WorldWideScience

Sample records for surviving troubled times

  1. VENEZUELA: TEACHING IN TROUBLED TIMES

    Directory of Open Access Journals (Sweden)

    Hugo Oré

    2017-06-01

    Full Text Available One of the key aspects of the teaching task is to keep up with the advances that continually come up in the areas in which they are experts; Aspect that at times for multiple reasons is not easy that is feasible. The updating in content, new technologies, as well as teaching and learning methodologies is required for the training of competent students capable of performing before their peers. This paper presents how the methodology of Project-Based Learning (ABP applied in the subject "Underground Water" of the civil engineering program of the Universidad Centroccidental Lisandro Alvarado, promoted the exchange of information, training of students in the field of software used In the area, as well as cooperation for the study of real situations in the context of the Lara state aquifers in Venezuela

  2. Introduction to "Standing together in Troubled Times"

    CERN Document Server

    Shifman, M

    2016-01-01

    This Introduction opens the book {\\sl Standing Together in Troubled Times} which presents a story of friendship between Wolfgang Pauli, one of the greatest theoretical physicists of the 20th century, and Charlotte Houtermans. They met at the very onset of the quantum era, in the late 1920s in Germany where Charlotte was a physics student at G\\"ottingen University. At that time G\\"ottingen was right at the heart of groundbreaking developments in physics. Both Pauli and Houtermans personally knew major participants in the quantum revolution. Caught between two evils -- German National Socialism and Soviet Communism -- Charlotte Houtermans would have likely perished if it were not for the brotherhood of physicists: Niels Bohr, Wolfgang Pauli, Albert Einstein, James Franck, Max Born, Robert Oppenheimer and many other noted scientists who tried to save friends and colleagues (either leftist sympathizers or Jews) who were in mortal danger of becoming entrapped in a simmering pre-WWII Europe. This book is based on n...

  3. Human genetics in troubled times and places.

    Science.gov (United States)

    Harper, Peter S

    2018-01-01

    The development of human genetics world-wide during the twentieth century, especially across Europe, has occurred against a background of repeated catastrophes, including two world wars and the ideological problems and repression posed by Nazism and Communism. The published scientific literature gives few hints of these problems and there is a danger that they will be forgotten. The First World War was largely indiscriminate in its carnage, but World War 2 and the preceding years of fascism were associated with widespread migration, especially of Jewish workers expelled from Germany, and of their children, a number of whom would become major contributors to the post-war generation of human and medical geneticists in Britain and America. In Germany itself, eminent geneticists were also involved in the abuses carried out in the name of 'eugenics' and 'race biology'. However, geneticists in America, Britain and the rest of Europe were largely responsible for the ideological foundations of these abuses. In the Soviet Union, geneticists and genetics itself became the object of persecution from the 1930s till as late as the mid 1960s, with an almost complete destruction of the field during this time; this extended also to Eastern Europe and China as part of the influence of Russian communism. Most recently, at the end of the twentieth century, China saw a renewal of government sponsored eugenics programmes, now mostly discarded. During the post-world war 2 decades, human genetics research benefited greatly from recognition of the genetic dangers posed by exposure to radiation, following the atomic bomb explosions in Japan, atmospheric testing and successive accidental nuclear disasters in Russia. Documenting and remembering these traumatic events, now largely forgotten among younger workers, is essential if we are to fully understand the history of human genetics and avoid the repetition of similar disasters in the future. The power of modern human genetic and genomic

  4. Emotionally Troubled Teens' Help-Seeking Behaviors: An Evaluation of Surviving the Teens® Suicide Prevention and Depression Awareness Program

    Science.gov (United States)

    Strunk, Catherine M.; Sorter, Michael T.; Ossege, Julianne; King, Keith A.

    2014-01-01

    Many school-based suicide prevention programs do not show a positive impact on help-seeking behaviors among emotionally troubled teens despite their being at high risk for suicide. This study is a secondary analysis of the Surviving the Teens® program evaluation to determine its effect on help-seeking behaviors among troubled youth. Results showed…

  5. Surviving Troubled Times: Five Best Practices for Training Solutions

    Science.gov (United States)

    Villachica, Steven W.; Stepich, Donald A.; Rist, Shannon

    2011-01-01

    The business of training and performance improvement has always been cyclical, with the fortunes of human resource development (HRD) and performance improvement professionals rising and falling with the economic fortunes of the workplace. The current economic downturn and nascent recovery represent an opportunity for HRD and performance…

  6. Toil and Trouble: On the Materiality of Time

    Directory of Open Access Journals (Sweden)

    Ross Chambers

    2014-03-01

    Full Text Available This article explores the nature of temporality, entropy and negentropy, drawing contemporary fiction by Graham Swift and Fiona McGregor as well as the autobiography of Wikileaks founder Julian Assange, to ask questions about history, time and life.

  7. The independent relationship between trouble controlling Facebook use, time spent on the site and distress

    OpenAIRE

    Muench, Fredrick; Hayes, Marie; Kuerbis, Alexis; Shao, Sijing

    2015-01-01

    Background and Aims There is an emerging literature base on the relationship between maladaptive traits and ?addiction? to social networking sites. These studies have operationalized addiction as either spending excessive amounts of time on social networking sites (SNS) or trouble controlling SNS use, but have not assessed the unique contribution of each of these constructs on outcomes in the same models. Moreover, these studies have exclusively been conducted with younger people rather than ...

  8. The independent relationship between trouble controlling Facebook use, time spent on the site and distress.

    Science.gov (United States)

    Muench, Fredrick; Hayes, Marie; Kuerbis, Alexis; Shao, Sijing

    2015-09-01

    There is an emerging literature base on the relationship between maladaptive traits and "addiction" to social networking sites. These studies have operationalized addiction as either spending excessive amounts of time on social networking sites (SNS) or trouble controlling SNS use, but have not assessed the unique contribution of each of these constructs on outcomes in the same models. Moreover, these studies have exclusively been conducted with younger people rather than a heterogeneous sample. This study examined the independent relationship of a brief Facebook addiction scale, time spent on Facebook, and Facebook checking on positive and negative social domains, while controlling for self-esteem and social desirability. Participants were recruited using e-mail, SNS posts and through Amazon's MTurk system. The sample included 489 respondents ages from 18 to approximately 70, who completed a 10-15 minute survey. Results indicate that neither time spent on Facebook nor Facebook checking was significantly associated with either self-esteem, fear of negative social evaluation or social comparison, while SNS addiction symptoms were each independently associated with Facebook usage. Neither time spent on Facebook nor SNS addiction symptoms were associated with positive social relationships. Overall results suggest that time on SNS and trouble controlling use should be considered independent constructs and that interventions should target underlying loss of control as the primary intervention target above ego syntonic time spent on the site.

  9. The independent relationship between trouble controlling Facebook use, time spent on the site and distress

    Science.gov (United States)

    Muench, Fredrick; Hayes, Marie; Kuerbis, Alexis; Shao, Sijing

    2015-01-01

    Background and Aims There is an emerging literature base on the relationship between maladaptive traits and “addiction” to social networking sites. These studies have operationalized addiction as either spending excessive amounts of time on social networking sites (SNS) or trouble controlling SNS use, but have not assessed the unique contribution of each of these constructs on outcomes in the same models. Moreover, these studies have exclusively been conducted with younger people rather than a heterogeneous sample. This study examined the independent relationship of a brief Facebook addiction scale, time spent on Facebook, and Facebook checking on positive and negative social domains, while controlling for self-esteem and social desirability. Methods Participants were recruited using e-mail, SNS posts and through Amazon’s MTurk system. The sample included 489 respondents ages from 18 to approximately 70, who completed a 10–15 minute survey. Results Results indicate that neither time spent on Facebook nor Facebook checking was significantly associated with either self-esteem, fear of negative social evaluation or social comparison, while SNS addiction symptoms were each independently associated with Facebook usage. Neither time spent on Facebook nor SNS addiction symptoms were associated with positive social relationships. Discussion Overall results suggest that time on SNS and trouble controlling use should be considered independent constructs and that interventions should target underlying loss of control as the primary intervention target above ego syntonic time spent on the site. PMID:26551906

  10. Collective familial decision-making in times of trouble: intergenerational solidarity in Ghana.

    Science.gov (United States)

    McGadney-Douglass, Brenda F; Douglass, Richard L

    2008-06-01

    In post-colonial populations the retention of the nuclear family concept of collectivism as the basis for decision-making is associated with familial and cultural survival. Collectivism within familial contexts provides intergenerational access to experience, information, resources, and sound decision making during times of conflict or dealing with the consequences of poverty. In contemporary Ghana inter-ethnic wars and conflict have marginalized minority groups, causing substantial internal displacement of people. Poverty and cultural issues have caused a persistently high level of child malnutrition and mortality in all areas of Ghana, including urban centers where appropriate food is in abundance. In each of these circumstances the senior women, particularly the grandmothers, have been found to be essential for child survival, protecting the family from dissolution, and ensuring intergenerational cultural transmission. This paper discusses the place of collective decision-making processes of older African women in two studies in Ghana that assessed the: (1) indigenous methods used for understanding and arresting violent ethnic conflict by internally displaced women who survived the 1994/95 Guinea Fowl War; and (2) parenting and grandparenting strategies from families who insured the survival of children suffering from kwashiorkor, a severe form of childhood malnutrition. In this paper, findings from qualitative interview data will include narratives and illustrative cases.

  11. Linking age, survival, and transit time distributions

    Science.gov (United States)

    Calabrese, Salvatore; Porporato, Amilcare

    2015-10-01

    Although the concepts of age, survival, and transit time have been widely used in many fields, including population dynamics, chemical engineering, and hydrology, a comprehensive mathematical framework is still missing. Here we discuss several relationships among these quantities by starting from the evolution equation for the joint distribution of age and survival, from which the equations for age and survival time readily follow. It also becomes apparent how the statistical dependence between age and survival is directly related to either the age dependence of the loss function or the survival-time dependence of the input function. The solution of the joint distribution equation also allows us to obtain the relationships between the age at exit (or death) and the survival time at input (or birth), as well as to stress the symmetries of the various distributions under time reversal. The transit time is then obtained as a sum of the age and survival time, and its properties are discussed along with the general relationships between their mean values. The special case of steady state case is analyzed in detail. Some examples, inspired by hydrologic applications, are presented to illustrate the theory with the specific results. This article was corrected on 11 Nov 2015. See the end of the full text for details.

  12. Distributed trouble-shooting

    NARCIS (Netherlands)

    Post, W.M.; Bogaard, S.A.A. van den; Rasker, P.C.

    2004-01-01

    When knowledge, required for trouble-shooting at sea, can be supplied real-time but from a distance, problems, such as with the limited availability of specialists, and the high costs of maintenance, may be tackled. Unclear is, however, how this redistribution of knowledge will work in practice. We

  13. How Old? Tested and Trouble-Free Ways to Convey Geologic Time

    Science.gov (United States)

    Clary, Renee

    2009-01-01

    Geologic time, or the time frame of our planet's history, is several orders of magnitude greater than general human understanding of "time." When students hear that our planet has a 4.6-billion-year history, they do not necessarily comprehend the magnitude of deep time, the huge expanse of time that has passed from the origin of Earth through the…

  14. Ultrasound Collaboration across Europe: An EFSUMB success story in politically troubled times?

    Science.gov (United States)

    Sidhu, P S

    2016-10-01

    the benchmark for ultrasound practice across the world and are often mimicked by others.This collaboration and continued output is important. With the recent Food and Drug Administration (United States of America) approval of the use of an ultrasound contrast agent for focal liver lesions, a worldwide change of practice will occur. This was achieved without a clinical trial in children, a previously unheard of occurrence and solely based on the experience, expertise and pioneering activities of investigators in Europe, many embolden by the support of colleagues across Europe sharing experience through EFSUMB. The lead in establishing ultrasound elastography has also originated in Europe with close and strong collaboration to produce guidelines, again pioneering the application of elastography to clinical situations. More important guidelines are on the horizon dealing with liver elastography, non-hepatic contrast ultrasound and gastrointestinal ultrasound.This success translates to the success of the journal, Ultraschall in der Medizine/European Journal of Ultrasound, with a rising impact factor, rising manuscript submissions and limited space. Where can authors in Europe publish their innovative research to continue this journey? This is one of the pitfalls of the European success story, perhaps in time we can resolve this by increasing on-line papers, increasing page numbers in the journal etc. but this is a problem of the publication industry in general.The most important element from this success story has to be the success of collaboration across the borders of the European nations, and this has also to be the success of the European Union in achieving this close scientific and medical environment. The potential adverse effect this will have on the scientific collaboration in the United Kingdom, my own area of professional activity, following a vote to re-consider membership of the European Union, is largely unpredictable. Nevertheless this is of great concern to

  15. Regression analysis of restricted mean survival time based on pseudo-observations

    DEFF Research Database (Denmark)

    Andersen, Per Kragh; Hansen, Mette Gerster; Klein, John P.

    censoring; hazard function; health economics; regression model; survival analysis; mean survival time; restricted mean survival time; pseudo-observations......censoring; hazard function; health economics; regression model; survival analysis; mean survival time; restricted mean survival time; pseudo-observations...

  16. Regression Analysis of Restricted Mean Survival Time Based on Pseudo-Observations

    DEFF Research Database (Denmark)

    Andersen, Per Kragh; Hansen, Mette Gerster; Klein, John P.

    2004-01-01

    censoring; hazard function; health economics; mean survival time; pseudo-observations; regression model; restricted mean survival time; survival analysis......censoring; hazard function; health economics; mean survival time; pseudo-observations; regression model; restricted mean survival time; survival analysis...

  17. Mother Trouble

    Directory of Open Access Journals (Sweden)

    Griselda Pollock

    2009-01-01

    this paper, I outline some of the fundamntals of this radical but not eccentric theoretical work, and introduce one of its most recent conceptual moves in which Ettinger challenges the psychoanalytical establishments failure of acknowledge as primal 'fantasies,'  addressing sourceless primal enigmas, the  emergent subject's anguish over insufficiency, devouring and abandonment. Placing Ettinger's work on primal fantasies and the maternal in the contcxt of Winnicott, Kristeva and Laplanche, this article points to the implications of this major theorization for rethinking and working with often unresolved mother/daughter/ daughter/mother relations whose psychic freight remains unrelieved in contemporary phallic psychoanalytical paradigms and for the interface of ethics and aesthetics for which models of  matrixial severality and transsubjective passages are rich already in potential examples (studies of Sylvia Plath, Louise Bourgeois and Berthe Morisot had to be cut for reasons of length and future possibilities, including responses to international and interethnic violence at the time of this article going to press.

  18. For Boys: Trouble "Down There"

    Science.gov (United States)

    ... Stepparents Be a Green Kid For Boys: Trouble "Down There" KidsHealth > For Kids > For Boys: Trouble "Down ... a doctor is a must. continue Other Trouble Down There It's also possible a boy might have ...

  19. A generalized additive regression model for survival times

    DEFF Research Database (Denmark)

    Scheike, Thomas H.

    2001-01-01

    Additive Aalen model; counting process; disability model; illness-death model; generalized additive models; multiple time-scales; non-parametric estimation; survival data; varying-coefficient models......Additive Aalen model; counting process; disability model; illness-death model; generalized additive models; multiple time-scales; non-parametric estimation; survival data; varying-coefficient models...

  20. Cranial trauma and the assessment of posttraumatic survival time

    NARCIS (Netherlands)

    Steyn, M.; de Boer, H. H. [=Hans H.; van der Merwe, A. E.

    2014-01-01

    Assessment of trauma on skeletal remains can be very difficult, especially when it comes to the estimation of posttraumatic survival time in partially healed lesions. The ability to reliably estimate the time an individual has survived after sustaining an injury is especially important in cases of

  1. Five-year survival and median survival time of nasopharyngeal carcinoma in Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Siti-Azrin, Ab Hamid; Norsa'adah, Bachok; Naing, Nyi Nyi

    2014-01-01

    Nasopharyngeal carcinoma (NPC) is the fourth most common cancer in Malaysia. The objective of this study was to determine the five-year survival rate and median survival time of NPC patients in Hospital Universiti Sains Malaysia (USM). One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities. The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001). The median survival of NPC patients is significantly longer for age≤50 years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.

  2. Time series modeling of system self-assessment of survival

    Energy Technology Data Exchange (ETDEWEB)

    Lu, H.; Kolarik, W.J. [Texas Tech Univ., Lubbock, TX (United States). Dept. of Industrial Engineering

    1999-06-01

    Self-assessment of survival for a system, subsystem or component is implemented by assessing conditional performance reliability in real-time, which includes modeling and analysis of physical performance data. This paper proposes a time series analysis approach to system self-assessment (prediction) of survival. In the approach, physical performance data are modeled in a time series. The performance forecast is based on the model developed and is converted to the reliability of system survival. In contrast to a standard regression model, a time series model, using on-line data, is suitable for the real-time performance prediction. This paper illustrates an example of time series modeling and survival assessment, regarding an excessive tool edge wear failure mode for a twist drill operation.

  3. Red cell survival time in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Rath, R.N.; Das, R.K.; Panda, R.K.; Mahakur, A.C.; Patnaik, S.R. (M.K.C.G. Medical College, Berhampur (India))

    1979-10-01

    The red cell survival time was estimated in 50 cases of chronic renal failure and 20 healthy subjects, using radioactive chromium /sup 51/Cr. The mean value of red cell survival half time (T1/2/sup 51/Cr) was determined to be 25.9 +- 1.1 days in control subjects. The red cell survival half time (17.9 +- 4.67 days) was found to be significantly decreased in cases of chronic renal failure, when compared to the control group. An inverse relationship was observed between T1/2/sup 51/Cr value and blood urea, serum creatinine, the magnitude of hypertension, and duration of illness, whereas, creatinine clearance showed a direct relationship. There was no increased splenic uptake of radioactive chromium, indicating that haemolysis occurred elsewhere in the circulation other than spleen. The possible mechanism for the reduction of red cell survival time and the effect of uraemic environment on it has been discussed.

  4. Piecewise exponential survival trees with time-dependent covariates.

    Science.gov (United States)

    Huang, X; Chen, S; Soong, S J

    1998-12-01

    Survival trees methods are nonparametric alternatives to the semiparametric Cox regression in survival analysis. In this paper, a tree-based method for censored survival data with time-dependent covariates is proposed. The proposed method assumes a very general model for the hazard function and is fully nonparametric. The recursive partitioning algorithm uses the likelihood estimation procedure to grow trees under a piecewise exponential structure that handles time-dependent covariates in a parallel way to time-independent covariates. In general, the estimated hazard at a node gives the risk for a group of individuals during a specific time period. Both cross-validation and bootstrap resampling techniques are implemented in the tree selection procedure. The performance of the proposed survival trees method is shown to be good through simulation and application to real data.

  5. Survival time of direct dental restorations in adults

    Directory of Open Access Journals (Sweden)

    Thaís Torres Barros Dutra

    Full Text Available AbstractIntroductionThe presence of dental caries is the main reason for the placement and replacement of restorations. Maintaining restorations to a satisfactory clinical condition is a challenge, despite the evolution of materials and surgical operative techniques.ObjectiveTo investigate the survival time and technical-operatory characteristics of dental restorations among adults in Teresina-PI.Material and methodData collection was carried out from September 2009 to January 2010 at a non-profit dental service. Data were collected at the moment of restoration replacement. The sample consisted of 262 defective restorations in 139 individuals. Survival time was calculated using the placement date that was registered on the individual’s dental form. Kruskal-Wallis and Mann-Whitney tests were used to compare the survival time of the different types of restorations and the chi-square test was used to assess the association between qualitative variables, at a 5% significance level.ResultThe median survival time of the restorations was 2 years. The survival time for amalgam was higher than for composite and glass ionomer cement (p=0.004. The most replaced dental material was the composite (66.4%. The majority of the replaced restorations had been placed in anterior teeth, in proximal surfaces.ConclusionAmalgam restorations have a longer survival time than composite resin. Technical and operatory variables had no influence on the survival time of restorations. Dental restorations have a low survival time and this fact might be associated with the decion-making process that is adopted by the professionals.

  6. Investigation of survival time of some poultry mycoplasmas.

    Science.gov (United States)

    Simon, A; Tamasi, G; Stipkovits, L

    1989-01-01

    Glucose-fermenting poultry mycoplasmas (Mycoplasma [M.] gallisepticum, M. pullorum, M. gallinaceum, M. gallopavonis) were tested in 2 experiments for their survival time at 20 degrees C and 37 degrees C on 18 different materials used on farms and in hatcheries. All mycoplasmas survived up to 16 days in egg yolk at both temperatures. On other materials, like egg shell, egg white, paper trails, feather, and others mycoplasmas generally survived 2 to 16 days at 20 degrees C. M. gallinaceum and M. gallopavonis proved more resistant to the environment than M. gallisepticum and M. pullorum.

  7. Troubling qualitative research/Troubling empathy

    DEFF Research Database (Denmark)

    Sørensen, Mariann B.

    This presentation aims to trouble the concept of empathy in qualitative inquiry from two perspectives having a phenomenological approach. As a supervisor I see students regard interviews as untouchable and be reluctant to bring in theory in their analysis because of empathy towards the interviewees....... As a researcher I experience problems interviewing nurses having focus on their “use of empathy” in the context of their institutional identity together with examining three other concepts: professional, personal and private. Concepts current in professions which focus on human relationships as – among others...... - nursing, teaching as well as the profession of psychologists. Thus, I want to problematize this dual perspective: empathy embedded in the method and as a theme or topic in interviews with professionals and the assumption that empathy might expand as well as limit the results of inquiry within different...

  8. Graphing survival curve estimates for time-dependent covariates.

    Science.gov (United States)

    Schultz, Lonni R; Peterson, Edward L; Breslau, Naomi

    2002-01-01

    Graphical representation of statistical results is often used to assist readers in the interpretation of the findings. This is especially true for survival analysis where there is an interest in explaining the patterns of survival over time for specific covariates. For fixed categorical covariates, such as a group membership indicator, Kaplan-Meier estimates (1958) can be used to display the curves. For time-dependent covariates this method may not be adequate. Simon and Makuch (1984) proposed a technique that evaluates the covariate status of the individuals remaining at risk at each event time. The method takes into account the change in an individual's covariate status over time. The survival computations are the same as the Kaplan-Meier method, in that the conditional survival estimates are the function of the ratio of the number of events to the number at risk at each event time. The difference between the two methods is that the individuals at risk within each level defined by the covariate is not fixed at time 0 in the Simon and Makuch method as it is with the Kaplan-Meier method. Examples of how the two methods can differ for time dependent covariates in Cox proportional hazards regression analysis are presented.

  9. The Troubled Teenager

    OpenAIRE

    Renshaw, Domeena

    1983-01-01

    Problems that may bring teenagers to the family physician's office include bizarre behavior such as drug or alcohol intoxication, psychosis, panic or anxiety attacks and stealing; being dangerous to themselves or to others; sexual emergencies including pregnancy, rape and incest; a crisis involving key people such as parents' divorce or illness; school phobia, and anxiety or other reactions to sickness, surgery or death. When evaluating troubled teens and their families, the physician should ...

  10. effect of liquid nitrogen storage time on the survival and ...

    African Journals Online (AJOL)

    Administrator

    Investigations were undertaken on the effect of liquid nitrogen (LN) storage time on survival and regeneration of somatic embryos of cocoa (Theobroma cacao l.). Somatic embryos from different cocoa genotypes (AMAZ 3-. 2, AMAZ 10-1, AMAZ 12, SIAL 93, and IMC 14) at 15.45% moisture content were cryopreserved in LN ...

  11. Effect of liquid nitrogen storage time on the survival and ...

    African Journals Online (AJOL)

    Investigations were undertaken on the effect of liquid nitrogen (LN) storage time on survival and regeneration of somatic embryos of cocoa (Theobroma cacao l.). Somatic embryos from different cocoa genotypes (AMAZ 3-2, AMAZ 10-1, AMAZ 12, SIAL 93, and IMC 14) at 15.45% moisture content were cryopreserved in LN ...

  12. Survival-time statistics for sample space reducing stochastic processes.

    Science.gov (United States)

    Yadav, Avinash Chand

    2016-04-01

    Stochastic processes wherein the size of the state space is changing as a function of time offer models for the emergence of scale-invariant features observed in complex systems. I consider such a sample-space reducing (SSR) stochastic process that results in a random sequence of strictly decreasing integers {x(t)},0≤t≤τ, with boundary conditions x(0)=N and x(τ) = 1. This model is shown to be exactly solvable: P_{N}(τ), the probability that the process survives for time τ is analytically evaluated. In the limit of large N, the asymptotic form of this probability distribution is Gaussian, with mean and variance both varying logarithmically with system size: 〈τ〉∼lnN and σ_{τ}^{2}∼lnN. Correspondence can be made between survival-time statistics in the SSR process and record statistics of independent and identically distributed random variables.

