin sensitivity among other effects. A workshop was conducted at the International Agency for Research on Cancer in April 2011 to discuss the role of physical activity on cancer survival and the methodology to develop multicentre randomized intervention trials, including the type of physical activity to implement and its association with nutritional recommendations. The authors discuss the beneficial effect of physical activity on cancer survival with a main focus on breast cancer and report the conclusions from this workshop.

  1. Association of Age and Packed Red Blood Cell Transfusion to One-Year Survival- an Observational Study of ICU Patients

    Science.gov (United States)

    Mudumbai, Seshadri C.; Cronkite, Ruth; Unger-Hu, Kirsten; Heidenreich, Paul; Gonzalez, Chris; Bertaccini, Edward; Stafford, Randall; Cason, Brian; Mariano, Edward R.; Wagner, Todd

    2014-01-01

    Objectives To compare the 1-year survival for different age strata of intensive care unit (ICU) patients after receipt of packed red blood cell (PRBC) transfusions. Background Despite guidelines documenting risks of PRBC transfusion and data showing that increasing age is associated with ICU mortality, little data exist on whether age alters the transfusion-related risk of decreased survival. Methods We retrospectively examined data on 2393 consecutive male ICU patients admitted to a tertiary-care hospital from 2003 to 2009 in age strata: 21–50, 51–60, 61–70, 71–80, and >80 years. We calculated Cox regression models to determine the modifying effect of age on the impact of PRBC transfusion on 1-year survival by using interaction terms between receipt of transfusion and age strata, controlling for type of admission and Charlson co-morbidity indices. We also examined the distribution of admission haematocrit and whether transfusion rates differed by age strata. Results All age strata experienced statistically similar risks of decreased 1-year survival after receipt of PRBC transfusions. However, patients age >80 were more likely than younger cohorts to have hematocrits of 25– 30% at admission and were transfused at approximately twice the rate of each of the younger age strata. Discussion We found no significant interaction between receipt of red cell transfusion and age, as variables, and survival at 1 year as an outcome. PMID:23480030

  2. Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: a retrospective matched cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Mingsheng; Wang, Haofan; Chen, Junwei; Bai, Mingjun; Wang, Long; Zhu, Kangshun; Jiang, Zaibo; Guan, Shouhai; Li, Zhengran; Qian, Jiesheng; Li, Mingan; Pang, Pengfei; Shan, Hong [Sun Yat-sen University, Department of Radiology, the Third Affiliated Hospital, Guangzhou (China); Sun Yat-Sen University, Department of Interventional Radiology, Ling-nan Hospital, Guangzhou (China); Sun Yat-sen University, Interventional Radiology Institute, Guangzhou (China); Lin, Qu [Sun Yat-sen University, Department of Oncology, the Third Affiliated Hospital, Guangzhou (China)

    2016-10-15

    To investigate the survival benefit of transarterial chemoembolization (TACE) plus Iodine125 seed implantation (TACE-Iodine125) in hepatitis B-related HCC patients with portal vein tumour thrombus (PVTT) and the underlying prognostic factors. A retrospective matched cohort study was performed on consecutive HCC patients with PVTT from January 2011 to June 2014. Seventy patients (TACE-Iodine125 group) who underwent TACE-Iodine125 were compared with a historical case-matched control group of 140 patients (TACE group) who received TACE alone. The survival of patients and the underlying prognostic factors were analysed. The median survival times of the TACE-Iodine125 and TACE groups were 11.0 and 7.5 months, respectively (p < 0.001). The survival probability at 12, 24, and 36 months was 50 %, 14.5 %, and 14.5 % vs. 25 %, 9 %, and 5 % in the TACE-Iodine125 and TACE groups, respectively (p < 0.001). The PVTT responders had better survival than the PVTT non-responders (p < 0.001). For the PVTT non-responders, there were no differences in the survival curves between the groups (p = 0.353). Multivariate analysis showed that type III PVTT (p < 0.001) and APS (p < 0.001) were independent predictors of poor prognosis. In contrast, the treatment modality of TACE-Iodine125 (p < 0.001) and PVTT response (p = 0.001) were favourable prognostic features. TACE combined with Iodine125 seed implantation may be a good choice for selected HB-HCC patients with PVTT. (orig.)

  3. Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis (ALS? A post-mortem study of 80 ALS patients.

    Directory of Open Access Journals (Sweden)

    Christian Burkhardt

    Full Text Available Non-invasive ventilation (NIV and percutaneous gastrostomy (PEG are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS. Their effect on survival is controversial and the impact on causes of death is unknown.To investigate the effect of NIV and PEG on survival and causes of death in ALS patients.Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015. Forty-two of these patients consented for genetic testing. Effects of NIV and PEG on survival and causes of death were analyzed in a multivariable Cox proportional hazard regression.Six patients, who requested assisted suicide causing drug-induced hypoxia, were excluded from final analysis. Respiratory failure was the main cause of death in 72 out of 74 patients. Fifteen out of 74 died of aspiration pneumonia 23/74 of bronchopneumonia and 8/74 of a combination of aspiration pneumonia and bronchopneumonia. Twenty died of hypoxia without concomitant infection, and six patients had pulmonary embolism alone or in combination with pneumonia. NIV (p = 0.01 and PEG (p<0.01 had a significant impact on survival. In patients using NIV bronchopneumonia was significantly more frequent (p <0.04 compared to non-NIV patients. This effect was even more pronounced in limb onset patients (p<0.002. Patients with C9orf72 hexanucleotide repeat expansions showed faster disease progression and shorter survival (p = 0.01.The use of NIV and PEG prolongs survival in ALS. This study supports current AAN and EFNS guidelines which recommend NIV and PEG as a treatment option in ALS. The risk of bronchopneumonia as cause of death may be increased by NIV.

  4. Survival prospects after acute myocardial infarction in the UK: a matched cohort study 1987–2011

    Science.gov (United States)

    Gitsels, Lisanne A; Kulinskaya, Elena; Steel, Nicholas

    2017-01-01

    Objectives Estimate survival after acute myocardial infarction (AMI) in the general population aged 60 and over and the effect of recommended treatments. Design Cohort study in the UK with routinely collected data between January 1987 and March 2011. Setting 310 general practices that contributed to The Health Improvement Network (THIN) database. Participants 4 cohorts who reached the age of 60, 65, 70, or 75 years between 1987 and 2011 included 16 744, 43 528, 73 728, and 76 392 participants, respectively. Participants with a history of AMI were matched on sex, year of birth, and general practice to 3 controls each. Outcome measures The hazard of all-cause mortality associated with AMI was calculated by a multilevel Cox's proportional hazards regression, adjusted for sex, year of birth, socioeconomic status, angina, heart failure, other cardiovascular conditions, chronic kidney disease, diabetes, hypertension, hypercholesterolaemia, alcohol consumption, body mass index, smoking status, coronary revascularisation, prescription of β-blockers, ACE inhibitors, calcium-channel blockers, aspirin, or statins, and general practice. Results Compared with no history of AMI by age 60, 65, 70, or 75, having had 1 AMI was associated with an adjusted hazard of mortality of 1.80 (95% CI 1.60 to 2.02), 1.71 (1.59 to 1.84), 1.50 (1.42 to 1.59), or 1.45 (1.38 to 1.53), respectively, and having had multiple AMIs with a hazard of 1.92 (1.60 to 2.29), 1.87 (1.68 to 2.07), 1.66 (1.53 to 1.80), or 1.63 (1.51 to 1.76), respectively. Survival was better after statins (HR range across the 4 cohorts 0.74–0.81), β-blockers (0.79–0.85), or coronary revascularisation (in first 5 years) (0.72–0.80); unchanged after calcium-channel blockers (1.00–1.07); and worse after aspirin (1.05–1.10) or ACE inhibitors (1.10–1.25). Conclusions The hazard of death after AMI is less than reported by previous studies, and standard treatments of aspirin or ACE inhibitors prescription

  5. Case definition in survival studies of out-of-hospital cardiac arrest.

    Science.gov (United States)

    Joslyn, S A

    1994-05-01

    The purpose of this investigation was to determine problems with case definition and selection biases in studies of survival from out-of-hospital cardiac arrest, by comparing characteristics of subjects with cardiac arrest who entered the emergency medical services (EMS) system and those who did not enter the system. Data for 143 prehospital cardiac arrest patients in Johnson County, Iowa, were obtained from death certificates and EMS reports. Approximately one half of cardiac arrest patients entered the EMS system. Mean total number of causes of death listed on death certificates was significantly higher in subjects who did not enter the EMS system. Several factors, including age, sex, and number of causes of death listed on death certificates were significant univariate factors in whether a cardiac arrest victim entered the EMS system, but multivariate logistic regression indicated age by itself was the most significant factor. These results indicate there are possible initial biases determining who will enter the EMS system, which affects the generalizability of previous studies.

  6. Cancer survival in China, 2003-2005: a population-based study.

    Science.gov (United States)

    Zeng, Hongmei; Zheng, Rongshou; Guo, Yuming; Zhang, Siwei; Zou, Xiaonong; Wang, Ning; Zhang, Limei; Tang, Jingao; Chen, Jianguo; Wei, Kuangrong; Huang, Suqin; Wang, Jian; Yu, Liang; Zhao, Deli; Song, Guohui; Chen, Jianshun; Shen, Yongzhou; Yang, Xiaoping; Gu, Xiaoping; Jin, Feng; Li, Qilong; Li, Yanhua; Ge, Hengming; Zhu, Fengdong; Dong, Jianmei; Guo, Guoping; Wu, Ming; Du, Lingbin; Sun, Xibin; He, Yutong; Coleman, Michel P; Baade, Peter; Chen, Wanqing; Yu, Xue Qin

    2015-04-15

    Limited population-based cancer registry data available in China until now has hampered efforts to inform cancer control policy. Following extensive efforts to improve the systematic cancer surveillance in this country, we report on the largest pooled analysis of cancer survival data in China to date. Of 21 population-based cancer registries, data from 17 registries (n = 138,852 cancer records) were included in the final analysis. Cases were diagnosed in 2003-2005 and followed until the end of 2010. Age-standardized relative survival was calculated using region-specific life tables for all cancers combined and 26 individual cancers. Estimates were further stratified by sex and geographical area. The age-standardized 5-year relative survival for all cancers was 30.9% (95% confidence intervals: 30.6%-31.2%). Female breast cancer had high survival (73.0%) followed by cancers of the colorectum (47.2%), stomach (27.4%), esophagus (20.9%), with lung and liver cancer having poor survival (16.1% and 10.1%), respectively. Survival for women was generally higher than for men. Survival for rural patients was about half that of their urban counterparts for all cancers combined (21.8% vs. 39.5%); the pattern was similar for individual major cancers except esophageal cancer. The poor population survival rates in China emphasize the urgent need for government policy changes and investment to improve health services. While the causes for the striking urban-rural disparities observed are not fully understood, increasing access of health service in rural areas and providing basic health-care to the disadvantaged populations will be essential for reducing this disparity in the future. © 2014 UICC.

  7. Vaccinia scars associated with better survival for adults. An observational study from Guinea-Bissau

    DEFF Research Database (Denmark)

    Aaby, Peter; Gustafson, Per; Roth, Adam Anders Edvin

    2006-01-01

    Live vaccines including BCG and measles may have non-targeted beneficial effects on childhood survival in areas with high mortality. The authors therefore undertook a survey of vaccinia scars to evaluate subsequent mortality.......Live vaccines including BCG and measles may have non-targeted beneficial effects on childhood survival in areas with high mortality. The authors therefore undertook a survey of vaccinia scars to evaluate subsequent mortality....

  8. SAMPLE SIZE DETERMINATION IN NON-RADOMIZED SURVIVAL STUDIES WITH NON-CENSORED AND CENSORED DATA

    OpenAIRE

    Faghihzadeh, S.; M. Rahgozar

    2003-01-01

    Introduction: In survival analysis, determination of sufficient sample size to achieve suitable statistical power is important .In both parametric and non-parametric methods of classic statistics, randomn selection of samples is a basic condition. practically, in most clinical trials and health surveys randomn allocation is impossible. Fixed - effect multiple linear regression analysis covers this need and this feature could be extended to survival regression analysis. This paper is the resul...

  9. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses

    DEFF Research Database (Denmark)

    Christophersen, Mogens Teken; Dupont, Nana Hee; Berg-Sørensen, Kristina S.

    2014-01-01

    or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2...... or were euthanized (CI: 19 – 32%; 48/189), while 75% survived to discharge (CI: 68 – 81%). Conclusions: The short term survival rates of Danish horses with colic were similar or lower to those reported from other countries. Apart from variability of veterinary care, attitudes towards euthanasia vary among...... the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners ’ attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias...

  10. Changes in the management and survival rates of patients with oral cancer: a 30-year single-institution study.

    Science.gov (United States)

    Seo, Bo-Yun; Lee, Chung-O; Kim, Jin-Wook

    2016-02-01

    The aim of the present study was to evaluate changes in the management and 5-year survival rates of patients with oral cancer in our department over a 30-year period. We investigated the patient distributions, treatment methods, method of neck dissection according to cancer stage, and 5-year survival rates for 700 oral cancer patients over the periods of 1982-1996 (256 patients), 1999-2006 (248 patients), and 2007-2011 (196 patients). Stage IV patients were the largest group in all of the time periods evaluated. Although surgery and radiotherapy were the most common methods in all periods (over 50%), the prevalence of patients who underwent concomitant chemoradiotherapy increased from 7.0% to 16.2%. The use of radical neck dissection decreased from 43.0% to 5.3%, while conservative surgical methods increased from 24.1% to 76.3%. Lastly, the overall 5-year survival rate increased from 31.6% to 63.5% during the study period. Although the 5-year survival rate reached the same level as that of other developed countries during the course of our study, most patients continue to come to the hospital with stage IV disease. In order to increase the 5-year survival rate of oral carcinoma, it may be necessary to improve public education and social efforts relevant to early diagnosis.

  11. Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands.

    Science.gov (United States)

    Petersen, Japke F; Timmermans, Adriana J; van Dijk, Boukje A C; Overbeek, Lucy I H; Smit, Laura A; Hilgers, Frans J M; Stuiver, Martijn M; van den Brekel, Michiel W M

    2017-10-28

    Hypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1-T4 hypopharynx cancer between 1991 and 2010 in the Netherlands. Patients were recorded by the national cancer registry database and verified by a national pathology database. 2999 patients were identified. The incidence increased significantly with 4.1% per year until 1997 and decreased non-significantly afterwards. For women, the incidence increased with 1.7% per year during the entire study period. Total laryngectomy as primary treatment significantly decreased, whereas radiotherapy and chemoradiation increased. The 5-year overall survival significantly increased from 28% in 1991-2000 to 34% in 2001-2010. Overall survival for T3 was equal for total laryngectomy and (chemo)radiotherapy, but for T4-patients the survival was significantly better after primary total laryngectomy (± adjuvant radiotherapy). This large population-based study demonstrates a shift in treatment preference towards organ preservation therapies. The 5-year overall survival increased significantly in the second decade. The assumed equivalence of organ preservation and laryngectomy may require reconsideration for T4 disease.

  12. Diagnosis, treatment characteristics, and survival of women with breast cancer aged 65 and above: a hospital-based retrospective study.

    Science.gov (United States)

    Kartal, Mehtap; Tezcan, Sabahat; Canda, Tulay

    2013-08-28

    Breast cancer incidence in women increases with age, while survival rates decrease. Studies interpret this result as meaning higher comorbidity, diagnosis at later stages of the disease, and less effective treatment in the elderly. The aim of this study is to evaluate the diagnosis and treatment characteristics of breast cancer and their effect on the survival of women aged 65 and above. The data within the files of 1064 women with breast cancer, who were followed-up in Dokuz Eylul University Medical Faculty Hospital between 2000 and 2006, were reviewed retrospectively. The survival probabilities at years 1 and 5 were calculated by life table analysis. The Kaplan-Meier test was used for calculating mean survival time, and the differences between groups were evaluated by log-rank test. The backward elimination method was used for multivariate analysis, and a -2 log-likelihood ratio was used for comparison of different models. Of the patients, 25.3% were aged 65 and above at the time of the diagnosis. Patients in this group had more comorbidities and were more likely to be diagnosed at advanced stages than younger patients. Additionally, they had lower rates of surgical treatment, chemotherapy or radiotherapy. One and 5-year survival probabilities among age groups were 96.1% and 84.5%, respectively, for <65 years, 93.5% and 84.8%, respectively, for 65-69, 98.7% and 84.0%, respectively, for 70-74, and 85.5% and 59.6%, respectively, for 75 years and above. In the multivariate model, age, clinical stage, and comorbidity were found to be negatively associated with the survival rate. The survival of women with breast cancer aged 65 and above was affected negatively by age at diagnosis, clinical stage, and the presence of comorbidity. Early diagnosis also is very important for elderly women. Additionally, because of higher comorbidity, their evaluation and treatment should be planned by an interdisciplinary team.

  13. 90Y Radioembolization of Colorectal Hepatic Metastases Using Glass Microspheres: Safety and Survival Outcomes from a 531-Patient Multicenter Study.

    Science.gov (United States)

    Hickey, Ryan; Lewandowski, Robert J; Prudhomme, Totianna; Ehrenwald, Eduardo; Baigorri, Brian; Critchfield, Jeffrey; Kallini, Joseph; Gabr, Ahmed; Gorodetski, Boris; Geschwind, Jean-Francois; Abbott, Andrea; Shridhar, Ravi; White, Sarah B; Rilling, William S; Boyer, Brendan; Kauffman, Shannon; Kwan, Sharon; Padia, Siddarth A; Gates, Vanessa L; Mulcahy, Mary; Kircher, Sheetal; Nimeiri, Halla; Benson, Al B; Salem, Riad

    2016-05-01

    Hepatic metastases of colorectal carcinoma are a leading cause of cancer-related mortality. Most colorectal liver metastases become refractory to chemotherapy and biologic agents, at which point the median overall survival declines to 4-5 mo. Radioembolization with (90)Y has been used in the salvage setting with favorable outcomes. This study reports the survival and safety outcomes of 531 patients treated with glass-based (90)Y microspheres at 8 institutions, making it the largest (90)Y study for patients with colorectal liver metastases. Data were retrospectively compiled from 8 institutions for all (90)Y glass microsphere treatments for colorectal liver metastases. Exposure to chemotherapeutic or biologic agents, prior liver therapies, biochemical parameters before and after treatment, radiation dosimetry, and complications were recorded. Uni- and multivariate analyses for predictors of survival were performed. Survival outcomes and clinical or biochemical adverse events were recorded. In total, 531 patients received (90)Y radioembolization for colorectal liver metastases. The most common clinical adverse events were fatigue (55%), abdominal pain (34%), and nausea (19%). Grade 3 or 4 hyperbilirubinemia occurred in 13% of patients at any time. The median overall survival from the first (90)Y treatment was 10.6 mo (95% confidence interval, 8.8-12.4). Performance status, no more than 25% tumor burden, no extrahepatic metastases, albumin greater than 3 g/dL, and receipt of no more than 2 chemotherapeutic agents independently predicted better survival outcomes. This multiinstitutional review of a large cohort of patients with colorectal liver metastases treated with (90)Y radioembolization using glass microspheres has demonstrated promising survival outcomes with low toxicity and low side effects. The outcomes were reproducible and consistent with prior reports of radioembolization. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  14. Survival after traumatic spinal cord injury in Denmark: a hospital-based study among patients injured in 1990-2012.

    Science.gov (United States)

    Noe, B B; Stapelfeldt, C M; Parner, E T; Mikkelsen, E M

    2017-04-01

    Hospital-based cohort study at Spinal Cord Injury Centre of Western Denmark (VCR). To examine the overall survival and mortality over time adjusted for age at the time of injury and gender. Review of medical records of traumatic spinal cord injury (TSCI) patients admitted at VCR between 1990 and 2012. The patients were followed up until death, emigration or end of study (December 2014). Survival and mortality rate ratios (MRRs) with 95% confidence intervals (CI) were estimated for sub-groups defined by year of injury (1990-1994, 1995-1999, 2000-2004, 2005-2009 and 2010-2012). Mortality was analysed using Cox proportional hazard regression. Adjustment for gender and age at injury was performed (restricted cubic splines). In total, 665 patients (males 82%) were followed; 136 (20%) patients died during the observation period. Two-year survival varied from 93% in 2005-2009 to 98% in 2000-2004. Using 1990-1994 as a reference, the adjusted MRRs varied between 1.22 (CI: 0.43; 3.42) and 0.48 (CI: 0.13; 2.71). The 5- and 10-year survival varied between 85% (2005-2009) and 95% (1990-1994), and between 77% (2005-2009) and 91% (1990-1994), respectively. No trend over time was observed either for 2-, 5- or 10-year survival. Men's mortality did not differ consistently from that of women. Except for the most recent time period, the overall survival after TSCI was higher among those aged injury. Survival after TSCI in Denmark did not change considerably from 1990 to 2014, and there seemed to be no gender difference. Mortality was highest among patients above 60 years of age at injury.

  15. spa Typing and Multilocus Sequence Typing Show Comparable Performance in a Macroepidemiologic Study of Staphylococcus aureus in the United States

    Science.gov (United States)

    O'Hara, F. Patrick; Suaya, Jose A.; Ray, G. Thomas; Baxter, Roger; Brown, Megan L.; Mera, Robertino M.; Close, Nicole M.; Thomas, Elizabeth

    2016-01-01

    A number of molecular typing methods have been developed for characterization of Staphylococcus aureus isolates. The utility of these systems depends on the nature of the investigation for which they are used. We compared two commonly used methods of molecular typing, multilocus sequence typing (MLST) (and its clustering algorithm, Based Upon Related Sequence Type [BURST]) with the staphylococcal protein A (spa) typing (and its clustering algorithm, Based Upon Repeat Pattern [BURP]), to assess the utility of these methods for macroepidemiology and evolutionary studies of S. aureus in the United States. We typed a total of 366 clinical isolates of S. aureus by these methods and evaluated indices of diversity and concordance values. Our results show that, when combined with the BURP clustering algorithm to delineate clonal lineages, spa typing produces results that are highly comparable with those produced by MLST/BURST. Therefore, spa typing is appropriate for use in macroepidemiology and evolutionary studies and, given its lower implementation cost, this method appears to be more efficient. The findings are robust and are consistent across different settings, patient ages, and specimen sources. Our results also support a model in which the methicillin-resistant S. aureus (MRSA) population in the United States comprises two major lineages (USA300 and USA100), which each consist of closely related variants. PMID:26669861

  16. Women show a higher level of anxiety during IVF treatment than men and hold different concerns: a cohort study.

    Science.gov (United States)

    Schaller, Martin Alexander; Griesinger, Georg; Banz-Jansen, Constanze

    2016-05-01

    The aim of the present study was to determine levels of anxiety during the course of IVF treatment and gender differences in treatment anxiety. This was a prospective cohort study set in a university affiliated, tertiary care IVF program. 119 women and 82 men entering the clinic to undergo IVF treatment filled out questionnaires containing the Spielberger state-trait-anxiety-inventory (STAI) as well as further items on specific stress triggers. Women and men undergoing IVF have higher levels of anxiety than the average population in Germany. Overall, female patients show significantly higher values (mean ± SD) for state and trait anxiety (47.4 ± 11.0 and 40.1 ± 9.85) than their male partners (41.4 ± 9.66 and 35.3 ± 8.57, p anxiety the failure to achieve a successful pregnancy, scoring significantly higher on questions like 'obtaining a negative pregnancy test' (3.24 ± 0.82, p anxiety during IVF treatment and hold different concerns. Neither of the sexes appears to be familiar with the risks associated with multiple pregnancies, a matter that should better be addressed.

  17. spa Typing and Multilocus Sequence Typing Show Comparable Performance in a Macroepidemiologic Study of Staphylococcus aureus in the United States.

    Science.gov (United States)

    O'Hara, F Patrick; Suaya, Jose A; Ray, G Thomas; Baxter, Roger; Brown, Megan L; Mera, Robertino M; Close, Nicole M; Thomas, Elizabeth; Amrine-Madsen, Heather

    2016-01-01

    A number of molecular typing methods have been developed for characterization of Staphylococcus aureus isolates. The utility of these systems depends on the nature of the investigation for which they are used. We compared two commonly used methods of molecular typing, multilocus sequence typing (MLST) (and its clustering algorithm, Based Upon Related Sequence Type [BURST]) with the staphylococcal protein A (spa) typing (and its clustering algorithm, Based Upon Repeat Pattern [BURP]), to assess the utility of these methods for macroepidemiology and evolutionary studies of S. aureus in the United States. We typed a total of 366 clinical isolates of S. aureus by these methods and evaluated indices of diversity and concordance values. Our results show that, when combined with the BURP clustering algorithm to delineate clonal lineages, spa typing produces results that are highly comparable with those produced by MLST/BURST. Therefore, spa typing is appropriate for use in macroepidemiology and evolutionary studies and, given its lower implementation cost, this method appears to be more efficient. The findings are robust and are consistent across different settings, patient ages, and specimen sources. Our results also support a model in which the methicillin-resistant S. aureus (MRSA) population in the United States comprises two major lineages (USA300 and USA100), which each consist of closely related variants.

  18. Cefepime shows good efficacy and no antibiotic resistance in pneumonia caused by Serratia marcescens and Proteus mirabilis - an observational study.

    Science.gov (United States)

    Yayan, Josef; Ghebremedhin, Beniam; Rasche, Kurt

    2016-03-23

    Many antibiotics have no effect on Gram-positive and Gram-negative microbes, which necessitates the prescription of broad-spectrum antimicrobial agents that can lead to increased risk of antibiotic resistance. These pathogens constitute a further threat because they are also resistant to numerous beta-lactam antibiotics, as well as other antibiotic groups. This study retrospectively investigates antimicrobial resistance in hospitalized patients suffering from pneumonia triggered by Gram-negative Serratia marcescens or Proteus mirabilis. The demographic and clinical data analyzed in this study were obtained from the clinical databank of the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, for inpatients presenting with pneumonia triggered by S. marcescens or P. mirabilis from 2004 to 2014. An antibiogram was conducted for the antibiotics utilized as part of the management of patients with pneumonia triggered by these two pathogens. Pneumonia was caused by Gram-negative bacteria in 115 patients during the study period from January 1, 2004, to August 12, 2014. Of these, 43 (37.4 %) hospitalized patients [26 males (60.5 %, 95 % CI 45.9 %-75.1 %) and 17 females (39.5 %, 95 % CI 24.9 %-54.1 %)] with mean age of 66.2 ± 13.4 years had pneumonia triggered by S. marcescens, while 20 (17.4 %) patients [14 males (70 %, 95 % CI 49.9 %-90.1 %) and 6 females (30 %, 95 % CI 9.9 %-50.1 %)] with a mean age of 64.6 ± 12.8 years had pneumonia caused by P. mirabilis. S. marcescens showed an increased antibiotic resistance to ampicillin (100 %), ampicillin-sulbactam (100 %), and cefuroxime (100 %). P. mirabilis had a high resistance to tetracycline (100 %) and ampicillin (55 %). S. marcescens (P marcescens and P. mirabilis were resistant to several commonly used antimicrobial agents, but showed no resistance to cefepime.

  19. A Comparative Study of Defibrillator Leads at a Large-Volume Implanting Hospital: Results From the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS").

    Science.gov (United States)

    Cohen, Todd J; Asheld, Wilbur J; Germano, Joseph; Islam, Shahidul; Patel, Dhimesh

    2015-06-01

    .35% failure rate); none were recalled. Kaplan Meier analysis also showed lead failure occurred sooner in the recalled leads (P=.01). A total of 1493 patients died during the study (mechanism of death was largely unknown). There was a significant increase in mortality in the recalled lead group as compared with non-recalled leads (P=.01), but no significant difference in survival when comparing recalled leads from Medtronic with St. Jude Medical (P=.67). A multivariable Cox regression model revealed younger age, history of percutaneous coronary intervention, baseline rhythm other than atrial fibrillation or atrial flutter, combination polyurethane and silicone lead insulation, a second defibrillation coil, and recalled lead status all contributed to lead failure. This study demonstrated a significantly improved lead performance in the Boston Scientific and St. Jude leads as compared with Medtronic leads. Some lead construction variables (insulation and number of coils) also had a significant impact on lead failure, which was independent of the manufacturer. Recalled St. Jude leads performed better than recalled Medtronic leads in our study. Recalled St. Jude leads had no significant difference in lead failure when compared with the other manufacturer's non-recalled leads. Defibrillator recalled lead status was associated with an increased mortality as compared with non-recalled leads. This correlation was independent of the lead manufacturer and clinically significant even when considering known mortality risk factors. These results must be tempered by the largely unknown mechanism of death in these patients.