  13. Estimation of diver survival time in a lost bell

    Energy Technology Data Exchange (ETDEWEB)

    Tipton, M.J.; Franks, C. [Surrey Univ., Guildford (United Kingdom); Meneilly, G.S. [British Columbia Univ., Vancouver, BC (Canada). Dept. of Medicine; Mekjavic, I.B. [Simon Fraser University, Vancouver (Canada). Dept. of Kinesiology

    1997-04-01

    Mathematical models of the human thermoregulatory system have been used to make predictions of the likely survival of divers in a ``lost bell`` who can be exposed to very low ambient temperatures. The circumstances considered are not the most extreme but those where, partly by shivering, the individual can re-enter thermal balance. The ability accurately to predict the level and duration of metabolic heat production is critical for the estimation of survival time under these conditions. Limitations on the accuracy of current models arise from the lack of precision in modelling the intensity and duration of the metabolic (shivering) response. A different basis for predicting shivering endurance using the time to hypogylcaemia (blood glucose level less than 2.5 mmol/1) is proposed. This leads to predicted survival times ranging from 10 to over 24 hours for those individuals able to stabilise deep body temperature. This seems to be more consistent with the limited experimental data which exists than the 8-9 hours predicted by other models. In order to help maintain blood sugar levels, and hence metabolic heat production, it is recommended that emergency rations within bells should provide 500g of carbohydrate a day. (59 figures; 221 references). (UK)

  14. Integral Time and the Varieties of Post-Mortem Survival

    Directory of Open Access Journals (Sweden)

    Sean M. Kelly

    2008-06-01

    Full Text Available While the question of survival of bodily death is usually approached by focusing on the mind/body relation (and often with the idea of the soul as a special kind of substance, this paper explores the issue in the context of our understanding of time. The argument of the paper is woven around the central intuition of time as an “ever-living present.” The development of this intuition allows for a more integral or “complex-holistic” theory of time, the soul, and the question of survival. Following the introductory matter, the first section proposes a re-interpretation of Nietzsche’s doctrine of eternal recurrence in terms of moments and lives as “eternally occurring.” The next section is a treatment of Julian Barbour’s neo-Machian model of instants of time as configurations in the n-dimensional phase-space he calls “Platonia.” While rejecting his claim to have done away with time, I do find his model suggestive of the idea of moments and lives as eternally occurring. The following section begins with Fechner’s visionary ideas of the nature of the soul and its survival of bodily death, with particular attention to the notion of holonic inclusion and the central analogy of the transition from perception to memory. I turn next to Whitehead’s equally holonic notions of prehension and the concrescence of actual occasions. From his epochal theory of time and certain ambiguities in his reflections on the “divine antinomies,” we are brought to the threshold of a potentially more integral or “complex-holistic” theory of time and survival, which is treated in the last section. This section draws from my earlier work on Hegel, Jung, and Edgar Morin, as well as from key insights of Jean Gebser, for an interpretation of Sri Aurobindo’s inspired but cryptic description of the “Supramental Time Vision.” This interpretation leads to an alternative understanding of reincarnation—and to the possibility of its reconciliation

  15. Time dependent ethnic convergence in colorectal cancer survival in hawaii

    Directory of Open Access Journals (Sweden)

    Hundahl Scott A

    2003-02-01

    Full Text Available Abstract Background Although colorectal cancer death rates have been declining, this trend is not consistent across all ethnic groups. Biological, environmental, behavioral and socioeconomic explanations exist, but the reason for this discrepancy remains inconclusive. We examined the hypothesis that improved cancer screening across all ethnic groups will reduce ethnic differences in colorectal cancer survival. Methods Through the Hawaii Tumor Registry 16,424 patients diagnosed with colorectal cancer were identified during the years 1960–2000. Cox regression analyses were performed for each of three cohorts stratified by ethnicity (Caucasian, Japanese, Hawaiian, Filipino, and Chinese. The models included stage of diagnosis, year of diagnosis, age, and sex as predictors of survival. Results Mortality rates improved significantly for all ethnic groups. Moreover, with the exception of Hawaiians, rates for all ethnic groups converged over time. Persistently lower survival for Hawaiians appeared linked with more cancer treatment. Conclusion Ethnic disparities in colorectal cancer mortality rates appear primarily the result of differential utilization of health care. If modern screening procedures can be provided equally to all ethnic groups, ethnic outcome differences can be virtually eliminated.

  16. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... on one Side. Trouble Speaking. Trouble Seeing. Trouble Walking. Know Stroke, Know the Signs, Act in Time. ... seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe ...

  17. Rebalancing the Eurozone Troubled Economies

    Directory of Open Access Journals (Sweden)

    Ziółkowski Michał

    2014-10-01

    Full Text Available The aim of the article is to assess how much rebalancing of the six eurozone troubled economies (Ireland, Portugal, Spain, Italy, Greece, Cyprus was achieved since the outbreak of the financial crisis in 2007/2008, to what extent migrations were a mitigating factor on their labor markets and how much the troubled countries were assisted in their adjustment by other countries. The first part of the article shows an overall macroeconomic picture of the troubled economies' rebalancing together with a presentation of the etiology of the problem (i.e. accumulation of imbalances. The second part presents the role of migrations and the third part the role of the Eurosystem and international financial assistance in the rebalancing process. The research is based on comparing developments in selected indicators across countries. The conclusions are that the rebalancing in the troubled countries was either at most limited or actually their economies continued to fall out of balance (various indicators showing various developments make the situation ambiguous, migrations were either not much supportive for rebalancing of the troubled economies or they did not provide any dent to unemployment at all and that the troubled countries were provided with significant international assistance mainly in the form of the ECB policies causing the rise in the Target balances.

  18. Troubling Methods in Qualitative Inquiry and Beyond

    DEFF Research Database (Denmark)

    Tanggaard, Lene

    2013-01-01

    This present paper troubles and literally ‘shakes’ the idea of methods as the founding ground of qualitative inquiry. It does so by addressing the real-time messiness of research and the retrospective character of research reports. While the paper is not as such opposed to methods, it does sugges...... suggestion is that these open-ended and flexible strategies allow for an innovative approach to the development of a qualitative psychology while also serving to trouble (at least for a moment) the current popularity of methods in research.......This present paper troubles and literally ‘shakes’ the idea of methods as the founding ground of qualitative inquiry. It does so by addressing the real-time messiness of research and the retrospective character of research reports. While the paper is not as such opposed to methods, it does suggest...... that many actual research practices do not follow defined and regular plans as the terminology of methods inclines. However, rather than seeing the messiness as a bias to be eliminated, a more constructive approach is suggested. With the intention of inviting more creative and thought-provoking research...

  19. Trouble on tap.

    Science.gov (United States)

    Postel, S

    1989-01-01

    Water is central to food production, industrial expansion, and urban growth. The creative use of water has resulted in both the advance of the standard of living and the destruction of the environment. Exhausted rivers, falling water tables, and shrinking lakes indicate the abuse that the world water system has suffered. The Middle East, the region with the biggest problem, has a high population growth rate, which increases the load on the food production system and is the most heavily dependent upon irrigation. Water sources do not know political boundaries, as such, conflict may result in water-sharing agreements are not reached. Egypt is worst off because it relies entirely upon the Nile for its water, yet none of its tributaries are in Egypt. The water cycle has been most adversely affected in India where over US$12 billion has been spent on 1554 large dams and other measure designed to control water. However, over 10,000 villages across the subcontinent live with shortages. Heavy pumping has salinated much of the ground water, and New Delhi's water requirement is so high that it is available for only a few hours a day. China is also in serious trouble with 21% of the world population and only 8% of its renewable fresh water. The Aral sea in the Soviet Union is going to become several small brine lakes if drastic measures are not taken quickly. However, current plans will cost the Soviet economy US$78billion and a proposed Siberian river diversion project could cost US$150 billion. The most common solution to water shortages is the marketing of water; however, this system is still very inefficient. Government subsidies for water still greatly hinder the adaptation of water use policies that value this scarce resource equitably. There are no quick fixes to this problem as was speculated in the 1970s. People and governments must increase their awareness of the magnitude of the problem and begin to value water accordingly. Conservation, recycling, and other

  20. Troubling Gender through Mail Art

    Science.gov (United States)

    McGregor, Catherine

    2015-01-01

    A persistent and troubling trend in teacher education programmes is how gender is constructed heteronormatively. Finding ways that challenge novice teacher thinking about gender and gender identities has proven to be difficult ([Grace, A. P., and K. Wells. 2006. "The Quest for a Queer Inclusive Cultural Ethics: Setting Directions for…

  1. Survival

    Data.gov (United States)

    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...

  2. Rubber dam may increase the survival time of dental restorations.

    Science.gov (United States)

    Keys, William; Carson, Susan J

    2017-03-01

    Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, SciELO, Chinese BioMedical Literature Database, VIP, China National Knowledge Infrastructure, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online databases. Handsearches in a number of journals.Study selectionRandomised controlled trials, including split-mouth studies assessing the effects of rubber dam isolation for restorative treatments in dental patients.Data extraction and synthesisTwo review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies.ResultsFour studies involving a total of 1,270 patients were included. The studies were at high risk of bias. One trial was excluded from the analysis due to inconsistencies in the presented data. Restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). The rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.ConclusionsWe found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct

  3. Improving lung cancer survival; time to move on

    NARCIS (Netherlands)

    M.E. Heuvers (Marlies); J.P.J.J. Hegmans (Joost); B.H.Ch. Stricker (Bruno); J.G.J.V. Aerts (Joachim)

    2012-01-01

    textabstractBackground: During the past decades, numerous efforts have been made to decrease the death rate among lung cancer patients. Nonetheless, the improvement in long-term survival has been limited and lung cancer is still a devastating disease.Discussion: With this article we would like to

  4. Semiparametric Methods to Contrast Gap Time Survival Functions: Application to Repeat Kidney Transplantation

    OpenAIRE

    Shu, Xu; Schaubel, Douglas E.

    2015-01-01

    Times between successive events (i.e., gap times) are of great importance in survival analysis. Although many methods exist for estimating covariate effects on gap times, very few existing methods allow for comparisons between gap times themselves. Motivated by the comparison of primary and repeat transplantation, our interest is specifically in contrasting the gap time survival functions and their integration (restricted mean gap time). Two major challenges in gap time analysis are non-ident...

  5. Survey Article: Ukraine's Industrial Enterprise: Surviving Hard Times

    OpenAIRE

    Fyodor I Kushnirsky

    1994-01-01

    Ukraine's industrial organizational structure, retaining the features of a planned system, has been slow to change. The state plays a greater role in controlling industrial production there than in Russia. Along with privatization, the government encourages different types of associations and conglomerates. Industry's dismal performance could probably be worse without surviving strategies used by enterprise management, such as retaining working collectives, loyalty to suppliers and buyers, av...

  6. Prevent troubles due to retirement

    CERN Multimedia

    Raymond,J

    1983-01-01

    Le Docteur J.Raymond, medecin d'une institution hospitalière pour personnes agées, fait référence au Dr.Tournier (voir AUDIO-1983-008) et a pour thème: prévenir les troubles physiques et psychologiques liés à la retraite, étape à laquelle nous devons forcément aboutir.

  7. Navigating troubled waters

    DEFF Research Database (Denmark)

    Jørgensen, Andreas Møller; Andersen, Kim Normann

    2016-01-01

    between information abundance and centralized access. The four mechanisms are combined in the MIME framework. Research limitations/implications: The MIME framework includes mechanisms that are documented by the English-speaking research community, often with a substantial time lag. Others and potentially...... forceful mechanisms might not be reported in the research literature. Practical implications: Practitioners are encouraged to be cognizant of the variety of mechanisms that condition e-democracy; their internal components and external relations of e-democratic practices when designing, building...

  8. Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients.

    Science.gov (United States)

    Bo, Yacong; Yao, Mingjie; Zhang, Ling; Bekalo, Wolde; Lu, Weiquan; Lu, Quanjun

    2015-01-01

    We designed this study to determine the predictive value of Nutritional Risk Index (NRI) for postoperative survival time of patients who had undergone hepatectomy for primary liver cancer. The 620 patients who underwent hepatectomy for primary liver cancer (PLC) in the Department of Hepatobiliary Surgery, Cancer Hospital of Henan Province, Zhengzhou, China from December 1, 2008 to December 1, 2012 were followed up. A nutritional risk index (NRI) was used to screen the patients with malnutrition (NRI100) patients had longer postoperative survival time compared with malnourished patients. NRI values>100 was sig-nificantly associated with longer postoperative survival time. Cox proportional hazards model showed that NRI was an independent predictor of postoperative survival time and that NRI varied inversely with the risk of death. The patients with NRI values>100 survived longer than those with NRI values

  9. Surviving in a metastable de Sitter space-time

    Energy Technology Data Exchange (ETDEWEB)

    Kashyap, Sitender Pratap; Mondal, Swapnamay [Harish-Chandra Research Institute,Chhatnag Road, Jhusi, Allahabad 211019 (India); Sen, Ashoke [Harish-Chandra Research Institute,Chhatnag Road, Jhusi, Allahabad 211019 (India); School of Physics, Korea Institute for Advanced Study,Seoul 130-722 (Korea, Republic of); Verma, Mritunjay [Harish-Chandra Research Institute,Chhatnag Road, Jhusi, Allahabad 211019 (India); International Centre for Theoretical Sciences,Malleshwaram, Bengaluru 560 012 (India)

    2015-09-21

    In a metastable de Sitter space any object has a finite life expectancy beyond which it undergoes vacuum decay. However, by spreading into different parts of the universe which will fall out of causal contact of each other in future, a civilization can increase its collective life expectancy, defined as the average time after which the last settlement disappears due to vacuum decay. We study in detail the collective life expectancy of two comoving objects in de Sitter space as a function of the initial separation, the horizon radius and the vacuum decay rate. We find that even with a modest initial separation, the collective life expectancy can reach a value close to the maximum possible value of 1.5 times that of the individual object if the decay rate is less than 1% of the expansion rate. Our analysis can be generalized to any number of objects, general trajectories not necessarily at rest in the comoving coordinates and general FRW space-time. As part of our analysis we find that in the current state of the universe dominated by matter and cosmological constant, the vacuum decay rate is increasing as a function of time due to accelerated expansion of the volume of the past light cone. Present decay rate is about 3.7 times larger than the average decay rate in the past and the final decay rate in the cosmological constant dominated epoch will be about 56 times larger than the average decay rate in the past. This considerably weakens the lower bound on the half-life of our universe based on its current age.

  10. Improving lung cancer survival: Time to move on

    NARCIS (Netherlands)

    M.E. Heuvers (Marlies)

    2013-01-01

    markdownabstract__Abstract__ In 1761, lung cancer was first described as a distinct disease based on autopsies by Giovanni Morgagni. In 1810, Gaspard Laurent Bayle described lung cancer in more detail in his book entitled Recherches sur la phthisie pulmonaire. At that time it was an extremely

  11. Lessons from Cacti: How to Survive the Prickles of Life during Tough Times

    Science.gov (United States)

    Bigger, Alan S.; Bigger, Linda B.

    2009-01-01

    The saguaro cactus looked a little like humans, in different shapes and sizes. How on earth do they survive in a climate that seems so inhospitable? It is possible to learn lessons for life from a cactus, if one can only get beyond the thorns, and that these lessons will assist one to survive during tough or prickly times. These plants survive…

  12. Assessment of lead-time bias in estimates of relative survival for breast cancer.

    Science.gov (United States)

    Andersson, Therese M-L; Rutherford, Mark J; Humphreys, Keith

    2017-02-01

    Relative survival ratios (RSRs) can be useful for evaluating the impact of changes in cancer care on the prognosis of cancer patients or for comparing the prognosis for different subgroups of patients, but their use is problematic for cancer sites where screening has been introduced due to the potential of lead-time bias. Lead-time is survival time that is added to a patient's survival time because of an earlier diagnosis irrespective of a possibly postponed time of death. In the presence of screening it is difficult to disentangle how much of an observed improvement in survival is real and how much is due to lead-time bias. Even so, RSRs are often presented for breast cancer, a site where screening has led to early diagnosis, with the assumption that the lead-time bias is small. We describe a simulation-based framework for studying the lead-time bias due to mammography screening on RSRs of breast cancer based on a natural history model developed in a Swedish setting. We have performed simulations, using this framework, under different assumptions for screening sensitivity and breast cancer survival with the aim of estimating the lead-time bias. Screening every second year among ages 40-75 was introduced assuming that screening had no effect on survival, except for lead-time bias. Relative survival was estimated both with and without screening to enable quantification of the lead-time bias. Scenarios with low, moderate and high breast cancer survival, and low, moderate and high screening sensitivity were simulated, and the lead-time bias assessed in all scenarios. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Problems on a Part-time Job of Overseas Students as an Extra-status Activity : Troubles brought into Advisor's Room for Consultation

    OpenAIRE

    岡, 益巳

    2004-01-01

    The leagal term for a part-time job of college students from abroad is "activity other than that permitted by the status of residence previously granted". According to AIEJ research in 2001, over 76% of international students studying in Japan at private expenses engage in a part-time job. In this paper, I will mainly treat two big problems which some of those students may be involved in. One is non-payment of wages by an unprincipled employer, the other is deduction of income tax by both an ...

  14. 78 FR 4026 - Definition of Troubled Condition

    Science.gov (United States)

    2013-01-18

    ... ADMINISTRATION 12 CFR Parts 700, 701, 741, 747, and 750 RIN 3133-AD97 Definition of Troubled Condition AGENCY... a final rule amending the definition of ``troubled condition'' as that term is used to trigger the... officials, and as that term appears elsewhere in NCUA's regulations. Generally, the current definition...

  15. 77 FR 45285 - Definition of Troubled Condition

    Science.gov (United States)

    2012-07-31

    ... ADMINISTRATION 12 CFR Parts 700, 701, 741 and 750 RIN 3133-AD97 Definition of Troubled Condition AGENCY: National... proposes to amend the definition of ``troubled condition'' as that term appears in Sec. 701.14 and elsewhere in NCUA's regulations. Generally, under the current definition, only a state supervisory authority...

  16. Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times.

    Science.gov (United States)

    Memon, Khairuddin; Kulik, Laura; Lewandowski, Robert J; Wang, Edward; Riaz, Ahsun; Ryu, Robert K; Sato, Kent T; Marshall, Karen; Gupta, Ramona; Nikolaidis, Paul; Miller, Frank H; Yaghmai, Vahid; Senthilnathan, Seanthan; Baker, Talia; Gates, Vanessa L; Abecassis, Michael; Benson, Al B; Mulcahy, Mary F; Omary, Reed A; Salem, Riad

    2011-08-01

    It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with Child-Pugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and Mantel-Byar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P = .002 and .0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P = .0463 and .707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P < .0001 and .004, based on EASL and WHO criteria, respectively). The risk of death was lower for responders (P = .0132 and .010, based on EASL and WHO criteria, respectively). By the Mantel-Byar method, responders had longer survival than nonresponders, based on EASL criteria (P < .0001; P = .596 with WHO criteria). In the subanalysis, responders lived longer than patients with stable disease or progressive disease. Radiographic response to LRTs predicts survival time. EASL criteria for response more consistently predicted survival times than WHO criteria. The goal of LRT should be to achieve a radiologic response, rather than to stabilize disease. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

  17. Survival times for canine intranasal sarcomas treated with radiation therapy: 86 cases (1996-2011).

    Science.gov (United States)

    Sones, Evan; Smith, Annette; Schleis, Stephanie; Brawner, William; Almond, Gregory; Taylor, Kathryn; Haney, Siobhan; Wypij, Jackie; Keyerleber, Michele; Arthur, Jennifer; Hamilton, Terrance; Lawrence, Jessica; Gieger, Tracy; Sellon, Rance; Wright, Zack

    2013-01-01

    Sarcomas comprise approximately one-third of canine intranasal tumors, however few veterinary studies have described survival times of dogs with histologic subtypes of sarcomas separately from other intranasal tumors. One objective of this study was to describe median survival times for dogs treated with radiation therapy for intranasal sarcomas. A second objective was to compare survival times for dogs treated with three radiation therapy protocols: daily-fractionated radiation therapy; Monday, Wednesday, and Friday fractionated radiation therapy; and palliative radiation therapy. Medical records were retrospectively reviewed for dogs that had been treated with radiation therapy for confirmed intranasal sarcoma. A total of 86 dogs met inclusion criteria. Overall median survival time for included dogs was 444 days. Median survival time for dogs with chondrosarcoma (n = 42) was 463 days, fibrosarcoma (n = 12) 379 days, osteosarcoma (n = 6) 624 days, and undifferentiated sarcoma (n = 22) 344 days. Dogs treated with daily-fractionated radiation therapy protocols; Monday, Wednesday and Friday fractionated radiation therapy protocols; and palliative radiation therapy protocols had median survival times of 641, 347, and 305 days, respectively. A significant difference in survival time was found for dogs receiving curative intent radiation therapy vs. palliative radiation therapy (P = 0.032). A significant difference in survival time was also found for dogs receiving daily-fractionated radiation therapy vs. Monday, Wednesday and Friday fractionated radiation therapy (P = 0.0134). Findings from this study support the use of curative intent radiation therapy for dogs with intranasal sarcoma. Future prospective, randomized trials are needed for confirmation of treatment benefits. © 2012 Veterinary Radiology & Ultrasound.

  18. Technical troubles encountered in the seismic observation network of Pacific21

    National Research Council Canada - National Science Library

    Yuki, Yoshiki; Ishihara, Yasushi

    2009-01-01

    Real-time monitoring of broadband seismographs through the Internet enables us to discover various technical troubles of broadband seismic observation system of Pacific21 and to take measures to solve...

  19. List and liver transplant survival according to waiting time in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Salvalaggio, P R; Felga, G; Axelrod, D A; Della Guardia, B; Almeida, M D; Rezende, M B

    2015-03-01

    The time that patients with hepatocellular carcinoma (HCC) can safely remain on the waiting list for liver transplantation (LT) is unknown. We investigated whether waiting time on the list impacts transplant survival of HCC candidates and transplant recipients. This is a single-center retrospective study of 283 adults with HCC. Patients were divided in groups according to waiting-list time. The main endpoint was survival. The median waiting time for LT was 4.9 months. The dropout rates at 3-, 6-, and 12-months were 6.4%, 12.4%, and 17.7%, respectively. Mortality on the list was 4.8%, but varied depending of the time on the list. Patients who waited less than 3-months had an inferior overall survival when compared to the other groups (p = 0.027). Prolonged time on the list significantly reduced mortality in this analysis (p = 0.02, HR = 0.28). Model for End Stage Liver Disease (MELD) score at transplantation did also independently impact overall survival (p = 0.03, HR = 1.06). MELD was the only factor that independently impacted posttransplant survival (p = 0.048, HR = 1.05). We conclude that waiting time had no relation with posttransplant survival. It is beneficial to prolong the waiting list time for HCC candidates without having a negative impact in posttransplant survival. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  20. Troubling Adult Learning in the Present Time

    Science.gov (United States)

    Hill, Robert J.

    2008-01-01

    The French philosopher Michel Foucault asks, "What's going on just now? What's happening to everyone? What is this world, this period, this precise moment in which everyone is living? Answers to these questions have a profound impact on learning. Before probing Foucault's questions regarding the nature of this precise moment and how they relate to…

  1. Tobit regression for modeling mean survival time using data subject to multiple sources of censoring.

    Science.gov (United States)

    Gong, Qi; Schaubel, Douglas E

    2018-01-22

    Mean survival time is often of inherent interest in medical and epidemiologic studies. In the presence of censoring and when covariate effects are of interest, Cox regression is the strong default, but mostly due to convenience and familiarity. When survival times are uncensored, covariate effects can be estimated as differences in mean survival through linear regression. Tobit regression can validly be performed through maximum likelihood when the censoring times are fixed (ie, known for each subject, even in cases where the outcome is observed). However, Tobit regression is generally inapplicable when the response is subject to random right censoring. We propose Tobit regression methods based on weighted maximum likelihood which are applicable to survival times subject to both fixed and random censoring times. Under the proposed approach, known right censoring is handled naturally through the Tobit model, with inverse probability of censoring weighting used to overcome random censoring. Essentially, the re-weighting data are intended to represent those that would have been observed in the absence of random censoring. We develop methods for estimating the Tobit regression parameter, then the population mean survival time. A closed form large-sample variance estimator is proposed for the regression parameter estimator, with a semiparametric bootstrap standard error estimator derived for the population mean. The proposed methods are easily implementable using standard software. Finite-sample properties are assessed through simulation. The methods are applied to a large cohort of patients wait-listed for kidney transplantation. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Correlation between Pulmonary Function Indexes and Survival Time 
in Patients with Advanced Lung Cancer

    Directory of Open Access Journals (Sweden)

    Hui GE

    2013-07-01

    Full Text Available Background and objective To those patients with advanced lung cancer, the ultimate objective is to improve the curative effect and quality of life, lung function indexes are an important factor. We investigate the change of lung function and the relationship between pulmonary function indexs and survival time in patients with advanced lung cancer. Methods Lung function was detected in 59 cases with lung cancer and 63 normal controls. The relationship between pulmonary function indexs and survival time was analyzed. Results There was significant difference in ventilation function and diffusing capacity between in lung cancer group and control group. Vital capacity (VC, forced expiratory volume in one second (FEV1, forced vital capacity (FVC, peak expiratory flow (PEF, peak expiratory flow% (PEF%, maximal ventilatory volume (MVV were positively correlated with survival time in patients with advanced lung cancer (r=0.29, 0.28, 0.28, 0.27, 0.26, 0.28, P<0.05, residual volume/total lung capacity was negatively correlated with survival time (r=-0.31, P<0.05. Conclusion The lung function decreases in the patients with lung cancer. VC, FEV1, FVC, PEF, PEF%, MVV, residual volume/total lung capacity were correlated with survival time in patients with advanced lung cancer. The pulmonary function indexs were important marker of prognosis in patients with lung cancer.