  20. Socioeconomic disparity in survival after breast cancer in ireland: observational study.

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    Paul M Walsh

    Full Text Available We evaluated the relationship between breast cancer survival and deprivation using data from the Irish National Cancer Registry. Cause-specific survival was compared between five area-based socioeconomic deprivation strata using Cox regression. Patient and tumour characteristics and treatment were compared using modified Poisson regression with robust variance estimation. Based on 21356 patients diagnosed 1999-2008, age-standardized five-year survival averaged 80% in the least deprived and 75% in the most deprived stratum. Age-adjusted mortality risk was 33% higher in the most deprived group (hazard ratio 1.33, 95% CI 1.21-1.45, P<0.001. The most deprived groups were more likely to present with advanced stage, high grade or hormone receptor-negative cancer, symptomatically, or with significant comorbidity, and to be smokers or unmarried, and less likely to have breast-conserving surgery. Cox modelling suggested that the available data on patient, tumour and treatment factors could account for only about half of the survival disparity (adjusted hazard ratio 1.18, 95% CI 0.97-1.43, P = 0.093. Survival disparity did not diminish over time, compared with the period 1994-1998. Persistent survival disparities among Irish breast cancer patients suggest unequal use of or access to services and highlight the need for further research to understand and remove the behavioural or other barriers involved.

  1. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

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    Dykes Anna-Karin

    2011-02-01

    Full Text Available Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1% met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4% women reported experience of violence, and among these, 66 (2.5% women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26 of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08, OR 0.90, 95% CI (0.54-1.50, respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96. Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

  2. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term.

    Science.gov (United States)

    Finnbogadóttir, Hafrún; Dejin-Karlsson, Elisabeth; Dykes, Anna-Karin

    2011-02-21

    Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

  3. Clinical and biomarker changes in premanifest Huntington disease show trial feasibility: a decade of the PREDICT-HD study

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    Jane S Paulsen

    2014-04-01

    Full Text Available There is growing consensus that intervention and treatment of Huntington disease (HD should occur at the earliest stage possible. Various early-intervention methods for this fatal neurodegenerative disease have been identified, but preventive clinical trials for HD are limited by a lack of knowledge of the natural history of the disease and a dearth of appropriate outcome measures. Objectives of the current study are to document the natural history of premanifest HD progression in the largest cohort ever studied and to develop a battery of imaging and clinical markers of premanifest HD progression that can be used as outcome measures in preventive clinical trials. PREDICT-HD is a 32-site, international, observational study of premanifest HD, with annual examination of 1013 participants with premanifest HD and 301 gene-expansion negative controls between 2001 and 2012. Findings document 39 variables representing imaging, motor, cognitive, functional, and psychiatric domains, showing different rates of decline between premanifest Huntington disease and controls. Required sample size and models of premanifest HD are presented to inform future design of clinical and preclinical research. Preventive clinical trials in premanifest HD with participants who have a medium or high probability of motor onset are calculated to be as resource-effective as those conducted in diagnosed HD and could interrupt disease seven to twelve years earlier. Methods and measures for preventive clinical trials in premanifest HD more than a dozen years from motor onset are also feasible. These findings represent the most thorough documentation of a clinical battery for experimental therapeutics in stages of premanifest HD, the time period for which effective intervention may provide the most positive possible outcome for patients and their families affected by this devastating disease.

  4. Male breast carcinoma: correlation of ER, PR, Ki-67, Her2-Neu, and p53 with treatment and survival, a study of 65 cases.

    Science.gov (United States)

    Wang-Rodriguez, Jessica; Cross, Keith; Gallagher, Scott; Djahanban, Marcia; Armstrong, Janet M; Wiedner, Noel; Shapiro, David H

    2002-08-01

    Male breast cancer is rare, and experience of it in any single institution is limited. Our current understanding regarding its biology, natural history, and treatment strategies has been extrapolated from its female counterpart. The aim of this study is to evaluate the expression patterns of estrogen receptor (ER), progesterone receptor (PR), MiB1 (Ki67), Her-2/neu (c-erbB2), and p53 and to correlate them with the prognosis, presentation, staging, management, and survival/outcome in male breast carcinoma identified through the Veterans Administration nationwide cancer registry. Sixty-five cases of male breast cancer were reviewed for classification. Tumor blocks were requested from each institution for immunohistochemical staining and evaluation of ER, PR, p53, Her2-neu, and MiB1. Seventeen age- and disease-matched male veteran patients with breast gynecomastia were used as controls. Traditional prognostic data were collected for comparison with female breast cancers (i.e., age, lymph node status, clinical staging, tumor size, histological grade, and disease-free and overall survival). Male breast carcinoma had worse disease-free survival than controls (P =.03). The clinical stage regardless of tumor size or lymph node metastasis was the single most significant prognostic factor (P <.0001). ER-positive patients appeared to have a better survival than did ER-negative patients (P =.03, univariate; P not significant in multivariate) and did not benefit from treatment with tamoxifen (P =.0027, univariate; P =.42, multivariate). MiB1 and PR expressions did not correlate with treatment or survival, and p53 was associated with shorter disease free survival (P =.07, univariate; P =.047, multivariate). Stage for stage, Her2-neu was associated with shorter disease-free survival (P <.0001) and correlated with positive lymph nodes (P =.08). Surgery alone versus surgery with adjuvant treatments (chemotherapy, radiotherapy, tamoxifen, or combination) did not show any survival

  5. Children of low socioeconomic status show accelerated linear growth in early childhood; results from the Generation R Study.

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    Lindsay M Silva

    Full Text Available OBJECTIVES: People of low socioeconomic status are shorter than those of high socioeconomic status. The first two years of life being critical for height development, we hypothesized that a low socioeconomic status is associated with a slower linear growth in early childhood. We studied maternal educational level (high, mid-high, mid-low, and low as a measure of socioeconomic status and its association with repeatedly measured height in children aged 0-2 years, and also examined to what extent known determinants of postnatal growth contribute to this association. METHODS: This study was based on data from 2972 mothers with a Dutch ethnicity, and their children participating in The Generation R Study, a population-based cohort study in Rotterdam, The Netherlands (participation rate 61%. All children were born between April 2002 and January 2006. Height was measured at 2 months (mid-90% range 1.0-3.9, 6 months (mid-90% range 5.6-11.4, 14 months (mid-90% range 13.7-17.9 and 25 months of age (mid-90% range 23.6-29.6. RESULTS: At 2 months, children in the lowest educational subgroup were shorter than those in the highest (difference: -0.87 cm; 95% CI: -1.16, -0.58. Between 1 and 18 months, they grew faster than their counterparts. By 14 months, children in the lowest educational subgroup were taller than those in the highest (difference at 14 months: 0.40 cm; 95% CI: 0.08,0.72. Adjustment for other determinants of postnatal growth did not explain the taller height. On the contrary, the differences became even larger (difference at 14 months: 0.61 cm; 95% CI: 0.26,0.95; and at 25 months: 1.00 cm; 95% CI: 0.57,1.43 CONCLUSIONS: Compared with children of high socioeconomic status, those of low socioeconomic status show an accelerated linear growth until the 18th month of life, leading to an overcompensation of their initial height deficit. The long-term consequences of these findings remain unclear and require further study.

  6. Genome-wide association study identifies novel locus for neuroticism and shows polygenic association with Major Depressive Disorder

    Science.gov (United States)

    de Moor, Marleen H.M.; van den Berg, Stéphanie M.; Verweij, Karin J.H.; Krueger, Robert F.; Luciano, Michelle; Vasquez, Alejandro Arias; Matteson, Lindsay K.; Derringer, Jaime; Esko, Tõnu; Amin, Najaf; Gordon, Scott D.; Hansell, Narelle K.; Hart, Amy B.; Seppälä, Ilkka; Huffman, Jennifer E.; Konte, Bettina; Lahti, Jari; Lee, Minyoung; Miller, Mike; Nutile, Teresa; Tanaka, Toshiko; Teumer, Alexander; Viktorin, Alexander; Wedenoja, Juho; Abecasis, Goncalo R.; Adkins, Daniel E.; Agrawal, Arpana; Allik, Jüri; Appel, Katja; Bigdeli, Timothy B.; Busonero, Fabio; Campbell, Harry; Costa, Paul T.; Smith, George Davey; Davies, Gail; de Wit, Harriet; Ding, Jun; Engelhardt, Barbara E.; Eriksson, Johan G.; Fedko, Iryna O.; Ferrucci, Luigi; Franke, Barbara; Giegling, Ina; Grucza, Richard; Hartmann, Annette M.; Heath, Andrew C.; Heinonen, Kati; Henders, Anjali K.; Homuth, Georg; Hottenga, Jouke-Jan; Janzing, Joost; Jokela, Markus; Karlsson, Robert; Kemp, John P.; Kirkpatrick, Matthew G.; Latvala, Antti; Lehtimäki, Terho; Liewald, David C.; Madden, Pamela A.F.; Magri, Chiara; Magnusson, Patrik K.E.; Marten, Jonathan; Maschio, Andrea; Medland, Sarah E.; Mihailov, Evelin; Milaneschi, Yuri; Montgomery, Grant W.; Nauck, Matthias; Ouwens, Klaasjan G.; Palotie, Aarno; Pettersson, Erik; Polasek, Ozren; Qian, Yong; Pulkki-Råback, Laura; Raitakari, Olli T.; Realo, Anu; Rose, Richard J.; Ruggiero, Daniela; Schmidt, Carsten O.; Slutske, Wendy S.; Sorice, Rossella; Starr, John M.; Pourcain, Beate St; Sutin, Angelina R.; Timpson, Nicholas J.; Trochet, Holly; Vermeulen, Sita; Vuoksimaa, Eero; Widen, Elisabeth; Wouda, Jasper; Wright, Margaret J.; Zgaga, Lina; Scotland, Generation; Porteous, David; Minelli, Alessandra; Palmer, Abraham A.; Rujescu, Dan; Ciullo, Marina; Hayward, Caroline; Rudan, Igor; Metspalu, Andres; Kaprio, Jaakko; Deary, Ian J.; Räikkönen, Katri; Wilson, James F.; Keltikangas-Järvinen, Liisa; Bierut, Laura J.; Hettema, John M.; Grabe, Hans J.; van Duijn, Cornelia M.; Evans, David M.; Schlessinger, David; Pedersen, Nancy L.; Terracciano, Antonio; McGue, Matt; Penninx, Brenda W.J.H.; Martin, Nicholas G.; Boomsma, Dorret I.

    2015-01-01

    shows that neuroticism is influenced by many genetic variants of small effect that are either common or tagged by common variants. These genetic variants also influence MDD. Future studies should confirm the role of the MAGI1 locus for neuroticism, and further investigate the association of MAGI1 and the polygenic association to a range of other psychiatric disorders that are phenotypically correlated with neuroticism. PMID:25993607

  7. Application of Survival Analysis to Study Timing and Probability of Outcome Attainment by a Community College Student Cohort

    Science.gov (United States)

    Mourad, Roger; Hong, Ji-Hee

    2008-01-01

    This study applies competing risks survival analysis to describe outcome attainment for an entire cohort of students who first attended a Midwestern community college in the Fall Semester 2001. Outcome attainment included transfer to a four-year institution, degree/ certificate attainment from the community college under study, and transfer to a…

  8. Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: the Oregon Sudden Unexpected Death Study.

    Science.gov (United States)

    Teodorescu, Carmen; Reinier, Kyndaron; Uy-Evanado, Audrey; Ayala, Jo; Mariani, Ronald; Wittwer, Lynn; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S

    2012-09-01

    Studies evaluating a possible survival advantage from sudden cardiac arrest (SCA) in women have produced mixed results possibly due to a lack of comprehensive analyses. We hypothesized that race, socioeconomic status (SES), and elements of the lifetime clinical history influence gender effects and need to be incorporated within analyses of survival. Cases of SCA were identified from the ongoing, prospective, multiple-source Oregon Sudden Unexpected Death Study (population approximately one million). Subjects included were age ≥18 years who underwent attempted resuscitation by EMS providers. Pearson's chi-square tests and independent samples t tests or analysis of variance were used for univariate comparisons. We evaluated gender and race differences in survival adjusted for age, circumstances of arrest, disease burden, and socioeconomic status using a logistic regression model predicting survival. A total of 1,296 cases had resuscitation attempted (2002-2007; mean age 65 years, male 67%). Women were older than men (68 vs. 63 years, p ratio 1.85; 95% confidence interval (1.12-3.04)]. Despite older age, higher prevalence of SCA in the home, and higher rates of PEA, women had a survival advantage from ventricular fibrillation and pulseless electrical activity.

  9. Survival of extensive restorations in primary molars: 15-year practice-based study.

    Science.gov (United States)

    Tseveenjav, Battsetseg; Furuholm, Jussi; Mulic, Aida; Valen, Håkon; Maisala, Tuomo; Turunen, Seppo; Varsio, Sinikka; Auero, Merja; Tjäderhane, Leo

    2017-12-03

    Caries decline in the western world is accompanied by strong polarization among children; 8% of Finnish 5-year-olds having 76% of untreated caries. This high caries risk group needs preventive and restorative strategies. To explore survival of extensive restorations in primary molars. This study was based on health records from 2002 to 2016 of children under 18 years. Of severely affected primary molars (n = 1061), 41% were restored with preformed metal crowns (PMCs), 38% with glass-ionomer cement (GIC)/polyacid-modified resin composite (PAMRC)/resin-modified GIC (RMGIC), and 21% with resin composites (RC). Younger children (3-8) received 97% of the PMCs and 86% of GIC/PAMRC/RMGIC; older ones (≥9) 91% of the RC restorations. Neither amalgam nor indirect restorations were registered. General dentists (GDs) engaged in primary care restored with GIC/PAMRC/RMGIC (52%) or RC (48%). GDs in general anesthesia care service placed 66% and specializing/specialized dentists 31% of PMCs. PMCs had lower failure rate (1.4% vs 3.0%) than GIC/PAMRC/RMGIC (P = 0.001). Choosing PMCs reduced patient visits compared to other restorations (P < 0.001). Severely affected primary molars of children at high caries risk are better managed, using PMCs to optimize the resources in public oral health services. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Experimental and molecular dynamics studies showed that CBP KIX mutation affects the stability of CBP:c-Myb complex.

    Science.gov (United States)

    Odoux, Anne; Jindal, Darren; Tamas, Tamara C; Lim, Benjamin W H; Pollard, Drake; Xu, Wu

    2016-06-01

    The coactivators CBP (CREBBP) and its paralog p300 (EP300), two conserved multi-domain proteins in eukaryotic organisms, regulate gene expression in part by binding DNA-binding transcription factors. It was previously reported that the CBP/p300 KIX domain mutant (Y650A, A654Q, and Y658A) altered both c-Myb-dependent gene activation and repression, and that mice with these three point mutations had reduced numbers of platelets, B cells, T cells, and red blood cells. Here, our transient transfection assays demonstrated that mouse embryonic fibroblast cells containing the same mutations in the KIX domain and without a wild-type allele of either CBP or p300, showed decreased c-Myb-mediated transcription. Dr. Wright's group solved a 3-D structure of the mouse CBP:c-Myb complex using NMR. To take advantage of the experimental structure and function data and improved theoretical calculation methods, we performed MD simulations of CBP KIX, CBP KIX with the mutations, and c-Myb, as well as binding energy analysis for both the wild-type and mutant complexes. The binding between CBP and c-Myb is mainly mediated by a shallow hydrophobic groove in the center where the side-chain of Leu302 of c-Myb plays an essential role and two salt bridges at the two ends. We found that the KIX mutations slightly decreased stability of the CBP:c-Myb complex as demonstrated by higher binding energy calculated using either MM/PBSA or MM/GBSA methods. More specifically, the KIX mutations affected the two salt bridges between CBP and c-Myb (CBP-R646 and c-Myb-E306; CBP-E665 and c-Myb-R294). Our studies also revealed differing dynamics of the hydrogen bonds between CBP-R646 and c-Myb-E306 and between CBP-E665 and c-Myb-R294 caused by the CBP KIX mutations. In the wild-type CBP:c-Myb complex, both of the hydrogen bonds stayed relatively stable. In contrast, in the mutant CBP:c-Myb complex, hydrogen bonds between R646 and E306 showed an increasing trend followed by a decreasing trend, and hydrogen

  11. Postoperative deterioration in health related quality of life as predictor for survival in patients with glioblastoma: a prospective study.

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    Asgeir S Jakola

    Full Text Available BACKGROUND: Studies indicate that acquired deficits negatively affect patients' self-reported health related quality of life (HRQOL and survival, but the impact of HRQOL deterioration after surgery on survival has not been explored. OBJECTIVE: Assess if change in HRQOL after surgery is a predictor for survival in patients with glioblastoma. METHODS: Sixty-one patients with glioblastoma were included. The majority of patients (n = 56, 91.8% were operated using a neuronavigation system which utilizes 3D preoperative MRI and updated intraoperative 3D ultrasound volumes to guide resection. HRQOL was assessed using EuroQol 5D (EQ-5D, a generic instrument. HRQOL data were collected 1-3 days preoperatively and after 6 weeks. The mean change in EQ-5D index was -0.05 (95% CI -0.15-0.05 6 weeks after surgery (p = 0.285. There were 30 patients (49.2% reporting deterioration 6 weeks after surgery. In a Cox multivariate survival analysis we evaluated deterioration in HRQOL after surgery together with established risk factors (age, preoperative condition, radiotherapy, temozolomide and extent of resection. RESULTS: There were significant independent associations between survival and use of temozolomide (HR 0.30, p = 0.019, radiotherapy (HR 0.26, p = 0.030, and deterioration in HRQOL after surgery (HR 2.02, p = 0.045. Inclusion of surgically acquired deficits in the model did not alter the conclusion. CONCLUSION: Early deterioration in HRQOL after surgery is independently and markedly associated with impaired survival in patients with glioblastoma. Deterioration in patient reported HRQOL after surgery is a meaningful outcome in surgical neuro-oncology, as the measure reflects both the burden of symptoms and treatment hazards and is linked to overall survival.

  12. Health-Related Quality of Life, Cachexia and Overall Survival After Major Upper Abdominal Surgery: A Prospective Cohort Study.

    Science.gov (United States)

    Aahlin, E K; Tranø, G; Johns, N; Horn, A; Søreide, J A; Fearon, K C; Revhaug, A; Lassen, K

    2017-03-01

    Major upper abdominal surgery is often associated with reduced health-related quality of life and reduced survival. Patients with upper abdominal malignancies often suffer from cachexia, represented by preoperative weight loss and sarcopenia (low skeletal muscle mass) and this might affect both health-related quality of life and survival. We aimed to investigate how health-related quality of life is affected by cachexia and how health-related quality of life relates to long-term survival after major upper abdominal surgery. From 2001 to 2006, 447 patients were included in a Norwegian multicenter randomized controlled trial in major upper abdominal surgery. In this study, six years later, these patients were analyzed as a single prospective cohort and survival data were retrieved from the National Population Registry. Cachexia was derived from patient-reported preoperative weight loss and sarcopenia as assessed from computed tomography images taken within three months preoperatively. In the original trial, self-reported health-related quality of life was assessed preoperatively at trial enrollment and eight weeks postoperatively with the health-related quality of life questionnaire Short Form 36. A majority of the patients experienced improved mental health-related quality of life and, to a lesser extent, deteriorated physical health-related quality of life following surgery. There was a significant association between preoperative weight loss and reduced physical health-related quality of life. No association between sarcopenia and health-related quality of life was observed. Overall survival was significantly associated with physical health-related quality of life both pre- and postoperatively, and with postoperative mental health-related quality of life. The association between health-related quality of life and survival was particularly strong for postoperative physical health-related quality of life. Postoperative physical health-related quality of life

  13. Does comorbidity explain the ethnic inequalities in cervical cancer survival in New Zealand? A retrospective cohort study

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    Fleming Steven T

    2011-04-01

    Full Text Available Abstract Background There are large ethnic differences in cervical cancer survival in New Zealand that are only partly explained by stage at diagnosis. We investigated the association of comorbidity with cervical cancer survival, and whether comorbidity accounted for the previously observed ethnic differences in survival. Methods The study involved 1,594 cervical cancer cases registered during 1994-2005. Comorbidity was measured using hospital events data and was classified using the Elixhauser instrument; effects on survival of individual comorbid conditions from the Elixhauser instrument were also assessed. Cox regression was used to estimate adjusted cervical cancer mortality hazard ratios (HRs. Results Comorbidity during the year before diagnosis was associated with cervical cancer-specific survival: those with an Elixhauser count of ≥3 (compared with a count of zero had a HR of 2.17 (1.32-3.56. The HR per unit of Elixhauser count was 1.25 (1.11-1.40. However, adjustment for the Elixhauser instrument made no difference to the mortality HRs for Māori and Asian women (compared to 'Other' women, and made only a trivial difference to that for Pacific women. In contrast, concurrent adjustment for 12 individual comorbid conditions from the Elixhauser instrument reduced the Māori HR from 1.56 (1.19-2.05 to 1.44 (1.09-1.89, i.e. a reduction in the excess risk of 21%; and reduced the Pacific HR from 1.95 (1.21-3.13 to 1.62 (0.98-2.68, i.e. a reduction in the excess risk of 35%. Conclusions Comorbidity is associated with cervical cancer-specific survival in New Zealand, but accounts for only a moderate proportion of the ethnic differences in survival.

  14. Innovations’ Survival

    Directory of Open Access Journals (Sweden)

    Jakub Tabas

    2016-01-01

    Full Text Available Innovations currently represent a tool of maintaining the going concern of a business entity and its competitiveness. However, effects of innovations are not infinite and if an innovation should constantly preserve a life of business entity, it has to be a continual chain of innovations, i.e. continual process. Effective live of a single innovation is limited while the limitation is derived especially from industry. The paper provides the results of research on innovations effects in the financial performance of small and medium-sized enterprises in the Czech Republic. Objective of this paper is to determine the length and intensity of the effects of technical innovations in company’s financial performance. The economic effect of innovations has been measured at application of company’s gross production power while the Deviation Analysis has been applied for three years’ time series. Subsequently the Survival Analysis has been applied. The analyses are elaborated for three statistical samples of SMEs constructed in accordance to the industry. The results obtained show significant differences in innovations’ survival within these three samples of enterprises then. The results are quite specific for the industries, and are confronted and discussed with the results of authors’ former research on the issue.

  15. X-ray and Neutron Reflectivity Study Shows That CLIC1 Undergoes Cholesterol-Dependent Structural Reorganization in Lipid Monolayers.

    Science.gov (United States)

    Hossain, Khondker R; Holt, Stephen A; Le Brun, Anton P; Al Khamici, Heba; Valenzuela, Stella M

    2017-10-31

    CLIC1 belongs to the ubiquitous family of chloride intracellular ion channel proteins that are evolutionarily conserved across species. The CLICs are unusual in that they exist mainly as soluble proteins but possess the intriguing property of spontaneous conversion from the soluble to an integral membrane-bound form. This conversion is regulated by the membrane lipid composition, especially by cholesterol, together with external factors such as oxidation and pH. However, the precise physiological mechanism regulating CLIC1 membrane insertion is currently unknown. In this study, X-ray and neutron reflectivity experiments were performed to study the interaction of CLIC1 with different phospholipid monolayers prepared using POPC, POPE, or POPS with and without cholesterol in order to better understand the regulatory role of cholesterol in CLIC1 membrane insertion. Our findings demonstrate for the first time two different structural orientations of CLIC1 within phospholipid monolayers, dependent upon the absence or presence of cholesterol. In phospholipid monolayers devoid of cholesterol, CLIC1 was unable to insert into the lipid acyl chain region. However, in the presence of cholesterol, CLIC1 showed significant insertion within the phospholipid acyl chains occupying an area per protein molecule of 6-7 nm2 with a total CLIC1 thickness ranging from ∼50 to 56 Å across the entire monolayer. Our data strongly suggests that cholesterol not only facilitates the initial docking or binding of CLIC1 to the membrane but also promotes deeper penetration of CLIC1 into the hydrophobic tails of the lipid monolayer.

  16. Large population study shows that adolescents with celiac disease have an increased risk of multiple autoimmune and nonautoimmune comorbidities.

    Science.gov (United States)

    Assa, Amit; Frenkel-Nir, Yael; Tzur, Dorit; Katz, Lior H; Shamir, Raanan

    2017-06-01

    Celiac disease (CD) is a systemic disorder that is associated with various autoimmune disorders and a higher prevalence of other diagnoses and complications. This large, cross-sectional, population-based study investigated the associations between CD and various medical conditions during late adolescence. We included 2 001 353 Jewish Israeli adolescents who underwent a general health examination at a median age of 17.1 (16.9-17.4) years from 1988 to 2015. Comprehensive data regarding medical status were available for 1 588 041 (79%) subjects. A definite diagnosis of CD was based on accepted criteria. Covariate data included demographic measures and data on associated medical conditions. Overall, data on 7145 subjects with CD and 1 580 896 controls were analysed. Multivariate analyses showed that autoimmune diseases were significantly more common in subjects with CD, including insulin dependent diabetes, with an odds ratio (OR) of 5.5, inflammatory bowel diseases (OR = 3.8), arthritis (OR = 2.4), thyroid diseases (OR = 1.8) and psoriatic skin disorders (OR = 1.6). Further associations included asthma (OR = 1.5), bile stones (OR = 3.6), migraine (OR = 2.3), anaemia (OR = 1.7) and menstrual abnormalities (OR = 1.5). Long bone fractures and axial fractures were no more common in adolescents with CD than controls. CD was already associated with multiple comorbidities by adolescence, and these were not limited to autoimmune disorders. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Factors predicting survival in patients with early stage laryngeal cancer: A cohort study between 2000 to 2015.

    Science.gov (United States)

    Fararouei, Mohammad; Daneshi, Nima; Mohammadianpanah, Μohammad; Reza Tabatabaei, Hamid; Zare-Bandamiri, Mohammad; Dianatinasab, Mostafa

    2017-01-01

    In recent years, trends of treatment and survival of laryngeal cancer have received heightened attention. Despite the fact that most laryngeal cancers are diagnosed at early stage, a concern of worsening survival in patients with localized cancer has been raised but not consistently observed. This study aimed to determine factors affecting laryngeal cancer survival. This was a cohort study from 2000 to 2015 in which clinical and demographic characteristics of patients at early stage of laryngeal cancer were collected. Medical records and telephone interviews were used to define patient's demographic and clinical status during the study period. Multivariate Cox model was used as the main method for analyzing data. Age at diagnosis, type of treatment, stage, and tumor grade were statistically associated with patient survival. Older patients were more prone to worse prognosis (HR=1.69, 95% CI: 1.03-2.75, p=0.03). The results also suggested that people who had surgery compared with those who received only radiation therapy (RT) survived longer (HR=0.44, 95% CI: 0.20-0.94, p=0.03). Furthermore, for those whose tumor was grade 3 at diagnosis, the risk of death was 2.45-fold higher than those with grade 1 (HR =2.45, 95% CI: 1.19-5.40, p=0.01). Stage II patients experienced worse prognosis than stage I patients (HR=1.77, 95% CI: 1.06-2.93, p=0.02). This study revealed several factors that can influence patient survival rate, among them different therapeutic approaches.

  18. Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: a nationwide study.

    Directory of Open Access Journals (Sweden)

    Wen-Pyng Wu

    Full Text Available Paraquat poisoning associates very high mortality rate. Early treatment with hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST in combination with hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with hemoperfusion and the additional effects of IST combined with hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, P<0.001. The combined IST with methylprednisolone, cyclophosphamide and dexamethasone associates with the highest survival rate (48%, P<0.001. Moreover, patients younger than 45 years of age in the IST group had the best survival (41.0% vs. 33.7%, p<0.001. Our results support the use of IST with hemoperfusion for paraquat-poisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age.

  19. A longitudinal study of the survival of interproximal root caries lesions restored with glass ionomer cement via a minimally invasive approach.

    Science.gov (United States)

    Gilboa, Ilan; Cardash, Harold S; Baharav, Haim; Demko, Catherine A; Teich, Sorin T

    2012-01-01

    The prevalence of gingival recessions and the number of root surfaces exposed to the oral environment both increase with age. In turn, these increases place the older population at increased risk for caries; it is estimated that 23.7% of those over the age of 65 have root caries.1 Glass ionomer (GI) seems particularly suitable for restoring root lesions, as it has good esthetic and anti-cariogenic properties, allows for chemical bonding to teeth, and has gained wide acceptance. This article describes a minimally invasive approach for restoring interproximal root caries lesions with GI; in this study, 66 such lesions were restored and followed for up to 80 months. The results show that the radiographic quality score was the single most important predictor for restoration survival. High-quality restorations survived an average of 74 months (SE = 2.7), with a cumulative survival rate of 77.4% at 80 months. Age, gender, and periodontal status were unrelated to restoration survival.

  20. Disparities in pediatric leukemia early survival in Argentina: a population-based study.

    Science.gov (United States)

    Garibotti, Gilda; Moreno, Florencia; Dussel, Veronica; Orellana, Liliana

    2014-10-01

    To identify disparities-using recursive partitioning (RP)-in early survival for children with leukemias treated in Argentina, and to depict the main characteristics of the most vulnerable groups. This secondary data analysis evaluated 12-month survival (12-ms) in 3 987 children diagnosed between 2000 and 2008 with lymphoid leukemia (LL) and myeloid leukemia (ML) and registered in Argentina's population-based oncopediatric registry. Prognostic groups based on age at diagnosis, gender, socioeconomic index of the province of residence, and migration to a different province to receive health care were identified using the RP method. Overall 12-ms for LL and ML cases was 83.7% and 59.9% respectively. RP detected major gaps in 12-ms. Among 1-10-year-old LL patients from poorer provinces, 12-ms for those who did and did not migrate was 87.0% and 78.2% respectively. Survival of ML patients < 2 years old from provinces with a low/medium socioeconomic index was 38.9% compared to 62.1% for those in the same age group from richer provinces. For 2-14-year-old ML patients living in poor provinces, patient migration was associated with a 30% increase in 12-ms. Major disparities in leukemia survival among Argentine children were found. Patient migration and socioeconomic index of residence province were associated with survival. The RP method was instrumental in identifying and characterizing vulnerable groups.

  1. Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study.

    Science.gov (United States)

    Hashiba, Kiyoshi; Siqueira, Pablo R; Brasil, Horus A; D'Assunção, Marco Aurélio; Moribe, Daniel; Cassab, Jorge Carim

    2011-01-01

    The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair. To evaluate an endoscopic closure method for the gastric opening in natural orifice transenteric surgery Short-term survival animal study. Ten White Landrace pigs underwent a gastric perforation of 1.8 cm in diameter under general anesthesia. The opening was repaired with stitch assembled in a T-tag anchor placed through the gastric wall with a needle. A plastic transparent chamber, adapted to the endoscope tip protected the abdominal organs from the needle puncture outside the stomach. Six T-tags were placed in most cases and the stitches were tied with a metallic tie-knot, forming three sutures. The animals received liquids in the same operative day. One shoot antibiotic was used. The leakage test was performed with a forceps and by air distention. No complication was detected in the postoperative course. One month later the endoscopy revealed a scar and some suture material was observed in all animals. The antral anterior gastric wall was clear with few adhesions in the laparotomy performed in the same time. The adhesions were intense in an animal in which a cholecystectomy was performed before the repair. The endoscopic repair using T-tag and a protector chamber is feasible, easy to perform and safe. Further studies are needed to show the real value of this kind of procedure.

  2. Survival of Dental Implants Placed in Grafted and Nongrafted Bone: A Retrospective Study in a University Setting.

    Science.gov (United States)

    Tran, Duong T; Gay, Isabel C; Diaz-Rodriguez, Janice; Parthasarathy, Kavitha; Weltman, Robin; Friedman, Lawrence

    2016-01-01

    To compare dental implant survival rates when placed in native bone and grafted sites. Additionally, risk factors associated with dental implant loss were identified. This study was based on the hypothesis that bone grafting has no effect on implant survival rates. A retrospective chart review was conducted for patients receiving dental implants at the University of Texas, School of Dentistry from 1985 to 2012. Exclusion criteria included patients with genetic diseases, radiation and chemotherapy, or an age less than 18 years. To avoid misclassification bias, implants were excluded if bone grafts were only done at the same time of placement. Data on age, sex, tobacco use, diabetes, osteoporosis, anatomical location of the implant, implant length and width, bone graft, and professional maintenance were collected for analysis. A total of 1,222 patients with 2,729 implants were included. The cumulative survival rates at 5 and 10 years were 92% and 87% for implants placed in native bone and 90% and 79% for implants placed in grafted bone, respectively. The results from multivariate analysis (Cox regression) indicated no significant difference in survival between the two groups; having maintenance therapy after implant placement reduced the failure rate by 80% (P dental implant survival rate when implants were placed in native bone or bone-grafted sites. Smoking and lack of professional maintenance were significantly related to increased implant loss.

  3. A Retrospective Study of the 3-Year Survival Rate of Resin-Modified Glass-Ionomer Cement Class II Restorations in Primary Molars.

    Science.gov (United States)

    Webman, Mark; Mulki, Ezat; Roldan, Rosie; Arevalo, Oscar; Roberts, John F; Garcia-Godoy, Franklin

    2016-01-01

    To determine the three-year survival rate of Class II resin-modified glass-ionomer cement (RMGIC), Vitremer, restorations in primary molars and to compare these results with measurements of survival of Class II restorations of standard restorative materials. Data on Class II restorations placed in primary molars during a six-year period were collected through a chart review and radiographic evaluation in the office of a board-certified pediatric dentist. A radiograph showing that the restoration was intact was required at least 3 years after placement to qualify as successful. If no radiograph existed, the restoration was excluded. If the restoration was not found to be intact radiographically or was charted as having been replaced before three years it was recorded as a failure. The results of this study were then compared to other standard restorative materials using normalized annual failure rates. Of the 1,231 Class II resinmodified glass-ionomer cement restorations placed over six years 427 met the inclusion criteria. There was a 97.42% survival rate for a 3-year period equivalent to an annual failure rate of 0.86%. A novel approach comparing materials showed that in this study Vitremer compared very favorably to previously published success rates of other standard restorative materials (amalgam, composite, stainless steel crown, compomer) and other RMGIC studies.

  4. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study.

    Science.gov (United States)

    Cohen, Alasdair; Tao, Yong; Luo, Qing; Zhong, Gemei; Romm, Jeff; Colford, John M; Ray, Isha

    2015-01-01

    In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT) methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP) from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in rural China and to evaluate their effectiveness. We used a geographically stratified cross-sectional design in rural Guangxi Province to collect survey data from 450 households in the summer of 2013. Household drinking water samples were collected and assayed for Thermotolerant Coliforms (TTC), and physicochemical analyses were conducted for village drinking water sources. In the winter of 2013-2104, we surveyed 120 additional households and used remote sensors to corroborate self-reported boiling data. Our HWT prevalence estimates were: 27.1% boiling with electric kettles, 20.3% boiling with pots, 34.4% purchasing bottled water, and 18.2% drinking untreated water (for these analyses we treated bottled water as a HWT method). Households using electric kettles had the lowest concentrations of TTC (73% lower than households drinking untreated water). Multilevel mixed-effects regression analyses showed that electric kettles were associated with the largest Log10TTC reduction (-0.60, pwater (-0.45, pwater, electric kettle users also had the lowest risk of having TTC detected in their drinking water (risk ratio, RR = 0.49, 0.34-0.70, pwater users (RR = 0.70, 0.53-0.93, pwater access and reduce HAP exposure in rural China.

  5. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study

    Science.gov (United States)

    Cohen, Alasdair; Tao, Yong; Luo, Qing; Zhong, Gemei; Romm, Jeff; Colford, John M.; Ray, Isha

    2015-01-01

    Background In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT) methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP) from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in rural China and to evaluate their effectiveness. Methods We used a geographically stratified cross-sectional design in rural Guangxi Province to collect survey data from 450 households in the summer of 2013. Household drinking water samples were collected and assayed for Thermotolerant Coliforms (TTC), and physicochemical analyses were conducted for village drinking water sources. In the winter of 2013–2104, we surveyed 120 additional households and used remote sensors to corroborate self-reported boiling data. Findings Our HWT prevalence estimates were: 27.1% boiling with electric kettles, 20.3% boiling with pots, 34.4% purchasing bottled water, and 18.2% drinking untreated water (for these analyses we treated bottled water as a HWT method). Households using electric kettles had the lowest concentrations of TTC (73% lower than households drinking untreated water). Multilevel mixed-effects regression analyses showed that electric kettles were associated with the largest Log10TTC reduction (-0.60, pwater (-0.45, pwater, electric kettle users also had the lowest risk of having TTC detected in their drinking water (risk ratio, RR = 0.49, 0.34–0.70, pwater users (RR = 0.70, 0.53–0.93, pwater access and reduce HAP exposure in rural China. PMID:26421716

  6. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Alasdair Cohen

    Full Text Available In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in rural China and to evaluate their effectiveness.We used a geographically stratified cross-sectional design in rural Guangxi Province to collect survey data from 450 households in the summer of 2013. Household drinking water samples were collected and assayed for Thermotolerant Coliforms (TTC, and physicochemical analyses were conducted for village drinking water sources. In the winter of 2013-2104, we surveyed 120 additional households and used remote sensors to corroborate self-reported boiling data.Our HWT prevalence estimates were: 27.1% boiling with electric kettles, 20.3% boiling with pots, 34.4% purchasing bottled water, and 18.2% drinking untreated water (for these analyses we treated bottled water as a HWT method. Households using electric kettles had the lowest concentrations of TTC (73% lower than households drinking untreated water. Multilevel mixed-effects regression analyses showed that electric kettles were associated with the largest Log10TTC reduction (-0.60, p<0.001, followed by bottled water (-0.45, p<0.001 and pots (-0.44, p<0.01. Compared to households drinking untreated water, electric kettle users also had the lowest risk of having TTC detected in their drinking water (risk ratio, RR = 0.49, 0.34-0.70, p<0.001, followed by bottled water users (RR = 0.70, 0.53-0.93, p<0.05 and households boiling with pots (RR = 0.74, 0.54-1.02, p = 0.06.As far as we are aware, this is the first HWT-focused study in China, and the first to quantify the

  7. Online self-study of chest X-rays shows no difference between blocked and mixed practice.

    Science.gov (United States)

    Shah, Rupal; Sibbald, Matthew; Jaffer, Nasir; Probyn, Linda; Cavalcanti, Rodrigo B

    2016-05-01

    Chest radiograph interpretation is a complex skill and learners may benefit from deliberate instructional design modalities, such as mixed practice. Proposed benefits of mixed over blocked practice include the elimination of cueing and the highlighting of contrasting features. However, current evidence for the superiority of mixed practice is conflicting. This study compares mixed versus blocked practice, after the initial teaching of concepts, among medical students using online self-study chest X-ray (CXR) modules. Two online CXR modules were developed that cover identical content but differ in the organisation of practice images. Blocked modules provided practice CXRs after each category, whereas mixed modules randomly ordered practice radiographs after all categories had been taught. Medical students in Years 1-3 were randomised to either module and were tested on 20 new CXRs immediately after completion and at 2 weeks. The primary outcome was immediate diagnostic accuracy. Secondary outcomes included diagnostic accuracy at 2 weeks, time per module and reported module difficulty. A total of 58 medical students participated (32 in the blocked and 26 in the mixed module). Level of training and previous CXR experience were similar across the groups. Totals of 1160 and 1120 answers were evaluated for immediate and 2 week post-test scores, respectively. There were no significant differences in mean diagnostic accuracy between the blocked (mean score: 11.7/20) and mixed (mean score: 11.0/20) practice groups on immediate testing (t = 0.83, d.f. = 56, p = 0.41) or at 2 weeks (mean score: 11.2/20 versus 10.9/20; t = 0.518, d.f. = 54, p = 0.61). Post-test scores showed no correlation with training level (R = 0.23, p = 0.09) or completion time (R = -0.09, p = 0.5). Reported module difficulty was similar between the mixed (3.22/5) and blocked (3.19/5) groups. On multivariable linear regression controlling for completion time, training level and CXR experience, between

  8. Dietary Patterns and Long-Term Survival: A Retrospective Study of Healthy Primary Care Patients.

    Science.gov (United States)

    Shah, Nilay S; Leonard, David; Finley, Carrie E; Rodriguez, Fatima; Sarraju, Ashish; Barlow, Carolyn E; DeFina, Laura F; Willis, Benjamin L; Haskell, William L; Maron, David J

    2017-08-30

    Dietary patterns are related to mortality in selected populations with comorbidities. We studied whether dietary patterns are associated with long-term survival in a middle-aged, healthy population. In this observational cohort study at the Cooper Clinic preventive medicine center (Dallas, Tex), a volunteer sample of 11,376 men and women with no history of myocardial infarction or stroke completed a baseline dietary assessment between 1987 and 1999 and were observed for an average of 18 years. Proportional hazard regressions, including a tree-augmented model, were used to assess the association of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern, Mediterranean dietary pattern, and individual dietary components with mortality. The primary outcome was all-cause mortality. The secondary outcome was cardiovascular mortality. Mean baseline age was 47 years. Each quintile increase in the DASH diet score was associated with a 6% lower adjusted risk for all-cause mortality (P Mediterranean diet was not independently associated with all-cause or cardiovascular mortality. Solid fats and added sugars were the most predictive of mortality. Individuals who consumed >34% of their daily calories as solid fats had the highest risk for all-cause mortality. The DASH dietary pattern was associated with significantly lower all-cause mortality over approximately 2 decades of follow-up in a middle-aged, generally healthy population. Added solid fat and added sugar intake were the most predictive of all-cause mortality. These results suggest that promotion of a healthy dietary pattern should begin in middle age, before the development of comorbid risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Multinationals and plant survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2010-01-01

    The aim of this paper is twofold: first, to investigate how different ownership structures affect plant survival, and second, to analyze how the presence of foreign multinational enterprises (MNEs) affects domestic plants’ survival. Using a unique and detailed data set on the Swedish manufacturing...... sector, I am able to separate plants into those owned by foreign MNEs, domestic MNEs, exporting non-MNEs, and purely domestic firms. In line with previous findings, the result, when conditioned on other factors affecting survival, shows that foreign MNE plants have lower survival rates than non......-MNE plants. However, separating the non-MNEs into exporters and non-exporters, the result shows that foreign MNE plants have higher survival rates than non-exporting non-MNEs, while the survival rates of foreign MNE plants and exporting non-MNE plants do not seem to differ. Moreover, the simple non...

  10. Neurological impairment in a surviving twin following intrauterine fetal demise of the co-twin: a case study.

    Science.gov (United States)

    Forrester, K R; Keegan, K M; Schmidt, J W

    2013-01-01

    It has been established that twin pregnancies are at an increased risk for complications, including the risk of morbidity or mortality for one or both of the infants. Cerebral palsy and other associated neurological deficits also occur at higher rates in twin pregnancies. This report examines two cases of intrauterine demise of one twin with subsequent survival of the co-twin. In both cases, the surviving infant suffered significant neurological sequelae. Impairments observed in these two cases include multicystic encephalomalacia and periventricular leukomalacia as well as the subsequent development of cerebral palsy. This case study explores the predisposing factors, incidence, pathophysiology, consequences, and future research implications of these findings.

  11. Smoking and survival of colorectal cancer patients: population-based study from Germany.

    Science.gov (United States)

    Walter, Viola; Jansen, Lina; Hoffmeister, Michael; Ulrich, Alexis; Chang-Claude, Jenny; Brenner, Hermann

    2015-09-15

    Current evidence on the association between smoking and colorectal cancer (CRC) prognosis after diagnosis is heterogeneous and few have investigated dose-response effects or outcomes other than overall survival. Therefore, the association of smoking status and intensity with several prognostic outcomes was evaluated in a large population-based cohort of CRC patients; 3,130 patients with incident CRC, diagnosed between 2003 and 2010, were interviewed on sociodemographic factors, smoking behavior, medication and comorbidities. Tumor characteristics were collected from medical records. Vital status, recurrence and cause of death were documented for a median follow-up time of 4.9 years. Using Cox proportional hazards regression, associations between smoking characteristics and overall, CRC-specific, non-CRC related, recurrence-free and disease-free survival were evaluated. Among stage I-III patients, being a smoker at diagnosis and smoking ≥15 cigarettes/day were associated with lower recurrence-free (adjusted hazard ratios (aHR): 1.29; 95% confidence interval (CI): 0.93-1.79 and aHR: 1.31; 95%-CI: 0.92-1.87) and disease-free survival (aHR: 1.26; 95%-CI: 0.95-1.67 and aHR: 1.29; 95%-CI: 0.94-1.77). Smoking was associated with decreased survival in stage I-III smokers with pack years ≥20 (Overall survival: aHR: 1.40; 95%-CI: 1.01-1.95), in colon cancer cases (Overall survival: aHR: 1.51; 95%-CI: 1.05-2.17) and men (Recurrence-free survival: aHR: 1.51; 95%-CI: 1.09-2.10; disease-free survival: aHR: 1.49; 95%-CI: 1.12-1.97), whereas no associations were seen among women, stage IV or rectal cancer patients. The observed patterns support the existence of adverse effects of smoking on CRC prognosis among nonmetastatic CRC patients. The potential to enhance prognosis of CRC patients by promotion of smoking cessation, embedded in tertiary prevention programs warrants careful evaluation in future investigations. © 2015 UICC.

  12. EXPERIMENTAL CHALLENGE STUDY OF FV3-LIKE RANAVIRUS INFECTION IN PREVIOUSLY FV3-LIKE RANAVIRUS INFECTED EASTERN BOX TURTLES (TERRAPENE CAROLINA CAROLINA) TO ASSESS INFECTION AND SURVIVAL.

    Science.gov (United States)

    Hausmann, Jennifer C; Wack, Allison N; Allender, Matthew C; Cranfield, Mike R; Murphy, Kevin J; Barrett, Kevin; Romero, Jennell L; Wellehan, James F X; Blum, Stella A; Zink, M Christine; Bronson, Ellen

    2015-12-01

    The Maryland Zoo in Baltimore experienced an outbreak of Frog virus-3 (FV3)-like ranavirus during the summer of 2011, during which 14 of 27 (52%) of its captive eastern box turtles (Terrapene carolina carolina) survived. To assess survival, immunity, and viral shedding, an experimental challenge study was performed in which the surviving, previously infected turtles were reinfected with the outbreak strain of FV3-like ranavirus. Seven turtles were inoculated with virus intramuscularly and four control turtles received saline intramuscularly. The turtles were monitored for 8 wk with blood and oral swabs collected for quantitative polymerase chain reaction (qPCR). During that time, one of seven (14%) inoculated turtles and none of the controls (0%) died; there was no significant difference in survival. Clinical signs of the inoculated turtles, except for the turtle that died, were mild compared to the original outbreak. Quantitative PCR for FV3-like ranavirus on blood and oral swabs was positive for all inoculated turtles and negative for all controls. The turtle that died had intracytoplasmic inclusion bodies in multiple organs. Three inoculated and two control turtles were euthanized at the end of the study. No inclusion bodies were present in any of the organs. Quantitative PCR detected FV3-like ranavirus in the spleen of a control turtle, which suggested persistence of the virus. The surviving five turtles were qPCR-negative for FV3-like ranavirus from blood and oral swabs after brumation. Quantitative PCR for Terrapene herpesvirus 1 found no association between ranavirus infection and herpesvirus loads. In conclusion, previously infected eastern box turtles can be reinfected with the same strain of FV3-like ranavirus and show mild to no clinical signs but can shed the virus from the oral cavity.

  13. Cigarette smoking is associated with adverse survival among women with ovarian cancer: Results from a pooled analysis of 19 studies.

    Science.gov (United States)

    Praestegaard, Camilla; Jensen, Allan; Jensen, Signe M; Nielsen, Thor S S; Webb, Penelope M; Nagle, Christina M; DeFazio, Anna; Høgdall, Estrid; Rossing, Mary Anne; Doherty, Jennifer A; Wicklund, Kristine G; Goodman, Marc T; Modugno, Francesmary; Moysich, Kirsten; Ness, Roberta B; Edwards, Robert; Matsuo, Keitaro; Hosono, Satoyo; Goode, Ellen L; Winham, Stacey J; Fridley, Brooke L; Cramer, Daniel W; Terry, Kathryn L; Schildkraut, Joellen M; Berchuck, Andrew; Bandera, Elisa V; Paddock, Lisa E; Massuger, Leon F; Wentzensen, Nicolas; Pharoah, Paul; Song, Honglin; Whittemore, Alice; McGuire, Valerie; Sieh, Weiva; Rothstein, Joseph; Anton-Culver, Hoda; Ziogas, Argyrios; Menon, Usha; Gayther, Simon A; Ramus, Susan J; Gentry-Maharaj, Alexandra; Wu, Anna H; Pearce, Celeste L; Pike, Malcolm; Lee, Alice W; Sutphen, Rebecca; Chang-Claude, Jenny; Risch, Harvey A; Kjaer, Susanne K

    2017-06-01

    Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08-1.28) and former smokers (pHR = 1.10, 95% CI: 1.02-1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01-3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00-1.23; former smoking: pHR = 1.12, 95% CI: 1.04-1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis. © 2017 UICC.

  14. Survival of the fittest: retrospective cohort study of the longevity of Olympic medallists in the modern era.

    Science.gov (United States)

    Clarke, Philip M; Walter, Simon J; Hayen, Andrew; Mallon, William J; Heijmans, Jeroen; Studdert, David M

    2015-07-01

    To determine whether Olympic medallists live longer than the general population. Retrospective cohort study, with passive follow-up and conditional survival analysis to account for unidentified loss to follow-up. 15 174 Olympic athletes from nine country groups (United States, Germany, Nordic countries, Russia, United Kingdom, France, Italy, Canada, and Australia and New Zealand) who won medals in the Olympic Games held in 1896-2010. Medallists were compared with matched cohorts in the general population (by country, age, sex, and year of birth). Relative conditional survival. More medallists than matched controls in the general population were alive 30 years after winning (relative conditional survival 1.08,95% confidence interval 1.07 to1.10). Medallists lived an average of2.8 years longer than controls. Medallists in eight of the nine country groups had a significant survival advantage compared with controls. Gold, silver, and bronze medallists each enjoyed similar sized survival advantages. Medallists in endurance sports and mixed sports had a larger survival advantage over controls at 30 years (1.13, 1.09 to 1.17; 1.11,1.09 to 1.13) than that of medallists in power sports (1.05,1.01 to 1.08). Olympic medallists live longer than the general population, irrespective of country, medal, or sport. This study was not designed to explain this effect, but possible explanations include genetic factors, physical activity, healthy lifestyle, and the wealth and status that come with international sporting glory. 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.

  15. New Firm Survival: Industry versus Firm Effects

    NARCIS (Netherlands)

    D.B. Audretsch (David); P. Houweling (Patrick); A.R. Thurik (Roy)

    1997-01-01

    textabstractRecent studies show that the likelihood of survival differs significantly across firms. Both firm and industry characteristics are hypothesized to account for this heterogenity. Using a longitudinal database of manufacturing firms we investigate whether firm or industry characteristics

  16. Trends in treatment and survival for advanced laryngeal cancer : A 20-year population-based study in The Netherlands

    NARCIS (Netherlands)

    Timmermans, Adriana J.; van Dijk, Boukje A. C.; Overbeek, Lucy I. H.; van Velthuysen, Marie-Louise F.; van Tinteren, Harm; Hilgers, Frans J. M.; van den Brekel, Michiel W. M.

    BACKGROUND: The purpose of this study was to determine time trends for primary treatment modalities in advanced laryngeal cancer, overall survival (OS), and laryngectomy-free interval (LFI) over the last 2 decades in The Netherlands. METHODS: We conducted an analysis of T3 to T4 laryngeal cancer

  17. 40-year trends in an index of survival for all cancers combined and survival adjusted for age and sex for each cancer in England and Wales, 1971-2011: a population-based study.

    Science.gov (United States)

    Quaresma, Manuela; Coleman, Michel P; Rachet, Bernard

    2015-03-28

    Assessment of progress in cancer control at the population level is increasingly important. Population-based survival trends provide a key insight into the overall effectiveness of the health system, alongside trends in incidence and mortality. For this purpose, we aimed to provide a unique measure of cancer survival. In this observational study, we analysed trends in survival with population-based data for 7·2 million adults diagnosed with a first, primary, invasive malignancy in England and Wales during 1971-2011 and followed up to the end of 2012. We constructed a survival index for all cancers combined using data from the National Cancer Registry and the Welsh Cancer Intelligence and Surveillance Unit. The index is designed to be independent of changes in the age distribution of patients with cancer and of changes in the proportion of lethal cancers in each sex. We analysed trends in the cancer survival index at 1, 5, and 10 years after diagnosis for the selected periods 1971-72, 1980-81, 1990-91, 2000-01, 2005-06, and 2010-11. We also estimated trends in age-sex-adjusted survival for each cancer. We define the difference in net survival between the oldest (75-99 years) and youngest (15-44 years) patients as the age gap in survival. We evaluated the absolute change (%) in the age gap since 1971. The overall index of net survival increased substantially during the 40-year period 1971-2011, both in England and in Wales. For patients diagnosed in 1971-72, the index of net survival was 50% at 1 year after diagnosis. 40 years later, the same value of 50% was predicted at 10 years after diagnosis. The average 10% survival advantage for women persisted throughout this period. Predicted 10-year net survival adjusted for age and sex for patients diagnosed between 2010 and 2011 ranged from 1·1% for pancreatic cancer to 98·2% for testicular cancer. Net survival for the oldest patients (75-99 years) was persistently lower than for the youngest (15-44 years), even after

  18. Modeling longitudinal data and its impact on survival in observational nephrology studies: tools and considerations.

    Science.gov (United States)

    Streja, Elani; Goldstein, Leanne; Soohoo, Melissa; Obi, Yoshitsugu; Kalantar-Zadeh, Kamyar; Rhee, Connie M

    2017-04-01

    Nephrologists and kidney disease researchers are often interested in monitoring how patients' clinical and laboratory measures change over time, what factors may impact these changes, and how these changes may lead to differences in morbidity, mortality, and other outcomes. When longitudinal data with repeated measures over time in the same patients are available, there are a number of analytical approaches that could be employed to describe the trends and changes in these measures, and to explore the associations of these changes with outcomes. Researchers may choose a streamlined and simplified analytic approach to examine trajectories with subsequent outcomes such as estimating deltas (subtraction of the last observation from the first observation) or estimating per patient slopes with linear regression. Conversely, they could more fully address the data complexity by using a longitudinal mixed model to estimate change as a predictor or employ a joint model, which can simultaneously model the longitudinal effect and its impact on an outcome such as survival. In this review, we aim to assist nephrologists and clinical researchers by reviewing these approaches in modeling the association of longitudinal change in a marker with outcomes, while appropriately considering the data complexity. Namely, we will discuss the use of simplified approaches for creating predictor variables representing change in measurements including deltas and patient slopes, as well more sophisticated longitudinal models including joint models, which can be used in addition to simplified models based on the indications and objectives of the study as warranted. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  19. Survival of the project: a case study of ICT innovation in health care.

    Science.gov (United States)

    Andreassen, Hege K; Kjekshus, Lars Erik; Tjora, Aksel

    2015-05-01

    From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. A Trans-National Audience Study of a Global Format Genre: Talent Shows in Denmark, Finland, Germany and Great Britain

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt; Esser, Andrea; Keinonen, Heidi

    television formats, the musical talent show genre has been particularly successful in crossing cultural borders. Formats such as Idols, Got Talent, X Factor and, more recently, Voice have sold to a large variety of countries. As an example, Idols alone has been adapted in over 40 territories, covering all...... programming. A consensus seems to have developed that television formats such as Voice and X Factor to a considerable degree are adapted according to national audiences and, hence, national cultural tastes and mentalities. In our research approach, we recognize that musical talent shows appear to contribute...... of the communal viewing experience, real and imagined, national, sub-national and transnational; of identification, and of the meaning that viewers take from the musical talent show genre. (Part of the panel “Television across borders: The local-global nexus”)...