  3. Shouting at the Sky: Troubled Teens and the Promise of the Wild.

    Science.gov (United States)

    Ferguson, Gary

    This book describes a wilderness therapy program for troubled youth. Teenagers struggling with drugs, abusive or neglectful families, depression, suicidal thoughts, or their own impulses to lie or steal spend months in the Utah desert learning to survive in the wilderness, cooperate in group activities and problem solving, communicate with other…

  4. A Systematic Review of Testicle Survival Time After a Torsion Event.

    Science.gov (United States)

    Mellick, Larry Bruce; Sinex, James E; Gibson, Robert W; Mears, Kim

    2017-09-25

    The time window for possible salvage and survival of a torsed testicle is commonly thought to be 6 to 8 hours. However, survival of torsed testicles with or without subsequent atrophy is known to occur outside that critical time window. In this article, we performed a systematic review of the English literature to provide a more accurate understanding of reported time frames of testicle survival after a torsion event. The primary research question was to determine the relationship between time to treatment and the rate of survival for testicles of male patients presenting with testicular torsion (TT). A systematic review of the literature was performed and structured according to PRISMA guidelines. An exhaustive library search was performed after search strategies were developed for multiple databases that included PubMed, Cochrane library, Ovid MEDLINE, Web of Science, and ProQuest Theses and Dissertations. Two different searches were developed including "testicular torsion" and TT with the search term "time" added. Articles specifically reporting TT case series, testicle outcomes, and time to surgical or manual treatment were selected for review. In addition to and preceding the systematic review, an exhaustive manual search of the literature was also performed by the authors. As a result of these searches, a total of 30 studies with data considered relevant to the research question were included. The information extracted from the articles was tabulated with regard to time intervals to treatment and survival outcome. The systematic review process and protocol are reported in this article. A total of 30 studies were found that reported case series of TT patients and their outcomes as well as time to treatment reported in useful time frames. From these reports, a total of 2116 TT patients were culled, and their outcomes and time to treatment are reported. Because the time to treatment was reported variously in different case series, the 3 most common formats for

  5. Effect of first cannulation time and dialysis machine blood flows on survival of arteriovenous fistulas.

    Science.gov (United States)

    Wilmink, Teun; Powers, Sarah; Hollingworth, Lee; Stevenson, Tamasin

    2017-10-16

    To study the effect of cannulation time on arteriovenous fistula (AVF) survival. Analysis of two prospective databases of access operations and dialysis sessions from 12 January 2002 through 4 January 2015 with follow-up until 4 January 2016. First cannulation time (FCT), defined from operation to first cannulation, was categorized as machine blood flow rate (BFR) for the first 29 dialysis sessions on AVF was analysed. Altogether, 1167 AVF with functional dialysis use were analysed: 667 (57%) radial cephalic AVF, 383 (33%) brachiocephalic AVF and 117 (10%) brachiobasilic AVF. The 631 (54%) AVF created in on-dialysis patients were analysed separately from 536 (46%) AVF created in pre-dialysis patients. AVF survival was similar between cannulation categories for both pre-dialysis patients (P = 0.19) and on-dialysis patients (P = 0.83). Early cannulation was associated with similar AVF survival in both pre-dialysis patients (P = 0.82) and on-dialysis patients (P = 0.17). Six consecutive successful cannulations from the start were associated with improved AVF survival (P = 0.0002). A below-median BFR at the start of dialysis was associated with better AVF survival (P machine BFR in the first week of dialysis are associated with decreased AVF survival.

  6. The time dependent association of adrenaline administration and survival from out-of-hospital cardiac arrest.

    Science.gov (United States)

    Ewy, Gordon A; Bobrow, Bentley J; Chikani, Vatsal; Sanders, Arthur B; Otto, Charles W; Spaite, Daniel W; Kern, Karl B

    2015-11-01

    Recommended for decades, the therapeutic value of adrenaline (epinephrine) in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) is controversial. To investigate the possible time-dependent outcomes associated with adrenaline administration by Emergency Medical Services personnel (EMS). A retrospective analysis of prospectively collected data from a near statewide cardiac resuscitation database between 1 January 2005 and 30 November 2013. Multivariable logistic regression was used to analyze the effect of the time interval between EMS dispatch and the initial dose of adrenaline on survival. The primary endpoints were survival to hospital discharge and favourable neurologic outcome. Data from 3469 patients with witnessed OHCA were analyzed. Their mean age was 66.3 years and 69% were male. An initially shockable rhythm was present in 41.8% of patients. Based on a multivariable logistic regression model with initial adrenaline administration time interval (AATI) from EMS dispatch as the covariate, survival was greatest when adrenaline was administered very early but decreased rapidly with increasing (AATI); odds ratio 0.94 (95% Confidence Interval (CI) 0.92-0.97). The AATI had no significant effect on good neurological outcome (OR=0.96, 95% CI=0.90-1.02). In patients with OHCA, survival to hospital discharge was greater in those treated early with adrenaline by EMS especially in the subset of patients with a shockable rhythm. However survival rapidly decreased with increasing adrenaline administration time intervals (AATI). Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  7. Ozonated Olive Oils and Troubles

    Directory of Open Access Journals (Sweden)

    Bulent Uysal

    2014-04-01

    Full Text Available One of the commonly used methods for ozone therapy is ozonated oils. Most prominent type of used oils is extra virgin olive oil. But still, each type of unsaturated oils may be used for ozonation. There are a lot of wrong knowledge on the internet about ozonated oils and its use as well. Just like other ozone therapy studies, also the studies about ozone oils are inadequate to avoid incorrect knowledge. Current data about ozone oil and its benefits are produced by supplier who oversees financial interests and make misinformation. Despite the rapidly increasing ozone oil sales through the internet, its quality and efficacy is still controversial. Dozens of companies and web sites may be easily found to buy ozonated oil. But, very few of these products are reliable, and contain sufficiently ozonated oil. This article aimed to introduce the troubles about ozonated oils and so to inform ozonated oil users. [J Intercult Ethnopharmacol 2014; 3(2.000: 49-50

  8. Examining the Influence of Campus Climate on Students' Time to Degree: A Multilevel Discrete-Time Survival Analysis

    Science.gov (United States)

    Zhou, Ji; Castellanos, Michelle

    2013-01-01

    Utilizing longitudinal data of 3477 students from 28 institutions, we examine the effects of structural diversity and quality of interracial relation on students' persistence towards graduation within six years. We utilize multilevel discrete-time survival analysis to account for the longitudinal persistence patterns as well as the nested…

  9. The effect of time until surgical intervention on survival in dogs with secondary septic peritonitis.

    Science.gov (United States)

    Bush, Maxwell; Carno, Margaret A; St Germaine, Lindsay; Hoffmann, Daniel E

    2016-12-01

    This retrospective study examined the effect of time to intervention on outcome in cases of dogs with secondary septic peritonitis, and also searched for other potential prognostic factors. The medical records of 55 dogs were reviewed. No association was found between outcome and the time from hospital admission to surgical source control. However, several other factors were found to influence survival, including: age, needing vasopressors, lactate, pre-operative packed cell volume, serum alkaline phosphatase, serum total bilirubin, and post-operative serum albumin. These values were then used to create accurate pre- and post-operative survival prediction models.

  10. Graft pathology at the time of harvest: impact on long-term survival

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2014-12-01

    Full Text Available Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA, radial artery and saphenous vein grafts. There were 2 (3.0% hospital deaths and 9 (14.1% late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002; whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.

  11. Two Artificial Neural Networks for Modeling Discrete Survival Time of Censored Data

    Directory of Open Access Journals (Sweden)

    Taysseer Sharaf

    2015-01-01

    Full Text Available Artificial neural network (ANN theory is emerging as an alternative to conventional statistical methods in modeling nonlinear functions. The popular Cox proportional hazard model falls short in modeling survival data with nonlinear behaviors. ANN is a good alternative to the Cox PH as the proportionality of the hazard assumption and model relaxations are not required. In addition, ANN possesses a powerful capability of handling complex nonlinear relations within the risk factors associated with survival time. In this study, we present a comprehensive comparison of two different approaches of utilizing ANN in modeling smooth conditional hazard probability function. We use real melanoma cancer data to illustrate the usefulness of the proposed ANN methods. We report some significant results in comparing the survival time of male and female melanoma patients.

  12. An approach to the drone fleet survivability assessment based on a stochastic continues-time model

    Science.gov (United States)

    Kharchenko, Vyacheslav; Fesenko, Herman; Doukas, Nikos

    2017-09-01

    An approach and the algorithm to the drone fleet survivability assessment based on a stochastic continues-time model are proposed. The input data are the number of the drones, the drone fleet redundancy coefficient, the drone stability and restoration rate, the limit deviation from the norms of the drone fleet recovery, the drone fleet operational availability coefficient, the probability of the drone failure-free operation, time needed for performing the required tasks by the drone fleet. The ways for improving the recoverable drone fleet survivability taking into account amazing factors of system accident are suggested. Dependencies of the drone fleet survivability rate both on the drone stability and the number of the drones are analysed.

  13. Measurement of Survival Time in Brachionus Rotifers: Synchronization of Maternal Conditions.

    Science.gov (United States)

    Kaneko, Gen; Yoshinaga, Tatsuki; Gribble, Kristin E; Welch, David M; Ushio, Hideki

    2016-07-22

    Rotifers are microscopic cosmopolitan zooplankton used as models in ecotoxicological and aging studies due to their several advantages such as short lifespan, ease of culture, and parthenogenesis that enables clonal culture. However, caution is required when measuring their survival time as it is affected by maternal age and maternal feeding conditions. Here we provide a protocol for powerful and reproducible measurement of the survival time in Brachionus rotifers following a careful synchronization of culture conditions over several generations. Empirically, poor synchronization results in early mortality and a gradual decrease in survival rate, thus resulting in weak statistical power. Indeed, under such conditions, calorie restriction (CR) failed to significantly extend the lifespan of B. plicatilis although CR-induced longevity has been demonstrated with well-synchronized rotifer samples in past and present studies. This protocol is probably useful for other invertebrate models, including the fruitfly Drosophila melanogaster and the nematode Caenorhabditis elegans, because maternal age effects have also been reported in these species.

  14. Medical decisions for troubled breathing in nursing home residents.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Lipson, Steven

    2002-07-01

    This paper aims to gain insight into the medical decision-making processes undergone in a nursing home in response to troubled breathing. Participants were 20 residents of a large, nonprofit nursing home, six of whom died by the time of data collection. The mean age was 88 yr, and 70% were female. Diagnostic tests and medication were the most frequently used treatments. The most important considerations reported were the resident's quality of life, family wishes, and the relative effectiveness of alternative treatment options. In 45% of the cases, the physicians reported family involvement. In 30% of cases, the physicians would have wanted less treatment if they were in the resident's condition. Troubled breathing emerges as an end-of-life symptom for many residents. An analysis of the decision-making process and its evaluation could foster improved care of these symptoms.

  15. Random-effects regression analysis of correlated grouped-time survival data.

    Science.gov (United States)

    Hedeker, D; Siddiqui, O; Hu, F B

    2000-04-01

    Random-effects regression modelling is proposed for analysis of correlated grouped-time survival data. Two analysis approaches are considered. The first treats survival time as an ordinal outcome, which is either right-censored or not. The second approach treats survival time as a set of dichotomous indicators of whether the event occurred for time periods up to the period of the event or censor. For either approach both proportional hazards and proportional odds versions of the random-effects model are developed, while partial proportional hazards and odds generalizations are described for the latter approach. For estimation, a full-information maximum marginal likelihood solution is implemented using numerical quadrature to integrate over the distribution of multiple random effects. The quadrature solution allows some flexibility in the choice of distributions for the random effects; both normal and rectangular distributions are considered in this article. An analysis of a dataset where students are clustered within schools is used to illustrate features of random-effects analysis of clustered grouped-time survival data.

  16. Racial Disparities in Clinical Presentation and Survival Times Among Young-Onset Colorectal Adenocarcinoma.

    Science.gov (United States)

    Arshad, Hafiz Muhammad Sharjeel; Kabir, Christopher; Tetangco, Eula; Shah, Natahsa; Raddawi, Hareth

    2017-09-01

    Recently published data indicate increasing incidence of colorectal adenocarcinoma (CRC) in young-onset (racial disparities in presentation and survival times among non-Hispanic Blacks (NHB) and Hispanics compared with non-Hispanic Whites (NHW). A retrospective single-center cohort study was conducted from 2004 through 2014 using 96 patient medical charts with a diagnosis of young-onset CRC. Age, gender, primary site, and histological stage at the time of diagnosis were assessed for survival probabilities by racial group over a minimum follow-up period of 5 years. Among subjects with CRC diagnosis before 50 years of age, the majority of subjects were between 40 and 50 years, with CRC presentation occurring among this age group for 51 (79.7%) of NHW, 18 (81.8%) of NHB, and 5 (50.0%) of Hispanics. The majority of all patients presented with advanced stages of CRC (31.3% with stage III and 27.1% with stage IV). NHB exhibited statistically significantly worse survival compared to NHW (adjusted hazard ratio for death = 2.09; 95% confidence interval 1.14-3.84; P = 0.02). A possible trend of worse survival was identified for Hispanics compared to NHW, but this group was low in numbers and results were not statistically significant. Disparities between racial groups among young-onset CRC cases were identified in overall survival and reflect growing concern in rising incidence and differentiated care management.

  17. Looking inward: The impact of operative time on graft survival after liver transplantation.

    Science.gov (United States)

    Lee, David D; Li, Jun; Wang, Guihua; Croome, Kristopher P; Burns, Justin M; Perry, Dana K; Nguyen, Justin H; Hopp, Wallace J; Taner, C Burcin

    2017-10-01

    Operative time often has been cited as an important factor for postoperative outcomes. Despite this belief, most efforts to improve liver transplant outcomes have largely focused on only patient and donor factors, and little attention has been paid on operative time. The primary objective of this project was to determine the impact of operative time on graft survival after liver transplant. A retrospective review of 2,877 consecutive liver transplants performed at a single institution was studied. Data regarding recipient, donor, and operative characteristics, including detailed granular operative times were collected prospectively and retrospectively reviewed. Using an instrument variable approach, Cox multivariate modeling was performed to assess the impact of operative time without the confounding of known and unknown variables. Of the 2,396 patients who met the criteria for review, the most important factors determining liver transplant graft survival included recipient history of Hepatitis C (hazard ratio 1.45, P = .02), donor age (hazard ratio 1.23, P = .03), use of liver graft from donation after cardiac death donor (hazard ratio 1.50, P operative time (hazard ratio 1.26, P = .01). In detailed analysis of stages of the liver transplant operation, the time interval from incision to anhepatic phase was associated with graft survival (hazard ratio 1.33; P = .02). Using a novel instrument variable approach, we demonstrate that operative time (in particular, the time interval from incision to anhepatic time) has a significant impact on graft survival. It also seems that some of this efficiency is under the influence of the transplant surgeon. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Effect of bifidobacteria implantation on the survival time of whole-body irradiated mice

    Energy Technology Data Exchange (ETDEWEB)

    Yokokura, T.; Onoue, M.; Mutai, M. (Yakult Institute for Microbiological Research)

    1980-01-01

    Letahl dose (2 KR) of gamma-ray was irradiated on the whole bodies of mice. Survival time after irradiation was significantly longer in mice with administration of both Bifidobacterium breve YIT 4008 and transgalactosyl oligosaccharide than in mice with administration of either of the two or nothing.

  19. It's Deja Vu All over Again: Using Multiple-Spell Discrete-Time Survival Analysis.

    Science.gov (United States)

    Willett, John B.; Singer, Judith D.

    1995-01-01

    The multiple-spell discrete-time survival analysis method is introduced and illustrated using longitudinal data on exit from and reentry into the teaching profession. The method is applicable to many educational problems involving the sequential occurrence of disparate events or episodes. (SLD)

  20. Recidivism and Survival Time: Racial Disparity among Jail Ex-Inmates

    Science.gov (United States)

    Jung, Hyunzee; Spjeldnes, Solveig; Yamatani, Hide

    2010-01-01

    Incarcerated men, most of whom are recidivists, are disproportionately black. Much literature about prison ex-inmates reports on this disparity, yet little is known about racial disparity in recidivism rates among jail ex-inmates. This study examined recidivism rates and survival time (period from release date to rearrest) among male ex-inmates…

  1. Palliative sedation in advanced cancer patients: Does it shorten survival time? - A systematic review

    Directory of Open Access Journals (Sweden)

    B Barathi

    2013-01-01

    Full Text Available Background: Patients with advanced cancer often suffer from multiple refractory symptoms in the terminal phase of their life. Palliative sedation is one of the few ways to relieve this refractory suffering. Objectives: This systematic review investigated the effect of palliative sedation on survival time in terminally ill cancer patients. Materials and Methods: Six electronic databases were searched for both prospective and retrospective studies which evaluated the effect of palliative sedation on survival time. Only those studies which had a comparison group that did not receive palliative sedation were selected for the review. Abstracts of all retrieved studies were screened to include the most relevant studies and only studies which met inclusion criteria were selected. References of all retrieved studies were also screened for relevant studies. Selected studies were assessed for quality and data extraction was done using the structured data extraction form. Results: Eleven studies including four prospective and seven retrospective studies were identified. Mean survival time (MST was measured as the time from last admission until death. A careful analysis of the results of all the 11 studies indicated that MST of sedated and non-sedated group was not statistically different in any of the studies. Conclusion: This systematic review supports the fact that palliative sedation does not shorten survival in terminally ill cancer patients. However, this conclusion needs to be taken with consideration of the methodology, study design, and the population studied of the included studies in this review.

  2. Sex-related time-dependent variations in post-stroke survival-evidence of a female stroke survival advantage

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Dehlendorff, Christian; Andersen, Klaus Kaae

    2007-01-01

    of stroke and remained so during the first month suggesting a female survival advantage. Throughout the second month the rate reversed in favour of men suggesting that women in that period are paying a 'toll' for their initial survival advantage. Hereafter, the rate steadily decreased, and after 4 months...

  3. Survival probability and first-passage-time statistics of a Wiener process driven by an exponential time-dependent drift

    Science.gov (United States)

    Urdapilleta, Eugenio

    2011-02-01

    The survival probability and the first-passage-time statistics are important quantities in different fields. The Wiener process is the simplest stochastic process with continuous variables, and important results can be explicitly found from it. The presence of a constant drift does not modify its simplicity; however, when the process has a time-dependent component the analysis becomes difficult. In this work we analyze the statistical properties of the Wiener process with an absorbing boundary, under the effect of an exponential time-dependent drift. Based on the backward Fokker-Planck formalism we set the time-inhomogeneous equation and conditions that rule the diffusion of the corresponding survival probability. We propose as the solution an expansion series in terms of the intensity of the exponential drift, resulting in a set of recurrence equations. We explicitly solve the expansion up to second order and comment on higher-order solutions. The first-passage-time density function arises naturally from the survival probability and preserves the proposed expansion. Explicit results, related properties, and limit behaviors are analyzed and extensively compared to numerical simulations.

  4. Survival probability and first-passage-time statistics of a Wiener process driven by an exponential time-dependent drift.

    Science.gov (United States)

    Urdapilleta, Eugenio

    2011-02-01

    The survival probability and the first-passage-time statistics are important quantities in different fields. The Wiener process is the simplest stochastic process with continuous variables, and important results can be explicitly found from it. The presence of a constant drift does not modify its simplicity; however, when the process has a time-dependent component the analysis becomes difficult. In this work we analyze the statistical properties of the Wiener process with an absorbing boundary, under the effect of an exponential time-dependent drift. Based on the backward Fokker-Planck formalism we set the time-inhomogeneous equation and conditions that rule the diffusion of the corresponding survival probability. We propose as the solution an expansion series in terms of the intensity of the exponential drift, resulting in a set of recurrence equations. We explicitly solve the expansion up to second order and comment on higher-order solutions. The first-passage-time density function arises naturally from the survival probability and preserves the proposed expansion. Explicit results, related properties, and limit behaviors are analyzed and extensively compared to numerical simulations.

  5. 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.

  6. Cancer patient survival in Estonia 1995-2009: time trends and data quality.

    Science.gov (United States)

    Innos, K; Baburin, A; Aareleid, T

    2014-06-01

    Survival from most cancers in Estonia has been consistently below European average. The objective of this study was to examine recent survival trends in Estonia and to quantify the effect on survival estimates of the temporary disruption of the Estonian Cancer Registry (ECR) practices in 2001-2007 when death certificates could not be used for case ascertainment. ECR data on all adult cases of 16 common cancers diagnosed in Estonia during 1995-2008 and followed up for vital status until 2009 were used to estimate relative survival ratios (RSR). We used cohort analysis for patients diagnosed in 1995-1999 and 2000-2004; and period hybrid approach to obtain the most recent estimates (2005-2009). We compared five-year RSRs calculated from data sets with and without death certificate initiated (DCI) cases. A total of 64328 cancer cases were included in survival analysis. Compared with 1995-1999, five-year age-standardized RSR increased 20 percent units for prostate cancer, reaching 76% in 2005-2009. A rise of 10 percent units or more was also seen for non-Hodgkin lymphoma (five-year RSR 51% in 2005-2009), and cancers of rectum (49%), breast (73%) and ovary (37%). The effect of including/excluding DCI cases from survival analysis was small except for lung and pancreatic cancers. Relative survival continued to increase in Estonia during the first decade of the 21st century, although for many cancers, a gap between Estonia and more affluent countries still exists. Cancer control efforts should aim at the reduction of risk factors amenable to primary prevention, but also at the improvement of early diagnosis and ensuring timely and optimal care to all cancer patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. The effect of time until surgical intervention on survival in dogs with secondary septic peritonitis

    OpenAIRE

    Bush, Maxwell; Carno, Margaret A.; St. Germaine, Lindsay; Hoffmann, Daniel E.

    2016-01-01

    This retrospective study examined the effect of time to intervention on outcome in cases of dogs with secondary septic peritonitis, and also searched for other potential prognostic factors. The medical records of 55 dogs were reviewed. No association was found between outcome and the time from hospital admission to surgical source control. However, several other factors were found to influence survival, including: age, needing vasopressors, lactate, pre-operative packed cell volume, serum alk...

  8. Multiparametric analysis of magnetic resonance images for glioma grading and patient survival time prediction

    Energy Technology Data Exchange (ETDEWEB)

    Garzon, Benjamin (Dept. of Circulation and Medical Imaging, NTNU, Trondheim (Norway)), email: benjamin.garzon@ntnu.no; Emblem, Kyrre E. (The Interventional Center, Rikshospitalet, Oslo Univ. Hospital, Oslo (Norway); Dept. of Radiology, MGH-HST AA Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston (United States)); Mouridsen, Kim (Center of Functionally Integrative Neuroscience, Aarhus Univ., Aarhus (Denmark)); Nedregaard, Baard; Due-Toennessen, Paulina; Nome, Terje; Hald, John K. (Dept. of Radiology and Nuclear Medicine, Rikshospitalet, Oslo Univ. Hospital, Oslo (Norway)); Bjoernerud, Atle (The Interventional Center, Rikshospitalet, Oslo Univ. Hospital, Oslo (Norway)); Haaberg, Asta K. (Dept. of Circulation and Medical Imaging, NTNU, Trondheim (Norway); Dept. of Medical Imaging, St Olav' s Hospital, Trondheim (Norway)); Kvinnsland, Yngve (NordicImagingLab, Bergen (Norway))

    2011-11-15

    Background. A systematic comparison of magnetic resonance imaging (MRI) options for glioma diagnosis is lacking. Purpose. To investigate multiple MR-derived image features with respect to diagnostic accuracy in tumor grading and survival prediction in glioma patients. Material and Methods. T1 pre- and post-contrast, T2 and dynamic susceptibility contrast scans of 74 glioma patients with histologically confirmed grade were acquired. For each patient, a set of statistical features was obtained from the parametric maps derived from the original images, in a region-of-interest encompassing the tumor volume. A forward stepwise selection procedure was used to find the best combinations of features for grade prediction with a cross-validated logistic model and survival time prediction with a cox proportional-hazards regression. Results. Presence/absence of enhancement paired with kurtosis of the FM (first moment of the first-pass curve) was the feature combination that best predicted tumor grade (grade II vs. grade III-IV; median AUC 0.96), with the main contribution being due to the first of the features. A lower predictive value (median AUC = 0.82) was obtained when grade IV tumors were excluded. Presence/absence of enhancement alone was the best predictor for survival time, and the regression was significant (P < 0.0001). Conclusion. Presence/absence of enhancement, reflecting transendothelial leakage, was the feature with highest predictive value for grade and survival time in glioma patients

  9. Functional Status, Time to Transplantation, and Survival Benefit of Kidney Transplantation Among Wait-Listed Candidates

    Science.gov (United States)

    Reese, Peter P.; Shults, Justine; Bloom, Roy D.; Mussell, Adam; Harhay, Meera N.; Abt, Peter; Levine, Matthew; Johansen, Kirsten L.; Karlawish, Jason T.; Feldman, Harold I.

    2015-01-01

    Background In the context of an aging end-stage renal disease population with multiple comorbidities, transplantation professionals face challenges in evaluating the global health of patients awaiting kidney transplantation. Functional status might be useful for identifying which patients will derive a survival benefit from transplantation versus dialysis. Study Design Retrospective cohort study of wait-listed patients using data on functional status from a national dialysis provider linked to United Network for Organ Sharing registry data. Setting & Participants Adult kidney transplant candidates added to the waiting list between the years 2000 and 2006. Predictor Physical function scale of the Medical Outcomes Study 36-Item Short Form Healthy Survey, analyzed as a time-varying covariate. Outcomes Kidney transplantation; Survival benefit of transplantation versus remaining wait-listed. Measurements We used multivariable Cox regression to assess the association between physical function with study outcomes. In survival benefit analyses, transplant status was modeled as a time-varying covariate. Results The cohort comprised 19,242 kidney transplant candidates (median age, 51 years; 36% black race) receiving maintenance dialysis. Candidates in the lowest baseline physical function quartile were more likely to be inactivated (adjusted HR vs. highest quartile, 1.30; 95% CI, 1.21-1.39) and less likely to undergo transplantation (adjusted HR vs. highest quartile, 0.64; 95% CI, 0.61-0.68). After transplantation, worse physical function was associated with shorter 3-year survival (84% vs. 92% for the lowest vs. highest function quartiles). However, compared to dialysis, transplantation was associated with a statistically significant survival benefit by 9 months for patients in every function quartile. Limitations Functional status is self-reported. Conclusions Even patients with low function appear to live longer with kidney transplantation versus dialysis. For waitlisted

  10. Association of the Timing of Pregnancy With Survival in Women With Breast Cancer.

    Science.gov (United States)

    Iqbal, Javaid; Amir, Eitan; Rochon, Paula A; Giannakeas, Vasily; Sun, Ping; Narod, Steven A

    2017-05-01

    Increasing numbers of women experience pregnancy around the time of, or after, a diagnosis of breast cancer. Understanding the effect of pregnancy on survival in women with breast cancer will help in the counseling and treatment of these women. To compare the overall survival of women diagnosed with breast cancer during pregnancy or in the postpartum period with that of women who had breast cancer but did not become pregnant. This population-based, retrospective cohort study linked health administrative databases in Ontario, Canada, comprising 7553 women aged 20 to 45 years at the time of diagnosis with invasive breast cancer, from January 1, 2003, to December 31, 2014. Any pregnancy in the period from 5 years before, until 5 years after, the index date of the diagnosis of breast cancer. Women were classified into the following 4 exposure groups: no pregnancy (the referent), pregnancy before breast cancer, pregnancy-associated breast cancer, and pregnancy following breast cancer. Five-year actuarial survival rates for all exposure groups, age-adjusted and multivariable hazard ratios [HRs] of pregnancy for overall survival for all exposure groups, and time-dependent hazard ratios for women with pregnancy following breast cancer. Among the 7553 women in the study (mean age at diagnosis, 39.1 years; median, 40 years; range, 20-44 years) the 5-year actuarial survival rate was 87.5% (95% CI, 86.5%-88.4%) for women with no pregnancy, 85.3% (95% CI, 82.8%-87.8%) for women with pregnancy before breast cancer (age-adjusted hazard ratio, 1.03; 95% CI, 0.85-1.27; P = .73), and 82.1% (95% CI, 78.3%-85.9%) for women with pregnancy-associated breast cancer (age-adjusted hazard ratio, 1.18; 95% CI, 0.91-1.53; P = .20). The 5-year actuarial survival rate was 96.7% (95% CI, 94.1%-99.3%) for women who had pregnancy 6 months or more after diagnosis of breast cancer, vs 87.5% (95% CI, 86.5%-88.4%) for women with no pregnancy) (age-adjusted HR, 0.22; 95% CI, 0.10-0.49; P

  11. Evaluation of serum biochemical marker concentrations and survival time in dogs with protein-losing enteropathy.

    Science.gov (United States)

    Equilino, Mirjam; Théodoloz, Vincent; Gorgas, Daniela; Doherr, Marcus G; Heilmann, Romy M; Suchodolski, Jan S; Steiner, Jörg M; Burgener Dvm, Iwan A

    2015-01-01

    To evaluate serum concentrations of biochemical markers and survival time in dogs with protein-losing enteropathy (PLE). Prospective study. 29 dogs with PLE and 18 dogs with food-responsive diarrhea (FRD). Data regarding serum concentrations of various biochemical markers at the initial evaluation were available for 18 of the 29 dogs with PLE and compared with findings for dogs with FRD. Correlations between biochemical marker concentrations and survival time (interval between time of initial evaluation and death or euthanasia) for dogs with PLE were evaluated. Serum C-reactive protein concentration was high in 13 of 18 dogs with PLE and in 2 of 18 dogs with FRD. Serum concentration of canine pancreatic lipase immunoreactivity was high in 3 dogs with PLE but within the reference interval in all dogs with FRD. Serum α1-proteinase inhibitor concentration was less than the lower reference limit in 9 dogs with PLE and 1 dog with FRD. Compared with findings in dogs with FRD, values of those 3 variables in dogs with PLE were significantly different. Serum calprotectin (measured by radioimmunoassay and ELISA) and S100A12 concentrations were high but did not differ significantly between groups. Seventeen of the 29 dogs with PLE were euthanized owing to this disease; median survival time was 67 days (range, 2 to 2,551 days). Serum C-reactive protein, canine pancreatic lipase immunoreactivity, and α1-proteinase inhibitor concentrations differed significantly between dogs with PLE and FRD. Most initial biomarker concentrations were not predictive of survival time in dogs with PLE.

  12. Does prehospital time affect survival of major trauma patients where there is no prehospital care?

    Science.gov (United States)

    Dharap, S B; Kamath, S; Kumar, V

    2017-01-01

    Survival after major trauma is considered to be time dependent. Efficient prehospital care with rapid transport is the norm in developed countries, which is not available in many lower middle and low-income countries. The aim of this study was to assess the effect of prehospital time and primary treatment given on survival of major trauma patients in a setting without prehospital care. This prospective observational study was carried out in a university hospital in Mumbai, from January to December 2014. The hospital has a trauma service but no organized prehospital care or defined interhospital transfer protocols. All patients with life- and/or limb-threatening injuries were included in the study. Injury time and arrival time were noted and the interval was defined as "prehospital time" for the directly arriving patients and as "time to tertiary care" for those transferred. Primary outcome measure was in-hospital death (or discharge). Of 1181 patients, 352 were admitted directly from the trauma scene and 829 were transferred from other hospitals. In-hospital mortality was associated with age, mechanism and mode of injury, shock, Glasgow Coma Score prehospital time nor with time to tertiary care. Transferred patients had a significantly higher mortality (odds ratio = 1.869, 95% confidence interval = 1.233-2.561, P = 0.005) despite fewer patients with severe injury. Two hundred and ninety-four (35%) of these needed airway intervention while 108 (13%) needed chest tube insertion on arrival to the trauma unit suggesting inadequate care at primary facility. Mortality is not associated with prehospital time but with transfers from primary care; probably due to deficient care. To improve survival after major trauma, enhancement of resources for resuscitation and capacity building of on-duty doctors in primary centers should be a priority in countries with limited resources.

  13. Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

    Science.gov (United States)

    Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

    2017-11-01

    It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  14. Evaluation of Survival Time of Tooth Color Dental Materials in Primary Anterior Teeth

    Directory of Open Access Journals (Sweden)

    Behjat-Al-Molook Ajami

    2013-01-01

    Full Text Available Introduction: In restorative dentistry, selecting the proper material is an important factor for clinical success. The objective of this study was clinical evaluation of survival time of three tooth color materials in primary anterior teeth. Methods: In this interventional clinical trial study, 94 deciduous anterior teeth (36 teeth in boys, 58 teeth in girls belonging to 3-5 year old children in Pediatric Department of Mashhad Faculty of Dentistry, Iran were selected. Selective dental materials included compoglass, glass-ionomer Fuji II LC, and composite resin. The data were analyzed with Kaplan–Meyer and Log rank test. Results: compoglass had the highest survival time in comparison with composite and glass-ionomer. Nine months retention rate for teeth restored with compoglass, composite resin and glass-ionomer were estimated: 95%, 21%, and 12.5%, respectively. Conclusion: Compoglass can be a suitable material for anterior primary teeth restoration

  15. Mediation Analysis with Survival Outcomes: Accelerated Failure Time Versus Proportional Hazards Models

    Directory of Open Access Journals (Sweden)

    Lois A Gelfand

    2016-03-01

    Full Text Available Objective: Survival time is an important type of outcome variable in treatment research. Currently, limited guidance is available regarding performing mediation analyses with survival outcomes, which generally do not have normally distributed errors, and contain unobserved (censored events. We present considerations for choosing an approach, using a comparison of semi-parametric proportional hazards (PH and fully parametric accelerated failure time (AFT approaches for illustration.Method: We compare PH and AFT models and procedures in their integration into mediation models and review their ability to produce coefficients that estimate causal effects. Using simulation studies modeling Weibull-distributed survival times, we compare statistical properties of mediation analyses incorporating PH and AFT approaches (employing SAS procedures PHREG and LIFEREG, respectively under varied data conditions, some including censoring. A simulated data set illustrates the findings.Results: AFT models integrate more easily than PH models into mediation models. Furthermore, mediation analyses incorporating LIFEREG produce coefficients that can estimate causal effects, and demonstrate superior statistical properties. Censoring introduces bias in the coefficient estimate representing the treatment effect on outcome – underestimation in LIFEREG, and overestimation in PHREG. With LIFEREG, this bias can be addressed using an alternative estimate obtained from combining other coefficients, whereas this is not possible with PHREG.Conclusions: When Weibull assumptions are not violated, there are compelling advantages to using LIFEREG over PHREG for mediation analyses involving survival-time outcomes. Irrespective of the procedures used, the interpretation of coefficients, effects of censoring on coefficient estimates, and statistical properties should be taken into account when reporting results.

  16. Determination of the impact of melanoma surgical timing on survival using the National Cancer Database.

    Science.gov (United States)

    Conic, Ruzica Z; Cabrera, Claudia I; Khorana, Alok A; Gastman, Brian R

    2018-01-01

    The ideal timing for melanoma treatment, predominantly surgery, remains undetermined. Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery. To assess the impact of time to definitive melanoma surgery on overall survival. Patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified by using the National Cancer Database (N = 153,218). The t test and chi-square test were used to compare variables. Cox regression was used for multivariate analysis. In a multivariate analysis of patients in all stages who were treated between 90 and 119 days after biopsy (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.18) and more than 119 days (HR, 1.12; 95% CI, 1.02-1.22) had a higher risk for mortality compared with those treated within 30 days of biopsy. In a subgroup analysis of stage I, higher mortality risk was found in patients treated within 30 to 59 days (HR, 1.05; 95% CI, 1.01-1.1), 60 to 89 days (HR, 1.16; 95% CI, 1.07-1.25), 90 to 119 days (HR, 1.29; 95% CI, 1.12-1.48), and more than 119 days after biopsy (HR, 1.41; 95% CI, 1.21-1.65). Surgical timing did not affect survival in stages II and III. Melanoma-specific survival was not available. Expeditious treatment of stage I melanoma is associated with improved outcomes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Correlation between Pulmonary Function Indexes and Survival Time 
in Patients with Advanced Lung Cancer

    OpenAIRE

    Ge, Hui; Jiang, Zhenghua; Huang, Qian; Muyun ZHU; Yang, Jie

    2013-01-01

    Background and objective To those patients with advanced lung cancer, the ultimate objective is to improve the curative effect and quality of life, lung function indexes are an important factor. We investigate the change of lung function and the relationship between pulmonary function indexs and survival time in patients with advanced lung cancer. Methods Lung function was detected in 59 cases with lung cancer and 63 normal controls. The relationship between pulmonary function indexs and surv...

  18. Mechanisms explaining the association between low back trouble and deficits in information processing. A controlled study with follow-up.

    Science.gov (United States)

    Luoto, S; Taimela, S; Hurri, H; Alaranta, H

    1999-02-01

    A controlled study with a 6-month follow-up period. To find an explanation for the association between impairment in information processing, i.e., slow reaction times, and chronic low back trouble. Low back trouble, chronic pain in general, and depression have been associated with impaired cognitive functions and slow reaction times. It is a common phenomenon that the preferred hand performs better than the nonpreferred hand in motor tasks. The authors hypothesized that chronic low back trouble hampers the functioning of short-term memory in a way that leads the preferred hand to loose its advantage over the nonpreferred hand, but that the advantage would be restored during the rehabilitation. Sixty-one healthy control subjects and 68 patients with low back trouble participated in the study. Reaction times for the preferred and nonpreferred upper limbs were tested. A multiway analysis of covariance was used to examine the group, handedness, and rehabilitation effects on reaction times. The hypothesis was specifically tested with a third-degree interaction: group-handedness-rehabilitation. A significant interaction among group, handedness, and rehabilitation was found (P = 0.05). At the beginning, the reaction times for the preferred hand were faster among the control subjects (P = 0.001), but not among the patients with low back trouble (P = 0.62). After the rehabilitation, the preferred hand was faster both among the control subjects (P = 0.001) and the patients with low back trouble (P = 0.0002). During the rehabilitation, back pain, psychological distress, and general disability decreased significantly among the patients with chronic low back trouble. The results support the hypothesis that chronic low back trouble (i.e., pain, psychological distress, and general disability) hampers the functioning of short-term memory, which results in decreased speed of information processing among patients with chronic low back trouble.

  19. Tumor Cells Growth and Survival Time with the Ketogenic Diet in Animal Models: A Systematic Review.

    Science.gov (United States)

    Khodadadi, Soheila; Sobhani, Nafiseh; Mirshekar, Somaye; Ghiasvand, Reza; Pourmasoumi, Makan; Miraghajani, Maryam; Dehsoukhteh, Somayeh Shahraki

    2017-01-01

    Recently, interest in targeted cancer therapies via metabolic pathways has been renewed with the discovery that many tumors become dependent on glucose uptake during anaerobic glycolysis. Also the inability of ketone bodies metabolization due to various deficiencies in mitochondrial enzymes is the major metabolic changes discovered in malignant cells. Therefore, administration of a ketogenic diet (KD) which is based on high in fat and low in carbohydrates might inhibit tumor growth and provide a rationale for therapeutic strategies. So, we conducted this systematic review to assess the effects of KD on the tumor cells growth and survival time in animal studies. All databases were searched from inception to November 2015. We systematically searched the PubMed, Scopus, Google Scholars, Science Direct and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the quality of included studies we used SYRCLE's RoB tool. 268 articles were obtained from databases by primary search. Only 13 studies were eligible according to inclusion criteria. From included studies, 9 articles indicate that KD had a beneficial effect on tumor growth and survival time. Tumor types were included pancreatic, prostate, gastric, colon, brain, neuroblastoma and lung cancers. In conclusions, although studies in this field are rare and inconsistence, recent findings have demonstrated that KD can potentially inhibit the malignant cell growth and increase the survival time. Because of differences physiology between animals and humans, future studies in cancer patients treated with a KD are needed.

  20. Tumor cells growth and survival time with the ketogenic diet in animal models: A systematic review

    Directory of Open Access Journals (Sweden)

    Soheila Khodadadi

    2017-01-01

    Full Text Available Recently, interest in targeted cancer therapies via metabolic pathways has been renewed with the discovery that many tumors become dependent on glucose uptake during anaerobic glycolysis. Also the inability of ketone bodies metabolization due to various deficiencies in mitochondrial enzymes is the major metabolic changes discovered in malignant cells. Therefore, administration of a ketogenic diet (KD which is based on high in fat and low in carbohydrates might inhibit tumor growth and provide a rationale for therapeutic strategies. So, we conducted this systematic review to assess the effects of KD on the tumor cells growth and survival time in animal studies. All databases were searched from inception to November 2015. We systematically searched the PubMed, Scopus, Google Scholars, Science Direct and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the quality of included studies we used SYRCLE's RoB tool. 268 articles were obtained from databases by primary search. Only 13 studies were eligible according to inclusion criteria. From included studies, 9 articles indicate that KD had a beneficial effect on tumor growth and survival time. Tumor types were included pancreatic, prostate, gastric, colon, brain, neuroblastoma and lung cancers. In conclusions, although studies in this field are rare and inconsistence, recent findings have demonstrated that KD can potentially inhibit the malignant cell growth and increase the survival time. Because of differences physiology between animals and humans, future studies in cancer patients treated with a KD are needed.

  1. Influencing Positive Outcomes for Troubled Youth

    Science.gov (United States)

    Haggis, Diane

    2017-01-01

    The BHB Theory (Haggis, 2011) is based on an empirical case study that examined teachers' perceptions of what they do in their educational settings to create a positive learning environment for troubled youth in their classrooms. Research--including this study--indicates a need for transformational change in how teachers interrelate with students…

  2. A Dialogue on Reclaiming Troubled Youth

    Science.gov (United States)

    Aichhorn, August; Redl, Fritz

    2012-01-01

    This discussion is drawn from the writings of two eminent founders of strength-based approaches to troubled children and adolescents. August Aichhorn is best known for his classic book, "Wayward Youth," and Fritz Redl as co-author of "Children Who Hate". August Aichhorn and Anna Freud mentored a young educational psychologist, Fritz Redl…

  3. Bookstore in Trouble: The Proverbial Iceberg

    Science.gov (United States)

    Sanderson, Ivan L.

    1975-01-01

    Examines the plight of two troubled bookstores, both state system stores with state charters as nonprofit corporations, probing some of their weaknesses, failures, and resultant difficulties and the positive action, including structural change and new management, involved in recovery and restoration of adequate operating funds. (JT)

  4. Bridge over troubled water: Guidance crosses | Amundson ...

    African Journals Online (AJOL)

    This article is based on a keynote presentation at an international conference where the focus was cross-over career guidance. Simon and Garfunkel's popular song, "Bridge over troubled water", was used as a metaphor for exploring the cross-over theme. Some of the concepts under consideration included the working ...

  5. A radiographic study on temporomandibular joint trouble

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Byoung Woon; Ahn, Hyung Kyu [Dept. of Dental Radiology, Graduate School, Seoul National University, Seoul (Korea, Republic of)

    1979-11-15

    The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental Radiology at the Infirmary of College of Dentistry, Seoul National University, during the period from Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54 cm) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normal range was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41.1%. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71.5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.

  6. Functional status, time to transplantation, and survival benefit of kidney transplantation among wait-listed candidates.

    Science.gov (United States)

    Reese, Peter P; Shults, Justine; Bloom, Roy D; Mussell, Adam; Harhay, Meera N; Abt, Peter; Levine, Matthew; Johansen, Kirsten L; Karlawish, Jason T; Feldman, Harold I

    2015-11-01

    In the context of an aging end-stage renal disease population with multiple comorbid conditions, transplantation professionals face challenges in evaluating the global health of patients awaiting kidney transplantation. Functional status might be useful for identifying which patients will derive a survival benefit from transplantation versus dialysis. Retrospective cohort study of wait-listed patients using data for functional status from a national dialysis provider linked to United Network for Organ Sharing registry data. Adult kidney transplantation candidates added to the waiting list between 2000 and 2006. Physical Functioning scale of the Medical Outcomes Study 36-Item Short Form Health Survey, analyzed as a time-varying covariate. Kidney transplantation; survival benefit of transplantation versus remaining wait-listed. We used multivariable Cox regression to assess the association between physical function with study outcomes. In survival benefit analyses, transplantation status was modeled as a time-varying covariate. The cohort comprised 19,242 kidney transplantation candidates (median age, 51 years; 36% black race) receiving maintenance dialysis. Candidates in the lowest baseline Physical Functioning score quartile were more likely to be inactivated (adjusted HR vs highest quartile, 1.30; 95% CI, 1.21-1.39) and less likely to undergo transplantation (adjusted HR vs highest quartile, 0.64; 95% CI, 0.61-0.68). After transplantation, worse Physical Functioning score was associated with shorter 3-year survival (84% vs 92% for the lowest vs highest function quartiles). However, compared to dialysis, transplantation was associated with a statistically significant survival benefit by 9 months for patients in every function quartile. Functional status is self-reported. Even patients with low function appear to live longer with kidney transplantation versus dialysis. For wait-listed patients, global health measures such as functional status may be more useful in

  7. Time-Dependent Tree-Structured Survival Analysis with Unbiased Variable Selection through Permutation Tests

    Science.gov (United States)

    Wallace, M. L.

    2014-01-01

    Incorporating time-dependent covariates into tree-structured survival analysis (TSSA) may result in more accurate prognostic models than if only baseline values are used. Available time-dependent TSSA methods exhaustively test every binary split on every covariate; however, this approach may result in selection bias towards covariates with more observed values. We present a method that uses unbiased significance levels from newly proposed permutation tests to select the time-dependent or baseline covariate with the strongest relationship with the survival outcome. The specific splitting value is identified using only the selected covariate. Simulation results show that the proposed time-dependent TSSA method produces tree models of equal or greater accuracy as compared to baseline TSSA models, even with high censoring rates and large within-subject variability in the time-dependent covariate. To illustrate, the proposed method is applied to data from a cohort of bipolar youth to identify subgroups at risk for self-injurious behavior. PMID:25043382

  8. Impact of Treatment Time on the Survival of Patients Suffering from Invasive Fungal Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Patorn Piromchai

    2014-01-01

    Full Text Available Background Invasive fungal rhinosinusitis is an uncommon disease with high mortality rates. There is currently no consensus on the best treatment timing. We studied the impact of the treatment timing on the survival of patients experiencing invasive fungal rhinosinusitis. Methods We conducted a retrospective study of patients suffering from invasive fungal rhinosinusitis. The duration of symptoms, clinical presentations, clinical signs, diagnoses, treatments, and outcomes were collected. Results It was observed that more than 70% of the mortalities occurred within the subgroup of patients who exhibited symptoms of the disease within 14 days before admission. After adjusting for the confounders, the time taken to treat the patients was the most statistically significant predictor for mortality ( P = 0.045. We found no significant relationships between mortality and its significant covariates, which included the underlying diseases ( P = 0.91 or complications ( P = 0.55. Conclusions Our study demonstrates that the time taken to treat the patients is an important determinant for the survival of patients who are afflicted with invasive fungal rhinosinusitis. The appropriate treatments should be administered within 14 days from the time the symptoms begin to manifest.

  9. Impact of treatment time on the survival of patients suffering from invasive fungal rhinosinusitis.

    Science.gov (United States)

    Piromchai, Patorn; Thanaviratananich, Sanguansak

    2014-01-01

    Invasive fungal rhinosinusitis is an uncommon disease with high mortality rates. There is currently no consensus on the best treatment timing. We studied the impact of the treatment timing on the survival of patients experiencing invasive fungal rhinosinusitis. We conducted a retrospective study of patients suffering from invasive fungal rhinosinusitis. The duration of symptoms, clinical presentations, clinical signs, diagnoses, treatments, and outcomes were collected. It was observed that more than 70% of the mortalities occurred within the subgroup of patients who exhibited symptoms of the disease within 14 days before admission. After adjusting for the confounders, the time taken to treat the patients was the most statistically significant predictor for mortality (P = 0.045). We found no significant relationships between mortality and its significant covariates, which included the underlying diseases (P = 0.91) or complications (P = 0.55). Our study demonstrates that the time taken to treat the patients is an important determinant for the survival of patients who are afflicted with invasive fungal rhinosinusitis. The appropriate treatments should be administered within 14 days from the time the symptoms begin to manifest.

  10. Survival time of dogs with splenic hemangiosarcoma treated by splenectomy with or without adjuvant chemotherapy: 208 cases (2001-2012).

    Science.gov (United States)

    Wendelburg, Kristin M; Price, Lori Lyn; Burgess, Kristine E; Lyons, Jeremiah A; Lew, Felicia H; Berg, John

    2015-08-15

    To determine survival time for dogs with splenic hemangiosarcoma treated with splenectomy alone, identify potential prognostic factors, and evaluate the efficacy of adjuvant chemotherapy. Retrospective case series. 208 dogs. Medical records were reviewed, long-term follow-up information was obtained, and survival data were analyzed statistically. 154 dogs were treated with surgery alone, and 54 were treated with surgery and chemotherapy. Twenty-eight dogs received conventional chemotherapy, 13 received cyclophosphamide-based metronomic chemotherapy, and 13 received both conventional and metronomic chemotherapy. Median survival time of dogs treated with splenectomy alone was 1.6 months. Clinical stage was the only prognostic factor significantly associated with survival time. When the entire follow-up period was considered, there was no significant difference in survival time between dogs treated with surgery alone and dogs treated with surgery and chemotherapy. However, during the first 4 months of follow-up, after adjusting for the effects of clinical stage, survival time was significantly prolonged among dogs receiving any type of chemotherapy (hazard ratio, 0.6) and among dogs receiving both conventional and metronomic chemotherapy (hazard ratio, 0.4). Clinical stage was strongly associated with prognosis for dogs with splenic hemangiosarcoma. Chemotherapy was effective in prolonging survival time during the early portion of the follow-up period. Combinations of doxorubicin-based conventional protocols and cyclophosphamide-based metronomic protocols appeared to be more effective than either type of chemotherapy alone, but prolongations in survival time resulting from current protocols were modest.

  11. Survival Times of Meter-Sized Rock Boulders on the Surface of Airless Bodies

    Science.gov (United States)

    Basilevsky, A. T.; Head, J. W.; Horz, F.; Ramsley, K.