  1. Title: Trends in co-morbidities and survival for in-hospital cardiac arrest -A Swedish cohort study.

    Science.gov (United States)

    Hjalmarsson, Patrik; Memar, Mahta; Geara, Sammy-Jo; Bouzereau, Mathilde; Allberg, Anna; Elgadi, Abdelaziz; Piscator, Eva; Djärv, Therese

    2017-12-26

    Co-morbidities affect survival after in-hospital cardiac arrests (IHCA). The risk population for IHCA, i.e. the hospitalised patients, have a doubled increase in co-morbidities over time. A similar increase in co-morbidities among IHCAs might explain the relatively poor survival ratios despite improved care. To assess changes in the burden of baseline age-adjusted Charlson co-morbidity index (ACCI) scores among IHCAs as well as to assess its impact on survival in three time periods. All patients ≥18 years suffering an IHCA at Karolinska University Hospital between 1st January 2007 and 31st December 2015 were included. Data regarding the IHCA, patient characteristics, ACCI and 30 day survival were obtained from electronic patient records. Parameters included in ACCI were assessed as ICD-10 codes in the medical file at admission to hospital. The median ACCI with interquartile range (IQR) was presented per year. ACCI was categorised into low 0-2points, moderate 3-5points, high 6-8 points and very high ≥9 points. Differences in survival between 2007 and 2009 and 2010-2012 as well as 2013-2015 were stratified per ACCI category and assessed with adjusted logistic regression models and presented as Odds Ratios with 95% Confidence Intervals (OR, 95% CI). Adjustments included hospital site, sex, first rhythm, ECG-surveillance, witnessed or not, and location of the IHCA. In all, 1373 patients suffered an IHCA, of whom 376 (27%) survived at least 30 days. The ACCI remained almost constant over time at median 4, IQR 3-6. Patients with low or moderate ACCI more than doubled their survival in 2013-2015 compared to 2007-2009 (adjusted OR 2.61 95% CI1.38-4.94 and OR 1.87 95% CI 1.14-3.09 respectively). This cohort study illuminates an almost constant burden of co-morbidities over time among patients suffering an IHCA. Further, the study highlights that 30-day survival has almost doubled from 2007 to 2009 to 2013-2015 among those with low to moderate AccI. Copyright © 2017

  2. Survival in Mediterranean Ambulatory Patients With Chronic Heart Failure. A Population-based Study

    NARCIS (Netherlands)

    Frigola Capell, E.; Comin-Colet, J.; Davins-Miralles, J.; Gich-Saladich, I.J.; Wensing, M.; Verdu-Rotellar, J.M.

    2013-01-01

    INTRODUCTION AND OBJECTIVES: Scarce research has been performed in ambulatory patients with chronic heart failure in the Mediterranean area. Our aim was to describe survival trends in our target population and the impact of prognostic factors. METHODS: We carried out a population-based retrospective

  3. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients.

    Science.gov (United States)

    Bedrosian, Isabelle; Hu, Chung-Yuan; Chang, George J

    2010-03-17

    Despite increased demand for contralateral prophylactic mastectomy (CPM), the survival benefit of this procedure remains uncertain. We used the Surveillance, Epidemiology, and End Results database to identify 107 106 women with breast cancer who had undergone mastectomy for treatment between 1998 and 2003 and a subset of 8902 women who also underwent CPM during the same period. Associations between predictor variables and the likelihood of undergoing CPM were evaluated by use of chi(2) analyses. Risk-stratified (estrogen receptor [ER] status, stage, and age) adjusted survival analyses were performed by using Cox regression. Statistical tests were two-sided. In a univariate analysis, CPM was associated with improved disease-specific survival (hazard ratio [HR] of death = 0.63, 95% confidence interval [CI] = 0.57 to 0.69; P mastectomy also had a lower overall risk for contralateral breast cancer than women with ER-negative tumors (0.46% vs 0.90%, difference = 0.44%; P < .001). CPM is associated with a small improvement in 5-year breast cancer-specific survival mainly in young women with early-stage ER-negative breast cancer. This effect is related to a higher baseline risk of contralateral breast cancer.

  4. A nationwide study of the epidemiology, treatment and survival of oropharyngeal carcinoma in the Netherlands

    NARCIS (Netherlands)

    S. Mak-Kregar (S.); F.J.M. Hilgers; P.C. Levendag (Peter); H. Manni (Hans); H. Lubsen (Herman); J.L.N. Roodenburg; J.M.H. van der Beek (Johan); A.G.L. van der Meij (A. G L)

    1995-01-01

    textabstractSeven head and neck oncology cooperative groups in the Netherlands have reviewed the epidemiology, staging, treatment and survival of oropharyngeal carcinoma patients treated between 1986 and 1990. In all, 640 patients with squamous cell carcinoma (628, 98%) or undifferentiated carcinoma

  5. Genome-wide association study of prostate cancer-specific survival

    DEFF Research Database (Denmark)

    Szulkin, Robert; Karlsson, Robert; Whitington, Thomas

    2015-01-01

    BACKGROUND: Unnecessary intervention and overtreatment of indolent disease are common challenges in clinical management of prostate cancer. Improved tools to distinguish lethal from indolent disease are critical. METHODS: We performed a genome-wide survival analysis of cause-specific death in 24,...

  6. An exploratory study of survival strategies of the refugees at Ijebu Oru

    African Journals Online (AJOL)

    This paper reviews the concept refugees, the survival strategies used by the refugees, international organizations and the host government's efforts to integrate the displaced people fully into the new environment, which they were forced to. The paper also argues that refugees' existence has stretched the basic facilities ...

  7. A study on the survival of primary molars with intact and with defective restorations

    NARCIS (Netherlands)

    Hilgert, L.A.; Frencken, J.E.F.M.; Amorim, R.G. de; Mulder, J.; Leal, S.C.

    2016-01-01

    BACKGROUND: Failed restorations in primary teeth are not always re-restored. Is re-restoration not required anymore? OBJECTIVE: To compare survival rates of primary molars with intact and defective amalgam and ART restorations. METHODS: A total of 649 restored primary molars, of which 162 were

  8. A Study on the Factors Influencing the Growth and Survival of ...

    African Journals Online (AJOL)

    Nafiisah

    rate (SGR) and survival were obtained at temperature of 28°C (1.43 ± 0.15 g and ... Information on growth rates, larval ecology, habitat use, ecological role, and ... 6 specimens per 1.5 square metre. Experiment 2 is an investigation of the effect of temperature. Temperatures (28 and 32 ºC) were adjusted using a Rod Heater.

  9. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses.

    Science.gov (United States)

    Christophersen, Mogens T; Dupont, Nana; Berg-Sørensen, Kristina S; Konnerup, Christel; Pihl, Tina H; Andersen, Pia H

    2014-04-08

    Outcomes of colic treatment are of great interest to clinicians, horse owners and insurers. One commonly used criterion of success is the overall short-term survival rate. This is used as to compare treatments and to measure quality of veterinary care, but may be biased by demographic or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2) to compare these rates with those published in other comparable studies. The overall survival rate for colic horses over the 10-year study period was 68% (confidence intervals (CI): 66-71%; 1087/1588). In the medical group, 1093 horses, short-term survival was 87% (CI: 85-89%). Thirty one % of referred horses were given diagnoses requiring surgical intervention (CI: 29-33%). In this group 32% of the horses were euthanized before surgery (CI: 28-36%; 159/495). Of the surgical cases 27% (CI: 23-31%) were euthanized or died during surgery. Of the horses that recovered from surgery 25% died or were euthanized (CI: 19-32%; 48/189), while 75% survived to discharge (CI: 68-81%). The short term survival rates of Danish horses with colic were similar or lower to those reported from other countries. Apart from variability of veterinary care, attitudes towards euthanasia vary among the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners' attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias. If the survival rates are to be compared between hospitals, techniques or surgeons, prospective studies including mutually agreed-on disease severity scores and a predefined set of reasons for euthanasia are needed.

  10. Adult children's socioeconomic resources and mothers' survival after a breast cancer diagnosis: a Swedish population-based cohort study.

    Science.gov (United States)

    Brooke, Hannah L; Ringbäck Weitoft, Gunilla; Talbäck, Mats; Feychting, Maria; Ljung, Rickard

    2017-03-30

    Socioeconomic inequalities in survival after breast cancer persist worldwide. We aim to determine whether adult offspring's socioeconomic resources contribute to inequalities in mothers' survival after breast cancer. 14 231 women, aged 65-79 years, with a child aged ≥30 years and a first primary diagnosis of breast cancer in the National Cancer Register between 2001 and 2010 were followed until death, 10 years after diagnosis, or end of study (December 2015). Relative survival proportions and excess mortality within 10 years of diagnosis by strata of offspring's education level and disposable income were estimated using flexible parametric models accounting for measures of mothers' socioeconomic position and expected mortality in the general population. 4292 women died during 102 236 person-years of follow-up. Crude 10-year relative survival proportions for mothers of children with >14, 12-14 and education were 0.89 (0.87 to 0.91), 0.87 (0.85 to 0.89) and 0.79 (0.76 to 0.81), respectively. Compared with mothers of children with >14 years of education, mothers of children with education had substantially higher excess mortality (excess HR 1.69 (1.38 to 2.07) and 1.22 (1.00 to 1.48), respectively). Higher mortality did not differ between tertiles of offspring's disposable income. Adult offspring's education level may contribute to inequalities in mothers' survival after breast cancer. Clinicians should be aware of the educational context beyond the individual and women with less educated offsprings may require extra support. This should be considered in future research, policy frameworks and interventions aimed at reducing survival inequalities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. HUMEX, a study on the survivability and adaptation of humans to long- duration exploratory missions

    Science.gov (United States)

    Horneck, G.

    for terrestrial applications. Likewise advanced life support systems with a high degree of autonomy and regenerative capacity and synergy effects were considered where bioregenerative life support systems and biodiagnistic systems become essential especially for the long-term Mars scenario. A roadmap for a future European strategy leading to a potential European participation in a cooperative human exploratory mission, either to the Moon or to Mars, was produced. Ref. Horneck et al. HUMEX, study on the Survivability and Adaptation of Humans to Long-Duration Exploratory Missions, ESA SP (in press)

  12. Large-scale experimental studies show unexpected amino acid effects on protein expression and solubility in vivo in E. coli

    Science.gov (United States)

    2011-01-01

    The biochemical and physical factors controlling protein expression level and solubility in vivo remain incompletely characterized. To gain insight into the primary sequence features influencing these outcomes, we performed statistical analyses of results from the high-throughput protein-production pipeline of the Northeast Structural Genomics Consortium. Proteins expressed in E. coli and consistently purified were scored independently for expression and solubility levels. These parameters nonetheless show a very strong positive correlation. We used logistic regressions to determine whether they are systematically influenced by fractional amino acid composition or several bulk sequence parameters including hydrophobicity, sidechain entropy, electrostatic charge, and predicted backbone disorder. Decreasing hydrophobicity correlates with higher expression and solubility levels, but this correlation apparently derives solely from the beneficial effect of three charged amino acids, at least for bacterial proteins. In fact, the three most hydrophobic residues showed very different correlations with solubility level. Leu showed the strongest negative correlation among amino acids, while Ile showed a slightly positive correlation in most data segments. Several other amino acids also had unexpected effects. Notably, Arg correlated with decreased expression and, most surprisingly, solubility of bacterial proteins, an effect only partially attributable to rare codons. However, rare codons did significantly reduce expression despite use of a codon-enhanced strain. Additional analyses suggest that positively but not negatively charged amino acids may reduce translation efficiency in E. coli irrespective of codon usage. While some observed effects may reflect indirect evolutionary correlations, others may reflect basic physicochemical phenomena. We used these results to construct and validate predictors of expression and solubility levels and overall protein usability, and we

  13. Showing Value (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2009-06-01

    librarians on student achievement. Todd notes, “If we do not show value, we will not have a future. Evidence-based practice is not about the survival of school librarians, it’s about the survival of our students” (40. In this issue we feature school libraries and their connection to evidence based practice. Former Editor-in-Chief, Lindsay Glynn, began putting the wheels in motion for this feature almost a year ago. She invited Carol Gordon and Ross Todd to act as guest editors of the section, drawing upon their contacts and previous work in this field. The result is an issue with five feature articles exploring different aspects of the connection between school libraries and evidence based practice, from the theoretical to the practical. In addition, there is a thought-provoking Commentary by David Loertscher, asking whether we need the evolutionary model of evidence based practice, or something more revolutionary!In addition to the Feature section, we have a well-rounded issue with articles on the topics of library human resources, and the development of a scholars’ portal. As well, there are a record 10 evidence summaries and our educational EBL101 column. I hope there is something for everyone in this issue of EBLIP – enjoy, and see you soon in Stockholm!

  14. The Association between Phase Angle of Bioelectrical Impedance Analysis and Survival Time in Advanced Cancer Patients: Preliminary Study.

    Science.gov (United States)

    Lee, So Yeon; Lee, Yong Joo; Yang, Jung-Hwa; Kim, Chul-Min; Choi, Whan-Seok

    2014-09-01

    A frequent manifestation of advanced cancer patients is malnutrition, which is correlated with poor prognosis and high mortality. Bioelectrical impedance analysis (BIA) is an easy-to-use and non-invasive technique to evaluate changes in body composition and nutritional status. We investigated BIA-derived phase angle as a prognostic indicator for survival in advanced cancer patients. Twenty-eight patients treated at the hospice center of Seoul St. Mary's Hospital underwent BIA measurements from January, 2013 to May, 2013. We also evaluated palliative prognostic index (PPI) and palliative performance scale to compare with the prognostic value of phase angle. Cox's proportional hazard models were constructed to evaluate the prognostic effect of phase angle. The Kaplan Meier method was used to calculate survival. Using univariate Cox analysis, phase angle (hazard ratio [HR], 0.61/per degree increase; 95% confidence interval [CI], 0.42 to 0.89; P = 0.010), PPI (HR, 1.21; 95% CI, 1.00 to 1.47; P = 0.048) were found to be significantly associated with survival. Adjusting age, PPI, body mass index, phase angle significantly showed association with survival in multivariate analysis (HR, 0.64/per degree increase; 95% CI, 0.42 to 0.95; P = 0.028). Survival time of patients with phase angle ≥ 4.4° was longer than patients with phase angle < 4.4° (log rank, 6.208; P-value = 0.013). Our data suggest BIA-derived phase angle may serve as an independent prognostic indicator in advanced cancer patients.

  15. N.Y.C. Study Finds Gains for Charters: Research Shows Schools Closing City-Suburb Gap

    Science.gov (United States)

    Viadero, Debra

    2009-01-01

    New York City's charter schools are making strides in closing achievement gaps between disadvantaged inner-city students and their better-off suburban counterparts, a new study concludes. The study, conducted by Stanford University researcher Caroline M. Hoxby and her co-authors Sonali Mararka and Jenny Kang, is based on eight years of data for…

  16. Study shows that young adults diagnosed with severe attention deficit hyperactivity disorder as children have more driving risks

    Science.gov (United States)

    1996-07-01

    The National Highway Traffic Safety Administration sponsored a study to assess whether Attention Deficit Hyperactivity Disorder (ADHD) diagnosed during childhood would be a risk factor for poorer driving performance during early adulthood. This Traff...

  17. Cardiac torsion-strain relationships in fatigued primary biliary cirrhosis patients show accelerated aging: a pilot cross-sectional study

    National Research Council Canada - National Science Library

    Kieren G. Hollingsworth; Guy A. MacGowan; Louise Morris; Matthew G. D. Bates; Roy Taylor; David E. J. Jones; Julia L. Newton; Andrew M. Blamire

    2012-01-01

    .... The manifestation of this risk is not clear. This pilot study investigated whether alterations in cardiac torsion and strain could be detected in fatigued or nonfatigued early-stage PBC patients...

  18. Patients with chronic pain after abdominal surgery show less preoperative endogenous pain inhibition and more postoperative hyperalgesia: a pilot study.

    NARCIS (Netherlands)

    Wilder-Smith, O.H.G.; Schreyer, T.; Scheffer, G.J.; Arendt-Nielsen, L.

    2010-01-01

    Chronic pain is common and undesirable after surgery. Progression from acute to chronic pain involves altered pain processing. The authors studied relationships between presence of chronic pain versus preoperative descending pain control (diffuse noxious inhibitory controls; DNICs) and postoperative

  19. Extraversion predicts longer survival in gorillas: an 18-year longitudinal study

    Science.gov (United States)

    Weiss, Alexander; Gartner, Marieke C.; Gold, Kenneth C.; Stoinski, Tara S.

    2013-01-01

    Personality plays an important role in determining human health and risk of earlier death. However, the mechanisms underlying those associations remain unknown. We moved away from testing hypotheses rooted in the activities of modern humans, by testing whether these associations are ancestral and one side of a trade-off between fitness costs and benefits. We examined personality predictors of survival in 283 captive western lowland gorillas (Gorilla gorilla gorilla) followed for 18 years. We found that of four gorilla personality dimensions—dominance, extraversion, neuroticism and agreeableness—extraversion was associated with longer survival. This effect could not be explained by demographic information or husbandry practices. These findings suggest that understanding how extraversion and other personality domains influence longevity requires investigating the evolutionary bases of this association in nonhuman primates and other species. PMID:23222443

  20. Combining Gait Speed and Recall Memory to Predict Survival in Late Life: Population-Based Study.

    Science.gov (United States)

    Marengoni, Alessandra; Bandinelli, Stefania; Maietti, Elisa; Guralnik, Jack; Zuliani, Giovanni; Ferrucci, Luigi; Volpato, Stefano

    2017-03-01

    To evaluate the relationship between gait speed, recall memory, and mortality. A cohort study (last follow-up December 2009). Tuscany, Italy. Individual data from 1,014 community-dwelling older adults aged 60 years or older with baseline gait speed and recall memory measurements and follow-up for a median time of 9.10 (IQR 7.1;9.3) years. Participants were a mean (SD) age of 73.9 (7.3) years, and 55.8% women. Participants walking faster than 0.8 m/s were defined as fast walkers; good recall memory was defined as a score of 2 or 3 in the 3-word delayed recall section of the Mini-Mental State Examination. All-cause mortality. There were 302 deaths and the overall 100 person-year death rate was 3.77 (95% CI: 3.37-4.22). Both low gait speed and poor recall memory were associated with mortality when analysed separately (HR = 2.47; 95% CI: 1.87-3.27 and HR = 1.47; 95% CI: 1.16-1.87, respectively). When we grouped participants according to both recall and gait speed, death rates (100 person-years) progressively increased from those with both good gait speed and memory (2.0; 95% CI: 1.6-2.5), to those with fast walk but poor memory (3.4; 95% CI: 2.8-4.2), to those with slow walk and good memory (8.8; 95% CI: 6.4-12.1), to those with both slow walk and poor memory (13.0; 95% CI: 10.6-16.1). In multivariate analysis, poor memory significantly increases mortality risk among persons with fast gait speed (HR = 1.40; 95% CI: 1.04-1.89). In older persons, gait speed and recall memory are independent predictors of expected survival. Information on memory function might better stratify mortality risk among persons with fast gait speed. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  1. Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study.

    Science.gov (United States)

    Lunde, Hanne Marie Bøe; Assmus, Jörg; Myhr, Kjell-Morten; Bø, Lars; Grytten, Nina

    2017-08-01

    Survival and causes of death (COD) in multiple sclerosis (MS) provide ultimate endpoints. We aimed to investigate survival and COD in a 60-year population-based MS cohort compared with the general population. All patients with incident multiple sclerosis (MS) (N=1388) with onset during 1953-2012 in Hordaland County, Western Norway, were included. Data were obtained from patient records at Haukeland University Hospital and linked to the Norwegian COD registry. Survival adjusted for sex, age and disease course were estimated by Kaplan-Meier analyses from birth and from disease onset. Mortality and COD in MS relative to the general population were examined by standardised mortality ratio (SMR). Of 1388 patients, 291 had deceased, mainly of MS (56.4%). Median life expectancy was 74.7 years for MS and 81.8 years for the general population (p0.0001); 2.9 in women and 2.5 in men (p=0.0009). SMR was 2.4 in RRMS and 3.9 in PPMS (p<0.0001). SMR from disease onset during 1953-1974 was 3.1; 2.6 during 1975-1996 and 0.7 during 1997-2012 (p<0.0083). No difference in cause-specific deaths were found (p=0.0871). We found a 7-year shorter life expectancy and almost threefold higher mortality in MS compared with the general population. A rise in survival in MS was observed during the entire observation period. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. [Clinical study on effect of keeping perioperative normal body temperature on skin flap survival].

    Science.gov (United States)

    Xu, Hongwei; Luo, Jun; Huang, Fuguo

    2007-07-01

    To investigate the effect of perioperative body temperature on the survival of skin flap grafting. From July 2005 to November 2006, 50 cases of I-II grade patients undergoing elective skin flap grafting were randomly divided 2 groups. Pharyngeal temperature (PT) and skin temperature (ST) were monitored and recorded every 15 minutes. Operative time, anesthetic time, time from the end of operation to extubation, the volume of blood transfusion, the volume of fluid transfusion and the flap survival 7 days after operation were recorded. In the experimental group, the body temperature was maintained in normal range with water market and forced air heater. In the control group, the body temperature was only monitored without any treatment. Results There were no significant differences in operating room temperature, operative time, anesthetic time, the volume of blood transfusion and fluid transfusion between 2 groups (P > 0.05). After induction, PT decreased gradually in both groups during the first 45 minutes, compared with the time point of intubation (P 0.05); and ST rose in both groups during the first 45 minutes, compared with the time point of intubation (P 0.05). In the control group, both PT and ST decreased gradually and time-dependently compared with the time point of intubation (P skin flap grafts survived in the experimental group, and skin flap grafts necrosed in 2 cases in the control group. Keeping normal body temperature can improve the survival of skin flap grafting. Therefore, the body temperature should be monitored and maintained in a normal range.

  3. Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study

    OpenAIRE

    Kiyoshi Hashiba; Siqueira, Pablo R.; Brasil, Horus A.; Marco Aurélio D'Assunção; Daniel Moribe; Jorge Carim Cassab

    2011-01-01

    CONTEXT: The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair. OBJECTIVE: To evaluate an endoscopic closure method for the gastric opening in natural orifice transenteric surgery DESIGN: Short-term survival animal study. METHODS: Ten White Landrace pigs underwent a gastric perforation of 1.8 cm in diameter under general anesthesia. The opening was re...

  4. Inherited variants in the MC1R gene and survival from cutaneous melanoma: a BioGenoMEL study

    Science.gov (United States)

    Davies, John R; Randerson-Moor, Juliette; Kukalizch, Kairen; Harland, Mark; Kumar, Rajiv; Madhusudan, Srinivasan; Nagore, Eduardo; Hansson, Johan; Höiom, Veronica; Ghiorzo, Paola; Gruis, Nelleke A; Kanetsky, Peter A; Wendt, Judith; Pjanova, Dace; Puig, Susana; Saiag, Philippe; Schadendorf, Dirk; Soufir, Nadem; Okamoto, Ichiro; Affleck, Paul; García-Casado, Zaida; Ogbah, Zighereda; Ozola, Aija; Queirolo, Paola; Sucker, Antje; Barrett, Jennifer H; van Doorn, Remco; Bishop, D Timothy; Newton-Bishop, Julia

    2012-01-01

    Summary Inherited MC1R variants modulate MITF transcription factor signaling, which in turn affects tumor cell proliferation, apoptosis, and DNA repair. The aim of this BioGenoMEL collaborative study in 10 melanoma cohorts was to test the hypothesis that inherited variants thereby moderate survival expectation. A survival analysis in the largest cohort (Leeds) was carried out adjusting for factors known to impact on survival. The results were then compared with data from nine smaller cohorts. The absence of any consensus MC1R alleles was associated with a significantly lower risk of death in the Leeds set (HR, 0.64; 95% CI, 0.46–0.89) and overall in the 10 data sets (HR, 0.78; 95% CI, 0.65–0.94) with some support from the nine smaller data sets considered together (HR, 0.83; 95% CI, 0.67–1.04). The data are suggestive of a survival benefit for inherited MC1R variants in melanoma patients. PMID:22325793

  5. Long-term survivals of 'direct-wax' cast gold onlays: a retrospective study in a general dental practice.

    Science.gov (United States)

    Bandlish, Lalit Kumar; Mariatos, G

    2009-08-08

    Compared to other restoration types, indirect cast posterior restorations of partial coverage exhibit one of the longest survivals. The purpose of the current study was to estimate the success rates of 'direct-wax' cast gold onlays. According to the direct wax technique, the wax pattern is shaped intra-orally followed by direct casting without the need for impressions, resulting in low cost and short processing time. A retrospective survival study was undertaken at a mixed National Health Service and private general dental practice based in London. Patients with direct-wax onlays attending over a period of four months for regular check-ups or dental treatment were recruited. Patient discomfort, pain or sensitivity was recorded. Restoration location, extension, marginal fit, and tooth vitality were also recorded. Restoration failure was defined in the event of recurrent caries, pulp infection for vital teeth, increase in the size of periapical radiolucency for non-vital teeth, and restoration decementation. Survival estimates were calculated using the Kaplan-Meier algorithm. One hundred and ninety-four onlays in 56 patients were examined. Four restorations (2.1%) had failed, mainly due to recurrent caries. The cumulative survival probability was estimated at 415.3 (95% Confidence Interval: 403.0, 427.7) months (34.6, 95% CI: 33.6, 35.6 years), while the 10-year and 20-year survival rates were 97.0% and 94.1% respectively. Vital teeth, compared to non-vital ones, and onlay extension encompassing both the mesial and distal tooth surfaces exhibited significantly (P cast gold restorations of partial coverage were a highly successful treatment option for posterior restorations in a general dental practice environment.

  6. Genome-wide association study identifies the GLDC/IL33 locus associated with survival of osteosarcoma patients.

    Science.gov (United States)

    Koster, Roelof; Panagiotou, Orestis A; Wheeler, William A; Karlins, Eric; Gastier-Foster, Julie M; Caminada de Toledo, Silvia Regina; Petrilli, Antonio S; Flanagan, Adrienne M; Tirabosco, Roberto; Andrulis, Irene L; Wunder, Jay S; Gokgoz, Nalan; Patiño-Garcia, Ana; Lecanda, Fernando; Serra, Massimo; Hattinger, Claudia; Picci, Piero; Scotlandi, Katia; Thomas, David M; Ballinger, Mandy L; Gorlick, Richard; Barkauskas, Donald A; Spector, Logan G; Tucker, Margaret; Belynda, D Hicks; Yeager, Meredith; Hoover, Robert N; Wacholder, Sholom; Chanock, Stephen J; Savage, Sharon A; Mirabello, Lisa

    2017-12-06

    Survival rates for osteosarcoma, the most common primary bone cancer, have changed little over the past three decades and are particularly low for patients with metastatic disease. We conducted a multi-institutional genome-wide association study (GWAS) to identify germline genetic variants associated with overall survival in 632 patients with osteosarcoma, including 523 patients of European ancestry and 109 from Brazil. We conducted a time-to-event analysis and estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models, with and without adjustment for metastatic disease. The results were combined across the European and Brazilian case sets using a random-effects meta-analysis. The strongest association after meta-analysis was for rs3765555 at 9p24.1, which was inversely associated with overall survival (HR = 1.76; 95% CI 1.41-2.18, p = 4.84 × 10-7 ). After imputation across this region, the combined analysis identified two SNPs that reached genome-wide significance. The strongest single association was with rs55933544 (HR = 1.9; 95% CI 1.5-2.4; p = 1.3 × 10-8 ), which localizes to the GLDC gene, adjacent to the IL33 gene and was consistent across both the European and Brazilian case sets. Using publicly available data, the risk allele was associated with lower expression of IL33 and low expression of IL33 was associated with poor survival in an independent set of patients with osteosarcoma. In conclusion, we have identified the GLDC/IL33 locus on chromosome 9p24.1 as associated with overall survival in patients with osteosarcoma. Further studies are needed to confirm this association and shed light on the biological underpinnings of this susceptibility locus. © 2017 UICC.

  7. Population-based study shows that Hirschsprung disease does not have a negative impact on education and income.

    Science.gov (United States)

    Granström, Anna Löf; Svenningsson, Anna; Nordenskjöld, Agneta; Wester, Tomas

    2016-12-01

    Hirschsprung disease is a multifactorial disease, which is mainly treated during childhood. There is a risk of impaired bowel function for a long time after surgery, and its impact on adult life has not been well studied. This study assessed whether having Hirschsprung disease affected social parameters such as educational level and income. This nationwide, population-based cohort study included all patients with Hirschsprung disease, registered in the Swedish National Patient Register from 1964 and 2013, who were each matched by age and sex to ten individuals randomly selected from the Swedish Population Register. The study outcomes were the highest educational level and individual disposable income in 2013 registered by Statistics Sweden. The study comprised 389 patients and 3847 controls, both 76% male, with a median age of 25 years. There were no statistically significant differences in highest educational level between the groups (p = 0.327). The median individual disposable income was 142 200 (0-817 200) Swedish Krona in the patient group and 159 000 (0-3 418 900) in the control group (p = 0.615). The highest educational level and the individual disposable income did not differ between patients with Hirschsprung disease and controls, indicating that the disease had a low impact on these parameters. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  8. Effect of pathologic fractures on survival in multiple myeloma patients: a case control study

    Directory of Open Access Journals (Sweden)

    Yilmaz Mustafa

    2008-06-01

    Full Text Available Abstract Background Multiple Myeloma (MM is a B cell neoplasm characterized by the clonal proliferation of plasma cells. Skeletal complications are found in up to 80% of myeloma patients at presentation and are major cause of morbidity. Methods 49 patients were enrolled with MM admitted to Black Sea Technical University Hospital between 2002–2005. Pathologic fractures (PFs were determined and the patients with or without PF were followed up minumum 3 years for survival analysis. Results PF was observed in 24 patients (49% and not observed in 25 patients (51%. The risk of death was increased in the patients with PF compared with patients who had no fractures. While overall survival was 17.6 months in the patients with PFs, it was 57.3 months in the patients with no PFs. Conclusion These findings suggest that PFs may induce reduced survival and increased mortality in the MM patients, however, larger sample size is essential to draw clearer conclusions added to these data.

  9. Preliminary study of tumor heterogeneity in imaging predicts two year survival in pancreatic cancer patients.

    Directory of Open Access Journals (Sweden)

    Jayasree Chakraborty

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC is one of the most lethal cancers in the United States with a five-year survival rate of 7.2% for all stages. Although surgical resection is the only curative treatment, currently we are unable to differentiate between resectable patients with occult metastatic disease from those with potentially curable disease. Identification of patients with poor prognosis via early classification would help in initial management including the use of neoadjuvant chemotherapy or radiation, or in the choice of postoperative adjuvant therapy. PDAC ranges in appearance from homogeneously isoattenuating masses to heterogeneously hypovascular tumors on CT images; hence, we hypothesize that heterogeneity reflects underlying differences at the histologic or genetic level and will therefore correlate with patient outcome. We quantify heterogeneity of PDAC with texture analysis to predict 2-year survival. Using fuzzy minimum-redundancy maximum-relevance feature selection and a naive Bayes classifier, the proposed features achieve an area under receiver operating characteristic curve (AUC of 0.90 and accuracy (Ac of 82.86% with the leave-one-image-out technique and an AUC of 0.80 and Ac of 75.0% with three-fold cross-validation. We conclude that texture analysis can be used to quantify heterogeneity in CT images to accurately predict 2-year survival in patients with pancreatic cancer. From these data, we infer differences in the biological evolution of pancreatic cancer subtypes measurable in imaging and identify opportunities for optimized patient selection for therapy.

  10. Preliminary study of tumor heterogeneity in imaging predicts two year survival in pancreatic cancer patients.

    Science.gov (United States)

    Chakraborty, Jayasree; Langdon-Embry, Liana; Cunanan, Kristen M; Escalon, Joanna G; Allen, Peter J; Lowery, Maeve A; O'Reilly, Eileen M; Gönen, Mithat; Do, Richard G; Simpson, Amber L

    2017-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers in the United States with a five-year survival rate of 7.2% for all stages. Although surgical resection is the only curative treatment, currently we are unable to differentiate between resectable patients with occult metastatic disease from those with potentially curable disease. Identification of patients with poor prognosis via early classification would help in initial management including the use of neoadjuvant chemotherapy or radiation, or in the choice of postoperative adjuvant therapy. PDAC ranges in appearance from homogeneously isoattenuating masses to heterogeneously hypovascular tumors on CT images; hence, we hypothesize that heterogeneity reflects underlying differences at the histologic or genetic level and will therefore correlate with patient outcome. We quantify heterogeneity of PDAC with texture analysis to predict 2-year survival. Using fuzzy minimum-redundancy maximum-relevance feature selection and a naive Bayes classifier, the proposed features achieve an area under receiver operating characteristic curve (AUC) of 0.90 and accuracy (Ac) of 82.86% with the leave-one-image-out technique and an AUC of 0.80 and Ac of 75.0% with three-fold cross-validation. We conclude that texture analysis can be used to quantify heterogeneity in CT images to accurately predict 2-year survival in patients with pancreatic cancer. From these data, we infer differences in the biological evolution of pancreatic cancer subtypes measurable in imaging and identify opportunities for optimized patient selection for therapy.

  11. The Design and Analysis of Salmonid Tagging Studies in the Columbia Basin : Volume XVII : Effects of Ocean Covariates and Release Timing on First Ocean-Year Survival of Fall Chinook Salmon from Oregon and Washington Coastal Hatcheries.

    Energy Technology Data Exchange (ETDEWEB)

    Burgess, Caitlin; Skalski, John R.

    2001-05-01

    Effects of oceanographic conditions, as well as effects of release-timing and release-size, on first ocean-year survival of subyearling fall chinook salmon were investigated by analyzing CWT release and recovery data from Oregon and Washington coastal hatcheries. Age-class strength was estimated using a multinomial probability likelihood which estimated first-year survival as a proportional hazards regression against ocean and release covariates. Weight-at-release and release-month were found to significantly effect first year survival (p < 0.05) and ocean effects were therefore estimated after adjusting for weight-at-release. Negative survival trend was modeled for sea surface temperature (SST) during 11 months of the year over the study period (1970-1992). Statistically significant negative survival trends (p < 0.05) were found for SST during April, June, November and December. Strong pairwise correlations (r > 0.6) between SST in April/June, April/November and April/December suggest the significant relationships were due to one underlying process. At higher latitudes (45{sup o} and 48{sup o}N), summer upwelling (June-August) showed positive survival trend with survival and fall (September-November) downwelling showed positive trend with survival, indicating early fall transition improved survival. At 45{sup o} and 48{sup o}, during spring, alternating survival trends with upwelling were observed between March and May, with negative trend occurring in March and May, and positive trend with survival occurring in April. In January, two distinct scenarios of improved survival were linked to upwelling conditions, indicated by (1) a significant linear model effect (p < 0.05) showing improved survival with increasing upwelling, and (2) significant bowl-shaped curvature (p < 0.05) of survival with upwelling. The interpretation of the effects is that there was (1) significantly improved survival when downwelling conditions shifted to upwelling conditions in January (i

  12. Stories that Show How to Study and How to Learn: An Experience in the Portuguese School System

    Science.gov (United States)

    Rosario, Pedro; Nunez Perez, Jose Carlos; Gonzalez-Pienda, Julio Antonio

    2004-01-01

    Within the framework of new study programs for Portuguese mandatory education, we carried out a research program at the school "Nossa Senhora do Rosario," under the coordination of this article's first author. Self-regulation of learning is the conceptual framework for the project, called "(Des)venturas do Testas"…

  13. Study shows aspirin reduces the risk and recurrence of prostate cancer in African-American men | Center for Cancer Research

    Science.gov (United States)

    African-American men who take a daily dose of aspirin experience a significantly lower risk of developing advanced prostate cancer – the aggressive and deadly form of the disease – than African-American men who do not regularly use aspirin, according to a study from the Center for Cancer Research (CCR) Laboratory of Human Carcinogenesis. Learn more...

  14. A Case Study Showing How One Young Child Represented Issues Concerned with Attachment and Separation in Her Spontaneous Explorations

    Science.gov (United States)

    Arnold, Cath

    2009-01-01

    This paper presents a case study of a young child, demonstrating evidence of a connection between "enveloping" objects and understanding presence and absence of a temporary and permanent nature. The starting point for the researcher was: an interest in identifying schemas or repeated patterns in order to understand cognitive development and; a…

  15. Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition.

    Science.gov (United States)

    Ramchandani, Meena; Selke, Stacy; Magaret, Amalia; Barnum, Gail; Huang, Meei-Li Wu; Corey, Lawrence; Wald, Anna

    2017-11-25

    Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time. Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1-24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms. The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log 10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005). Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Predictors of survival in octogenarians after mitral valve surgery for degenerative disease: The Mitral Surgery in Octogenarians study.

    Science.gov (United States)

    Chivasso, Pierpaolo; Bruno, Vito D; Farid, Shakil; Malvindi, Pietro Giorgio; Modi, Amit; Benedetto, Umberto; Ciulli, Franco; Abu-Omar, Yasir; Caputo, Massimo; Angelini, Gianni D; Livesey, Steve; Vohra, Hunaid A

    2017-11-20

    An increasing number of octogenarians are referred to undergo mitral valve surgery for degenerative disease, and percutaneous approaches are being increasingly used in this subgroup of patients. We sought to determine the survival and its predictors after Mitral valve Surgery in Octogenarians (MiSO) in a multicenter UK study of high-volume specialized centers. Pooled data from 3 centers were collected retrospectively. To identify the predictors of short-term composite outcome of 30 days mortality, acute kidney injury, and cerebrovascular accident, a multivariable logistic regression model was developed. Multiple Cox regression analysis was performed for late mortality. Kaplan-Meier curves were generated for long-term survival in various subsets of patients. Receiver operating characteristic analysis was done to determine the predictive power of the logistic European System for Cardiac Operative Risk Evaluation. A total of 247 patients were included in the study. The median follow-up was 2.9 years (minimum 0, maximum 14 years). A total of 150 patients (60.7%) underwent mitral valve repair, and 97 patients (39.3%) underwent mitral valve replacement. Apart from redo cardiac surgery (mitral valve repair 6 [4%] vs mitral valve replacement 11 [11.3%], P = .04) and preoperative atrial fibrillation (mitral valve repair 79 [52.6%] vs mitral valve replacement 34 [35.1%], P mitral valve repair group (10.2 ± 11.8 vs 13.7 ± 15.2 in mitral valve replacement; P = .07). No difference was found between groups for duration of cardiopulmonary bypass and aortic crossclamp times. The 30-day mortality for the whole cohort was 13.8% (mitral valve repair 4.7% vs mitral valve replacement 18.6%; P mitral valve replacement (OR, 7.7; 95% CI, 4.04-14.9; P mitral valve repair vs mitral valve replacement: 89.9% vs 70.7% at 1 year, 69.6% vs 54% at 5 years, and 51.8% vs 35.5% at 10 years; P = .0005). Cox proportional hazard model results showed mitral valve replacement (hazard

  17. Technical considerations in the study of /sup 111/In-oxine labelled platelet survival patterns in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Sharefkin, J.; Rich, N.M.

    1982-04-01

    A detailed technique for labelling canine platelets with /sup 111/In-oxine for the study of platelet survival patterns in four to six dogs at a time was developed. Useful modifications of earlier methods included splitting of the platelet rich plasma into multiple aliquots to improve pelleting efficiency at low gravity forces, use of saved platelet poor plasma to flush out injection syringes, and prompt use of commercial /sup 111/In-oxine sources 3 to 5 minutes after mixing with Ringer's Citrate Dextrose. Avoidable pitfalls of the method included excessive lengths of incubation time in plasma free medium and loss of labelling efficacy by exposure of the chelate to iron or other metal contaminants in glassware. The method was used to study changes in platelet survival time in dogs with large synthetic arterial prostheses, and gave results in good agreement with earlier studies using /sup 51/Cr labelled platelets.

  18. Matrix metalloproteinase genes are associated with breast cancer risk and survival: the Breast Cancer Health Disparities Study.

    Directory of Open Access Journals (Sweden)

    Martha L Slattery

    Full Text Available Matrix metalloproteinases (MMPs contribute to cancer through their involvement in cancer invasion and metastasis. We evaluated genetic variation in MMP1 (9 SNPs, MMP2 (8 SNPs, MMP3 (4 SNPs, and MMP9 (3 SNPs and breast cancer risk among Hispanic (2111 cases, 2597 controls and non-Hispanic white (NHW (1481 cases, 1586 controls women in the Breast Cancer Health Disparities Study. Ancestral informative markers (n = 104 were assessed to determine Native American (NA ancestry. MMP1 [4 single nucleotide polymorphisms (SNPs] and MMP2 (2 SNPs were associated with breast cancer overall. MMP1 rs996999 had strongest associations among women with the most NA ancestry (OR 1.61,95% CI 1.09,2.40 as did MMP3 rs650108 (OR 1.36, 95% CI 1.05,1.75 and MMP9 rs3787268 (OR 1.52, 95% CI 1.09,2.13. The adaptive rank truncated product (ARTP showed a significant pathway p(artp  value of 0.04, with a stronger association among women with the most NA ancestry (p(artp = 0.02. Significant pathway genes using the ARTP were MMP1 for all women (p(artp = 0.02 and MMP9 for women with the most NA ancestry (p(artp = 0.024; MMP2 was borderline significant overall (p(artp =0.06 and MMP1 and MMP3 were borderline significant for women with the most NA ancestry (p(artp = 0.07 and 0.06 respectively. MMP1 and MMP2 were associated with ER+/PR+ and ER+/PR-tumors; MMP3 and MMP9 were associated with ER-/PR- tumors. The pathway was highly significant with survival (p(artp = 0.0041 with MMP2 having the strongest gene association (p(artp = 0.0007. Our findings suggest that genetic variation in MMP genes influence breast cancer development and survival in this genetically admixed population.

  19. Persistent transcriptional responses show the involvement of feed-forward control in a repeated dose toxicity study.

    Science.gov (United States)

    Souza, Terezinha M; Rieswijk, Linda; Beucken, Twan van den; Kleinjans, Jos; Jennen, Danyel

    2017-01-15

    Chemical carcinogenesis, albeit complex, often relies on modulation of transcription through activation or repression of key transcription factors. While analyzing extensive networks may hinder the biological interpretation, one may focus on dynamic network motifs, among which persistent feed-forward loops (FFLs) are known to chronically influence transcriptional programming. Here, to investigate the relevance a FFL-oriented approach in depth, we have focused on aflatoxin B1-induced transcriptomic alterations during distinct states of exposure (daily administration during 5days followed by a non-exposed period) of human hepatocytes, by exploring known interactions in human transcription. Several TF-coding genes were persistently deregulated after washout of AFB1. Oncogene MYC was identified as the prominent regulator and driver of many FFLs, among which a FFL comprising MYC/HIF1A was the most recurrent. The MYC/HIF1A FFL was also identified and validated in an independent set as the master regulator of metabolic alterations linked to initiation and progression of carcinogenesis, i.e. the Warburg effect, possibly as result of persistent intracellular alterations arising from AFB1 exposure (nuclear and mitochondrial DNA damage, oxidative stress, transcriptional activation by secondary messengers). In summary, our analysis shows the involvement of FFLs as modulators of gene expression suggestive of a carcinogenic potential even after termination of exposure. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

    OpenAIRE

    Dykes Anna-Karin; Dejin-Karlsson Elisabeth; Finnbogadóttir Hafrún

    2011-01-01

    Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based ...

  1. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study

    OpenAIRE

    Alasdair Cohen; Yong Tao; Qing Luo; Gemei Zhong; Jeff Romm; Colford, John M.; Isha Ray

    2015-01-01

    In rural China ~607 million people drink boiled water, yet little is known about prevailing household water treatment (HWT) methods or their effectiveness. Boiling, the most common HWT method globally, is microbiologically effective, but household air pollution (HAP) from burning solid fuels causes cardiovascular and respiratory disease, and black carbon emissions exacerbate climate change. Boiled water is also easily re-contaminated. Our study was designed to identify the HWT methods used in...

  2. The Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET) study: a food-based multicentre randomized controlled trial.

    Science.gov (United States)

    Henriksen, Hege Berg; Ræder, Hanna; Bøhn, Siv Kjølsrud; Paur, Ingvild; Kværner, Ane Sørlie; Billington, Siv Åshild; Eriksen, Morten Tandberg; Wiedsvang, Gro; Erlund, Iris; Færden, Arne; Veierød, Marit Bragelien; Zucknick, Manuela; Smeland, Sigbjørn; Blomhoff, Rune

    2017-01-30

    Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50-80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2-9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for

  3. Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study

    Directory of Open Access Journals (Sweden)

    Kiyoshi Hashiba

    2011-06-01

    Full Text Available CONTEXT: The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair. OBJECTIVE: To evaluate an endoscopic closure method for the gastric opening in natural orifice transenteric surgery DESIGN: Short-term survival animal study. METHODS: Ten White Landrace pigs underwent a gastric perforation of 1.8 cm in diameter under general anesthesia. The opening was repaired with stitch assembled in a T-tag anchor placed through the gastric wall with a needle. A plastic transparent chamber, adapted to the endoscope tip protected the abdominal organs from the needle puncture outside the stomach. Six T-tags were placed in most cases and the stitches were tied with a metallic tie-knot, forming three sutures. The animals received liquids in the same operative day. One shoot antibiotic was used. The leakage test was performed with a forceps and by air distention. RESULTS: No complication was detected in the postoperative course. One month later the endoscopy revealed a scar and some suture material was observed in all animals. The antral anterior gastric wall was clear with few adhesions in the laparotomy performed in the same time. The adhesions were intense in an animal in which a cholecystectomy was performed before the repair. CONCLUSION: The endoscopic repair using T-tag and a protector chamber is feasible, easy to perform and safe. Further studies are needed to show the real value of this kind of procedure.

  4. A multidisciplinary clinic approach improves survival in ALS: a comparative study of ALS in Ireland and Northern Ireland.

    Science.gov (United States)

    Rooney, James; Byrne, Susan; Heverin, Mark; Tobin, Katy; Dick, Alison; Donaghy, Colette; Hardiman, Orla

    2015-05-01

    Amyotrophic lateral sclerosis (ALS) is a progressive debilitating neurodegenerative disease, with a life expectancy of 3-5 years from first symptom. There is compelling evidence that those who attend a multidisciplinary clinic experience improved survival. The purpose of the study was to explore the survival of patients with ALS ascertained through population-based Registers in the Republic of Ireland (RoI) and Northern Ireland (NI), and to determine whether centralisation of services confers advantage compared with community-based care supported by a specialist care worker. The island of Ireland is divided into two countries, RoI and NI, each with an independent healthcare system. Both countries have population-based ALS Registers with full ascertainment. Data from all 719 incident ALS cases from Ireland and NI, diagnosed between 1 January 2005 and 31 December 2010, were used in the analysis. A survival benefit was identified for patients who attended the multidisciplinary ALS clinic in the RoI. (HR 0.59, 95% CI 0.49 to 0.71, p<0.001). This difference was preserved following multivariate analysis. A trend towards improved survival was noted for patients with ALS from NI when compared with RoI patients who did not attend a multidisciplinary clinic. Centralised multidisciplinary care confers a survival advantage for patients with ALS and is superior to devolved community-based care. We propose that multiple decision-making processes within a multidisciplinary setting lead to an enriched set of clinical encounters for the patient and carer that enhances clinical outcome. 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.

  5. The performance of different propensity score methods for estimating absolute effects of treatments on survival outcomes: A simulation study.

    Science.gov (United States)

    Austin, Peter C; Schuster, Tibor

    2016-10-01

    Observational studies are increasingly being used to estimate the effect of treatments, interventions and exposures on outcomes that can occur over time. Historically, the hazard ratio, which is a relative measure of effect, has been reported. However, medical decision making is best informed when both relative and absolute measures of effect are reported. When outcomes are time-to-event in nature, the effect of treatment can also be quantified as the change in mean or median survival time due to treatment and the absolute reduction in the probability of the occurrence of an event within a specified duration of follow-up. We describe how three different propensity score methods, propensity score matching, stratification on the propensity score and inverse probability of treatment weighting using the propensity score, can be used to estimate absolute measures of treatment effect on survival outcomes. These methods are all based on estimating marginal survival functions under treatment and lack of treatment. We then conducted an extensive series of Monte Carlo simulations to compare the relative performance of these methods for estimating the absolute effects of treatment on survival outcomes. We found that stratification on the propensity score resulted in the greatest bias. Caliper matching on the propensity score and a method based on earlier work by Cole and Hernán tended to have the best performance for estimating absolute effects of treatment on survival outcomes. When the prevalence of treatment was less extreme, then inverse probability of treatment weighting-based methods tended to perform better than matching-based methods. © The Author(s) 2014.

  6. A Birth Cohort Analysis to Study Dog Walking in Adolescence Shows No Relationship with Objectively Measured Physical Activity

    Directory of Open Access Journals (Sweden)

    Carri Westgarth

    2017-05-01

    Full Text Available Physical inactivity during childhood and adolescence is a serious health concern. There are few studies of the activity undertaken by adolescents when walking with the family dog, and the effect of this on objectively measured physical activity levels. Objective measures of physical activity using accelerometers were recorded at age 11–12, 13–14, and 15–16 years in the Avon Longitudinal Study of Parents and Children (ALSPAC (ALSPAC, UK birth cohort during the 2000s. Family pet ownership was collected retrospectively using a questionnaire at age 18 years, for the ages 7, 11, 13, and 15 years. In addition, approximate frequency per week of walks undertaken with dogs were also reported. Multilevel, multivariable modeling was used to investigate the relationship between dog ownership and dog walking status, and physical activity outcomes. There were a total of 4,373 complete data observations for use in 2,055 children. Reported participation in dog walking tended to increase during adolescence, as did dog ownership. The majority of who own dogs reported walking them either 2–6 times/week (range 39–46% or never (range 27–37%. A small minority (7–8% reported walking their dog every day. Most reported never walking any other dog either (94–87%. We found no evidence for an association between dog ownership or reported dog walking, and objectively measured physical activity (counts per minute, P = 0.3, or minutes of moderate-to-vigorous physical activity, P = 0.7 during adolescence. This study provides no evidence to support a relationship between adolescent dog ownership and physical activity, and demonstrates the importance of using objective activity measures and considering dog walking rather than just dog ownership.

  7. Heart transplant centers with multidisciplinary team show a higher level of chronic illness management - Findings from the International BRIGHT Study.

    Science.gov (United States)

    Cajita, Maan Isabella; Baumgartner, Eva; Berben, Lut; Denhaerynck, Kris; Helmy, Remon; Schönfeld, Sandra; Berger, Gabriele; Vetter, Christine; Dobbels, Fabienne; Russell, Cynthia L; De Geest, Sabina

    The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM). The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers with a multidisciplinary team may offer higher levels of CIM, a care model that has the potential to improve outcomes after HTx. We conducted a secondary analysis of the BRIGHT study, a cross-sectional study in 11 countries. Multidisciplinarity in the 36 HTx centers was assessed through HTx director reports and was defined as having a team that was composed of physician(s), nurse(s), and another healthcare professional (either a social worker, psychiatrist, psychologist, pharmacist, dietician, physical therapist, or occupational therapist). CIM was assessed with the Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression assessed the relationship between multidisciplinarity and the level of CIM. Twenty-nine (80.6%) of the HTx centers had a multidisciplinary team. Furthermore, multidisciplinarity was significantly associated with higher levels of CIM (β = 5.2, P = 0.042). Majority of the HTx centers follows the ISHLT recommendation for a multidisciplinary approach. Multidisciplinarity was associated with CIM and point toward a structural factor that needs to be in place for moving toward CIM. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. [Case study shows that the case manager function for cancer patients is used unevenly across the different cancer forms].

    Science.gov (United States)

    Jakobsen, Stein Finne; Bjerrum, Anne; Grønberg, Tanja Le; Thomsen, Pauline; Topp, Charlotte

    2015-06-08

    This case study of the obligatory case manager function for cancer patients explores by whom and for what the function is used. It draws on quantitative data from a database, focus group interviews with case managers at Rigshospitalet and telephone interviews with patients and relatives. The conclusion is that across the different cancer forms patients are using the function unevenly. This can probably be explained by the varying organizational set-ups for patient trajectories across departments. The individual patients and relatives express satisfaction with the information and assistance received from the case managers.

  9. Comparative metabolomic studies of Alkanivorax xenomutans showing differential power output in a three chambered microbial fuel cell.

    Science.gov (United States)

    Mahidhara, Ganesh; Ch, Sasikala; Ch, Venkata Ramana

    2017-06-01

    Metabolomic study of electrogenic bacteria is a necessity to understand the extent of complex organic matter degradation and to invent new co-culture techniques to achieve complete degradation. In this study, we have subjected Alkanivorax xenomutans (KCTC 23751T; NBRC 108843T), a bacterium capable for biodegradation of complex hydrocarbons, to oxic and anoxic conditions in a three chambered microbial fuel cell. In an attempt to understand the molecular mechanisms during the electrogenic processes of A. xenomutans, intra cellular (endo metabolome or the fingerprint) and exo metabolome (extracellular metabolome or the foot print) were analyzed under oxic and anoxic conditions, using FTIR and GC-MS. Interpretation of the data revealed higher number of metabolites in the anoxic fraction as compared to oxic fraction. In addition, expression of putative metabolites that influence electron transfer like flavins, fumarate and quinones were found to be predominant in the organisms when grown in anoxic conditions. Hence, the presence of anoxic conditions governed the electrogenic bacteria to produce enhanced power output by modulating differential metabolomic profiling, compared to the culture grown in oxic conditions.

  10. Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care.

    Science.gov (United States)

    Benini, Franca; Piga, Simone; Zangardi, Tiziana; Messi, Gianni; Tomasello, Caterina; Pirozzi, Nicola; Cuttini, Marina

    2016-05-01

    Italian national guidelines on pain management were published in 2010, but there is little information on how effective pain management is in paediatric emergency care, with other countries reporting poor levels. Using headache as an indicator, we described pain assessment in Italian emergency departments and identified predictors of algometric scale use. All Italian paediatric and maternal and child hospitals participated, plus four general hospitals. Data on all children aged 4-14 years admitted during a one-month period with headache as their chief complaint were abstracted from clinical records. Multivariable analyses identified predictors of algometric assessment, taking into account the cluster study design. We studied 470 admissions. During triage, pain was assessed using a standardised scale (41.5%), informally (15.5%) or was not recorded (42.9%). Only 32.1% of the children received analgesia in the emergency department. The odds ratios for predictors of algometric assessment were non-Italian nationality (3.6), prehospital medication (1.8), admission to a research hospital (7.3) and a more favourable nurses-to-admissions ratio of 10.8 for the highest versus lowest tertile. Despite national guidelines, paediatric pain assessment in Italian emergency care was suboptimal. Hospital variables appeared to be stronger predictors of adequate assessment than patient characteristics. ©2016 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  11. Survival after surgery and stereotactic radiosurgery for patients with multiple intracranial metastases: results of a single-center retrospective study.