    2015-01-01

    This study considers the survival times of meter-sized rock boulders on the surfaces of several airless bodies. As the starting point, we employ estimates of the survival times of such boulders on the surface of the Moon by[1], then discuss the role of destruction due to day-night temperature cycling, consider the meteorite bombardment environment on the considered bodies in terms of projectile flux and velocities and finally estimate the survival times. Survival times of meter-sized rocks on lunar surface: The survival times of hand specimen-sized rocks exposed to the lunar surface environment were estimated based on experiments modeling the destruction of rocks by meteorite impacts, combined with measurements of the lunar surface meteorite flux, (e.g.,[2]). For estimations of the survival times of meter-sized lunar boulders, [1] suggested a different approach based on analysis of the spatial density of boulders on the rims of small lunar craters of known absolute age. It was found that for a few million years, only a small fraction of the boulders ejected by cratering process are destroyed, for several tens of million years approx.50% are destroyed, and for 200-300 Ma, 90 to 99% are destroyed. Following [2] and other works, [1] considered that the rocks are mostly destroyed by meteorite impacts. Destruction of rocks by thermal-stress. However, high diurnal temperature variations on the surface of the Moon and other airless bodies imply that thermal stresses may also be a cause of surface rock destruction. Delbo et al. [3] interpreted the observed presence of fine debris on the surface of small asteroids as due to thermal surface cycling. They stated that because of the very low gravity on the surface of these bodies, ejecta from meteorite impacts should leave the body, so formation there of fine debris has to be due to thermal cycling. Based on experiments on heating-cooling of cm-scale pieces of ordinary and carbonaceous chondrites and theoretical modeling of

  12. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    McMillan, Matthew T. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Ojerholm, Eric [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Roses, Robert E., E-mail: Robert.Roses@uphs.upenn.edu [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Plastaras, John P.; Metz, James M. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Mamtani, Ronac [Department of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A. [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Stripp, Diana; Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Datta, Jashodeep [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States)

    2015-10-01

    Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered.

  13. Timing of adjuvant chemotherapy and its relation to survival among patients with stage III colon cancer.

    Science.gov (United States)

    Bos, A C R K; van Erning, F N; van Gestel, Y R B M; Creemers, G J M; Punt, C J A; van Oijen, M G H; Lemmens, V E P P

    2015-11-01

    Currently available data suggest that delaying the start of adjuvant chemotherapy in colon cancer patients has a detrimental effect on survival. We analysed which factors impact on the timing of adjuvant chemotherapy and evaluated the influence on overall survival (OS). Stage III colon cancer patients who underwent resection and received adjuvant chemotherapy between 2008 and 2013 were selected from the Netherlands Cancer Registry. Timing of adjuvant chemotherapy was subdivided into: ⩽ 4, 5-6, 7-8, 9-10, 11-12 and 13-16 weeks post-surgery. Multivariable regressions were performed to assess the influence of several factors on the probability of starting treatment within 8 weeks post-surgery and to evaluate the association of timing of adjuvant chemotherapy with 5-year OS. 6620 patients received adjuvant chemotherapy, 14% commenced after 8 weeks. Factors associated with starting treatment after 8 weeks were older age (Odds ratio (OR) 65-74 versus colon cancer patients within 8 weeks post-surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Integrated survival analysis using an event-time approach in a Bayesian framework

    Science.gov (United States)

    Walsh, Daniel P.; Dreitz, VJ; Heisey, Dennis M.

    2015-01-01

    Event-time or continuous-time statistical approaches have been applied throughout the biostatistical literature and have led to numerous scientific advances. However, these techniques have traditionally relied on knowing failure times. This has limited application of these analyses, particularly, within the ecological field where fates of marked animals may be unknown. To address these limitations, we developed an integrated approach within a Bayesian framework to estimate hazard rates in the face of unknown fates. We combine failure/survival times from individuals whose fates are known and times of which are interval-censored with information from those whose fates are unknown, and model the process of detecting animals with unknown fates. This provides the foundation for our integrated model and permits necessary parameter estimation. We provide the Bayesian model, its derivation, and use simulation techniques to investigate the properties and performance of our approach under several scenarios. Lastly, we apply our estimation technique using a piece-wise constant hazard function to investigate the effects of year, age, chick size and sex, sex of the tending adult, and nesting habitat on mortality hazard rates of the endangered mountain plover (Charadrius montanus) chicks. Traditional models were inappropriate for this analysis because fates of some individual chicks were unknown due to failed radio transmitters. Simulations revealed biases of posterior mean estimates were minimal (≤ 4.95%), and posterior distributions behaved as expected with RMSE of the estimates decreasing as sample sizes, detection probability, and survival increased. We determined mortality hazard rates for plover chicks were highest at weights and/or whose nest was within agricultural habitats. Based on its performance, our approach greatly expands the range of problems for which event-time analyses can be used by eliminating the need for having completely known fate data.

  15. Molecular clock evidence for survival of Antarctic cyanobacteria (Oscillatoriales, Phormidium autumnale) from Paleozoic times.

    Science.gov (United States)

    Strunecký, Otakar; Elster, Josef; Komárek, Jiří

    2012-11-01

    Cyanobacteria are well adapted to freezing and desiccation; they have been proposed as possible survivors of comprehensive Antarctic glaciations. Filamentous types from the order Oscillatoriales, especially the species Phormidium autumnale Kützing ex Gomont 1892, have widely diverse morphotypes that dominate in Antarctic aquatic microbial mats, seepages, and wet soils. Currently little is known about the dispersion of cyanobacteria in Antarctica and of their population history. We tested the hypothesis that cyanobacteria survived Antarctic glaciations directly on site after the Gondwana breakup by using the relaxed and strict molecular clock in the analysis of the 16S rRNA gene. We estimated that the biogeographic history of Antarctic cyanobacteria belonging to P. autumnale lineages has ancient origins. The oldest go further back in time than the breakup of Gondwana and originated somewhere on the supercontinent between 442 and 297 Ma. Enhanced speciation rate was found around the time of the opening of the Drake Passage (c. 31-45 Ma) with beginning of glaciations (c. 43 Ma). Our results, based primarily on the strains collected in maritime Antarctica, mostly around James Ross Island, support the hypothesis that long-term survival took place in glacial refuges. The high morphological diversification of P. autumnale suggested the coevolution of lineages and formation of complex associations with different morphologies, resulting in a specific endemic Antarctic cyanobacterial flora. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  16. Association of bystander cardiopulmonary resuscitation and survival according to ambulance response-times after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik

    2016-01-01

    Background: Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective...... was to examine the association of bystander CPR with survival as time to advanced treatment increases. Methods: We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry. Multiple logistic regression analysis was used...... out-of-hospital cardiac arrest statistics, an additional 233 patients could potentially be saved annually if response time was reduced from 10 to 5 minutes and 119 patients if response time was reduced from 7 (the median response time in this study) to 5 minutes. Conclusions: The absolute survival...

  17. Twins--twice more trouble?

    Science.gov (United States)

    Santolaya, Joaquin; Faro, Revital

    2012-03-01

    Twin gestations are fascinating and are also high-risk pregnancies. They account for approximately 3% of all pregnancies in the United States. Major obstetrical complications associated with twin pregnancies include hypertensive disorders of pregnancy, gestational diabetes, and preterm delivery. In addition, the death rate for twins and the rate of severe handicap in very low birth weight survivors of twin pregnancies is greater than that for singleton pregnancies. Ultrasound allows for stepwise evaluations at any time during a twin gestation. Current evidence suggests that uncomplicated diamniotic twins with concordant and appropriate growth beyond 24 weeks' gestation should be managed conservatively and the time and mode of delivery should be determined on the basis of obstetrical history and fetal presentations. Perinatal management of the remaining twin pregnancies depends on good clinical judgment, which is improved by the use of ultrasound imaging.

  18. Survival analysis using S analysis of time-to-event data

    CERN Document Server

    Tableman, Mara

    2003-01-01

    Survival Analysis Using S: Analysis of Time-to-Event Data is designed as a text for a one-semester or one-quarter course in survival analysis for upper-level or graduate students in statistics, biostatistics, and epidemiology. Prerequisites are a standard pre-calculus first course in probability and statistics, and a course in applied linear regression models. No prior knowledge of S or R is assumed. A wide choice of exercises is included, some intended for more advanced students with a first course in mathematical statistics. The authors emphasize parametric log-linear models, while also detailing nonparametric procedures along with model building and data diagnostics. Medical and public health researchers will find the discussion of cut point analysis with bootstrap validation, competing risks and the cumulative incidence estimator, and the analysis of left-truncated and right-censored data invaluable. The bootstrap procedure checks robustness of cut point analysis and determines cut point(s). In a chapter ...

  19. Time trend analysis of primary tumor resection for stage IV colorectal cancer: less surgery, improved survival.

    Science.gov (United States)

    Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy; Skibber, John M; Rodriguez-Bigas, Miguel A; Feig, Barry W; Chang, George J

    2015-03-01

    With the advent of effective modern chemotherapeutic and biologic agents, primary tumor resection for patients with stage IV colorectal cancer (CRC) may not be routinely necessary. To evaluate the secular patterns of primary tumor resection use in stage IV CRC in the United States. A retrospective cohort study using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results CRC registry. Demographic and clinical factors were compared for 64,157 patients diagnosed with stage IV colon or rectal cancer from January 1, 1988, through December 31, 2010, who had undergone primary tumor resection and those who had not. Rates of primary tumor resection and median relative survival were calculated for each year. Joinpoint regression analysis was used to determine when a significant change in trend in the primary tumor resection rate had occurred. Logistic regression analysis was used to assess factors associated with primary tumor resection. Difference in primary tumor resection rates over time. Of the 64,157 patients with stage IV CRC, 43,273 (67.4%) had undergone primary tumor resection. The annual rate of primary tumor resection decreased from 74.5% in 1988 to 57.4% in 2010 (Ptrend toward fewer primary tumor resections was seen. Despite the decreasing primary tumor resection rate, patient survival rates improved. However, primary tumor resection may still be overused, and current treatment practices lag behind evidence-based treatment guidelines.

  20. Splenectomy increases the survival time of heart allograft via developing immune tolerance

    Science.gov (United States)

    2013-01-01

    Background The spleen is an active lymphoid organ. The effect of splenectomy on the immune response remains unclear. This study investigated whether splenectomy can induce immune tolerance and has a beneficial role in cardiac allograft. Methods Wistar rats were used for heart donors. The Sprague–Dawley (SD) rats designated as the recipients of heart transplantation (HT) were randomly assigned into four groups: sham, splenectomy, HT, splenectomy + HT. The survival of transplanted hearts was assessed by daily checking of abdominal palpation. At various time points after transplantation, the transplanted hearts were collected and histologically examined; the level of CD4+CD25+ T regulatory lymphocytes (Tregs) and rate of lymphocyte apoptosis (annexin-v+ PI+ cells) in the blood were analyzed by using flow cytometric method. Results 1) Splenectomy significantly prolonged the mean survival time of heart allografts (7 ± 1.1 days and 27 ± 1.5 days for HT and splenectomy + HT, respectively; n = 12-14/group, HT vs. splenectomy + HT, p Splenectomy delayed pathological changes (inflammatory cell infiltration, myocardial damage) of the transplanted hearts in splenectomy + HT rats; 3) The level of CD4+CD25+ Tregs in the blood of splenectomized rats was significantly increased within 7 days (2.4 ± 0.5%, 4.9 ± 1.3% and 5.3 ± 1.0% for sham, splenectomy and splenectomy + HT, respectively; n = 15/group, sham vs. splenectomy or splenectomy + HT, p splenectomy surgery and gradually decreased to baseline level; 4) Splenectomy increased the rate of lymphocyte apoptosis (day 7: 0.3 ± 0.05%, 3.9 ± 0.9% and 4.1 ± 0.9% for sham, splenectomy and splenectomy + HT, respectively; n = 15/group, sham vs. splenectomy or splenectomy + HT, p Splenectomy inhibits the development of pathology and prolongs the survival time of cardiac allograft. The responsible mechanism is associated with induction of immune

  1. Time-Varying Effects of Prognostic Factors Associated With Disease-Free Survival in Breast Cancer

    Science.gov (United States)

    Natarajan, Loki; Pu, Minya; Parker, Barbara A.; Thomson, Cynthia A.; Caan, Bette J.; Flatt, Shirley W.; Madlensky, Lisa; Hajek, Richard A.; Al-Delaimy, Wael K.; Saquib, Nazmus; Gold, Ellen B.

    2009-01-01

    Early detection and effective treatments have dramatically improved breast cancer survivorship, yet the risk of relapse persists even 15 years after the initial diagnosis. It is important to identify prognostic factors for late breast cancer events. The authors investigated time-varying effects of tumor characteristics on breast-cancer-free survival using data on 3,088 breast cancer survivors from 4 US states who participated in a randomized dietary intervention trial in 1995–2006, with maximum follow-up through 15 years (median, 9 years). A piecewise constant penalized spline approach incorporating time-varying coefficients was adopted, allowing for deviations from the proportional hazards assumption. This method is more flexible than standard approaches, provides direct estimates of hazard ratios across time intervals, and is computationally tractable. Having a stage II or III tumor was associated with a 3-fold higher hazard of breast cancer than having a stage I tumor during the first 2.5 years after diagnosis; this hazard ratio decreased to 2.1 after 7.7 years, but higher tumor stage remained a significant risk factor. Similar diminishing effects were found for poorly differentiated tumors. Interestingly, having a positive estrogen receptor status was protective up to 4 years after diagnosis but detrimental after 7.7 years (hazard ratio = 1.5). These results emphasize the importance of careful statistical modeling allowing for possibly time-dependent effects in long-term survivorship studies. PMID:19403844

  2. Practical considerations when analyzing discrete survival times using the grouped relative risk model.

    Science.gov (United States)

    Altman, Rachel MacKay; Henrey, Andrew

    2017-10-11

    The grouped relative risk model (GRRM) is a popular semi-parametric model for analyzing discrete survival time data. The maximum likelihood estimators (MLEs) of the regression coefficients in this model are often asymptotically efficient relative to those based on a more restrictive, parametric model. However, in settings with a small number of sampling units, the usual properties of the MLEs are not assured. In this paper, we discuss computational issues that can arise when fitting a GRRM to small samples, and describe conditions under which the MLEs can be ill-behaved. We find that, overall, estimators based on a penalized score function behave substantially better than the MLEs in this setting and, in particular, can be far more efficient. We also provide methods of assessing the fit of a GRRM to small samples.

  3. Irradiation shortens the survival time of red cells deficient in glucose-6-phosphate dehydrogenasee

    Energy Technology Data Exchange (ETDEWEB)

    Westerman, M.P. (Rush Medical College, Chicago, IL); Wald, N.; Diloy-Puray, M.

    1980-03-01

    X radiation of glucose-6-phosphate dehydrogenase (G6PD)-deficient red cells causes distinct shortening of their survival time. This is accompanied by significant lowering of reduced glutathione content and is not observed in similarly prepared and treated normal cells. The damage is most likely related to irradiation-induced formation of activated oxygen products and to their subsequent effects on the cells. Neither methemoglobin increases nor Heinz body formation were observed, suggesting that hemolysis occurred prior to these changes. The study provides a model for examining the effects of irradiation and activated oxygen on red cells and suggests that patients with G6PD deficiency who receive irradiation could develop severe hemolysis in certain clinical settings.

  4. Taxation’s Troubling Toxicity

    Directory of Open Access Journals (Sweden)

    Janet E. Milne

    2015-03-01

    Full Text Available Occupy Wall Street spurred cries of indignation, including calls to reform the tax code. This article examines the difficulty of raising taxes in the United States at a time when the federal government faces many needs and new taxes could help address the growing income disparity. In Part 1, it looks at several trends—the substantial federal deficit and rising debt, the lack of funding for infrastructure, and increasing income disparity among US residents—to establish the premise that resistance to higher taxes is troublesome. The article then turns to the question why taxes are viewed negatively. It surveys literature about the general public’s attitudes toward taxation (Part 2 and the intensely political views of taxation on and surrounding Capitol Hill (Part 3. Parts 2 and 3 confirm the challenges of raising federal taxes and find a range of forces at work with varying levels of intensity. Part 4 looks forward and considers mechanisms that might help overcome the perception of taxes as politically poisonous and increase their acceptance. The article draws on research from numerous disciplines, but its analysis of potential paths forward looks through the lens of the law at ways in which various legal procedures and legally oriented approaches might help overcome resistance. It concludes that taxation is politically toxic, which is troublesome given the important roles that taxation plays in society, but that there are some glimmers of hope that the structure and details of the law may help create some opportunities for change. Occupy Wall Street impulsó gritos de indignación, incluyendo una llamada a reformar el código tributario. Este artículo analiza la dificultad de aumentar los impuestos en Estados Unidos, en un momento en el que el gobierno federal se enfrenta a muchas necesidades, y la creación de nuevos impuestos podría ayudar a abordar la creciente disparidad de ingresos. En la Parte 1, se tratan diversas tendencias

  5. Survival analysis and prognostic factors of timing of first childbirth among women in Nigeria.

    Science.gov (United States)

    Fagbamigbe, Adeniyi Francis; Idemudia, Erhabor Sunday

    2016-05-13

    First childbirth in a woman's life is one of the most important events in her life. It marks a turnaround when she might have to drop roles of career building and education, for motherhood and parenthood. The timing of the commencement of these roles affects the child bearing behavior of women as they progress in their reproductive ages. Prevalent early first childbirth in Nigeria has been reported as the main cause of high population growth and high  fertility, mortality and morbidity among women, but little has been documented on the progression into first birth as well as factors affecting it in Nigeria. This paper modelled timing of first birth among women in Nigeria and determined socio-demographic and other factors affecting its timing. We hypothesized that background characteristics of a woman will influence her progression into having first birth. We developed and fitted a survival analysis model to understand the timing of first birth among women in Nigeria using a national representative 2013 NDHS data. Women with no children were right censored as of the date of the survey. The Kaplan Meier survival function was used to estimate the probabilities of first birth not occurring until certain ages of women while Cox proportional hazard regression was used to model the timing of first births at 5 % significance level. About 75.7 % of the respondents had given birth in the Northern region of Nigerian compared with 63.8 % in the South. Half (50.1 %) of the first childbirth occurred within the 15-19 years age bracket and 38.1 % within 20-29 years. The overall median survival time to first birth was 20 years (North 19, South 22), 27 years among women with higher education and 18 years for those with no formal education. The adjusted hazard of first birth was higher in the Northern region of Nigeria than in the South (aHR = 1.24, 95 % CI: 1.20-1.27), and higher in rural areas than in urban areas (aHR = 1.15, 95 % CI: 1.12-1.19). Also, hazard of earlier first

  6. The effect of timing of the first kidney transplantation on survival in children initiating renal replacement therapy

    DEFF Research Database (Denmark)

    Kramer, Anneke; Stel, Vianda S; Geskus, Ronald B

    2012-01-01

    Controversy exists concerning the timing of the first kidney transplantation for children who need to start renal replacement therapy (RRT). Our aim was to estimate the effect of timing of the first transplantation on patient survival in children, for the first time also taking into account...

  7. A mixed linear model controlling for case underascertainment across multiple cancer registries estimated time trends in survival.

    Science.gov (United States)

    Dahm, Stefan; Bertz, Joachim; Barnes, Benjamin; Kraywinkel, Klaus

    2018-01-10

    Large temporal and geographical variation in survival rates estimated from epidemiological cancer registries coupled with heterogeneity in death certificate only (DCO) notifications makes it difficult to interpret trends in survival. The aim of our study is to introduce a method for estimating such trends while accounting for heterogeneity in DCO notifications in a cancer site-specific manner. We used the data of 4.0 million cancer cases notified in 14 German epidemiological cancer registries. Annual 5-year relative survival rates from 2002 through 2013 were estimated, and proportions of DCO notifications were recorded. "DCO-excluded" survival rates were regressed on DCO proportions and calendar years using a mixed linear model with cancer registry as a random effect. Based on this model, trends in survival rates were estimated for Germany at 0% DCO. For most cancer sites and age groups, we estimated significant positive trends in survival. Age-standardized survival for all cancers combined increased by 7.1% units for women and 10.8% units for men. The described method could be used to estimate trends in cancer survival based on the data from epidemiological cancer registries with differing DCO proportions and with changing DCO proportions over time. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. The troubled employee. Legal and ethical considerations in managing the troubled employee.

    Science.gov (United States)

    Ament, W W

    1986-01-01

    Programs installed to deal with troubled employees are not simple to design because of many legal and ethical issues. The best interest of the employer can be in conflict with individual freedoms and result in a dilemma. The author addresses ethical, constitutional, and other legal considerations that bear.

  9. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone.

  10. Analysis of multilevel grouped survival data with time-varying regression coefficients.

    Science.gov (United States)

    Wong, May C M; Lam, K F; Lo, Edward C M

    2011-02-10

    Correlated or multilevel grouped survival data are common in medical and dental research. Two common approaches to analyze such data are the marginal and the random-effects approaches. Models and methods in the literature generally assume that the treatment effect is constant over time. A researcher may be interested in studying whether the treatment effects in a clinical trial vary over time, say fade out gradually. This is of particular clinical value when studying the long-term effect of a treatment. This paper proposed to extend the random effects grouped proportional hazards models by incorporating the possibly time-varying covariate effects into the model in terms of a state-space formulation. The proposed model is very flexible and the estimation can be performed using the MCMC approach with non-informative priors in the Bayesian framework. The method is applied to a data set from a prospective clinical trial investigating the effectiveness of silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish in arresting active dentin caries in the Chinese preschool children. It is shown that the treatment groups with caries removal prior to the topical fluoride applications are most effective in shortening the arrest times in the first 6-month interval, but their effects fade out rapidly since then. The effects of treatment groups without caries removal prior to topical fluoride application drop at a very slow rate and can be considered as more or less constant over time. The applications of SDF solution is found to be more effective than the applications of NaF vanish. Copyright © 2010 John Wiley & Sons, Ltd.

  11. Predicting time to recall in patients conditionally released from a secure forensic hospital: A survival analysis.

    Science.gov (United States)

    Jewell, Amelia; Cocks, Christopher; Cullen, Alexis E; Fahy, Tom; Dean, Kimberlie

    2018-01-17

    The recall of conditionally discharged forensic patients in England is a formal order from the Ministry of Justice under the Mental Health Act (1983) which has the power to revoke conditional release and direct readmission to hospital. Recall has significant implications for the individual and for hospital services, but despite this, little is known about predictors of recall for forensic patients. We examined the rate of recall for 101 patients conditionally discharged from medium secure forensic inpatient services between 2007 and 2013. Demographic, clinical, and forensic factors were examined as possible predictors of time to recall using Cox regression survival techniques. Conditionally discharged patients were followed for an average of 811 days, during which 45 (44.5%) were recalled to hospital. Younger age (HR 1.89; 95% CI 1.02-3.49; p = 0.04), non-white ethnicity (HR 3.44; 95% CI 1.45-8.13), substance abuse history (HR 2.52; 95% CI 1.17-5.43), early violence (HR 1.90; 95% CI 1.03-3.50), early childhood maladjustment (HR 1.92; 95% CI 1.01-3.68), treatment with a depot medication (HR 2.17; 95% CI 1.14-4.11), being known to mental health services (HR 3.44; 95% CI 1.06-11.16), and a psychiatric admission prior to the index admission (HR 2.44; 95% CI 1.08-5.52) were significantly associated with a shorter time to recall. Treatment with clozapine reduced the risk of recall to hospital (HR 0.40; 95% CI 0.20-0.79). Time to recall can be predicted by a range of factors that are readily available to clinical teams. Further research is required to determine if targeted interventions can modify the likelihood or time to recall for conditionally released forensic patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. The effect of time to defibrillation and targeted temperature management on functional survival after out-of-hospital cardiac arrest.

    Science.gov (United States)

    Drennan, Ian R; Lin, Steve; Thorpe, Kevin E; Morrison, Laurie J

    2014-11-01

    Cardiac arrest physiology has been proposed to occur in three distinct phases: electrical, circulatory and metabolic. There is limited research evaluating the relationship of the 3-phase model of cardiac arrest to functional survival at hospital discharge. Furthermore, the effect of post-cardiac arrest targeted temperature management (TTM) on functional survival during each phase is unknown. To determine the effect of TTM on the relationship between the time of initial defibrillation during each phase of cardiac arrest and functional survival at hospital discharge. This was a retrospective observational study of consecutive adult (≥18 years) out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythms. Included patients obtained a return of spontaneous circulation (ROSC) and were eligible for TTM. Multivariable logistic regression was used to determine predictors of functional survival at hospital discharge. There were 20,165 OHCA treated by EMS and 871 patients were eligible for TTM. Of these patients, 622 (71.4%) survived to hospital discharge and 487 (55.9%) had good functional survival. Good functional survival was associated with younger age (OR 0.94; 95% CI 0.93-0.95), shorter times from collapse to initial defibrillation (OR 0.73; 95% CI 0.65-0.82), and use of post-cardiac arrest TTM (OR 1.49; 95% CI 1.07-2.30). Functional survival decreased during each phase of the model (65.3% vs. 61.7% vs. 50.2%, Pdefibrillation and was decreased during each successive phase of the 3-phase model. Post-cardiac arrest TTM was associated with improved functional survival. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Restricted mean survival time over 15 years for patients starting renal replacement therapy.