    Science.gov (United States)

    Smith, Timothy R; Lall, Rohan R; Lall, Rishi R; Abecassis, Isaac Josh; Arnaout, Omar M; Marymont, MaryAnne H; Swanson, Kristin R; Chandler, James P

    2014-10-01

    Patients with systemic cancer and a single brain metastasis who undergo treatment with resection plus radiotherapy live longer and have a better quality of life than those treated with radiotherapy alone. Historically, whole-brain radiotherapy (WBRT) has been the mainstay of radiation therapy; however, it is associated with significant delayed neurocognitive sequelae. In this study, the authors looked at survival in patients with single and multiple intracranial metastases who had undergone surgery and adjuvant stereotactic radiosurgery (SRS) to the tumor bed and synchronous lesions. The authors retrospectively reviewed the records from an 8-year period at a single institution for consecutive patients with brain metastases treated via complete resection of dominant lesions and adjuvant radiosurgery. The cohort was analyzed for time to local progression, synchronous lesion progression, new intracranial lesion development, systemic progression, and overall survival. The Kaplan-Meier method (stratified by age, sex, tumor histology, and number of intracranial lesions prior to surgery) was used to calculate both progression-free and overall survival. A Cox proportional-hazards regression model was also fitted with the number of intracranial lesions as the predictor and survival as the outcome controlling for disease severity, age, sex, and primary histology. The median overall follow-up among the 150-person cohort eligible for analysis was 17 months. Patients had an average age of 46.2 years (range 16-82 years), and 62.7% were female. The mean (± standard deviation) number of intracranial lesions per patient was 2.5 ± 2.3. The mean time between surgery and stereotactic radiosurgery (SRS) was 3.2 ± 4.1 weeks. Primary cancers included lung cancer (43.3%), breast cancer (21.3%), melanoma (10.0%), renal cell carcinoma (6.7%), and colon cancer (6.7%). The average number of isocenters per treated lesion was 7.6 ± 6.6, and the average treatment dose was 17.8 ± 2.8 Gy. One

  12. A study of variation in rDNA ITS regions shows that two haplotypes coexist within a single aphid genome.

    Science.gov (United States)

    Fenton, B; Malloch, G; Germa, F

    1998-06-01

    We report variation in the rDNA internal transcribed spacers (ITSs) of aphid species, the first for these insects. Variation at 6 sites within ITS1 sequences of the green peach aphid, Myzus persicae, identified two haplotypes coexisting within the same individuals, indicating that molecular drive has not homogenised different copies of rDNA. During this study, we found that PCR can cause a precise 58-bp loss in the amplified copies of an ITS haplotype (type 1). This occurs in all detectable copies under routine PCR conditions, at different annealing temperatures and with Pfu and Taq polymerases. In addition, "hot-start" PCR exclusively copied a different, rare haplotype (type 2). These observations have important considerations for using PCR, as large deletions in PCR products may not reflect real deletions in the genome, and changes in PCR conditions may be needed to copy cryptic haplotypes.

  13. Dithiocarbamate-thiourea hybrids useful as vaginal microbicides also show reverse transcriptase inhibition: design, synthesis, docking and pharmacokinetic studies.

    Science.gov (United States)

    Bala, Veenu; Jangir, Santosh; Mandalapu, Dhanaraju; Gupta, Sonal; Chhonker, Yashpal S; Lal, Nand; Kushwaha, Bhavana; Chandasana, Hardik; Krishna, Shagun; Rawat, Kavita; Maikhuri, Jagdamba P; Bhatta, Rabi S; Siddiqi, Mohammad I; Tripathi, Rajkamal; Gupta, Gopal; Sharma, Vishnu L

    2015-02-15

    Prophylactic prevention is considered as the most promising strategy to tackle STI/HIV. Twenty-five dithiocarbamate-thiourea hybrids (14-38) were synthesized as woman controlled topical vaginal microbicides to counter Trichomonas vaginalis and sperm along with RT inhibition potential. The four promising compounds (18, 26, 28 and 33) were tested for safety through cytotoxic assay against human cervical cell line (HeLa) and compatibility with vaginal flora, Lactobacillus. Docking study of most promising vaginal microbicide (33) revealed that it docked in a position and orientation similar to known reverse transcriptase inhibitor Nevirapine. The preliminary in vivo pharmacokinetics of compound 33 was performed in NZ-rabbits to evaluate systemic toxicity in comparison to Nonoxynol-9. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Randomized, Controlled, Thorough QT/QTc Study Shows Absence of QT Prolongation with Luseogliflozin in Healthy Japanese Subjects.

    Directory of Open Access Journals (Sweden)

    Yuji Kumagai

    Full Text Available Luseogliflozin is a selective sodium glucose co-transporter 2 (SGLT2 inhibitor. To evaluate the cardiac safety of luseogliflozin, a thorough QT/QTc study was conducted in healthy Japanese subjects. The effects of moxifloxacin on QT prolongation in Japanese subjects were also evaluated. In this double-blind, placebo- and open-label positive-controlled, 4-way crossover study, 28 male and 28 female subjects received a single dose of luseogliflozin 5 mg (therapeutic dose, luseogliflozin 20 mg (supratherapeutic dose, placebo, and moxifloxacin 400 mg. Serial triplicate digital 12-lead electrocardiograms (ECGs were recorded before and after dosing, and results were analyzed using the Fridericia correction (QTcF method. Serial blood sampling was performed for pharmacokinetic analyses of luseogliflozin and moxifloxacin to analyze the relationship between QTcF interval and plasma concentration. The upper limits of the two-sided 90% confidence intervals (CIs for baseline and placebo-adjusted QTcF intervals (ΔΔQTcF in the 5 mg and 20 mg luseogliflozin groups were less than 10 ms at all time points. No correlation between plasma luseogliflozin concentrations and ΔΔQTcF was observed. In the moxifloxacin group, the lower limits of the two-sided 90% CIs for ΔΔQTcF were greater than 5 ms at all time points. A positive relationship was observed between plasma moxifloxacin concentration and change in ΔΔQTcF. Luseogliflozin was well tolerated at both dose levels. The majority of adverse events were mild in severity, and no serious or life-threatening adverse events occurred. Neither therapeutic (5 mg nor supratherapeutic (20 mg doses of luseogliflozin affected QT prolongation in healthy Japanese subjects.

  15. Financial crisis and collapsed banks: psychological distress and work related factors among surviving employees--a nation-wide study.

    Science.gov (United States)

    Snorradóttir, Ásta; Vilhjálmsson, Rúnar; Rafnsdóttir, Guðbjörg Linda; Tómasson, Kristinn

    2013-09-01

    The study considered psychological distress among surviving bank employees differently entangled in downsizing and restructuring following the financial crisis of 2008. A cross-sectional, nationwide study was conducted among surviving employees (N = 1880, response rate 68%). Multivariate analysis was conducted to assess factors associated with psychological distress. In the banks, where all employees experienced rapid and unpredictable organizational changes, psychological distress was higher among employees most entangled in the downsizing and restructuring process. Being subjected to downsizing within own department, salary cut, and transfer to another department, was directly related to increased psychological distress, controlling for background factors. The associations between downsizing, restructuring, and distress were reduced somewhat by adding job demands, job control, and empowering leadership to the model, however, adding social support had little effect on these associations. Employees most entangled in organizational changes are the most vulnerable and should be prioritized in workplace interventions during organizational changes. Copyright © 2013 Wiley Periodicals, Inc.

  16. Mono- and dinuclear manganese(III) complexes showing efficient catechol oxidase activity: syntheses, characterization and spectroscopic studies.

    Science.gov (United States)

    Banu, Kazi Sabnam; Chattopadhyay, Tanmay; Banerjee, Arpita; Mukherjee, Madhuparna; Bhattacharya, Santanu; Patra, Goutam Kumar; Zangrando, Ennio; Das, Debasis

    2009-10-28

    Four side-off compartmental ligands L1-L4 [L1 = N,N'-ethylenebis(3-formyl-5-methyl-salicylaldimine), L2 = N,N'-1-methylethylenebis(3-formyl-5-methylsalicylaldimine), L3 = N,N'-1,1-dimethylethylenebis(3-formyl-5-methylsalicylaldimine) and L4= N,N'-cyclohexenebis(3-formyl-5-methylsalicylaldimine)] having two binding sites, N2O2 and O4, have been chosen to synthesize mononuclear and dinuclear manganese(III) complexes with the aim to study their catecholase activity using 3,5-di-tert-butylcatechol (3,5-DTBC) as substrate in the presence of molecular oxygen. In all cases only mononuclear manganese complexes (1-4) were obtained, with manganese coordination taking place at the N2O2 binding site only, irrespective of the amount of manganese salt used. All these complexes have been characterized by routine physico-chemical techniques. Complex MnL2Cl.4H2O (2) has further been structurally characterized by X-ray single crystal structure analysis. Four dinuclear manganese complexes, 5-8, were obtained after condensing the two pending formyl groups on each ligand (L1-L4) with aniline followed by reaction with MnCl2 to put the second Mn atom onto another N2O2 site. The catalytic activity of all complexes 1-8 has been investigated following the oxidation of 3,5-di-tert-butylcatechol (3,5-DTBC) to 3,5-di-tert-butylbenzoquinone (3,5-DTBQ) with molecular oxygen in two different solvents, methanol and acetonitrile. The study reveals that the catalytic activity is influenced by the solvent and to a significant extent by the backbone of the diamine and the behavior seems to be related mainly to steric rather than electronic factors. Experimental data suggest that a correlation, the lower the E(1/2) value the higher the catalytic activity, can be drawn between E(1/2) and Vmax of the complexes in a particular solvent. The EPR measurements suggest that the catalytic property of the complexes is related to the metal center(s) participation rather than to a radical mechanism.

  17. Cancer Survivor Study (CASUS) on colorectal patients: longitudinal study on physical activity, fitness, nutrition, and its influences on quality of life, disease recurrence, and survival. Rationale and design.

    Science.gov (United States)

    Soares-Miranda, Luisa; Abreu, Sandra; Silva, Marco; Peixoto, Armando; Ramalho, Rosa; da Silva, Pedro Correia; Costa, Carla; Teixeira, João Paulo; Gonçalves, Carla; Moreira, Pedro; Mota, Jorge; Macedo, Guilherme

    2017-01-01

    Evidence suggests that being physically active in combination with a healthy diet contributes to diminish colorectal cancer risk. However, if this is true for colorectal cancer primary prevention, the same is not clear for its recurrence after colorectal cancer treatments. Data on cancer survival are scarce, and there is a need for greater attention on these survivors' lifestyle behavior. This manuscript describes rationale and design of the Cancer Survival Study (CASUS) on colorectal patients, a longitudinal observational study with the aim of investigating how physical activity, physical fitness, and dietary intake are related with their quality of life, disease recurrence, and survival. The CASUS on colorectal patients is a longitudinal cohort study on colorectal survivors, aged 18 years or older, recruited 6, 12, and 24 months after surgery. Upon recruitment, patients fill in a battery of questionnaires about physical activity, dietary intake, and quality of life, donate blood samples, do physical fitness tests, and use an accelerometer during 7 days. Repeated analyses will be performed to assess changes over time in physical activity, physical fitness, dietary intake, and other factors in relation to recurrence and survival. Results will contribute to highlight the role of physical activity, physical fitness, and nutrition in the quality of life of colorectal cancer survivors, recurrence, and survival. This study will provide important information for policymakers on the potential benefits of future physical activity and nutritional interventions, which are inexpensive, as a way to improve general health of colorectal cancer survivors.

  18. Area-based study shows most parents follow advice to reduce risk of sudden infant death syndrome.

    Science.gov (United States)

    Strömberg Celind, Frida; Wennergren, Göran; Möllborg, Per; Goksör, Emma; Alm, Bernt

    2017-04-01

    Guidance on reducing the risk of sudden infant death syndrome (SIDS) was successfully introduced to a number of countries in the early 1990s. The most important recommendations were supine sleeping for infants and non-smoking for mothers. This 2012-2014 study examined adherence to the national Swedish SIDS advice. We asked 1000 parents with infants registered at child healthcare centres in western Sweden to complete a questionnaire on infant care from birth to 12 months of age. We analysed 710 responses and found that, in the first three months, 1.3% of the infants were placed in the prone sleeping position and 14.3% were placed on their side. By three to five months, this had risen to 5.6% and 23.6%. In the first three months, 83.1% were breastfed, 84.1% used a pacifier and 44.2% shared their parents' bed, while 5.8% slept in another room. Bed sharing was more likely if infants were breastfed and less likely if they used pacifiers. During pregnancy, 2.8% of the mothers smoked and the mothers who had smoked during pregnancy were less likely to bed share. Overall adherence to the SIDS advice was good, but both prone and side sleeping practices should be targeted. ©2016 The Authors. Acta Paediatrica Published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  19. Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010.

    Science.gov (United States)

    Ofek Shlomai, Noa; Reichman, Brian; Lerner-Geva, Liat; Boyko, Valentina; Bar-Oz, Benjamin

    2014-05-01

    To assess whether the postnatal growth of preterm very-low-birthweight (VLBW) infants, as determined by measures of postnatal growth failure (PNGF), improved during the period 1995-2010 and to evaluate postnatal growth by gestational age (GA) and intrauterine growth groups. The study was based on the Israel national VLBW infant database and comprised 13 531 VLBW infants of 24-32 weeks' GA, discharged at a postmenstrual age of ≤40 weeks. Z-scores were determined for weight at birth and discharge. Severe and mild PNGF was defined as a decrease >2 and 1-2 z-scores, respectively. Three time periods were considered: 1995-2000, 2001-2005 and 2006-2010. Multinomial logistic regression was used to assess the independent effect of time period on PNGF. Severe PNGF decreased from 11.7% in 1995-2000 to 7.2% in 2001-2005 and 5.2% in 2006-2010. Infants born in 2006-2010 had sixfold lower odds for severe PNGF than babies born in 1995-2000 (adjusted odds ratio 0.17, 95% confidence interval 0.14-0.21) and

  20. A proteomic study of serum from children with autism showing differential expression of apolipoproteins and complement proteins.

    Science.gov (United States)

    Corbett, B A; Kantor, A B; Schulman, H; Walker, W L; Lit, L; Ashwood, P; Rocke, D M; Sharp, F R

    2007-03-01

    Modern methods that use systematic, quantitative and unbiased approaches are making it possible to discover proteins altered by a disease. To identify proteins that might be differentially expressed in autism, serum proteins from blood were subjected to trypsin digestion followed by liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS) on time-of-flight (TOF) instruments to identify differentially expressed peptides. Children with autism 4-6 years of age (n=69) were compared to typically developing children (n=35) with similar age and gender distributions. A total of 6348 peptide components were quantified. Of these, five peptide components corresponding to four known proteins had an effect size >0.99 with a Pautism compared to controls. The four proteins were: Apolipoprotein (apo) B-100, Complement Factor H Related Protein (FHR1), Complement C1q and Fibronectin 1 (FN1). In addition, apo B-100 and apo A-IV were higher in children with high compared to low functioning autism. Apos are involved in the transport of lipids, cholesterol and vitamin E. The complement system is involved in the lysis and removal of infectious organisms in blood, and may be involved in cellular apoptosis in brain. Despite limitations of the study, including the low fold changes and variable detection rates for the peptide components, the data support possible differences of circulating proteins in autism, and should help stimulate the continued search for causes and treatments of autism by examining peripheral blood.

  1. NMR-based metabolomics and breath studies show lipid and protein catabolism during low dose chronic T(1)AM treatment.

    Science.gov (United States)

    Haviland, J A; Reiland, H; Butz, D E; Tonelli, M; Porter, W P; Zucchi, R; Scanlan, T S; Chiellini, G; Assadi-Porter, F M

    2013-12-01

    3-Iodothyronamine (T1 AM), an analog of thyroid hormone, is a recently discovered fast-acting endogenous metabolite. Single high-dose treatments of T1 AM have produced rapid short-term effects, including a reduction of body temperature, bradycardia, and hyperglycemia in mice. The effect of daily low doses of T1 AM (10 mg/kg) for 8 days on weight loss and metabolism in spontaneously overweight mice was monitored. The experiments were repeated twice (n = 4). Nuclear magnetic resonance (NMR) spectroscopy of plasma and real-time analysis of exhaled (13) CO2 in breath by cavity ring down spectroscopy (CRDS) were used to detect T1 AM-induced lipolysis. CRDS detected increased lipolysis in breath shortly after T1 AM administration that was associated with a significant weight loss but independent of food consumption. NMR spectroscopy revealed alterations in key metabolites in serum: valine, glycine, and 3-hydroxybutyrate, suggesting that the subchronic effects of T1 AM include both lipolysis and protein breakdown. After discontinuation of T1 AM treatment, mice regained only 1.8% of the lost weight in the following 2 weeks, indicating lasting effects of T1 AM on weight maintenance. CRDS in combination with NMR and (13) C-metabolic tracing constitute a powerful method of investigation in obesity studies for identifying in vivo biochemical pathway shifts and unanticipated debilitating side effects. Copyright © 2013 The Obesity Society.

  2. A Pragmatic Study Shows Failure of Dental Composite Fillings Is Genetically Determined: A Contribution to the Discussion on Dental Amalgams.

    Science.gov (United States)

    Vieira, Alexandre R; Silva, Marília B; Souza, Kesia K A; Filho, Arnôldo V A; Rosenblatt, Aronita; Modesto, Adriana

    2017-01-01

    Composite resins for posterior tooth restorations have become a viable alternative to dental amalgam. Failures sometimes cannot be easily explained, and we hypothesize that a genetic component may influence longevity of restorations. We aimed to determine if there is any evidence for a difference in the performance of amalgams versus composite resin in extensive posterior restorations. We also aimed to determine if risk factors such as age, sex, smoking tobacco, alcohol drinking, diabetes status, and periodontal health status may have a role in the failures of extensive anterior composite restorations. Finally, we investigated if genetic variation in matrix metalloproteinases that are present in the mineralized dentin is associated with failure of composite resin. The data used to perform this research were obtained from the Dental Registry and DNA Repository project after screening 4,856 patients. All restorations were evaluated at times of 1, 2, and 5 years after the restoration placement. 6,266 amalgam and 2,010 composite restorations were analyzed in a total of 807 patients in a period of approximately 10 years (period corresponding to the database existence). An additional 443 extensive direct composite resin restorations in anterior teeth were also studied. Failure rates of amalgam and composite restorations are similar, and by the end of 5 years, composites outperformed amalgams slightly. Failures of anterior composite restorations occurred more often in males who smoked tobacco (p = 0.05), despite a similar number of females and males that smoked tobacco in the sample (116 individuals smoked tobacco, 54 females and 62 males). Alcohol drinking increased failure rate within 2 years (p = 0.03). We found a statistically significant association between matrix metalloproteinase 2 rs9923304 and failure of composite restorations (p = 0.007). Composite resins can replace amalgam restorations. Smoking tobacco and drinking alcohol will increase the

  3. Political Identitiy Of A Minority Group Study Of Noaulu State Community Survival Strategy In Sepa Central Maluku

    OpenAIRE

    Abdul Manaf Tubaka; Hamka Napping; Armin Arsyad; Tasrifin Tahara

    2015-01-01

    This study has five objectives. Firstly why religion of Noaulu can survive in the Midst of social change Increasingly. Secondly how the relationship that has developed between Naulu Community and the government maintains Reviews their identity. Thirdly how the government treats the minority of Noaulu along with Reviews their existence. Fourthly how the factors of social culture and politics influence the sustainability of the political dynamic of Noaulu community in Sepa. Sixthly how the sha...

  4. Mortality-related risk factors and long-term survival after 4460 liver resections in Sweden-a population-based study.

    Science.gov (United States)

    Gilg, Stefan; Sparrelid, Ernesto; Isaksson, Bengt; Lundell, Lars; Nowak, Greg; Strömberg, Cecilia

    2017-02-01

    The objectives of this study were to analyze the outcome after hepatectomy and to identify contributing factors to mortality and long-term survival in a population-based setting. A retrospective, nationwide register study was performed. All patients who underwent hepatectomy in Sweden between 2002 and 2011 were identified in the Swedish Hospital Discharge Registry using their unique personal identification numbers. This cohort was linked to the National Cancer Registry (cancer diagnosis), the National Registry of Causes of Death, and the Migration Registry. Survival analysis by Kaplan-Meier method was performed to assess long-term outcome. A Cox regression model was used to analyze risk factors affecting long-term survival. Overall, 4460 hepatectomies were performed. The 30- and 90-day mortalities were 1.8 and 3.1 %, respectively. The overall 5- and 10-year survival rates for all diagnoses were 45 and 38 %, respectively. Independent risk factors for 5-year mortality were as follows: patient age, comorbidity, male gender, intrahepatic/extrahepatic cholangiocarcinoma, gallbladder cancer, extent of hepatectomy, and hepatectomies performed at non-university hospitals. Re-resection (78.1 % with diagnosis "metastasis") was performed on 374 patients. In these patients, mortality risk decreased by >50 % (HR 0.42; 95 %, CI 0.33-0.53). In a population-based analysis, liver resections are done with a low mortality risk and good long-term outcome. Patients who underwent resection at a University Hospital showed a significant better outcome compared to patients resected at non-University Hospitals. These results support further centralization of liver surgery. Re-resection should be performed if feasible.

  5. Assessment of the survival of dental implants in irradiated jaws following treatment of oral cancer: A retrospective study

    Directory of Open Access Journals (Sweden)

    Meenakshi Chauhan Rana

    2016-01-01

    Full Text Available Background: In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasing widely used. Therefore, we evaluated the success of dental implants in the irradiated jaws of patients following treatment of oral cancer oral cancer treated patients. Materials and Methods: Data of oral cancer treated patients was collected retrospectively from 2002 to 2008. We took 46 oral cancer treated patients in which implants were placed in irradiated jaws for rehabilitation. Results: It was found that out of 162 dental implants placed, 52 failed. Furthermore, there was no variation in the implant survival rate in between both the jaws. Radiation dose of <50 Gy units also showed significantly increased amount of implant survival rate. Conclusions: Implant survival is multifactorial and depends upon a number of factors like level of radiation exposure in that area, time gap between last radiation doses etc., Further research is required in this field to improve the esthetics and quality of life of cancer treated patients.

  6. Evaluation of the liver injury unit scoring system to predict survival in a multinational study of pediatric acute liver failure.

    Science.gov (United States)

    Lu, Brandy R; Zhang, Song; Narkewicz, Michael R; Belle, Steven H; Squires, Robert H; Sokol, Ronald J

    2013-05-01

    To examine the predictive value of the Liver Injury Units (LIU) and admission values (aLIU) of bilirubin and prothrombin time and international normalized ratio scores in a large cohort from the Pediatric Acute Liver Failure (PALF) Study Group, a multinational prospective study. LIU and aLIU scores were calculated for 461 and 579 individuals, respectively, enrolled in the PALF study from 1999 to 2008. Receiver operator characteristic curves were used to evaluate the scores with respect to survival without liver transplantation (LT), death, or LT by 21 days after enrollment. At 21 days, 50.3% of participants were alive without LT, 36.2% underwent LT, and 13.4% died. The c-indices for transplant-free survival were 0.81 based on the LIU score with the international normalized ratio (95% CI, 0.78-0.85) and 0.76 based on the aLIU score (95% CI, 0.72-0.79). The LIU score predicted LT better than it predicted death (c-index for LT 0.84, c-index for death 0.76). Based on data from a large, multicenter cohort of patients with PALF, the LIU score was a better predictor of transplant-free survival than was the aLIU score. The LIU score might be a helpful, dynamic tool to predict clinical outcomes in patients with PALF. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Survival rate variation with different histological subtypes of poor prognostic male anal squamous cell carcinoma: a population-based study

    Science.gov (United States)

    Rai, Kelash; Vikash, Sindhu; Chen, Liaobin; Li, Jingfeng

    2017-01-01

    Background and objective The prognosis of male anal squamous cell carcinoma (MASCC) and female anal squamous cell carcinoma (FASCC) is variable. The influence of tumor subtype on the survival rate and gender is poorly known. Our study is the largest population-based study and aims to outline the difference in survival between MASCC and FASCC patients. Methods A retrospective population-based study was performed to compare the disease-specific mortalities (DSMs) between genders related to the tumor subtypes. The Surveillance, Epidemiology, and End Results (SEER) program database was employed to obtain the data from January 1988 to December 2014. Results A total of 4,516, (3,249 males and 1,267 females), patients with anal squamous cell carcinomas (ASCC) were investigated. The 5-year DSMs were 24.18% and 18.08% for men and women, respectively. The univariate analysis of the male basaloid squamous cell carcinoma (BSCC) and cloacogenic carcinoma (CC) patients demonstrated higher DSMs (P <0.001). Moreover, in the multivariate analysis, BSCC and CC were associated with soaring DSMs in male patients (P < 0.05). Conclusions In the cohort of BSCC and CC patients, male patients demonstrated a considerable decrease in survival rate compared to females. A more precise classification of ASCC and individualized management for MASCC are warranted. PMID:29137429

  8. Survival among Never-Smokers with Lung Cancer in the Cancer Care Outcomes Research and Surveillance Study.

    Science.gov (United States)

    Clément-Duchêne, Christelle; Stock, Shannon; Xu, Xiangyan; Chang, Ellen T; Gomez, Scarlett Lin; West, Dee W; Wakelee, Heather A; Gould, Michael K

    2016-01-01

    Differences in patient characteristics and outcomes have been observed among current, former, and never-smokers with lung cancer, but most prior studies included few never-smokers and were not prospective. We used data from a large, prospective study of lung cancer care and outcomes in the United States to compare characteristics of never-smokers and smokers with lung cancer and to examine survival among the never-smokers. Smoking status at diagnosis was determined by self-report and survival was determined from medical records and cancer registries, with follow-up through June 2010 or later. Cox regression was used to examine the association between smoking and survival, and to identify predictors of survival among never-smokers. Among 3,410 patients with lung cancer diagnosed between September 1, 2003 and October 14, 2005 who completed a baseline patient survey, there were 274 never-smokers (8%), 1,612 former smokers (47%), 1,496 current smokers or smokers who quit recently (44%), and 28 with missing information about smoking status (Never-smokers appeared more likely than former and current/recent smokers to be female and of Asian or Hispanic race/ethnicity, and to have adenocarcinoma histology, fewer comorbidities, private insurance, and higher income and education. Compared with never-smokers, the adjusted hazard of death from any cause was 29% higher among former smokers (hazard ratio, 1.29; 95% confidence interval, 1.08-1.55), and 39% higher among current/recent smokers (hazard ratio, 1.39; 95% confidence interval, 1.16-1.67). Factors predicting worse overall survival among never-smokers included Hispanic ethnicity, severe comorbidity, undifferentiated histology, and regional or distant stage. Never-smoking Hispanics appeared more likely to have regional or advanced disease at diagnosis and less likely to undergo surgical resection, although these differences were not statistically significant. Never-smokers with lung cancer are more likely than ever

  9. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: a population-based study

    NARCIS (Netherlands)

    Maaren, M.C. van; Munck, L.; Bock, G.H. de; Jobsen, J.J.; Dalen, T. van; Linn, S.C.; Poortmans, P.; Strobbe, L.J.A.; Siesling, S.

    2016-01-01

    BACKGROUND: Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving

  10. Metformin use and survival after non-small cell lung cancer: A cohort study in the US Military health system.

    Science.gov (United States)

    Lin, Jie; Gill, Abegail; Zahm, Shelia H; Carter, Corey A; Shriver, Craig D; Nations, Joel A; Anderson, William F; McGlynn, Katherine A; Zhu, Kangmin

    2017-07-15

    Research suggests that metformin may be associated with improved survival in cancer patients with type II diabetes. This study assessed whether metformin use after non-small cell lung cancer (NSCLC) diagnosis is associated with overall survival among type II diabetic patients with NSCLC in the U.S. military health system (MHS). The study included 636 diabetic patients with histologically confirmed NSCLC diagnosed between 2002 and 2007, identified from the linked database from the Department of Defense's Central Cancer Registry (CCR) and the Military Health System Data Repository (MDR). Time-dependent multivariate Cox proportional hazards models were used to assess the association between metformin use and overall survival during follow-up. Among the 636 patients, 411 died during the follow-up. The median follow-up time was 14.6 months. Increased post-diagnosis cumulative use (per 1 year of use) conferred a significant reduction in mortality (adjusted hazard ratio (HR) = 0.76; 95% CI = 0.65-0.88). Further analysis by duration of use revealed that compared to non-users, the lowest risk reduction occurred among patients with the longest duration of use (i.e. use for more than 2 years) (HR = 0.19; 95% CI = 0.09-0.40). Finally, the reduced mortality was particularly observed only among patients who also used metformin before lung cancer diagnosis and among patients at early stage of diagnosis. Prolonged duration of metformin use in the study population was associated with improved survival, especially among early stage patients. Future research with a larger number of patients is warranted. © 2017 UICC.

  11. Depression and Survival in a 17-Year Longitudinal Study of People With HIV: Moderating Effects of Race and Education.