    Science.gov (United States)

    Couchoud, Cécile; Dantony, Emmanuelle; Elsensohn, Mad-Hélénie; Villar, Emmanuel; Vigneau, Cécile; Moranne, Olivier; Rabilloud, Muriel; Ecochard, René

    2017-04-01

    The restricted mean survival time (RMST) estimates life expectancy up to a given time horizon and can thus express the impact of a disease. The aim of this study was to estimate the 15-year RMST of a hypothetical cohort of incident patients starting renal replacement therapy (RRT), according to their age, gender and diabetes status, and to compare it with the expected RMST of the general population. Using data from 67 258 adult patients in the French Renal Epidemiology and Information Network (REIN) registry, we estimated the RMST of a hypothetical patient cohort (and its subgroups) for the first 15 years after starting RRT (cRMST) and used the general population mortality tables to estimate the expected RMST (pRMST). Results were expressed in three different ways: the cRMST, which calculates the years of life gained under the hypothesis of 100% death without RRT treatment, the difference between the pRMST and the cRMST (the years lost), and a ratio expressing the percentage reduction of the expected RMST: (pRMST - cRMST)/pRMST. Over their first 15 years of RRT, the RMST of end-stage renal disease (ESRD) patients decreased with age, ranging from 14.3 years in patients without diabetes aged 18 years at ESRD to 1.8 years for those aged 90 years, and from 12.7 to 1.6 years, respectively, for those with diabetes; expected RMST varied from 15.0 to 4.1 years between 18 and 90 years. The number of years lost in all subgroups followed a bell curve that was highest for patients aged 70 years. After the age of 55 years in patients with and 70 years in patients without diabetes, the reduction of the expected RMST was >50%. While neither a clinician nor a survival curve can predict with absolute certainty how long a patient will live, providing estimates on years gained or lost, or percentage reduction of expected RMST, may improve the accuracy of the prognostic estimates that influence clinical decisions and information given to patients.

  14. Time preference and its relationship with age, health, and survival probability

    Directory of Open Access Journals (Sweden)

    Li-Wei Chao

    2009-02-01

    Full Text Available Although theories from economics and evolutionary biology predict that one's age, health, and survival probability should be associated with one's subjective discount rate (SDR, few studies have empirically tested for these links. Our study analyzes in detail how the SDR is related to age, health, and survival probability, by surveying a sample of individuals in townships around Durban, South Africa. In contrast to previous studies, we find that age is not significantly related to the SDR, but both physical health and survival expectations have a U-shaped relationship with the SDR. Individuals in very poor health have high discount rates, and those in very good health also have high discount rates. Similarly, those with expected survival probability on the extremes have high discount rates. Therefore, health and survival probability, and not age, seem to be predictors of one's SDR in an area of the world with high morbidity and mortality.

  15. The economic impact of the Troubled Assets Relief Programme ...

    African Journals Online (AJOL)

    The economic impact of the Troubled Assets Relief Programme (TARP) in the USA: an assessment of the level to which an optimal allocation of funds occurred. ... within this model: whether the Troubled Assets Relief Programme (TARP)1 bailout will give rise to greater economic effi ciencies and productivity, which would ...

  16. Troubled Ruminations about Parents: Conceptualization and Validation with Emerging Adults

    Science.gov (United States)

    Schwartz, Seth J.; Finley, Gordon E.

    2010-01-01

    This study was designed to introduce the construct of troubled ruminations about parents and to develop a brief screening instrument. An ethnically diverse sample of 1,376 university students completed the instrument and other measures of psychosocial functioning. Troubled ruminations about mothers and fathers were related to self-esteem, life…

  17. Dietary magnesium and copper affect survival time and neuroinflammation in chronic wasting disease.

    Science.gov (United States)

    Nichols, Tracy A; Spraker, Terry R; Gidlewski, Thomas; Cummings, Bruce; Hill, Dana; Kong, Qingzhong; Balachandran, Aru; VerCauteren, Kurt C; Zabel, Mark D

    2016-05-03

    Chronic wasting disease (CWD), the only known wildlife prion disease, affects deer, elk and moose. The disease is an ongoing and expanding problem in both wild and captive North American cervid populations and is difficult to control in part due to the extreme environmental persistence of prions, which can transmit disease years after initial contamination. The role of exogenous factors in CWD transmission and progression is largely unexplored. In an effort to understand the influence of environmental and dietary constituents on CWD, we collected and analyzed water and soil samples from CWD-negative and positive captive cervid facilities, as well as from wild CWD-endozootic areas. Our analysis revealed that, when compared with CWD-positive sites, CWD-negative sites had a significantly higher concentration of magnesium, and a higher magnesium/copper (Mg/Cu) ratio in the water than that from CWD-positive sites. When cevidized transgenic mice were fed a custom diet devoid of Mg and Cu and drinking water with varied Mg/Cu ratios, we found that higher Mg/Cu ratio resulted in significantly longer survival times after intracerebral CWD inoculation. We also detected reduced levels of inflammatory cytokine gene expression in mice fed a modified diet with a higher Mg/Cu ratio compared to those on a standard rodent diet. These findings indicate a role for dietary Mg and Cu in CWD pathogenesis through modulating inflammation in the brain.

  18. Long-Time Survival of a Patient with Metastatic Pancreatic Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Željko Soldić

    2011-08-01

    Full Text Available Pancreatic cancer is a malignant neoplasm of the pancreas. It does not cause any symptoms in the early stage, and later symptoms are nonspecific, thus the disease is usually diagnosed when already advanced. In 2008, pancreatic cancer ranked eighth on the list of the 10 most common cancers among men in Croatia and tenth on the list of the most common cancers among Croatian women. Pancreatic cancer has a poor prognosis, with a survival time of only 6–8 months for metastatic disease. Gemcitabine is the standard chemotherapeutic option. Other chemotherapeutic agents include5-fluorouracil and leucovorin. In this paper, we present a case of a patient diagnosed with locally advanced and metastatic pancreatic cancer, who is still alive and currently receives his fourth line of chemotherapy 5 years after the diagnosis. Following disease progression on gemcitabine chemotherapy, he was treated with chemoradiotherapy which, however, had no effect. We then applied cisplatin monochemotherapy which offered excellent disease control, was well tolerated by the patient and, although somewhat obsolete in this form, showed to be a valuable chemotherapeutic option.

  19. The accuracy of survival time prediction for patients with glioma is improved by measuring mitotic spindle checkpoint gene expression.

    Directory of Open Access Journals (Sweden)

    Li Bie

    Full Text Available Identification of gene expression changes that improve prediction of survival time across all glioma grades would be clinically useful. Four Affymetrix GeneChip datasets from the literature, containing data from 771 glioma samples representing all WHO grades and eight normal brain samples, were used in an ANOVA model to screen for transcript changes that correlated with grade. Observations were confirmed and extended using qPCR assays on RNA derived from 38 additional glioma samples and eight normal samples for which survival data were available. RNA levels of eight major mitotic spindle assembly checkpoint (SAC genes (BUB1, BUB1B, BUB3, CENPE, MAD1L1, MAD2L1, CDC20, TTK significantly correlated with glioma grade and six also significantly correlated with survival time. In particular, the level of BUB1B expression was highly correlated with survival time (p<0.0001, and significantly outperformed all other measured parameters, including two standards; WHO grade and MIB-1 (Ki-67 labeling index. Measurement of the expression levels of a small set of SAC genes may complement histological grade and other clinical parameters for predicting survival time.

  20. Time trends in population-based breast cancer survival in Estonia: analysis by age and stage.

    Science.gov (United States)

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

    2014-02-01

    Survival from breast cancer (BC) in Estonia has been consistently among the lowest in Europe. The aim of this study was to examine most recent trends in BC survival in Estonia by age and stage. The trends in overall BC incidence and mortality are also shown in the paper. Estonian Cancer Registry data on all cases of BC, diagnosed in women in Estonia during 1995-2007 (n = 7424) and followed up for vital status through 2009, were used to estimate relative survival ratios (RSR). Period hybrid approach was used to obtain the most recent estimates (2005-2009). Stage was classified as localized, local/regional spread or distant. BC incidence continued to rise throughout the study period, but mortality has been in steady decline since 2000. The distribution of patients shifted towards older age and earlier stage at diagnosis. Overall age-standardized five-year RSR increased from 63% in 1995-1999 to 74% in 2005-2009. Younger age groups experienced a more rapid improvement compared to women over 60. Significant survival increase was observed for both localized and locally/regionally spread BC with five-year RSRs reaching 96% and 70% in 2005-2009, respectively; the latest five-year RSR for distant BC was 11%. Survival for T4 tumors was poor and large age difference was seen for locally/regionally spread BC. Considerable improvement in BC survival was observed over the study period. Women under 60 benefited most from both earlier diagnosis and treatment advances of locally/regionally spread cancers. However, the survival gap with more developed countries persists. Further increase in survival, but also decline in BC mortality in Estonia could be achieved by facilitating early diagnosis in all age groups, but particularly among women over 60. Investigations should continue to clarify the underlying mechanisms of the stage-specific survival deficit in Estonia.

  1. The Northern Ireland troubles and limb loss: a retrospective study.

    Science.gov (United States)

    Graham, L E; Parke, R C

    2004-12-01

    The Troubles in Northern Ireland have now lasted 34 years. Divisions and strife between the opposing loyalist and republican communities, and between the communities and the security forces, have led to thousands of deaths and injuries. The violence has often been indiscriminate injuring and killing totally innocent people. Staff at the Regional Disablement Services at Musgrave Park Hospital, Belfast have had the responsibility for helping to rehabilitate those who have suffered limb loss, both civilians and security forces personnel. In this study the authors present patient demographics for those survivors, referred for prosthetic fitting, who have sustained limb amputations as a result of the Troubles from 1969 to 2003, with the cause of injury, resulting levels of amputation, associated injuries, time to first prosthetic fitting and reason for any delay in fitting identified. One hundred and twenty-nine (129) patients sustained amputations, 110 male and 19 female with an age range at the time of injury from 7 to 60 years. Seventy-two (72) were civilian. Ninety-three (93) underwent immediate amputation, the most frequent level of amputation being trans-femoral. Delayed healing of deep wounds was the most common reason for delayed amputation; other causes were chronic osteomyelitis, malunited fractures and failed arthrodesis, often associated with chronic pain. Ninety-two (92) patients required amputation of one limb or part thereof, 35 required amputation of 2 limbs and 2 underwent triple amputation. Three (3) patients lost both hands. Sixty seven percent (67%) had other associated physical injuries. Thirty-two (32) patients had a delay of 6 months or more in fitting a prosthesis. The most common cause of injury was the car bomb.

  2. Surviving blind decomposition: A distributional analysis of the time-course of complex word recognition.

    Science.gov (United States)

    Schmidtke, Daniel; Matsuki, Kazunaga; Kuperman, Victor

    2017-11-01

    The current study addresses a discrepancy in the psycholinguistic literature about the chronology of information processing during the visual recognition of morphologically complex words. Form-then-meaning accounts of complex word recognition claim that morphemes are processed as units of form prior to any influence of their meanings, whereas form-and-meaning models posit that recognition of complex word forms involves the simultaneous access of morphological and semantic information. The study reported here addresses this theoretical discrepancy by applying a nonparametric distributional technique of survival analysis (Reingold & Sheridan, 2014) to 2 behavioral measures of complex word processing. Across 7 experiments reported here, this technique is employed to estimate the point in time at which orthographic, morphological, and semantic variables exert their earliest discernible influence on lexical decision RTs and eye movement fixation durations. Contrary to form-then-meaning predictions, Experiments 1-4 reveal that surface frequency is the earliest lexical variable to exert a demonstrable influence on lexical decision RTs for English and Dutch derived words (e.g., badness; bad + ness), English pseudoderived words (e.g., wander; wand + er) and morphologically simple control words (e.g., ballad; ball + ad). Furthermore, for derived word processing across lexical decision and eye-tracking paradigms (Experiments 1-2; 5-7), semantic effects emerge early in the time-course of word recognition, and their effects either precede or emerge simultaneously with morphological effects. These results are not consistent with the premises of the form-then-meaning view of complex word recognition, but are convergent with a form-and-meaning account of complex word recognition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Trouble Seeing. Trouble Walking. Know Stroke, Know the Signs, Act in Time. Announcer: Most people know what ... a stroke, but you need to know the signs and act in time. Here are the signs ...

  4. Association of serum lipid levels over time with survival in incident peritoneal dialysis patients.

    Science.gov (United States)

    Park, Cheol Ho; Kang, Ea Wha; Park, Jung Tak; Han, Seung Hyeok; Yoo, Tae-Hyun; Kang, Shin-Wook; Chang, Tae Ik

    The association of dyslipidemia with mortality has not been fully evaluated in patients on peritoneal dialysis (PD). Moreover, changes in lipids levels over time and associated death risk have not yet been studied in this population. We studied the association of time-updated serum lipid concentrations with all-cause and cardiovascular (CV) mortalities in a 10-year cohort of 749 incident PD patients. Association was assessed using time-varying Cox proportional hazard regression models with adjustment for multiple variables including statin therapy. During a median follow-up of 36 (interquartile range, 21-61) months, 273 all-cause and 107 CV deaths occurred. Compared with those with total cholesterol (TC) of 180 to <210 or low-density lipoprotein cholesterol (LDL-C) of 100 to <130 mg/dL, hazard ratios (95% confidence interval) of the lowest TC (<150 mg/dL) and LDL-C (<70 mg/dL) were 2.32 (1.61-3.35) and 2.02 (1.45-2.83) for all-cause mortality and 1.87 (1.04-3.37) and 1.92 (1.13-3.26) for CV mortality, respectively. Lower triglyceride (<100 mg/dL) and high-density lipoprotein cholesterol (<30 mg/dL) levels were associated with higher all-cause mortality (1.66 [1.11-2.47] and 1.57 [1.08-2.29]) but not with CV mortality. Contrary to the general population, lower TC and LDL-C levels over time were significantly associated with both worse survival and increased CV mortality in incident PD patients. Although lower triglyceride and high-density lipoprotein cholesterol concentrations were associated with significantly higher all-cause mortality, they failed to show any clear association with CV mortality. The underlying mechanisms responsible for this apparent paradox await further investigations. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  5. Entrainment and Survival Time of the Llsvps: Effects of Flow in the Thermochemical Pile Interior

    Science.gov (United States)

    Mulyukova, E.; Steinberger, B. M.; Dabrowski, M.; Sobolev, S. V.

    2013-12-01

    One of the most robust results from tomographic studies is the existence of two antipodally located Large Low Shear Velocity Provinces (LLSVPs) at the base of the mantle, which appear to be chemically denser than the ambient mantle. Results from reconstruction studies (Torsvik et al., 2006) infer that the LLSVPs are stable, long-lived, and are sampled by deep mantle plumes that rise predominantly from their margins. The amount of the anomalous LLSVP-material that gets entrained into the rising plumes poses a constraint on the survival time of the LLSVPs, as well as on the plume buoyancy, on the lithospheric uplift associated with plume interaction and geochemical signature of the erupted lavas observed at the Earth's surface. Recent estimates for the plume responsible for the formation of the Siberian Flood Basalts give about 15% of entrained dense recycled oceanic crust, which made the hot mantle plume almost neutrally buoyant (Sobolev et al., 2011). If it wasn't for the destabilizing flow, or entrainment, by the hot rising plumes, the anomalously dense material in the Earth's deep mantle may have never made its way to the surface. In order for the entrainment to take place, the destabilizing viscous stresses acting on a volume of anomalously dense material must exceed the gravitationally stabilizing stresses associated with buoyancy. At what conditions are these criteria met in a dynamically active deep mantle? To investigate this question, we perform numerical simulations of thermal convection with presence of a chemically dense basal layer in a 2D Cartesian box. In agreement with other studies, we find that the governing parameters are the buoyancy ratio between the thermal and the chemical density anomalies, as well as the viscosity variations. We observe that for a range of these parameters, an internal convective flow in the interior of the dense layer can develop. This internal flow has an important effect on the evolution of the entire system. First of all

  6. Time to adjuvant chemotherapy following colorectal cancer resection is associated with an improved survival.

    Science.gov (United States)

    Day, A R; Middleton, G; Smith, R V P; Jourdan, I C; Rockall, T A

    2014-05-01

    Multicentre randomized trials have demonstrated equivalent long-term outcomes for open and laparoscopic resection of colon cancer. Some studies have indicated a possible survival advantage in certain patients undergoing laparoscopic resection. Patients who receive adjuvant chemotherapy in improved survival. Data were collated for patients having an elective laparoscopic or open resection for non-metastatic colorectal cancer between October 2003 and December 2010 and subsequently having adjuvant chemotherapy. Survival analysis was conducted. In all, 209 patients received adjuvant chemotherapy following open (n = 76) or laparoscopic (n = 133) surgery. Median length of stay was 3 days with laparoscopic resection and 6 days with open resection (P chemotherapy was 52 with laparoscopic resection and 58 with open resection (P = 0.008). The 5-year overall survival was 89.6% in patients receiving chemotherapy in chemotherapy chemotherapy. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  7. Troubling the canon: bisexuality and queer theory.

    Science.gov (United States)

    Gammon, Mark A; Isgro, Kirsten L

    2006-01-01

    This essay explores the notion that bisexuality and contemporary bisexual political movements both align and trouble canons of queer theories of sexuality and gender. This project provides an historical review and assessment of recent bisexual theorizing to highlight key themes in its evolution as well as a discussion of how these themes have shaped the relationship of bisexuality and queer theory. Drawing on this assessment and a wider discussion of GLBT scholarship, we invite critical inquiry regarding the implications of bisexual theorizing on queer theory and vice versa. We address questions of bisexual epistemologies, its discursive roles within queer theory, and its impact on queer politics and organizing. Noting bisexuality's absence in much of this research and scholarship, we suggest these projects have been limited in their ability to fully and effectively address sexual subjectivity both in theory and in its everyday lived experience.

  8. Ozonated olive oils and the troubles

    Science.gov (United States)

    Uysal, Bulent

    2014-01-01

    One of the commonly used methods for ozone therapy is ozonated oils. Most prominent type of used oils is extra virgin olive oil. But still, each type of unsaturated oils may be used for ozonation. There are a lot of wrong knowledge on the internet about ozonated oils and its use as well. Just like other ozone therapy studies, also the studies about ozone oils are inadequate to avoid incorrect knowledge. Current data about ozone oil and its benefits are produced by supplier who oversees financial interests and make misinformation. Despite the rapidly increasing ozone oil sales through the internet, its quality and efficacy is still controversial. Dozens of companies and web sites may be easily found to buy ozonated oil. But, very few of these products are reliable, and contain sufficiently ozonated oil. This article aimed to introduce the troubles about ozonated oils and so to inform ozonated oil users. PMID:26401346

  9. Ozonated olive oils and the troubles.

    Science.gov (United States)

    Uysal, Bulent

    2014-01-01

    One of the commonly used methods for ozone therapy is ozonated oils. Most prominent type of used oils is extra virgin olive oil. But still, each type of unsaturated oils may be used for ozonation. There are a lot of wrong knowledge on the internet about ozonated oils and its use as well. Just like other ozone therapy studies, also the studies about ozone oils are inadequate to avoid incorrect knowledge. Current data about ozone oil and its benefits are produced by supplier who oversees financial interests and make misinformation. Despite the rapidly increasing ozone oil sales through the internet, its quality and efficacy is still controversial. Dozens of companies and web sites may be easily found to buy ozonated oil. But, very few of these products are reliable, and contain sufficiently ozonated oil. This article aimed to introduce the troubles about ozonated oils and so to inform ozonated oil users.

  10. Troubled times, troubled relationships: how economic resources, gender beliefs, and neighborhood disadvantage influence intimate partner violence.

    Science.gov (United States)

    Golden, Shelley D; Perreira, Krista M; Durrance, Christine Piette

    2013-07-01

    We evaluate race/ethnicity and nativity-based disparities in three different types of intimate partner violence (IPV) and examine how economic hardship, maternal economic dependency, maternal gender beliefs, and neighborhood disadvantage influence these disparities. Using nationally representative data from urban mothers of young children who are living with their intimate partners (N = 1,886), we estimate a series of unadjusted and adjusted logit models on mothers' reports of physical assault, emotional abuse, and coercion. When their children were age 3, more than one in five mothers were living with a partner who abused them. The prevalence of any IPV was highest among Hispanic (26%) and foreign-born (35%) mothers. Economic hardship, economic dependency on a romantic partner, and traditional gender beliefs each increased women's risk for exposure to one or more types of IPV, whereas neighborhood conditions were not significantly related to IPV in adjusted models. These factors also explained most of the racial/ethnic and nativity disparities in IPV. Policies and programs that reduce economic hardship among women with young children, promote women's economic independence, and foster gender equity in romantic partnerships can potentially reduce multiple forms of IPV.

  11. Breast cancer and leptomeningeal disease (LMD): hormone receptor status influences time to development of LMD and survival from LMD diagnosis.

    Science.gov (United States)

    Yust-Katz, S; Garciarena, P; Liu, D; Yuan, Y; Ibrahim, N; Yerushalmi, R; Penas-Prado, M; Groves, M D

    2013-09-01

    Leptomeningeal disease (LMD) occurs in 5 % of breast cancer patients. The aim of this study was to identify risk factors related to survival and time to development of LMD in breast cancer patients. A retrospective analysis of breast cancer patients with LMD, evaluated in MDACC between 1995 and 2011. 103 patients with diagnosis of breast cancer and LMD were identified (one male). The median age at LMD diagnosis was 49.2 years. 78.2 % had invasive ductal carcinoma. Hormone receptors (HRs) were positive in 55.3 % of patients, 47.4 % were human epidermal growth factor receptor 2-positive and 22.8 % were triple negative. 52 % of the patients were treated with WBRT, 19 % with spinal radiation, 36 % with systemic chemotherapy and 55 % with intrathecal chemotherapy. Estimated median overall survival from time of breast cancer diagnosis was 3.66 years. Median survival from time of LMD diagnosis was 4.2 months. Time from breast cancer diagnosis to LMD was 2.48 years. In multivariate analysis, HR status and stage at diagnosis were significantly associated with time to LMD diagnosis (p < 0.05). In triple negative patients, time to LMD was shorter. In patients who were HR positive, time to LMD was longer. Survival from LMD diagnosis was significantly associated with both treatment, as well as positive HR status (multivariate analysis p < 0.05). In conclusion LMD has dismal prognosis in breast cancer patients. HR status contributes to time to LMD diagnosis and survival from LMD diagnosis. The impact of treatment aimed at LMD cannot be ascertained in our retrospective study due to the inherent bias associated with the decision to treat.

  12. Patients with type 2 diabetes benefit from primary care-based disease management: a propensity score matched survival time analysis.

    Science.gov (United States)

    Drabik, Anna; Büscher, Guido; Thomas, Karsten; Graf, Christian; Müller, Dirk; Stock, Stephanie

    2012-08-01

    This study aimed to assess the impact of a nationwide German diabetes mellitus disease management program (DMP) on survival time and costs in comparison to routine care. The authors conducted a retrospective observational cohort study using routine administration data from Germany's largest sickness fund to identify insured suffering from diabetes in 2002. A total of 95,443 insured with type 2 diabetes mellitus who were born before January 1, 1962 met the defined inclusion criteria, resulting in 19,888 pairs of DMP participants and nonparticipants matched for socioeconomic and health status using propensity score matching methods. This is the first time propensity score matching has been used to evaluate a survival benefit of DMPs. In the time frame analyzed (3 years), mean survival time for the DMP group was 1045 days vs. 985 days for the routine care group (Pdiabetes mellitus in the German Statutory Health Insurance showed a significant benefit in survival time. They also incurred lower costs compared to propensity score matched insured in routine care.

  13. Differences in the timing of cardio-respiratory development determine whether marine gastropod embryos survive or die in hypoxia.

    Science.gov (United States)

    Rudin-Bitterli, Tabitha S; Spicer, John I; Rundle, Simon D

    2016-04-01

    Physiological plasticity of early developmental stages is a key way by which organisms can survive and adapt to environmental change. We investigated developmental plasticity of aspects of the cardio-respiratory physiology of encapsulated embryos of a marine gastropod, Littorina obtusata, surviving exposure to moderate hypoxia (PO2 =8 kPa) and compared the development of these survivors with that of individuals that died before hatching. Individuals surviving hypoxia exhibited a slower rate of development and altered ontogeny of cardio-respiratory structure and function compared with normoxic controls (PO2 >20 kPa). The onset and development of the larval and adult hearts were delayed in chronological time in hypoxia, but both organs appeared earlier in developmental time and cardiac activity rates were greater. The velum, a transient, 'larval' organ thought to play a role in gas exchange, was larger in hypoxia but developed more slowly (in chronological time), and velar cilia-driven, rotational activity was lower. Despite these effects of hypoxia, 38% of individuals survived to hatching. Compared with those embryos that died during development, these surviving embryos had advanced expression of adult structures, i.e. a significantly earlier occurrence and greater activity of their adult heart and larger shells. In contrast, embryos that died retained larval cardio-respiratory features (the velum and larval heart) for longer in chronological time. Surviving embryos came from eggs with significantly higher albumen provisioning than those that died, suggesting an energetic component for advanced development of adult traits. © 2016. Published by The Company of Biologists Ltd.

  14. Determine the Influence of Time Held in “Knockdown” Anesthesia on Survival and Stress of Surgically Implanted Juvenile Salmonids

    Energy Technology Data Exchange (ETDEWEB)

    Woodley, Christa M.; Wagner, Katie A.; Knox, Kasey M.

    2012-01-31

    The Juvenile Salmon Acoustic Telemetry System (JSATS) was developed for the U.S. Army Corp of Engineers Portland District (USACE) to address questions related to survival and performance measures of juvenile salmonids as they pass through the Federal Columbia River Power System (FCRPS). Researchers using JSATS acoustic transmitters (ATs) were tasked with standardizing the surgical implantation procedure to ensure that the stressors of handling and surgery on salmonids were consistent and less likely to cause effects of tagging in survival studies. Researchers questioned whether the exposure time in 'knockdown' anesthesia (or induction) to prepare fish for surgery could influence the survival of study fish (CBSPSC 2011). Currently, fish are held in knockdown anesthesia after they reach Stage 4 anesthesia until the completion of the surgical implantation of a transmitter, varies from 5 to 15 minutes for studies conducted in the Columbia Basin. The Columbia Basin Surgical Protocol Steering Committee (CBSPSC ) expressed concern that its currently recommended 10-minute maximum time limit during which fish are held in anesthetic - tricaine methanesulfonate (MS-222, 80 mg L-1 water) - could increase behavioral and physiological costs, and/or decrease survival of outmigrating juvenile salmonids. In addition, the variability in the time fish are held at Stage 4 could affect the data intended for direct comparison of fish within or among survival studies. Under the current recommended protocol, if fish exceed the 10-minute time limit, they are to be released without surgical implantation, thereby increasing the number of fish handled and endangered species 'take' at the bypass systems for FCRPS survival studies.

  15. Analysis of individual- and time-specific covariate effects on survival of Serinus serinus in north-eastern Spain

    Science.gov (United States)

    Conroy, M.J.; Senar, J.C.; Domenech, J.

    2002-01-01

    We developed models for the analysis of recapture data for 2678 serins (Serinus serinus) ringed in north-eastern Spain since 1985. We investigated several time- and individual-specific factors as potential predictors of overall mortality and dispersal patterns, and of gender and age differences in these patterns. Time-specific covariates included minimum daily temperature, days below freezing, and abundance of a strong competitor, siskins (Carduelis spinus) during winter, and maximum temperature and rainfall during summer. Individual covariates included body mass (i.e. body condition), and wing length (i.e. flying ability), and interactions between body mass and environmental factors. We found little support of a predictive relationship between environmental factors and survival, but good evidence of relationships between body mass and survival, especially for juveniles. Juvenile survival appears to vary in a curvilinear manner with increasing mass, suggesting that there may exist an optimal mass beyond which increases are detrimental. The mass-survival relationship does seem to be influenced by at least one environmental factor, namely the abundance of wintering siskins. When siskins are abundant, increases in body mass appear to relate strongly to increasing survival. When siskin numbers are average or low the relationship is largely reversed, suggesting that the presence of strong competition mitigates the otherwise largely negative aspects of greater body mass. Wing length in juveniles also appears to be related positively to survival, perhaps largely due to the influence of a few unusually large juveniles with adult-like survival. Further work is needed to test these relationships, ideally under experimentation.

  16. Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.

    Science.gov (United States)

    Angthong, Chayanin; Angthong, Wirana; Harnroongroj, Thos; Naito, Masatoshi; Harnroongroj, Thossart

    2013-01-01

    Survival rates are poorer after a second hip fracture than after a first hip fracture. Previous survival studies have included in-hospital mortality. Excluding in-hospital deaths from the analysis allows survival times to be evaluated in community-based patients. There is still a lack of data regarding the effects of subsequent fractures on survival times after hospital discharge following an initial hip fracture. This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival of community-dwelling individuals after hospital discharge or after the time of the fracture if they did not need hospitalization. Demographic data, causes of death, and mortality rates were recorded. Differences in mortality rates between the patient groups and hazard ratios were calculated. Mortality rates during the first year and from 1 to 5 years after the most recent fracture were 5.6% and 1.4%, respectively, in patients with subsequent fractures, and 4.7% and 1.4%, respectively, in patients without subsequent fractures. These rates did not differ significantly between the groups. Cox regression analysis and calculation of hazard ratios did not show significant differences between patients with subsequent fractures and those without. On univariate and multivariate analyses, age fracture. This study found that survival times did not differ significantly between patients with and without subsequent major long-bone fractures after hip fracture. Therefore, all

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Evaluation of the Risk of Relapse in Classical Hodgkin Lymphoma at Event-Free Survival Time Points and Survival Comparison With the General Population in British Columbia.

    Science.gov (United States)

    Hapgood, Greg; Zheng, Yvonne; Sehn, Laurie H; Villa, Diego; Klasa, Richard; Gerrie, Alina S; Shenkier, Tamara; Scott, David W; Gascoyne, Randy D; Slack, Graham W; Parsons, Christina; Morris, James; Pickles, Tom; Connors, Joseph M; Savage, Kerry J

    2016-07-20

    Studies in classical Hodgkin lymphoma (cHL) typically measure the time to events from diagnosis. We evaluated the risk of relapse at event-free survival time points in cHL and compared the risk of death to expected mortality rates in British Columbia (BC). The BC Cancer Agency Lymphoid Cancer Database was screened to identify all patients age 16 to 69 years diagnosed with cHL between 1989 and 2012 treated with the chemotherapy regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (or equivalent). We compared the observed mortality to the general population using age-, sex-, and calendar period-generated expected mortality rates from BC life-tables. Relative survival was calculated using a conditional approach and expressed as a standardized mortality ratio of observed-to-expected deaths. One thousand four hundred two patients were identified; 749 patients were male (53%), the median age was 32 years, and 68% had advanced-stage disease. The median follow-up time was 8.4 years. Seventy-two percent of relapses occurred within the first 2 years of diagnosis. For all patients, the 5-year risk of relapse from diagnosis was 18.1% but diminished to 5.6% for patients remaining event free at 2 years. For advanced-stage patients who were event free at 2 years, the 5-year risk of relapse was only 7.6%, and for those who were event free at 3 years, it was comparable to that of limited-stage patients (4.1% v 2.5%, respectively; P = .07). Furthermore, international prognostic score ≥ 4 and bulky disease were no longer prognostic in patients who were event free at 1 year. Although the relative survival improved as patients remained in remission, it did not normalize compared with the general population. Patients with cHL who are event free at 2 years have an excellent outcome regardless of baseline prognostic factors. All patients with cHL had an enduring increased risk of death compared with the general population. © 2016 by American Society of Clinical Oncology.

  19. The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2016-12-01

    Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

  20. Relationship between Plasma Fibroblast Growth Factor-23 Concentration and Survival Time in Cats with Chronic Kidney Disease.

    Science.gov (United States)

    Geddes, R F; Elliott, J; Syme, H M

    2015-01-01

    Fibroblast growth factor-23 (FGF-23) and parathyroid hormone (PTH) are commonly increased in cats with azotemic chronic kidney disease (CKD). Both are predictors of survival time in human patients, but these relationships have not previously been examined in the cat. To investigate the relationship between plasma FGF-23 and PTH concentrations at diagnosis of CKD in cats with survival time and with disease progression over 12 months. 214 azotemic, client-owned cats (≥9 years). Retrospective study: Biochemical and urinary variables at diagnosis of azotemic CKD, including plasma FGF-23 and PTH concentrations were assessed as predictors of survival time (all-cause mortality) using Cox regression, and as predictors of CKD progression over 12 months using logistic regression. In the final multivariable Cox regression model, survival was negatively associated with plasma creatinine (P = .002) and FGF-23 concentrations (P = .014), urine protein-to-creatinine ratio (P cats with CKD, independent of other factors including plasma creatinine and phosphate concentrations. Further work is required to assess if FGF-23 contributes directly to CKD progression, but regardless these findings may make FGF-23 a useful biomarker for predicting poorer outcomes in cats with CKD. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  1. Prognostic value of a decreased tongue strength for survival time in patients with amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Alexander Geurts; J. Weikamp; J. Hendriks; J. Schelhaas; Bert de Swart

    2012-01-01

    Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in

  2. Prognostic value of decreased tongue strength on survival time in patients with amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Weikamp, J.G.; Schelhaas, H.J.; Hendriks, J.C.M.; Swart, B.J.M. de; Geurts, A.C.H.

    2012-01-01

    Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in

  3. 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

  4. Survival of Patients on Hemodialysis and Predictors of Mortality: a Single-Centre Analysis of Time-Dependent Factors.

    Science.gov (United States)

    Ossareh, Shahrzad; Farrokhi, Farhat; Zebarjadi, Marjan

    2016-11-01

    This study aimed to evaluate the outcome and predictors of survival in hemodialysis patients of Hasheminejad Kidney Center where a comprehensive dialysis care program has been placed since 2004. Data of 560 hemodialysis patients were used to evaluate 9-year survival rates and predictors of mortality. Cox regression models included comorbidities as well as averaged and 6-month-averaged time-dependent values of laboratory findings as independent factors. Survival rates were 91.9%, 66.0%, 46.3%, and 28.5%,  at 1, 3, 5, and 9 years, respectively, in all patients and 90.8%, 61.6%, 42.1%, and 28.0% in 395 incident patients starting hemodialysis after 2004. Adjusted survival models demonstrated age, male sex, diabetes mellitus, cardiovascular disease, and high-risk vascular access as baseline predictors of mortality, as well as averaged low hemoglobin level (hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.36 to 2.90) and a single-pool KT/V patients have relatively comparable survival rates with high-profile dialysis centers. Aiming to better achieve the recommended targets, especially hemoglobin and nutritional and bone metabolism factors, should be considered for optimal dialysis outcomes.

  5. Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival.

    Science.gov (United States)

    van Harten, Michel C; Hoebers, Frank J P; Kross, Kenneth W; van Werkhoven, Erik D; van den Brekel, Michiel W M; van Dijk, Boukje A C

    2015-03-01

    Waiting to start treatment has been shown to be associated with tumor progression and upstaging in head and neck squamous cell carcinomas (HNSCCs). This diminishes the chance of cure and might lead to unnecessary mortality. We investigated the association between waiting times and survival in the Netherlands and assessed which factors were associated to longer waiting times. Patient (age, sex, socioeconomic status (SES), tumor (site, stage) and treatment (type, of institute of diagnosis/treatment) characteristics for patients with HNSCC who underwent treatment were extracted from the Netherlands Cancer Registry (NCR) for 2005-2011. Waiting time was defined as the number of days between histopathological diagnosis and start of treatment. Univariable and multivariable Cox regression was used to evaluate survival. In total, 13,140 patients were included, who had a median waiting time of 37days. Patients who were more likely to wait longer were men, patients with a low SES, oropharynx tumors, stage IV tumors, patients to be treated with radiotherapy or chemoradiation, and patients referred for treatment to a Head and Neck Oncology Center (HNOC) from another hospital. The 5-year overall survival was 58% for all patients. Our multivariable Cox regression model showed that longer waiting time, was significantly related to a higher hazard of dying (p<0.0001). This is the first large population-based study showing that longer waiting time for surgery, radiotherapy or chemoradiation is a significant negative prognostic factor for HNSCC patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. The dwell time and survival rates of PICC placement after balloon angioplasty in patient with unexpected central venous obstruction.

    Science.gov (United States)

    Kim, Ki Hyun; Park, Sang Woo; Chang, Il Soo; Yim, Younghee

    2016-09-21

    To evaluate the dwell time and actual survival rates of peripherally inserted central catheter (PICC) placements after balloon angioplasty in patients with unexpected central venous obstructions. Data were obtained on all PICC insertions performed in a tertiary care hospital from August 2008 to December 2013. Thirty-five PICCs attempted after balloon angioplasty in 25 patients (15 male and 10 female patients; mean age, 63 years). Fisher's exact test was used to test for differences in reasons for catheter removal between the groups of patients with stenosis or obstructions. Survival curves for PICC dwell time of all patients, stenosis group, and obstruction group were generated separately using Kaplan-Meier survival analysis and compared with log-rank tests. There were a total 21 obstructions and 14 stenoses. The overall technical success rate of PICC placement after balloon angioplasty was 94% (33 of 35 procedures). The PICC dwell time was determined for 27 PICCs and ranged from 4 to 165 days (mean, 39.6 days). Among all PICCs, 16 were removed early, resulting in an actual survival rate of 40.7% (11 of 27 PICCs). There were no significant differences in reasons for catheter removal between the stenosis and obstruction groups (p = 0.24). The dwell times for both groups were not significantly different by Kaplan-Meier analysis (p = 0.54). PICC placement after balloon angioplasty is a good treatment option for patients with unexpected central venous lesions, and offers high technical success rates. The actual survival rate was relatively lower (40.7%) than that from previous studies.

  7. Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.

    Directory of Open Access Journals (Sweden)

    Jean-Francois Brasme

    Full Text Available BACKGROUND: The long time to diagnosis of medulloblastoma, one of the most frequent brain tumors in children, is the source of painful remorse and sometimes lawsuits. We analyzed its consequences for tumor stage, survival, and sequelae. PATIENTS AND METHODS: This retrospective population-based cohort study included all cases of pediatric medulloblastoma from a region of France between 1990 and 2005. We collected the demographic, clinical, and tumor data and analyzed the relations between the interval from symptom onset until diagnosis, initial disease stage, survival, and neuropsychological and neurological outcome. RESULTS: The median interval from symptom onset until diagnosis for the 166 cases was 65 days (interquartile range 31-121, range 3-457. A long interval (defined as longer than the median was associated with a lower frequency of metastasis in the univariate and multivariate analyses and with a larger tumor volume, desmoplastic histology, and longer survival in the univariate analysis, but not after adjustment for confounding factors. The time to diagnosis was significantly associated with IQ score among survivors. No significant relation was found between the time to diagnosis and neurological disability. In the 62 patients with metastases, a long prediagnosis interval was associated with a higher T stage, infiltration of the fourth ventricle floor, and incomplete surgical resection; it nonetheless did not influence survival significantly in this subgroup. CONCLUSIONS: We found complex and often inverse relations between time to diagnosis of medulloblastoma in children and initial severity factors, survival, and neuropsychological and neurological outcome. This interval appears due more to the nature of the tumor and its progression than to parental or medical factors. These conclusions should be taken into account in the information provided to parents and in expert assessments produced for malpractice claims.

  8. Effect of length biased sampling of unobserved sojourn times on the survival distribution when disease is screen detected.

    Science.gov (United States)

    Kafadar, Karen; Prorok, Philip C

    2009-07-20

    Data can arise as a length-biased sample rather than as a random sample; e.g. a sample of patients in hospitals or of network cable lines (experimental units with longer stays or longer lines have greater likelihoods of being sampled). The distribution arising from a single length-biased sampling (LBS) time has been derived (e.g. (The Statistical Analysis of Discrete Time Events. Oxford Press: London, 1972)) and applies when the observed outcome relates to the random variable subjected to LBS. Zelen (Breast Cancer: Trends in Research and Treatment. Raven Press: New York, 1976; 287-301) noted that cases of disease detected from a screening program likewise form a length-biased sample among all cases, since longer sojourn times afford greater likelihoods of being screen detected. In contrast to the samples on hospital stays and cable lines, however, the length-biased sojourns (preclinical durations) cannot be observed, although their subsequent clinical durations (survival times) are. This article quantifies the effect of LBS of the sojourn times (or pre-clinical durations) on the distribution of the observed clinical durations when cases undergo periodic screening for the early detection of disease. We show that, when preclinical and clinical durations are positively correlated, the mean, median, and quartiles of the distribution of the clinical duration from screen-detected cases can be substantially inflated-even in the absence of any benefit on survival from the screening procedure. Screening studies that report mean survival time need to take account of the fact that, even in the absence of any real benefit, the mean survival among cases in the screen-detected group will be longer than that among interval cases or among cases that arise in the control arm, above and beyond lead time bias, simply by virtue of the LBS phenomenon

  9. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Stroke Materials  » Loading the player... Video Transcript Weakness on one Side. Trouble Speaking. Trouble ... Stroke: Know the Signs. Act in Time. Ambulance Video Loading the player... This PSA alerts audiences about ...

  10. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Know Stroke Home » Stroke Materials » Loading the player... Video Transcript Weakness on one Side. Trouble Speaking. Trouble ... Stroke: Know the Signs. Act in Time. Ambulance Video Loading the player... This PSA alerts audiences about ...

  11. [Relationships between Serum Albumin and Urea Level and the Clinical Pathological Characteristics and Survival Time in Patients with Lung Cancer].

    Science.gov (United States)

    Li, Yalun; Li, Lei; Zhang, Li; Li, Weimin

    2017-03-20

    Lung cancer is the most common malignancy and is the leading cause of cancer-related death worldwide. Thus, this disease severely threatens human health. This study aims to identify the relationships between serum albumin and urea level and the clinical pathological characteristics and survival time in patients with lung cancer. A total of 1,098 patients with lung cancer were diagnosed by pathology and tested the serum albumin and urea level in West China Hospital of Sichuan University during January 2008 to December 2013. According to the levels of albumin and urea, patients were divided into the normal level group (negative group) and abnormal level group (positive group). The differences of patients' clinical pathological characteristics and survival time in the two groups were analyzed. Differences in age, sex, histological classification, liver metastasis and pleural metastasis were statistically significant between the two groups of serum albumin (Purea. In different histological classification between the two groups of serum albumin, the median survival period of squamous cell carcinoma was 36 months and 19 monthes, adenocarcinoma was 35 months and 15 monthes, the abnormal group were all significantly lower than those in the normal group. The median survival period was no significant difference between the two groups of urea. The level of serum albumin is an important indicator for prognosis.

  12. Meta-analysis of the effects of beta blocker on survival time in cancer patients.

    Science.gov (United States)

    Choi, Chel Hun; Song, Taejong; Kim, Tae Hyun; Choi, Jun Kuk; Park, Jin-Young; Yoon, Aera; Lee, Yoo-Young; Kim, Tae-Joong; Bae, Duk-Soo; Lee, Jeong-Won; Kim, Byoung-Gie

    2014-07-01

    This study was to elucidate the potential benefit of beta blockers on cancer survival. We comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to April 2013. Two authors independently screened and reviewed the eligibility of each study and coded the participants, treatment, and outcome characteristics. The primary outcomes were overall survival (OS) and disease-free survival (DFS). Twelve studies published between 1993 and 2013 were included in the final analysis. Four papers reported results from 10 independent groups, resulting in a total of 18 comparisons based on data obtained from 20,898 subjects. Effect sizes (hazard ratios, HR) were heterogeneous, and random-effects models were used in the analyses. The meta-analysis demonstrated that beta blocker use is associated with improved OS (HR 0.79; 95 % CI 0.67-0.93; p = 0.004) and DFS (HR 0.69; 95 % CI 0.53-0.91; p = 0.009). Although statistically not significant, the effect size was greater in patients with low-stage cancer or cancer treated primarily with surgery than in patients with high-stage cancer or cancer treated primarily without surgery (HR 0.60 vs. 0.78, and 0.60 vs. 0.80, respectively). Although only two study codes were analyzed, the studies using nonselective beta blockers showed that there was no overall effect on OS (HR 0.52, 95 % CI 0.09-3.04). This meta-analysis provides evidence that beta blocker use can be associated with the prolonged survival of cancer patients, especially patients with early-stage cancer treated primarily with surgery.

  13. Fluid Regulation and Time Course of Erythropoietin during Multifactorial Strain of Austrian Special Forces Survival Training

    Science.gov (United States)

    2001-03-01

    It seems that EPO production and release is diminished by nutritional factors, i.e. mainly caloric intake, during prolonged physical strain. In the...sign for a haemolytic anaemia with impaired erythropoiesis (20) which would be in line with decreased EPO values found during the survival training...total body iron stores. The classical biochemical constellation of an haemolytic anaemia might be misleading under the described conditions. The body

  14. Bayesian Variable Selection in High Dimensional Survival Time Cancer Genomic Datasets using Nonlocal Priors

    OpenAIRE

    Nikooienejad, Amir; Wang, Wenyi; Johnson, Valen E.

    2017-01-01

    Variable selection in high dimensional cancer genomic studies has become very popular in the past decade, due to the interest in discovering significant genes pertinent to a specific cancer type. Censored survival data is the main data structure in such studies and performing variable selection for such data type requires certain methodology. With recent developments in computational power, Bayesian methods have become more attractive in the context of variable selection. In this article we i...

  15. Managing hospitals in turbulent times: do organizational changes improve hospital survival?

    Science.gov (United States)

    Lee, S Y; Alexander, J A

    1999-10-01

    To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around.

  16. Using simulation to interpret a discrete time survival model in a complex biological system: fertility and lameness in dairy cows.

    Directory of Open Access Journals (Sweden)

    Christopher D Hudson

    Full Text Available The ever-growing volume of data routinely collected and stored in everyday life presents researchers with a number of opportunities to gain insight and make predictions. This study aimed to demonstrate the usefulness in a specific clinical context of a simulation-based technique called probabilistic sensitivity analysis (PSA in interpreting the results of a discrete time survival model based on a large dataset of routinely collected dairy herd management data. Data from 12,515 dairy cows (from 39 herds were used to construct a multilevel discrete time survival model in which the outcome was the probability of a cow becoming pregnant during a given two day period of risk, and presence or absence of a recorded lameness event during various time frames relative to the risk period amongst the potential explanatory variables. A separate simulation model was then constructed to evaluate the wider clinical implications of the model results (i.e. the potential for a herd's incidence rate of lameness to influence its overall reproductive performance using PSA. Although the discrete time survival analysis revealed some relatively large associations between lameness events and risk of pregnancy (for example, occurrence of a lameness case within 14 days of a risk period was associated with a 25% reduction in the risk of the cow becoming pregnant during that risk period, PSA revealed that, when viewed in the context of a realistic clinical situation, a herd's lameness incidence rate is highly unlikely to influence its overall reproductive performance to a meaningful extent in the vast majority of situations. Construction of a simulation model within a PSA framework proved to be a very useful additional step to aid contextualisation of the results from a discrete time survival model, especially where the research is designed to guide on-farm management decisions at population (i.e. herd rather than individual level.

  17. Effects of interspecific competition, predation, and their interaction on survival and development time of immature Anopheles quadrimaculatus.

    Science.gov (United States)

    Knight, Tiffany M; Chase, Jonathan M; Goss, Charles W; Knight, Jennifer J

    2004-12-01

    We examined the effect of predation by the backswimmer (Notonecta undulata; Hemiptera: Notonectidae), competition by zooplankton and snails, and both predation and competition on the survival and development time of larval Anopheles quadrimaculatus mosquitoes in experimental mesocosms. We found that both predation and interspecific competition greatly reduced the survivorship of larvae and the number of larvae emerging into adulthood. Treatments with both predators and competitors had fewer larvae transitioning among instars and into adulthood but not in an additive way. In addition, mosquito larvae in the presence of predators and competitors took two days longer to emerge than where predators and competitions were absent. Our work provides evidence that biotic interactions, such as predation and competition, can strongly regulate the number of mosquito larvae by reducing the number of larvae that survive through instars and to emergence and by increasing the generation time.

  18. Rat Strains Bred for Low and High Aerobic Running Capacity do not Differ in Their Survival Time to Hemorrhage

    Science.gov (United States)

    2009-12-01

    maximal oxygen consumption ( Vo2max ) was 12% greater during normoxia and 20% greater during hypoxia in the HCR vs LCR (12). This enhanced Vo2max ...mitochondria) rather than differences in cardiac output, and also occurred in the absence of differences in oxygen delivery. By generation 15, VO2max ...survival time of HCR and LCR lines to the same controlled hemorrhage. We hypothesized that a strain with improved VO2max (i.e., HCR) would demonstrate an

  19. Effect of intestinal microflora on the survival time of mice exposed to lethal whole-body. gamma. irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Onoue, M.; Uchida, K.; Yokokura, T.; Takahashi, T.; Mutai, M.

    1981-11-01

    The effect of intestinal microflora on the survival time of mice exposed to 2-kR whole-body ..gamma.. irradiation was studied using germfree, monoassociated, and conventionalized ICR mice. The germfree mice were monoassociated with 1 of 11 bacterial strains, which were isolated from the fresh feces of conventional mice, 2 weeks prior to irradiation. All mice died within 3 weeks after irradiation. Monoassociation with Fusobacterium sp., Streptococcus faecalis, Escherichia coli, or Pseudomonas sp. significantly reduced the mean survival time compared to that of germfree mice. In contrast, monoassociation with Clostridium sp., Bifidobacterium pseudolongum, or Lactobacillus acidophilus significantly prolonged the mean survival time compared to that of germfree mice. This suggests that the latter organisms may perform some activity to protect the mice from radiation injury. In this histopathological autopsy examination, the main lesions were hypocellularity in hematopoietic organs and hemorrhage in various organs. Neither karyorrhexis nor desquamation of intestinal mucosal cells was observed in any mice. From these observations, it is suggested that the death of these mice was related to hematopoietic damage. Bacterial invasion into various organs was observed in conventionalized and Pseudomonas-, E. coli-, or S. faecalis-monoassociated mice but not in Clostridium-, B. pseudolongum-, L. acidophilus-, or Fusobacterium-monoassociated mice.

  20. 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.

  1. Relationships among the cervical mucus urea and acetone, accuracy of insemination timing, and sperm survival in Holstein cows.

    Science.gov (United States)

    Beran, J; Stádník, L; Ducháček, J; Okrouhlá, M; Doležalová, M; Kadlecová, V; Ptáček, M

    2013-11-01

    The objectives of this study were to evaluate the relationships among urea and acetone content in cows' cervical mucus (CM), its crystallization type (CT) and sperm survival (SS) after timed AI. Samples of CM were collected from 192 Holstein cows treated by Ovsynch(®) protocol. Analysis of the urea and acetone content for identification of the metabolic status, the arborization test for evaluation of insemination timing and the short-term heat test of SS for assessment of its suitability as a biological matrix were performed. The data set was analyzed by the GLM procedure using SAS(®). The results documented the existence of substantial differences in individual response to the Ovsynch(®) protocol causing insemination of 55.2% cows at an inappropriate time. The urea content was found as a possible indicator of a cow's metabolism and/or of insemination timing, concentrations of less than 500 mg/L corresponded (Pacetone content on SS were determined. The greatest values of SS were detected in cows with an expected response to precisely timed oestrus documented by the corresponding CT. Greater values of urea (>260 mg/L) and acetone (>5mg/L) negatively affected SS as well (P<0.05-0.01). The results confirmed that the accuracy of insemination timing can be affected by the metabolism intensity, just as CM quality directly influences sperm survival. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Associations of red and processed meat with survival after colorectal cancer and differences according to timing of dietary assessment.