    Science.gov (United States)

    Ironson, Gail; Fitch, Calvin; Stuetzle, Rick

    2017-09-01

    The prevalence of clinically significant depressive symptoms is three times higher in people living with HIV than in the general population. Although studies have shown that depression predicts worse course with HIV, few have investigated its relationship with mortality, and none have had a 17-year follow-up period and been conducted entirely during the time since the advent of protease inhibitors. We followed a diverse sample of HIV-positive people (N = 177) in the mid-range of illness for a study on stress and coping. Participants were assessed every 6 months (for 12 years) via blood draw, questionnaires, and interview. Depression was measured using the Beck Depression Inventory. The study began in March 1997 and mortality was assessed in April 2014. In the primary analysis depression, analyzed as a continuous variable, significantly predicted all-cause mortality (hazard ratio = 1.038, 95% confidence interval = 1.008-1.068). With Beck Depression Inventory scores dichotomized, the hazard ratio was 2.044 (95% confidence interval = 1.176-3.550). Furthermore, this result was moderated by race and educational attainment such that depression only predicted worse survival for non-African Americans and those with a college education or higher. Depression is associated with worse long-term survival in people with HIV during 17 years of follow-up. Interventions targeting depression may improve well-being and potentially survival in individuals with HIV. However, since depression did not predict survival in African Americans or those with low education, more research is needed to identify risk factors for long term outcomes in these groups.

  12. Prognostic factors associated with survival in patients with symptomatic spinal bone metastases: a retrospective cohort study of 1 043 patients

    Science.gov (United States)

    Bollen, Laurens; van der Linden, Yvette M.; Pondaag, Willem; Fiocco, Marta; Pattynama, Bas P.M.; Marijnen, Corrie A.M.; Nelissen, Rob G.H.H.; Peul, Wilco C.; Dijkstra, P.D. Sander

    2014-01-01

    Background Expected survival is a major factor influencing extent of treatment for symptomatic spinal bone metastases (SBM). Predictive models have been developed, but their use can lead to over- or undertreatment.. The study objective was to identify prognostic factors associated with survival in patients with symptomatic SBM and to create a validated risk stratification model. Methods All patients who were treated for symptomatic SBM between 2001 and 2010 were included in this single center retrospective study. Medical records were reviewed for type of primary cancer, performance status, presence of visceral, brain and bone metastases, number and location of spinal metastases, and neurological functioning. Performance status was assessed with the Karnofsky performance score and neurological functioning with the Frankel scale. Analysis was performed using Kaplan-Meier curves, univariate log-rank tests, Cox regression models, and Harrell's C statistic. Results A total of 1 043 patients were studied. The most prevalent tumors were those of breast (n = 299), lung (n = 250), and prostate (n = 215). Median follow-up duration was 6.6 years, and 6 patients were lost to follow-up. Based on the results of the uni- and multivariate analyses, 4 categories were created. Median survival in category A was 31.2 months (95% CI, 25.2–37.3 months), 15.4 months (95% CI, 11.9–18.2 months) for category B, 4.8 months (95% CI, 4.1–5.4 months) for category C, and 1.6 months (95% CI, 1.4–1.9 months) for category D. Harrell's C statistic was calculated after the model was applied to an external dataset, yielding a result of 0.69. Conclusion Assessing patients according to the presented model results in 4 categories with significantly different survival times. PMID:24470544

  13. The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study.

    Science.gov (United States)

    Tan, Cindy S Y; Read, Jane A; Phan, Viet H; Beale, Philip J; Peat, Jennifer K; Clarke, Stephen J

    2015-02-01

    Malnutrition and elevated inflammatory markers have a negative impact on clinical outcomes in cancer patients. Few studies have investigated the associations between inflammatory makers, nutritional status and survival. This study investigates the association between nutritional status, inflammatory markers and overall survival (OS) in patients with advanced cancer. This prospective cohort study recruited 114 adult patients from January 2007 to January 2010. It included patients diagnosed with advanced cancer, good Eastern Cooperative Oncology Group (ECOG) performance status 0-2, a prognosis of more than 3 months and had not received chemotherapy for advanced cancer prior to enrollment. Baseline data were collected prior to commencement of chemotherapy. Patients were followed up from the date of baseline nutritional assessment until the date of death or the date that data were last updated, whichever came first. Malnourished cancer patients had statistically significant higher concentrations of serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) or modified Glasgow Prognostic Score (mGPS) prior to starting chemotherapy. In univariate analyses to predict survival, mGPS 1 or 2 had a hazard ratio (HR) of 1.81 (95 % confidence interval (CI) 1.13-2.89) and NLR ≥ 5 had a HR of 1.13 (95 % CI 1.08-4.60) and malnutrition (HR of 1.66 for Patient-Generated Subjective Global Assessment (PG-SGA) B (95 % CI 1.02-2.71), and HR for severely malnourished patients (PG-SGA C) was 2.73 (95 % CI 1.50-4.96). Inflammatory markers were statistically associated with malnutrition. Malnutrition and mGPS were significant independent predictors of overall survival in patients with advanced cancer.

  14. Surgical fusion of early onset severe scoliosis increases survival in Rett syndrome: a cohort study.

    Science.gov (United States)

    Downs, Jenny; Torode, Ian; Wong, Kingsley; Ellaway, Carolyn; Elliott, Elizabeth J; Izatt, Maree T; Askin, Geoffrey N; Mcphee, Bruce I; Cundy, Peter; Leonard, Helen

    2016-06-01

    Scoliosis is a common comorbidity in Rett syndrome and spinal fusion may be recommended if severe. We investigated the impact of spinal fusion on survival and risk of severe lower respiratory tract infection in Rett syndrome. Data were ascertained from hospital medical records, the Australian Rett Syndrome Database, a longitudinal and population-based registry, and from the Australian Institute of Health and Welfare National Death Index database. Cox regression and generalized estimating equation models were used to estimate the effects of spinal surgery on survival and severe respiratory infection respectively in 140 females who developed severe scoliosis (Cobb angle ≥45°) before adulthood. After adjusting for mutation type and age of scoliosis onset, the rate of death was lower in the surgery group (hazard ratio [HR] 0.30, 95% confidence interval [CI] 0.12-0.74; p=0.009) compared to those without surgery. Rate of death was particularly reduced for those with early onset scoliosis (HR 0.17, 95% CI 0.06-0.52; p=0.002). There was some evidence to suggest that spinal fusion was associated with a reduction in risk of severe respiratory infection among those with early onset scoliosis (risk ratio 0.41, 95% CI 0.16-1.03; p=0.06). With appropriate cautions, spinal fusion confers an advantage to life expectancy in Rett syndrome. © 2015 Mac Keith Press.

  15. Survival prognosis after the start of a renal replacement therapy in the Netherlands: A retrospective cohort study

    NARCIS (Netherlands)

    A.C. Hemke (Aline); M.B.A. Heemskerk (Martin); M. van Diepen (Merel); W. Weimar (Willem); F.W. Dekker (Friedo); A.J. Hoitsma (Andries)

    2013-01-01

    textabstractBackground: There is no single model available to predict the long term survival for patients starting renal replacement therapy (RRT). The available models either predict survival on dialysis until transplantation, survival on the transplant waiting list, or survival after

  16. A comparison of the conditional inference survival forest model to random survival forests based on a simulation study as well as on two applications with time-to-event data.

    Science.gov (United States)

    Nasejje, Justine B; Mwambi, Henry; Dheda, Keertan; Lesosky, Maia

    2017-07-28

    Random survival forest (RSF) models have been identified as alternative methods to the Cox proportional hazards model in analysing time-to-event data. These methods, however, have been criticised for the bias that results from favouring covariates with many split-points and hence conditional inference forests for time-to-event data have been suggested. Conditional inference forests (CIF) are known to correct the bias in RSF models by separating the procedure for the best covariate to split on from that of the best split point search for the selected covariate. In this study, we compare the random survival forest model to the conditional inference model (CIF) using twenty-two simulated time-to-event datasets. We also analysed two real time-to-event datasets. The first dataset is based on the survival of children under-five years of age in Uganda and it consists of categorical covariates with most of them having more than two levels (many split-points). The second dataset is based on the survival of patients with extremely drug resistant tuberculosis (XDR TB) which consists of mainly categorical covariates with two levels (few split-points). The study findings indicate that the conditional inference forest model is superior to random survival forest models in analysing time-to-event data that consists of covariates with many split-points based on the values of the bootstrap cross-validated estimates for integrated Brier scores. However, conditional inference forests perform comparably similar to random survival forests models in analysing time-to-event data consisting of covariates with fewer split-points. Although survival forests are promising methods in analysing time-to-event data, it is important to identify the best forest model for analysis based on the nature of covariates of the dataset in question.

  17. Sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the CPRD primary care database.

    Science.gov (United States)

    Fairhurst, Caroline; Martin, Fabiola; Watt, Ian; Doran, Tim; Bland, Martin; Brackenbury, William J

    2016-09-06

    Voltage-gated sodium channel (VGSC)-inhibiting drugs are commonly used to treat epilepsy and cardiac arrhythmia. VGSCs are also widely expressed in various cancers, including those of the breast, bowel and prostate. A number of VGSC-inhibiting drugs have been shown to inhibit cancer cell proliferation, invasion, tumour growth and metastasis in preclinical models, suggesting that VGSCs may be novel molecular targets for cancer treatment. Surprisingly, we previously found that prior exposure to VGSC-inhibiting drugs may be associated with reduced overall survival in patients with cancer, but we were unable to control for the cause of death or indication for prescription. The purpose of the present study is to interrogate a different database to further investigate the relationship between VGSC-inhibiting drugs and cancer-specific survival. A cohort study using primary care data from the Clinical Practice Research Datalink database will include patients with diagnosis of breast, bowel and prostate cancer (13 000). The primary outcome will be cancer-specific survival from the date of cancer diagnosis. Cox proportional hazards regression will be used to compare survival of patients taking VGSC-inhibiting drugs (including antiepileptic drugs and class I antiarrhythmic agents) with patients with cancer not taking these drugs, adjusting for cancer type, age and sex. Drug exposure will be treated as a time-varying covariate to account for potential immortal time bias. Various sensitivity and secondary analyses will be performed. The project has been reviewed and approved by the University of York Ethical Review Process. Results will be presented at an international conference and published in open access peer-reviewed journals according to the STROBE and RECORD guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Early colonoscopy confers survival benefits on colon cancer patients with pre-existing iron deficiency anemia: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Chieh-Lin Jerry Teng

    Full Text Available This study aimed to examine the prognostic significance of pre-existing iron deficiency anemia (IDA and the benefits of early colonoscopy in patients with colon cancer, since these have not been clearly established to date. Using the Taiwanese National Health Insurance Research Database, we retrieved and retrospectively reviewed the records of patients aged ≥ 55 years who were diagnosed with colon cancer between 2000 and 2005. The patient cohort was divided into two groups: patients with (n = 1,260 or without (n = 15,912 an IDA diagnosis during ≤ 18 months preceding the date of colon cancer diagnosis. We found that diabetes (27.9% vs. 20.3%, p<0.0001, cardiovascular disease (61.6% vs. 54.7%, p<0.001, and chronic kidney disease (4.6% vs. 2.2%, p<0.0001 were more common among patients with IDA than among those without IDA. The median overall survival times for patients with IDA and those without IDA were 4.6 and 5.7 years, respectively (p = 0.002. Patients who underwent colonoscopy ≤ 30 days, 31-90, and ≥ 91 days after IDA diagnosis showed median overall survival times of 5.79, 4.43, and 4.04 years, respectively (p = 0.003. Delayed colonoscopy was an independent factor associated with poor overall survival (adjusted hazard ratio, 1.28; 95% confidence interval, 1.07-1.53; p = 0.01. In conclusion, colon cancer patients with IDA were more likely to experience comorbidities than were those without IDA. Pre-existing IDA was a poor prognostic factor in adult men and postmenopausal women who had colon cancer. Early colonoscopy could improve overall survival possibly by facilitating early diagnosis and treatment.

  19. A population-based study of survival and discharge status for survivors after head injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Teasdale, T W

    2004-01-01

    -Meier survival functions were calculated for these two categories. Hospital records for a random sample of 389 survivors in 1997 after cranial fracture, acute brain lesion or chronical subdural haematoma, which occurred in 1982, 1987 and 1992 in patients aged 15 years or more at injury, were reviewed. Survivors......OBJECTIVES: Creation of a basis for the planning of rehabilitation after head injury in Denmark. MATERIALS AND METHODS: Patients with cranial fractures or traumatic cerebral lesions occurring in Denmark in 1979-93 were identified by computerized searches in the national hospital register. Kaplan...... were characterized by age, gender, place and severity of injury, as well as neurophysical, speech and mental deficits at discharge from hospital. RESULTS: Acute/subacute mortality of hospitalized patients was 27% for cerebral lesions and 4% after cranial fracture. As attrition by death outweighed...

  20. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy...... and Survival study) (n = 6,080) and whether this was associated with eplerenone's beneficial effects on cardiovascular outcomes....

  1. 10-year survival evaluation for glass-fiber-supported postendodontic restoration: a prospective observational clinical study.

    Science.gov (United States)

    Naumann, Michael; Koelpin, Manja; Beuer, Florian; Meyer-Lueckel, Hendrik

    2012-04-01

    Glass-fiber-reinforced endodontic posts (GFRPs), in combination with composite resin core materials, are commonly used to build up damaged endodontically treated teeth. However, long-term clinical data are scarce. Thus, the aim of this investigation was to evaluate the survival of 3 different GFRP systems, taking into account several other relevant factors. One-hundred forty-nine GFRPs in 122 patients were followed for up to 120 months. GFRPs were adhesively luted using the etch-and-rinse technique. The core was built with a chemically curing composite resin and restored according to the specific prosthetic treatment plan. Cox proportional hazards models were used to evaluate the association between clinical variables and the time until failure. Within 10 years, 55 failures could be observed (annual failure rate = 4.6%) with the most frequent ones being post fracture, loss of post retention (both n = 17), endodontic problems (n = 7), and those resulting in tooth extraction (n = 10). Sixty posts could be followed up for 105 to 120 months (34 posts lost to follow-up, [mean (standard deviation) survival time: 74 (43) months]). In crude analyses, only the tooth type in favor of posterior teeth compared with anterior teeth and the number of remaining cavity walls (in favor of ≥ 1 compared with no wall) were significantly associated with the failure rate. Cox regression analysis revealed a significant hazard ratio of 2.0 (95% confidence interval, 1.1-3.5; P = .021) for tooth type in favor of posterior teeth. The relatively high annual failure rate of GFRPs highlights that the treatment decision should take into account the most relevant factors as tooth type and the number of remaining cavity walls. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Does postoperative radiation therapy impact survival in non-metastatic sarcomatoid renal cell carcinoma? A SEER-based study.

    Science.gov (United States)

    Eminaga, Okyaz; Akbarov, Ilgar; Wille, Sebastian; Engelmann, Udo

    2015-10-01

    The effect of adjuvant radiation therapy on survival in sarcomatoid renal cell carcinoma (sRCC) with no evidence of distant metastasis remains unclear. Subjects diagnosed with non-metastatic sRCC were identified using the Surveillance Epidemiology and End Results (SEER) (2004-2012) database and divided into groups based on their surgical treatment (ST): no surgery or radiation therapy (NSR); partial nephrectomy (PNE); radical nephrectomy with ureterectomy and bladder cuff resection (RNE + UE + BLAD); and radical nephrectomy (RNE). Certain radical nephrectomy cases also received adjuvant external-beam radiation therapy (RNE + RAD). The Kaplan-Meier method was used to estimate overall survival (OS). A multivariable competing risks regression analysis was used to calculate disease-specific survival (DSS) probability and to determine factors associated with cause-specific mortality (CSM). A total of 408 patients were included in this study. The 5-year OS and predicted DSS were significantly higher in the patients who underwent STs (i.e., PNE, RNE + UE + BLAD, RNE, and RNE + RAD) (20.1-54.0 and 20.1-59.9 %, respectively) than in the NSR group (9.0 and 11.6 %, respectively) (P therapy did not increase OS in non-metastatic sRCC patients.

  3. Trends in the receipt of guideline care and survival for women with ovarian cancer: A population-based study.

    Science.gov (United States)

    Warren, Joan L; Harlan, Linda C; Trimble, Edward L; Stevens, Jennifer; Grimes, Melvin; Cronin, Kathleen A

    2017-06-01

    We assessed trends in the receipt of guideline care and 2-year cause-specific survival for women diagnosed with ovarian cancer. This retrospective cohort analysis used National Cancer Institute's Patterns of Care studies data for women diagnosed with ovarian cancer in 2002 and 2011 (weighted n=6427). Data included patient characteristics, treatment type, and provider characteristics. We used logistic regression to evaluate the association of year of diagnosis with receipt of guideline surgery, multiagent chemotherapy, or both. Two-year cause-specific survival, 2002-2013, was assessed using SEER data. The adjusted rate of women who received stage-appropriate surgery, 48%, was unchanged from 2002 to 2011. Gynecologic oncologist (GO) consultations increased from 43% (2002) to 78% (2011). GO consultation was a significant predictor for receipt of guideline care, although only 40% of women who saw a GO received guideline surgery and chemotherapy. The percent of women who received guideline surgery and chemotherapy increased significantly from 32% in 2002 to 37% in 2011. From 2002 to 2011, 2-year cause-specific ovarian cancer survival was unchanged for Stages I-III cancers, with slight improvement for Stage IV cancers. Receipt of guideline care has improved modestly from 2002-2011 for women with ovarian cancer. Current treatment is far below clinical recommendations and may explain limited improvement in 2-year cause-specific survival. Most women consulted a GO in 2011 yet did not receive guideline care. There needs to be a better understanding of the decision-making process about treatment during the consultation with GOs and other factors precluding receipt of guideline care. Published by Elsevier Inc.

  4. A clinical study on survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo.

    Science.gov (United States)

    Salihu, Sami; Güven, Orhan; Gllareva, Enis; Prekazi, Mergime; Salihu, Leminot

    2014-12-01

    The aim of this study is to find out the survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo and to see the effect of stage of disease on the success of surgical treatment. 789 patients with SCCLL who were referred to the Department of Maxillofacial Surgery, University Clinical Centre of Kosovo, were examined during a period of 20 years (between 1993 and 2013). 614 (77.82%) of these patients received treatment and have regularly visited the department once every 3 months for post-operative controls. Data have been collected from these 614 patients for 10 years; thus the follow-up period lasts for 10 years for every patient under control. The collected data were analysed using Chi square test. Patients were classified by sex, aetiology, stage of the disease, location of the disease, the treatment patients received, metastasis rate and survival rate. The most susceptible patients were those at ages between 50 and 70. The youngest patient was 8 years old whereas the oldest was 92. The male-female ratio was 5:1. 57% of the patients had been working outdoors and had been exposed to sunlight. Ten years survival rate for the Stages I, II, III and IV was 91.7%, 83.7%, 28% and 11.4% respectively. It was found that the success of the surgery was closely related with the stage of disease and early diagnosis. Training the relevant parties (i.e., the people, family doctors etc.) on early diagnosis would improve the survival rate. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Blood Transfusion and Survival for Resected Adrenocortical Carcinoma: A Study from the United States Adrenocortical Carcinoma Group.

    Science.gov (United States)

    Poorman, Caroline E; Postlewait, Lauren M; Ethun, Cecilia G; Tran, Thuy B; Prescott, Jason D; Pawlik, Timothy M; Wang, Tracy S; Glenn, Jason; Hatzaras, Ioannis; Shenoy, Rivfka; Phay, John E; Keplinger, Kara; Fields, Ryan C; Jin, Linda X; Weber, Sharon M; Salem, Ahmed; Sicklick, Jason K; Gad, Shady; Yopp, Adam C; Mansour, John C; Duh, Quan-Yang; Seiser, Natalie; Solorzano, Carmen C; Kiernan, Colleen M; Votanopoulos, Konstantinos I; Levine, Edward A; Staley, Charles A; Poultsides, George A; Maithel, Shishir K

    2017-07-01

    Perioperative blood transfusion is associated with decreased survival in pancreatic, gastric, and liver cancer. The effect of transfusion in adrenocortical carcinoma (ACC) has not been studied. Patients with available transfusion data undergoing curative-intent resection of ACC from 1993 to 2014 at 13 institutions comprising the United States Adrenocortical Carcinoma Group were included. Factors associated with blood transfusion were determined. Primary and secondary end points were recurrence-free survival (RFS) and overall survival (OS), respectively. Out of 265 patients, 149 were included for analysis. Out of these, 57 patients (38.3%) received perioperative transfusions. Compared to nontransfused patients, transfused patients more commonly had stage 4 disease (46% vs 24%, P = 0.01), larger tumors (15.8 vs 10.2 cm, P Transfusion was associated with decreased RFS (8.9 vs 24.7 months, P = 0.006) and OS (22.8 vs 91.0 months, P transfusion, stage IV, hormonal hypersecretion, and adjuvant therapy were associated with decreased RFS. On multivariable analysis, only transfusion [hazard ratio (HR) = 1.7, 95% confidence interval (CI) =1.0-2.9, P = 0.04], stage IV (HR = 3.2, 95% CI = 1.7-5.9, P transfusion HR = 2.0, 95% CI = 1.1-3.8, P = 0.02; stage 4 HR = 6.2, 95% CI = 3.1-12.4, P 2 units of packed red blood cells in median RFS (8.9 vs 8.4 months, P = 0.95) or OS (26.5 vs 18.6 months, P = 0.63). Perioperative transfusion is associated with earlier recurrence and decreased survival after curative-intent resection of ACC. Strategies and protocols to minimize blood transfusion should be developed and followed.

  6. Major clinical events, signs and severity assessment scores related to actual survival in patients who died from primary biliary cirrhosis. A long-term historical cohort study

    NARCIS (Netherlands)

    van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW

    1999-01-01

    BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with

  7. Political Identitiy Of A Minority Group Study Of Noaulu State Community Survival Strategy In Sepa Central Maluku

    Directory of Open Access Journals (Sweden)

    Abdul Manaf Tubaka

    2017-01-01

    Full Text Available This study has five objectives. Firstly why religion of Noaulu can survive in the Midst of social change Increasingly. Secondly how the relationship that has developed between Naulu Community and the government maintains Reviews their identity. Thirdly how the government treats the minority of Noaulu along with Reviews their existence. Fourthly how the factors of social culture and politics influence the sustainability of the political dynamic of Noaulu community in Sepa. Sixthly how the shared value that has been applied by Noaulu community and the political identity as addressing the political dynamic of the social structure of society. This study used a qualitative method with the approach of verstehen or understanding to dig the data is from inside inside view of values or meanings that comes from the subject of the study through the individuals and the phenomenon of political identity in Noaulu community. Data were gained through the observation depth interview and documentation. The analysis of data begins with making the abstraction Categorization coding checking the correctness of the data and then interpreting the data is and drawing the conclusion. Results of the study Showed that firstly the religion Becomes the adhesive strength of identity that Allows the sustainability of Noaulu Community. Secondly each of the minority community it will adapt Strategically to the power of the state in the relations of Resistance in compliance. Thirdly the New Order State has made the space plurality of race religion and ethnicity in the political stability that is rigid Thus it turns off the articulation space of religion and cultural identity of each minority group. Fourthly factors of social cultural political and give impact in the area of social relations culture and politics as well. Fifthly each of minority community always possess shared values such as high trust commitment to the religion loyaity to the group and the value of reciprocity

  8. Breast conserving therapy versus mastectomy in T1-2N2 stage breast cancer : a population based study on 10-year overall, relative and distant metastasis-free survival in 3,071 patients

    NARCIS (Netherlands)

    van Maaren, M.C.; de Munck, L.; Jobsen, J.J.; Poortmans, P.; de Bock, G.H.; Siesling, S.; Strobbe, L.J.A.

    2016-01-01

    Background: Recent observational studies showed improved survival after breast conserving therapy (surgery with radiation therapy, BCT) compared to mastectomy (MAST) in T1−2N0−2 stage breast cancer. However, N2 stage is described to affect patients’ prognosis dramatically compared to N0−1 stage, and

  9. Transrectal rigid-hybrid NOTES cholecystectomy can be performed without peritoneal contamination: a controlled porcine survival study.

    Science.gov (United States)

    Müller, Philip C; Senft, Jonas D; Gath, Philip; Steinemann, Daniel C; Nickel, Felix; Billeter, Adrian T; Müller-Stich, Beat P; Linke, Georg R

    2018-01-01

    The risk of infectious complications due to peritoneal contamination is a major concern and inhibits the widespread use of transrectal NOTES. A standardized rectal washout with a reversible colon occlusion device in situ has previously shown potential in reducing peritoneal contamination. The aim of this study was to compare the peritoneal contamination rate and inflammatory reaction for transrectal cholecystectomy after ideal rectal preparation (trCCE) and standard laparoscopic cholecystectomy (lapCCE) in a porcine survival experiment. Twenty pigs were randomized to trCCE (n = 10) or lapCCE (n = 10). Before trCCE, rectal washout was performed with saline solution. A colon occlusion device was then inserted and a second washout with povidone-iodine was performed. The perioperative course and the inflammatory reaction (leukocytes, C-reactive protein) were compared. At necropsy, 14 days after surgery the abdominal cavity was screened for infectious complications and peritoneal swabs were obtained for comparison of peritoneal contamination. Peritoneal contamination was lower after trCCE than after lapCCE (0/10 vs. 6/10; p = 0.003). No infectious complications were found at necropsy in either group and postoperative complications did not differ (p = 1.0). Immediately after the procedure, leukocytes were higher after lapCCE (17.0 ± 2.7 vs. 14.6 ± 2.3; p = 0.047). Leukocytes and C-reactive protein showed no difference in the further postoperative course. Intraoperative complications and total operation time (trCCE 114 ± 32 vs. 111 ± 27 min; p = 0.921) did not differ, but wound closure took longer for trCCE (31.5 ± 19 vs. 13 ± 5 min; p = 0.002). After standardized rectal washout with a colon occlusion device in situ, trCCE was associated without peritoneal contamination and without access-related infectious complications. Based on the findings of this study, a randomized controlled clinical study comparing clinical outcomes of trCCE with

  10. Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study.

    Science.gov (United States)

    Spiers, Johanna; Buszewicz, Marta; Chew-Graham, Carolyn A; Gerada, Clare; Kessler, David; Leggett, Nick; Manning, Chris; Taylor, Anna Kathryn; Thornton, Gail; Riley, Ruth

    2017-10-01

    GPs are under increasing pressure due to a lack of resources, a diminishing workforce, and rising patient demand. As a result, they may feel stressed, burnt out, anxious, or depressed. To establish what might help or hinder GPs experiencing mental distress as they consider seeking help for their symptoms, and to explore potential survival strategies. The authors recruited 47 GP participants via e-mails to doctors attending a specialist service, adverts to local medical committees (LMCs) nationally and in GP publications, social media, and snowballing. Participants self-identified as either currently living with mental distress, returning to work following treatment, off sick or retired early as a result of mental distress, or without experience of mental distress. Interviews were conducted face to face or over the telephone. Transcripts were uploaded to NVivo 11 and analysed using thematic analysis. Barriers and facilitators were related to work, stigma, and symptoms. Specifically, GPs discussed feeling a need to attend work, the stigma surrounding mental ill health, and issues around time, confidentiality, and privacy. Participants also reported difficulties accessing good-quality treatment. GPs also talked about cutting down or varying work content, or asserting boundaries to protect themselves. Systemic changes, such as further information about specialist services designed to help GPs, are needed to support individual GPs and protect the profession from further damage. © British Journal of General Practice 2017.

  11. In vitro study of disinfectants on the embryonation and survival of Toxascaris leonina eggs.

    Science.gov (United States)

    El-Dakhly, Kh M; Aboshinaf, A S M; Arafa, W M; Mahrous, L N; El-Nahass, E; Gharib, A F; Holman, P J; Craig, T M

    2017-10-04

    The effect of six available and commercial disinfectants on the embryonation and larval development of Toxascaris leonina eggs was studied. Dettol® and Virkon® both induced a 100% reduction in larval development (P ≤ 0.05). Dettol® resulted in deformed eggshells and a halt in embryonal development at 1 week post exposure. All Virkon®-treated eggs showed an early embryonic lysis 24 h post exposure. TH4+ and 70% ethanol both significantly (P ≤ 0.05) affected larval development, with 58.8 and 85.8% reduction, respectively. Neither sodium hypochlorite nor phenol significantly affected larval development (2.8 and 21.0%, respectively). Sodium hypochlorite treatment caused a visible decortication of the eggshell; however, phenol-treated embryonated Toxascaris eggs appeared more or less morphologically normal. In conclusion, the disinfectants tested induced variable degrees of decortication and suppression of larval development. Virkon®S was the most effective disinfectant against Toxascaris eggs, suggesting that it is the most advisable one to use. To the best of our knowledge, this is the first report of the use of Virkon®S as an ovicide and/or larvicide of helminths, particularly Toxascaris leonina.

  12. Overweight is associated with a favorable survival in patients with colorectal cancer: a prospective cohort study in an Asian population.

    Science.gov (United States)

    Min, Yang Won; Kim, Su-A; Lee, Jun Hee; Kim, Jin Young; Chang, Dong Kyung; Rhee, Poong-Lyul; Kim, Jae J; Rhee, Jong Chul; Kim, Young-Ho

    2012-10-01

    The influence of body mass index (BMI) on the outcome of patients with colorectal cancer (CRC) is largely unknown, particularly in an Asian population. Therefore, we investigated the influence of BMI on survival of patients who underwent surgical treatment for CRC in Korean population. This prospective cohort study included CRC patients who underwent surgery between June 2003 and May 2005. Study participants were divided into two BMI groups: normal weight (<23 kg/m(2)) and overweight (≥23 kg/m(2)). A total of 509 CRC patients were included in this study. Of these, 318 patients (62.5%) were male, and the mean ± SD age was 59.1 ± 11.3 years. Two hundred eighteen patients (42.8%) were included in the normal-weight group and 291 (57.2%) were included in the overweight group. During a follow-up of 62.8 ± 27.2 months, 100 (19.6%) of the 509 eligible patients died, and 72 (15.0%) of 479 experienced recurrence. The overall survival of overweight group was more favorable compared with that of the normal-weight group (P = 0.001), while there was no significant difference in recurrence (P = 0.735). Compared with the normal-weight group, the hazard ratios of death and recurrence, respectively, were 0.615 (95% confidence interval 0.408-925; P = 0.020) and 0.992 (95% confidence interval 0.613-1.604; P = 0.973) for the overweight group. Overweight is not associated with an increased risk of cancer recurrence but rather is associated a favorable overall survival in Asian CRC patients undergoing surgery.

  13. Determinants of survival in adult HIV patients on antiretroviral therapy in Eastern Uttar Pradesh: A prospective study

    Directory of Open Access Journals (Sweden)

    Jaya Chakravarty

    2014-01-01

    Full Text Available Background & objectives: The National AIDS Control Organization (NACO of India has been providing free ARV (antiretroviral drugs since 2004. b0 y 2012, 486,173 patients had received treatment through the antiretroviral therapy (ART centres. The objective of this observational study was to assess the factors determining survival of patients on ART under routine programme conditions in an ART centre in north India five years after its inception. Methods: Treatment naive HIV positive patients who were enrolled in the ART centre between May 2009 and May 2010 and started on ART as per the Revised NACO guidelines 2009, were included in the study and outcome was assessed after two years of follow up. Results: A total of 1689 patients were included in the analysis, of whom 272 (16.10% expired, 205 (12.13% were lost to follow up (LFU, 526 (31.14% were transferred out to other facilities and 686 (40.63% were alive at the end of two years. Majority (92% of the deaths occurred in the first six months of therapy. Age >30 yr, male gender, poor functional status, haemoglobin level <11 g/dl, body weight <45 kg and CD4 count <100/μl at baseline had significantly higher relative hazard of death. Most LFU also occurred in the first six months and these patients had significantly low CD4 count, weight, haemoglobin level and higher number of patients in Stages III and IV as compared to those who survived. Interpretation & conclusions: The study findings revealed poor survival in the first six months of therapy especially in those with severe immunosuppression. This emphasizes the need for early enrolment into the programme. The high LFU occurring early after initiation of therapy suggests the urgent need to build an efficient patient retrieval system in the programme.

  14. Incidence and survival of oropharyngeal cancer in Denmark: a nation-wide, population-based study from 1980 to 2014.

    Science.gov (United States)

    Jensen, Jakob Schmidt; Jensen, David Hebbelstrup; Grønhøj, Christian; Karnov, Kirstine Kim Schmidt; Nørregaard, Cecilie; Agander, Tina Klitmøller; Specht, Lena; von Buchwald, Christian

    2017-10-23

    Oropharyngeal carcinomas (OPCs) constitute a significant and increasing proportion of head and neck carcinomas and are an important global cause of morbidity and mortality. The purpose of this study was to determine trends in incidence and survival in OPC in the Danish population from 1980 to 2014. This study included all patients registered in the nationwide Danish Cancer Registry over the period 1980-2014. The age-adjusted incidence rates (AAIR) per 100,000, annual percentage change (APC) and average annual percent change (AAPC) were evaluated. Five-year relative survival (RS) was calculated with Cox regression analyses in relation to gender, anatomical location and histology. A total of 6555 patients (69% male) were included, with a median age at diagnosis of 60 years. The AAIR of patients with OPC increased from 0.815 per 100,000 in 1980 to 4.51 per 100,000 in 2014 with an AAPC of 5.3. The 5-year RS increased significantly from 33.1% over the period 1980-1984 to 58.5% (25.4% points) over the period 2010-2014. With no significant difference stratified for gender. Tumors located at the palatine tonsils (n = 3333) and salivary gland OPC (n = 90) had significantly better survival compared with other sub-locations and histology subtypes. In the APC model the birth cohort effect rate ratio increased until 1925 and then decreased until 1935 from which point it increased in the last cohorts. In this population-based study, we observed a significant increase in the incidence of OPCs and in the RS for OPC. We also identified a profound birth cohort effect on the incidence.

  15. A meta-analysis of four genome-wide association studies of survival to age 90 years or older

    DEFF Research Database (Denmark)

    Newman, Anne B; Walter, Stefan; Lunetta, Kathryn L

    2010-01-01

    BACKGROUND: Genome-wide association studies (GWAS) may yield insights into longevity. METHODS: We performed a meta-analysis of GWAS in Caucasians from four prospective cohort studies: the Age, Gene/Environment Susceptibility-Reykjavik Study, the Cardiovascular Health Study, the Framingham Heart...... Study, and the Rotterdam Study participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Longevity was defined as survival to age 90 years or older (n = 1,836); the comparison group comprised cohort members who died between the ages of 55 and 80 years (n = 1...... significant SNPs, 24 were independent signals, and 16 of these SNPs were successfully genotyped in the second discovery stage, with one association for rs9664222, reaching 6.77 x 10(-7) for the combined meta-analysis of CHARGE and the stage 2 cohorts. The SNP lies in a region near MINPP1 (chromosome 10...

  16. Does a mandibular access osteotomy improve survival in pT2 oral tongue cancers? Retrospective study at a single institution.

    Science.gov (United States)

    Ong, H S; Gokavarapu, S; Tian, Z; Li, J; Cao, W; Zhang, C P

    2018-03-01

    The surgical approach to the resection of oral tongue cancers can involve transoral resection (TOR) or a temporary mandibulotomy access (TMA). There are no relevant guidelines, and the oncological safety of TOR needs consideration. The objective of this study was to investigate TMA and TOR in pT2 oral tongue cancer surgery with regard to cancer outcomes. Demographic, surgical, and histology data from primary pT2 tongue cancers were recorded and evaluated through multivariate Cox regression for local recurrence (LR), disease-free survival (DFS), and overall survival (OS). A total of 166 patients with pT2 primary oral tongue cancer fulfilled the inclusion criteria; TOR was used in 95 patients and TMA in 71 patients. The minimum follow-up was 29 months. Group comparisons showed a significantly higher frequency of perineural spread (P=0.013) in the TMA group; a higher frequency of involved margins on initial resection was seen in TOR patients (P=0.010). Adjuvant postoperative radiotherapy was preferred in the TMA group, in line with the high pN positive status. Multivariate Cox regression showed significantly higher LR and lower DFS in the TOR group despite stratification of the major prognostic factors. The 5-year survival rate was reduced to 82.2% in the TOR group, while it remained constant at 93.0% in the TMA group. TMA provided superior local control and DFS compared to TOR in pT2 tongue cancers. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Prognostic factors for survival outcome after in-hospital cardiac arrest: An observational study of the oriental population in Taiwan

    Directory of Open Access Journals (Sweden)

    Chung-Ting Chen

    2016-01-01

    Conclusion: Based on data from a single hospital registry in East Asia, a shorter duration of resuscitation was demonstrated to be a predictor of immediate survival with ROSC and survival to hospital discharge.

  18. Socioeconomic status and event free survival in pediatric acute lymphoblastic leukemia: a population-based cohort study.

    Science.gov (United States)

    Gupta, Sumit; Sutradhar, Rinku; Guttmann, Astrid; Sung, Lillian; Pole, Jason D

    2014-12-01

    The impact of socioeconomic status (SES) upon childhood cancer outcomes has not been extensively examined. Our objective was to determine the association between SES and event-free survival (EFS) among children with acute lymphoblastic leukemia (ALL) diagnosed in Ontario, Canada from 1995-2011 (N=1541) using Cox proportional hazards. Neither neighborhood-level median income quintile, distance from tertiary center, or rural residence significantly predicted EFS in the context of a universal healthcare system. Immigrant children experienced significantly superior EFS; confounding by ethnicity could not be ruled out. Confirmatory studies using additional individual-level SES variables are warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Prosthetic outcomes and survival rates of implants placed with guided flapless surgery using stereolithographic templates: a retrospective study.

    Science.gov (United States)

    Lal, Kunal; Eisig, Sidney B; Fine, James B; Papaspyridakos, Panos

    2013-01-01

    Recent technologic advances allow clinicians to place dental implants using computer-generated templates. However, there are limited data regarding treatment outcomes for implants placed using these techniques. The purpose of this retrospective study was to report the 2- to 4-year prosthetic outcomes and survival of dental implants placed by postdoctoral residents with a flapless surgical protocol using computer-based planning and stereolithographic surgical templates. Thirty-six patients were treated using the NobelGuide concept, comprising an image-based three-dimensional implant planning software and flapless implant surgery with stereolithographic templates.

  20. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  1. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    well GUTS, calibrated with short-term survival data of Gammarus pulex exposed to four pesticides, can forecast effects of longer-term pulsed exposures. Thirdly, we tested the ability of GUTS to estimate 14-day median effect concentrations of malathion for a range of species and use these estimates...

  2. Challenges in the estimation of Net SURvival: The CENSUR working survival group.

    Science.gov (United States)

    Giorgi, R

    2016-10-01

    Net survival, the survival probability that would be observed, in a hypothetical world, where the cancer of interest would be the only possible cause of death, is a key indicator in population-based cancer studies. Accounting for mortality due to other causes, it allows cross-country comparisons or trends analysis and provides a useful indicator for public health decision-making. The objective of this study was to show how the creation and formalization of a network comprising established research teams, which already had substantial and complementary experience in both cancer survival analysis and methodological development, make it possible to meet challenges and thus provide more adequate tools, to improve the quality and the comparability of cancer survival data, and to promote methodological transfers in areas of emerging interest. The Challenges in the Estimation of Net SURvival (CENSUR) working survival group is composed of international researchers highly skilled in biostatistics, methodology, and epidemiology, from different research organizations in France, the United Kingdom, Italy, Slovenia, and Canada, and involved in French (FRANCIM) and European (EUROCARE) cancer registry networks. The expected advantages are an interdisciplinary, international, synergistic network capable of addressing problems in public health, for decision-makers at different levels; tools for those in charge of net survival analyses; a common methodology that makes unbiased cross-national comparisons of cancer survival feasible; transfer of methods for net survival estimations to other specific applications (clinical research, occupational epidemiology); and dissemination of results during an international training course. The formalization of the international CENSUR working survival group was motivated by a need felt by scientists conducting population-based cancer research to discuss, develop, and monitor implementation of a common methodology to analyze net survival in order

  3. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study.

    Science.gov (United States)

    Jeeruphan, Thanawan; Jantarat, Jeeraphat; Yanpiset, Kallaya; Suwannapan, Lalida; Khewsawai, Phannarai; Hargreaves, Kenneth M

    2012-10-01

    There are numerous challenges in treating immature permanent teeth with a diagnosis of pulp necrosis. Three general treatment options are calcium hydroxide apexification, mineral trioxide aggregate (MTA) apexification, and revascularization. The objective of this retrospective study was to evaluate radiographic and clinical outcomes of immature teeth treated with 1 of these 3 methods. Clinical outcome data and radiographs were collected from 61 cases (ie, 22 calcium hydroxide apexification cases, 19 MTA apexification cases, and 20 revascularization cases). Both tooth survival and clinical success rates were analyzed. In addition, the preoperative and recall radiographs were analyzed to calculate the percentage increase in root width and length. The percentage change of root width was significantly greater in the revascularization group (28.2%) compared with the MTA apexification (0.0%) and calcium hydroxide apexification groups (1.5%). In addition, the percentage increase of root length was significantly greater in the revascularization group (14.9%) compared with the MTA (6.1%) and calcium hydroxide apexification groups (0.4%). Moreover, the survival rate of the revascularization-treated teeth (100%) and MTA apexification-treated teeth (95%) were greater than the survival rates observed in teeth treated with calcium hydroxide (77.2%). In this study, revascularization was associated with significantly greater increases in root length and thickness in comparison with calcium hydroxide apexification and MTA apexification as well as excellent overall survival rates. Copyright © 2012 American Association of Endodontists. All rights reserved.

  4. Survival and other clinical outcomes of maintenance hemodialysis patients in Taiwan: a 5-year multicenter follow-up study.

    Science.gov (United States)

    Chen, Huan-Sheng; Cheng, Chun-Ting; Hou, Chun-Cheng; Liou, Hung-Hsiang; Lim, Paik-Seong

    2014-10-01

    The increasing aging and diabetes mellitus (DM) patients in dialysis population make the quality maintenance of dialysis an imperative issue. Recently, an increasing number of dialysis centers were run by private dialysis providers, many of which apply quality assurance programs and performance management systems to dialysis care. We studied patients in dialysis facilities in Taiwan run by a private chain to see clinical outcomes of centers operating under these systemic strategies. Hemodialysis patients from January 1, 2008 to December 31, 2012 in 25 dialysis facilities in Taiwan, which received the management and consultation from a dialysis service provider, NephroCare (NC), were included. Data pivotal to quality of dialysis were analyzed. During a 5-year interval, 5161 hemodialysis patients were included. For volume control, the proportion of patients with weight gain ≥4.5% decreases from 41.7% to 30.2%. Mean Kt/V is 1.74 ± 0.28. Mean albumin level is 3.92 ± 0.38 g/dL. Patients with phosphate <5.5 mg/dL is up to 71.8%. The mean hemoglobin level is 10.70 ± 1.40 g/dL. More than 80% of patients have adequate iron status. Further, 73% of patients use native arteriovenous fistula. Hospitalization-free survival rate was 56% at the fifth year. Patient survival rate at the fifth year was 66.4%. Overall clinical performances were maintained very stable in NC facilities from this temporal data analysis. The hospitalization and survival rate also compare favorably with those reported internationally. These results warrant further studies to justify the application of this kind of quality assurance programs and performance management systems in dialysis care. © 2014 International Society for Hemodialysis.

  5. Survival and success rates of immediately and early loaded implants: 12-month results from a multicentric randomized clinical study.

    Science.gov (United States)

    Grandi, Tommaso; Garuti, Giovanna; Guazzi, Paolo; Tarabini, Luciano; Forabosco, Andrea

    2012-06-01

    Our objective was to compare survival and peri-implant bone levels of immediately nonocclusally vs early loaded implants in partially edentulous patients up to 12 months after implant placement. Eighty patients (inclusion criteria: general good health, good oral hygiene, 30-65 years old; exclusion criteria: head and neck irradiation/cancer, pregnancy, uncontrolled diabetes, substance abuse, bruxism, lack of opposing occluding dentition, smokers >10 cigarettes/day, need for bone augmentation procedures) were selected in 5 Italian study centers and randomized into 2 groups: 40 patients in the immediately loaded group (minimal insertion torque 30 Ncm) and 40 patients in the early loaded group. Immediately loaded implants were provided with nonoccluding temporary restorations. Final restorations were provided 2 months later. Early loaded implants were provided with a definitive restoration after 2 months. Peri-implant bone resorption was evaluated radiographically with software (ImageJ 1.42). No dropout occurred. Both groups gradually lost peri-implant bone. After 12 months, patients of both groups lost an average of 0.4 mm of peri-implant bone. There were no statistically significant differences (evaluated with t test) between the 2 loading strategies for peri-implant bone level changes at 2 (P = .6730), 6 (P = .6613) and 12 (P = .5957) months or for survival rates (100% in both groups). If adequate primary stability is achieved, immediate loading of dental implants can provide similar success rates, survival rates, and peri-implant bone resorption as compared with early loading, as evaluated in the present study.

  6. Smoking cessation and survival in lung, upper aero-digestive tract and bladder cancer: cohort study.

    Science.gov (United States)

    Koshiaris, C; Aveyard, P; Oke, J; Ryan, R; Szatkowski, L; Stevens, R; Farley, A

    2017-10-10

    The aim was to examine the association between smoking cessation and prognosis in smoking-related cancer as it is unclear that cessation reduces mortality. In this retrospective cohort study from 1999 to 2013, we assessed the association between cessation during the first year after diagnosis and all-cause and cancer-specific mortality. Of 2882 lung, 757 upper aero-digestive tract (UAT) and 1733 bladder cancer patients 27%, 29% and 21% of lung, UAT and bladder cancer patients quit smoking. In lung cancer patients that quit, all-cause mortality was significantly lower (HR: 0.82 (0.74-0.92), while cancer-specific mortality (HR: 0.89 (0.76-1.04) and death due to index cancer (HR: 0.90 (0.77-1.05) were non-significantly lower. In UAT cancer, all-cause mortality (HR: 0.81 (0.58-1.14), cancer-specific mortality (HR: 0.84 (0.48-1.45), and death due to index cancer (HR: 0.75 (0.42-1.34) were non-significantly lower. There was no evidence of an association between quitting and mortality in bladder cancer. The HRs were 1.02 (0.81-1.30) for all-cause, 1.23 (0.81-1.86) for cancer specific, and 1.25 (0.71-2.20) for death due to index cancer. These showed a non-significantly lower risk in sensitivity analyses. People with lung and possibly UAT cancer who quit smoking have a lower risk of mortality than people who continue smoking.

  7. Survival analysis of orthodontic mini-implants.

    Science.gov (United States)

    Lee, Shin-Jae; Ahn, Sug-Joon; Lee, Jae Won; Kim, Seong-Hun; Kim, Tae-Woo

    2010-02-01

    Survival analysis is useful in clinical research because it focuses on comparing the survival distributions and the identification of risk factors. Our aim in this study was to investigate the survival characteristics and risk factors of orthodontic mini-implants with survival analyses. One hundred forty-one orthodontic patients (treated from October 1, 2000, to November 29, 2007) were included in this survival study. A total of 260 orthodontic mini-implants that had sandblasted (large grit) and acid-etched screw parts were placed between the maxillary second premolar and the first molar. Failures of the implants were recorded as event data, whereas implants that were removed because treatment ended and those that were not removed during the study period were recorded as censored data. A nonparametric life table method was used to visualize the hazard function, and Kaplan-Meier survival curves were generated to identify the variables associated with implant failure. Prognostic variables associated with implant failure were identified with the Cox proportional hazard model. Of the 260 implants, 22 failed. The hazard function for implant failure showed that the risk is highest immediately after placement. The survival function showed that the median survival time of orthodontic mini-implants is sufficient for relatively long orthodontic treatments. The Cox proportional hazard model identified that increasing age is a decisive factor for implant survival. The decreasing pattern of the hazard function suggested gradual osseointegration of orthodontic mini-implants. When implants are placed in a young patient, special caution is needed to lessen the increased probability of failure, especially immediately after placement.

  8. Concomitant 177Lu-DOTATATE and Capecitabine Therapy in Patients With Advanced Neuroendocrine Tumors: A Long-term-Outcome, Toxicity, Survival, and Quality-of-Life Study.

    Science.gov (United States)

    Ballal, Sanjana; Yadav, Madhav P; Damle, Nishikant A; Sahoo, Ranjit K; Bal, Chandrasekhar

    2017-11-01

    The purpose of this study was to evaluate the outcome, toxicity, survival, and quality of life in patients with advanced neuroendocrine tumors. One hundred sixty-seven patients were enrolled in the study. All patients underwent baseline Ga-DOTANOC PET/CT scans. Lu-DOTATATE therapy was administered quarterly along with oral capecitabine therapy in group 1 patients (n = 88), whereas group 2 patients (n = 79) were treated only with Lu-DOTATATE. Hematologic, kidney function, liver function tests and chromogranin A levels were recorded before and after therapy at 2-week, 4-week, and 3-month intervals. Biochemical and morphological responses were assessed with the trend in chromogranin A levels and Response Evaluation Criteria in Solid Tumors 1.1 criteria, respectively. There was no significant difference in the hemoglobin levels after Lu-DOTATATE therapy (P = 0.4892). In most patients, there was a decrease in the platelet levels; however, all the patients had platelet counts greater than 100,000/μL with no platelet toxicity. There was no toxicity related to leukocytes. Two patients showed renal insufficiencies. No hepatotoxicity was observed in any of the patients. According to Response Evaluation Criteria in Solid Tumors 1.1 criteria, in group 1 patients, the response was partial response in 34% of the patients, stable disease in 50.2%, and progressive disease in 6.8% versus partial response in 6.3%, stable disease in 60.9%, and progressive disease in 26.5% among group 2 patients. The median overall survival (OS) and progression-free survival (PFS) was not reached in group 1 patients. The median OS and PFS in group 2 patients were 48 months. Ki-67 tumor proliferation index was significantly associated with increased risk of disease progression. Addition of capecitabine therapy with Lu-DOTATATE therapy lengthens the OS and PFS. Patients with aggressive disease may benefit from this synergetic therapeutic approach.

  9. Potential for improved survival with intensification of daunorubicin based induction chemotherapy in acute myeloid leukemia patients who do not receive transplant: A multicenter retrospective study.

    Science.gov (United States)

    Reagan, John L; Sullivan, Matthew R; Winer, Eric S; Lansigan, Frederick; Cardin, Michael S; Castillo, Jorge J

    2015-08-01

    During induction daunorubicin intensification from 45 mg/m(2)/day to 90 mg/m(2)/day has shown improved response and survival rates in AML patients. We retrospectively reviewed outcomes of daunorubicin 60 mg/m(2)/day (DNR60) versus daunorubicin 90 mg/m(2)/day (DNR90) in adult AML patients. Newly diagnosed AML patients ≥18 years who received 7+3 with or without etoposide as frontline therapy from 1/1/2006 to 5/1/2013 were identified. Chi-square and Wilcoxon rank sum tests were used to compare characteristics. Kaplan-Meier curves were estimated for overall survival (OS). Univariate and multivariate Cox proportional hazard regression models were developed to determine independent predictors for survival. A total of 128 patients were included (DNR90=48 patients, DNR60=80 patients). The estimated 3-year OS rate in the DNR90 group was 56% (95% CI 38-70%), while in the DNR60 group was 34% (95% CI 23-44%). Multivariate analysis (MVA) in non-allotransplanted patients showed that unfavorable cytogenetics and worse performance status were associated with decreased OS while DNR intensification, etoposide use and site were associated with improved OS. In MVA of allotransplanted patients re-induction based on day-14 marrow was associated with worse OS. Based on our retrospective study, initial DNR based induction chemotherapy intensification improved OS in non-allotransplanted patients. Prospective studies are needed to confirm this preliminary finding. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Association with pregnancy increases the risk of local recurrence but does not impact overall survival in breast cancer: A case-control study of 87 cases.

    Science.gov (United States)

    Genin, A S; De Rycke, Y; Stevens, D; Donnadieu, A; Langer, A; Rouzier, R; Lerebours, F

    2016-12-01

    Pregnancy-associated breast cancer (PABC) constitutes 7% of all BCs in young women. The prognosis of PABC remains controversial. In this study, we evaluated the impact of the association of pregnancy with BC on the rates of overall survival (OS), disease free survival (DFS), and distant and local recurrence-free survival. We conducted a retrospective unicenter case-control study. We enrolled PABC patients treated at our institution between 1992 and 2009. For each case, 2 BC controls were matched for age and year of diagnosis. Univariate and multivariate analyses were performed to assess the parameters associated with prognosis. Eighty-seven PABC patients were enrolled and matched with 174 controls. The univariate analysis did not reveal any significant differences in OS, DFS or distant recurrence rates between the 2 groups. Pregnancy associated status, a tumor larger than T2 and neoadjuvant chemotherapy as the primary treatment were significantly associated with an increased risk of local relapse. The multivariate analysis showed that the pregnancy associated status and the tumor size were strong prognostic factors of local recurrence. Pregnancy associated status negates the prognostic value of tumor size, as both T0-T2 and T3-T4 PABC patients have the same poor prognosis as control BC patients with T3-T4 tumors. Interestingly, although PABC patients have more locally advanced tumors, they did not have a higher rate of radical surgery than the control BC patients. Pregnancy associated status is a strong prognostic factor of local relapse in BC. In PABC patients, when possible, radical surgery should be the preferred first treatment step. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. [A middle to long-term clinical study on pars flaccida and pars tensa cholesteatoma using survival analysis].

    Science.gov (United States)

    Somekawa, Yukihiro; Nagashima, Tsutomu; Masaki, Tomoyuki; Asano, Katsuji; Yajima, Ryoto; Himi, Tetsuo

    2014-12-01

    The current clinical study was performed on 311 cases of pars flaccida and 89 cases of pars tensa cholesteatoma which were treated with canal wall reconstructed tympanoplasty between 1991 and 2012. The average follow-up time of these patients was 5.3 years. Since follow-up periods were different in each case and some censored patients were involved, we used survival analysis on this study to discuss the cumulative rates of disease-free successful cases and the rates of recurrent cholesteatoma throughout the postoperative course. The disease-free successful cases were defined as those cases in which patients were both out of re-operation with recurrent and residual cholesteatoma and out of revision operation with another problem, furthermore, maintained good hearing outcome. Based on the criteria set by the Japan Otological Society (2010), the cases that satisfied the following were evaluated as good hearing results; (a) a successful case in which preoperative bone conduction was used, and (b) a case in which the postoperative air-bone gap was within 20dB after tympanoplasty for chronic otitis media. The analysis results were shown for each of (a) and (b). 1. In pars flaccida cholesteatoma, the 5-year survival rate of successful case was (a) 76.1% and (b) 83.9%, the 10-year survival rate was (a) 58.9% and (b) 73.0%. In pars tensa cholesteatoma, the 5-year survival rate of successful cases was (a) 57.7% and (b) 63.5%, the 10-year rate was (a) 42.1% and (b) 56.9%. A significant difference was seen between pars flaccida and pars tensa cholesteatoma (p pars flaccida cholesteatoma, the 5-year recurrence rate was 7.6% and the 10-year rate was 15.3%, and the recurrence rate increased gradually throughout the follow-up period. On the other hand, in pars tensa cholesteatoma, the increase in the recurrence rate reached a peak 15.8% at 5.5 years after the surgery. A long-term follow-up is necessary when evaluating the clinical results after tympanoplasty.

  12. Simple parametric survival analysis with anonymized register data: A cohort study with truncated and interval censored event and censoring times

    Directory of Open Access Journals (Sweden)

    Kristiansen Ivar S

    2011-08-01

    Full Text Available Abstract Background To preserve patient anonymity, health register data may be provided as binned data only. Here we consider as example, how to estimate mean survival time after a diagnosis of metastatic colorectal cancer from Norwegian register data on time to death or censoring binned into 30 day intervals. All events occurring in the first three months (90 days after diagnosis were removed to achieve comparability with a clinical trial. The aim of the paper is to develop and implement a simple, and yet flexible method for analyzing such interval censored and truncated data. Methods Considering interval censoring a missing data problem, we implement a simple multiple imputation strategy that allows flexible sensitivity analyses with respect to the shape of the censoring distribution. To allow identification of appropriate parametric models, a χ2-goodness-of-fit test--also imputation based--is derived and supplemented with diagnostic plots. Uncertainty estimates for mean survival times are obtained via a simulation strategy. The validity and statistical efficiency of the proposed method for varying interval lengths is investigated in a simulation study and compared with simpler alternatives. Results Mean survival times estimated from the register data ranged from 1.2 (SE = 0