    Science.gov (United States)

    Carr, Prudence R; Jansen, Lina; Walter, Viola; Kloor, Matthias; Roth, Wilfried; Bläker, Hendrik; Chang-Claude, Jenny; Brenner, Hermann; Hoffmeister, Michael

    2016-01-01

    Little is known about the prognostic impact of red and processed meat intake or about changes in consumption after a diagnosis of colorectal cancer (CRC). We investigated associations of baseline red and processed meat with survival outcomes and explored changes in intake among CRC survivors 5 y after diagnosis. A total of 3122 patients diagnosed with CRC between 2003 and 2010 were followed for a median of 4.8 y [DACHS (Darmkrebs: Chancen der Verhütung durch Screening) study]. Patients provided information on diet and other factors in standardized questionnaires at baseline and at the 5-y follow-up. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. Among patients with stage I-III CRC, baseline red and processed meat intake was not associated with overall (>1 time/d compared with processed meat at the 5-y follow-up than at baseline (concordance rate: 39%; κ-value: 0.10; 95% CI: 0.07, 0.13). Our findings suggest that baseline red and processed meat intake is not associated with poorer survival among patients with CRC. The potential interaction with KRAS mutation status warrants further evaluation. Major changes in consumption measured at the 5-y follow-up may have had an impact on our survival estimates. © 2016 American Society for Nutrition.

  3. Diabetes, hypertension and hyperlipidemia: prevalence over time and impact on long-term survival after liver transplantation.

    Science.gov (United States)

    Parekh, J; Corley, D A; Feng, S

    2012-08-01

    With increasing short-term survival, the transplant community has turned its focus to delineating the impact of medical comorbidities on long-term outcomes. Unfortunately, conditions such as diabetes, hypertension and hyperlipidemia are difficult to track and often managed outside of the transplant center by primary care providers. We collaborated with Kaiser Permanente Northern California to create a database of 598 liver transplant recipients, which incorporates diagnostic codes along with laboratory and pharmacy data. Specifically, we determined the prevalence of diabetes, hypertension and hyperlipidemia both before and after transplant and evaluated the influence of disease duration as a time-dependent covariate on posttransplant survival. The prevalence of these comorbidities increased steadily from the time of transplant to 7 years after transplant. The estimated risk for all-cause mortality (hazard ratio = 1.07 per year increment, 95% CI 1.01-1.13, p hyperlipidemia. Greater attention to management of diabetes may mitigate its negative impact on long-term survival in liver transplant recipients. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. Applied the additive hazard model to predict the survival time of patient with diffuse large B- cell lymphoma and determine the effective genes, using microarray data

    Directory of Open Access Journals (Sweden)

    Arefa Jafarzadeh Kohneloo

    2015-09-01

    Full Text Available Background: Recent studies have shown that effective genes on survival time of cancer patients play an important role as a risk factor or preventive factor. Present study was designed to determine effective genes on survival time for diffuse large B-cell lymphoma patients and predict the survival time using these selected genes. Materials & Methods: Present study is a cohort study was conducted on 40 patients with diffuse large B-cell lymphoma. For these patients, 2042 gene expression was measured. In order to predict the survival time, the composition of the semi-parametric additive survival model with two gene selection methods elastic net and lasso were used. Two methods were evaluated by plotting area under the ROC curve over time and calculating the integral of this curve. Results: Based on our findings, the elastic net method identified 10 genes, and Lasso-Cox method identified 7 genes. GENE3325X increased the survival time (P=0.006, Whereas GENE3980X and GENE377X reduced the survival time (P=0.004. These three genes were selected as important genes in both methods. Conclusion: This study showed that the elastic net method outperformed the common Lasso method in terms of predictive power. Moreover, apply the additive model instead Cox regression and using microarray data is usable way for predict the survival time of patients.

  5. Wind speed during migration influences the survival, timing of breeding, and productivity of a neotropical migrant, Setophaga petechia.

    Directory of Open Access Journals (Sweden)

    Anna Drake

    Full Text Available Over the course of the annual cycle, migratory bird populations can be impacted by environmental conditions in regions separated by thousands of kilometers. We examine how climatic conditions during discrete periods of the annual cycle influence the demography of a nearctic-neotropical migrant population of yellow warblers (Setophaga petechia, that breed in western Canada and overwinter in Mexico. We demonstrate that wind conditions during spring migration are the best predictor of apparent annual adult survival, male arrival date, female clutch initiation date and, via these timing effects, annual productivity. We find little evidence that conditions during the wintering period influence breeding phenology and apparent annual survival. Our study emphasizes the importance of climatic conditions experienced by migrants during the migratory period and indicates that geography may play a role in which period most strongly impacts migrant populations.

  6. Relationships between Serum Albumin and Urea Level and the Clinical Pathological Characteristics and Survival Time in Patients with Lung Cancer

    Directory of Open Access Journals (Sweden)

    Yalun LI

    2017-03-01

    Full Text Available Background and objective Lung cancer is the most common malignancy and is the leading cause of cancer-related death worldwide. Thus, this disease severely threatens human health. This study aims to identify the relationships between serum albumin and urea level and the clinical pathological characteristics and survival time in patients with lung cancer. Methods A total of 1,098 patients with lung cancer were diagnosed by pathology and tested the serum albumin and urea level in West China Hospital of Sichuan University during January 2008 to December 2013. According to the levels of albumin and urea, patients were divided into the normal level group (negative group and abnormal level group (positive group. The differences of patients' clinical pathological characteristics and survival time in the two groups were analyzed. Results Differences in age, sex, histological classification, liver metastasis and pleural metastasis were statistically significant between the two groups of serum albumin (P<0.05. Differences in age, intrapulmonary metastasis of 312 patients of squamous cell carcinoma and differences in age, sex, stages, pleural metastasis of 612 patients of adenocarcinoma between the two groups of serum albumin (P<0.05. There were no significant differences between the two groups of urea. In different histological classification between the two groups of serum albumin, the median survival period of squamous cell carcinoma was 36 months and 19 monthes, adenocarcinoma was 35 months and 15 monthes, the abnormal group were all significantly lower than those in the normal group. The median survival period was no significant difference between the two groups of urea. Conclusion The level of serum albumin is an important indicator for prognosis.

  7. Queer as Folk and the trouble with slash

    Directory of Open Access Journals (Sweden)

    Kyra Hunting

    2012-09-01

    Full Text Available The Showtime TV series Queer as Folk (2000–2005 brought same-sex relationships and sex scenes to prime-time television, putting the stuff of slash up on the small screen. Despite incorporating many slash tropes into the canonical text, Queer as Folk troubles many of the traditional assumptions about how fan fiction and slash operate, particularly the association of slash with subversion. The intertextual relationship between canonically queer texts and their attendant fandoms requires new frameworks for exploring traditional fan fiction subgenres such as slash. When the canonical text itself is queer, gestures and genres that have generally been considered subversive can in fact be more conservative than the canonical text itself. When the political stakes of a canonical series are clear and explicitly progressive, the intertextual relationship between canon and fandom can be particularly important and uniquely problematic, as this case study of Queer as Folk demonstrates in its assessment of the complexities that arise when the canon itself is queer.

  8. 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 = 0.09 to 3.2 (0.31 years depending on period of diagnosis and choice of parametric model. The shape of the censoring distribution within intervals did generally not influence results, whereas the choice of parametric model did, even when different models fit the data equally well. In simulation studies both simple midpoint imputation and multiple imputation yielded nearly unbiased analyses (relative biases of -0.6% to 9.4% and confidence intervals with near-nominal coverage probabilities (93.4% to 95.7% for censoring intervals shorter than six months. For 12 month censoring intervals, multiple imputation provided better protection against bias, and coverage probabilities

  9. Efficacy of Re-188-labelled sulphur colloid on prolongation of survival time in melanoma-bearing animals

    Energy Technology Data Exchange (ETDEWEB)

    Chen, F.D.; Hsieh, B.T. E-mail: bthsieh@iner.gov.tw; Wang, H.E.; Ou, Y.H.; Yang, W.K.; Whang-Peng, J.; Liu, R.S.; Knapp, F.F.; Ting, G.; Yen, S.H

    2001-10-01

    In this study, the effectiveness of a {sup 188}Re labeled sulfur colloid with two particle size ranges was used to evaluate the effectiveness of this agent on melanoma tumors in mice in terms of animal lifespan. Methods: Two separate group of animals were used for investigating biodistribution and survival time. A total of 188 B16F10-melanoma-bearing BDF{sub 1} mice were injected intraperitoneally with 3.7 MBq (0.1mCi)/2mL of radiolabeled sulfur colloid ten days after intraperitoneal inoculation of 5x10{sup 5} B16F10 melanoma cells/2ml. For group 1, 30 mice were sacrificed at 1, 4, 24, 48 and 72 hours for biodistribution studies. In group 2, 158 mice were divided into 9 groups (n=16{approx}18/groups)each receiving respectively tumor alone, tumor with normal saline, cold colloid or hot colloid with 16, 23, 31, 46, 62, or 124 MBq activity. Each of these colloid groups was further divided into two groups, one receiving smaller particle sizes (<3{mu}m:80.4 {+-}7.2%, colloid 1) and the other receiving larger particle sizes (<3{mu}m:12.3{+-}1.0%, colloid 2). The animals were checked daily until death and their survival recorded. Results: Colloid 2 showed higher accumulation in almost all tissues, the highest accumulation organ was tumor ({approx} 40%), then spleen ({approx}20%), stomach ({approx}15%), diaphragm ({approx}3%), and liver ({approx}2%). There was a significant increase in survival time with increasing amount of the larger-particle-size colloid. Administered levels of 16-31 MBq/mouse were most efficacious and with higher amounts the survival times decreased significantly below that of the controls. There was a significant difference in the dose-response curves for the two preparations. Protection factors (1/Relative-risk) of nearly 5 were achieved using the larger colloid size, and nearly 30 using the smaller colloid size. An amount of 16-31 MBq of the colloid 2 was the optimal activity in these studies. On the one hand, the survival data agreed well with the

  10. Genetic relationship of discrete-time survival with fertility and production in dairy cattle using bivariate models

    Directory of Open Access Journals (Sweden)

    Alenda Rafael

    2007-07-01

    Full Text Available Abstract Bivariate analyses of functional longevity in dairy cattle measured as survival to next lactation (SURV with milk yield and fertility traits were carried out. A sequential threshold-linear censored model was implemented for the analyses of SURV. Records on 96 642 lactations from 41 170 cows were used to estimate genetic parameters, using animal models, for longevity, 305 d-standardized milk production (MY305, days open (DO and number of inseminations to conception (INS in the Spanish Holstein population; 31% and 30% of lactations were censored for DO and INS, respectively. Heritability estimates for SURV and MY305 were 0.11 and 0.27 respectively; while heritability estimates for fertility traits were lower (0.07 for DO and 0.03 for INS. Antagonist genetic correlations were estimated between SURV and fertility (-0.78 and -0.54 for DO and INS, respectively or production (-0.53 for MY305, suggesting reduced functional longevity with impaired fertility and increased milk production. Longer days open seems to affect survival more than increased INS. Also, high productive cows were more problematic, less functional and more liable to being culled. The results suggest that the sequential threshold model is a method that might be considered at evaluating genetic relationship between discrete-time survival and other traits, due to its flexibility.

  11. Desiccation survival time for eggs of a widespread and invasive Australian mosquito species, Aedes (Finlaya) notoscriptus (Skuse).

    Science.gov (United States)

    Faull, K J; Webb, C; Williams, C R

    2016-06-01

    The Australian native mosquito Aedes (Finlaya) notoscriptus (Skuse) is closely associated with natural and artificial water holding receptacles. Eggs are laid in habitats where they are exposed to drying conditions as water levels fluctuate. Withstanding desiccation enables survival in challenging environments and increases the potential for establishment in non-native habitats. Until now, the desiccation resistance of Ae. notoscriptus eggs has been unknown despite the historical invasive success of this important dog heartworm and arbovirus vector. Viability and mean survival times of eggs from two Ae. notoscriptus populations (metropolitan areas of Sydney, NSW and Adelaide, SA) were evaluated, with eggs stored under three dryness conditions for up to 367 days. Our results revealed that Ae. notoscriptus eggs can withstand desiccation for extended periods, under a variety of conditions, with approximately 9-13% egg viability recorded after one year. This prolonged egg survival reflects the widespread distribution of this mosquito in Australia and its history of incursions and subsequent establishment in non-native habitats. Differences in mean egg volume were recorded in addition to significantly different egg length to width ratios for the two populations, which may reflect adaptation to biotope of origin and an associated likelihood of drought and drying conditions. The results of this study suggest that the desiccation resistant eggs of Ae. notoscriptus make this species highly adaptable, increasing the risk of movement to non-endemic regions of the world. © 2016 The Society for Vector Ecology.

  12. The State of English Education: Considering Possibilities in Troubled Times

    Science.gov (United States)

    Hawthorne, Shaun; Goodwyn, Andy; George, Marshall; Reid, Louann; Shoffner, Melanie

    2012-01-01

    For the "Extending the Conversation" section in this issue, the authors invited English educators from the United States and abroad to reflect on the state of English education in their countries. All five contributors have interacted through their participation in the NCTE Annual Convention, the CEE summer summits, the International…

  13. Neurogenesis and the Spacing Effect: Learning over Time Enhances Memory and the Survival of New Neurons

    Science.gov (United States)

    Sisti, Helene M.; Glass, Arnold L.; Shors, Tracey J.

    2007-01-01

    Information that is spaced over time is better remembered than the same amount of information massed together. This phenomenon, known as the spacing effect, was explored with respect to its effect on learning and neurogenesis in the adult dentate gyrus of the hippocampal formation. Because the cells are generated over time and because learning…

  14. The effect of time of planting at stake on cocoa seedling survival ...

    African Journals Online (AJOL)

    Studies were conducted at the Cocoa Research Institute of Ghana, Tafo and its sub-station at Bunso, from 1994 to 1997 to re-appraise the success of cocoa etablishment from seeds sown at stake at specified times of the year before the onset of the dry season. The treatments consisted of four times within the year when ...

  15. Does the benefit on survival from leisure time physical activity depend on physical activity at work?

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Marott, Jacob Louis; Gyntelberg, Finn

    2013-01-01

    To investigate if persons with high physical activity at work have the same benefits from leisure time physical activity as persons with sedentary work.......To investigate if persons with high physical activity at work have the same benefits from leisure time physical activity as persons with sedentary work....

  16. Vitamin D Depletion in Pregnancy Decreases Survival Time, Oxygen Saturation, Lung Weight and Body Weight in Preterm Rat Offspring.

    Directory of Open Access Journals (Sweden)

    Sine Lykkedegn

    Full Text Available Animal studies suggest a role of vitamin D in fetal lung development although not studied in preterm animals. We tested the hypothesis that vitamin D depletion aggravates respiratory insufficiency in preterm rat offspring. Furthermore, the effects of vitamin D depletion on growth and lung surfactant were investigated. Female Sprague-Dawley rats were randomly assigned low vitamin D (VDL or control diet before mating and followed with serum 25-hydroxyvitamin D (s-25(OHD determinations. After cesarean section at gestational day 19 (E19 or day 22 (E22, placental weight, birth weight, crown-rump-length (CRL, oxygenation (SaO2 at 30 min and survival time were recorded. The pup lungs were analyzed for phospholipid levels, surfactant protein A-D mRNA and the expression of the vitamin D receptor (VDR. S-25(OHD was significantly lower in the VDL group at cesarean section (12 vs. 30nmol/L, p<0.0001. Compared to the controls, E19 VDL pups had lower birth weight (2.13 vs. 2.29g, p<0.001, lung weight (0.09 vs. 0.10g, p = 0.002, SaO2 (54% vs. 69%, p = 0.002 as well as reduced survival time (0.50 vs. 1.25h, p<0.0001. At E22, the VDL-induced pulmonary differences were leveled out, but VDL pups had lower CRL (4.0 vs. 4.5cm, p<0.0001. The phospholipid levels and the surfactant protein mRNA expression did not differ between the dietary groups. In conclusion, Vitamin D depletion led to lower oxygenation and reduced survival time in the preterm offspring, associated with reduced lung weight and birth weight. Further studies of vitamin D depletion in respiratory insufficiency in preterm neonates are warranted.

  17. Differential presentation and survival of de novo and recurrent metastatic breast cancer over time: 1990-2010.

    Science.gov (United States)

    Malmgren, Judith A; Mayer, Musa; Atwood, Mary K; Kaplan, Henry G

    2017-10-16

    Differences in de novo (dnMBC) and recurrent metastatic breast cancer (rMBC) presentation and survival over time have not been adequately described. A retrospective cohort study, 1990-2010, with follow up through 2015 of dnMBC patients (stage IV at diagnosis) and rMBC patients with subsequent distant metastatic recurrence (stage I-III initial diagnosis) [dnMBC = 247, rMBC = 911)]. Analysis included Chi squared tests of categorical variables, Kaplan-Meier survival estimates, and Cox proportional adjusted hazard ratios (HzR) and 95% confidence intervals (CI). Disease specific survival (DSS) was time from diagnosis or distant recurrence to BC death. Over time, 1990-1998, 1999-2004, and 2005-2010, dnMBC incidence was constant (3%) and rMBC incidence decreased [18% to 7% (p negative breast cancer (HR-negative/HER2-negative) (p = 0.049). Five-year dnMBC DSS was 44% vs. 21% for rMBC (p year dnMBC DSS improved over time [28% to 55% (p = 0.008)] and rMBC worsened [23% to 13%, p = 0.065)]. Worse DSS was associated with HR-negative status (HzR = 1.63; 1.41, 1.89), rMBC (HzR = 1.88; 1.58, 2.23), older age (70 +) (HzR = 1.88; 1.58, 2.24), > 1 distant metastases (HzR 1.39; 1.20, 1.62), and visceral dominant disease (HzR 1.22; 1.05, 1.43). After 1998, HER2-positive disease was associated with better DSS (HzR = 0.72, 95% CI 0.56, 0.93). Factors associated with the widening survival gap and non-equivalence between dnMBC and rMBC and decreased rMBC incidence warrant further study.

  18. Influence of application sequence and timing of eugenol and lauric arginate (LAE) on survival of spoilage organisms.

    Science.gov (United States)

    Manrique, Yudith; Gibis, Monika; Schmidt, Herbert; Weiss, Jochen

    2017-06-01

    The effectiveness of sequential applications of the antimicrobials eugenol and lauric arginate (LAE) was investigated against Staphylococcus carnosus, Listeria innocua, Escherichia coli K12, and Pseudomonas fluorescens. The antimicrobials were applied simultaneously at half of their minimum lethal concentrations (MLC) or sequentially at t = 0 h and t = 3, 4, 6 or 8 h. Bacterial survival was determined by direct plate counts. Survivals kinetic were fitted to a growth and mortality model to obtain characteristic parameters that described time-dependent changes from growth to mortality or vice versa. The most effective was a simultaneous exposure of both antimicrobials to the spoilage organisms at the beginning of the incubation period. Efficiency decreases depending on order and timing of the two antimicrobials were observed upon sequential treatments. These were most effective when antimicrobials where applied within a short time period (3-4 h) and when eugenol was first applied against S. carnosus and P. fluorescens. No sequence effects were observed for L. innocua, and sequential treatments proved to be ineffective against E. coli K12. These results were attributed to cells adapting to the first applied antimicrobial. In some cases, this provided protection against the second antimicrobial rendering the overall treatment less effective. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 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.

  20. Expectation-maximization algorithms for learning a finite mixture of univariate survival time distributions from partially specified class values

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youngrok [Iowa State Univ., Ames, IA (United States)

    2013-05-15

    Heterogeneity exists on a data set when samples from di erent classes are merged into the data set. Finite mixture models can be used to represent a survival time distribution on heterogeneous patient group by the proportions of each class and by the survival time distribution within each class as well. The heterogeneous data set cannot be explicitly decomposed to homogeneous subgroups unless all the samples are precisely labeled by their origin classes; such impossibility of decomposition is a barrier to overcome for estimating nite mixture models. The expectation-maximization (EM) algorithm has been used to obtain maximum likelihood estimates of nite mixture models by soft-decomposition of heterogeneous samples without labels for a subset or the entire set of data. In medical surveillance databases we can find partially labeled data, that is, while not completely unlabeled there is only imprecise information about class values. In this study we propose new EM algorithms that take advantages of using such partial labels, and thus incorporate more information than traditional EM algorithms. We particularly propose four variants of the EM algorithm named EM-OCML, EM-PCML, EM-HCML and EM-CPCML, each of which assumes a specific mechanism of missing class values. We conducted a simulation study on exponential survival trees with five classes and showed that the advantages of incorporating substantial amount of partially labeled data can be highly signi cant. We also showed model selection based on AIC values fairly works to select the best proposed algorithm on each specific data set. A case study on a real-world data set of gastric cancer provided by Surveillance, Epidemiology and End Results (SEER) program showed a superiority of EM-CPCML to not only the other proposed EM algorithms but also conventional supervised, unsupervised and semi-supervised learning algorithms.

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

    Science.gov (United States)

    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.

  2. Assessment of chronic effects of tebuconazole on survival, reproduction and growth of Daphnia magna after different exposure times.

    Science.gov (United States)

    Sancho, E; Villarroel, M J; Ferrando, M D

    2016-02-01

    The effect of the fungicide tebuconazole (0.41, 0.52, 0.71 and 1.14mg/L) on survival, reproduction and growth of Daphnia magna organisms was monitored using 14 and 21 days exposure tests. A third experiment was performed by exposing D. magna to the fungicide for 14 days followed by 7 days of recovery (14+7). In order to test fungicide effects on D. magna, parameters as survival, mean whole body length, mean total number of neonates per female, mean number of broods per female, mean brood size per female, time to first brood/reproduction and intrinsic rate of natural increase (r) were used. Reproduction was seriously affected by tebuconazole. All tebuconazole concentrations tested affected the number of broods per female and day to first brood. At 14-days test, number of neonates per female and body size decreased by concentrations of tebuconazole higher than 0.52mg/L, whereas at 21-days test both parameters were affected at all the concentrations tested. Survival of the daphnids after 14 days fungicide exposure did not exhibited differences among experimental and control groups. In this experiment r value was reduced (in a 22%) when animals were exposed to concentrations of 0.71mg/L and 1.14mg/L. Survival of daphnids exposed during 21 days to 1.14mg/L declined, and the intrinsic rate of natural increase (r) decreased in a 30 % for tebuconazole concentrations higher than 0.41mg/L. Longevity of daphnids pre-exposed to tebuconazole for 14 days and 7 days in clean water did not show differences from control values and all of them survived the 21 days of the test. However, after 7 days in fungicide free medium animals were unable to restore control values for reproductive parameters and length. The maximum acceptable toxicant concentration (MATC) was calculated using the r values as parameter of evaluation. MATC estimations were 0.61mg/L and 0.46mg/L for 14 and 21 days, respectively. Results showed that the number of neonates per female was the highest sensitive

  3. A special case of reduced rank models for identification and modelling of time varying effects in survival analysis.

    Science.gov (United States)

    Perperoglou, Aris

    2016-12-10

    Flexible survival models are in need when modelling data from long term follow-up studies. In many cases, the assumption of proportionality imposed by a Cox model will not be valid. Instead, a model that can identify time varying effects of fixed covariates can be used. Although there are several approaches that deal with this problem, it is not always straightforward how to choose which covariates should be modelled having time varying effects and which not. At the same time, it is up to the researcher to define appropriate time functions that describe the dynamic pattern of the effects. In this work, we suggest a model that can deal with both fixed and time varying effects and uses simple hypotheses tests to distinguish which covariates do have dynamic effects. The model is an extension of the parsimonious reduced rank model of rank 1. As such, the number of parameters is kept low, and thus, a flexible set of time functions, such as b-splines, can be used. The basic theory is illustrated along with an efficient fitting algorithm. The proposed method is applied to a dataset of breast cancer patients and compared with a multivariate fractional polynomials approach for modelling time-varying effects. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Vitamin D Depletion in Pregnancy Decreases Survival Time, Oxygen Saturation, Lung Weight and Body Weight in Preterm Rat Offspring.

    Science.gov (United States)

    Lykkedegn, Sine; Sorensen, Grith Lykke; Beck-Nielsen, Signe Sparre; Pilecki, Bartosz; Duelund, Lars; Marcussen, Niels; Christesen, Henrik Thybo

    2016-01-01

    Animal studies suggest a role of vitamin D in fetal lung development although not studied in preterm animals. We tested the hypothesis that vitamin D depletion aggravates respiratory insufficiency in preterm rat offspring. Furthermore, the effects of vitamin D depletion on growth and lung surfactant were investigated. Female Sprague-Dawley rats were randomly assigned low vitamin D (VDL) or control diet before mating and followed with serum 25-hydroxyvitamin D (s-25(OH)D) determinations. After cesarean section at gestational day 19 (E19) or day 22 (E22), placental weight, birth weight, crown-rump-length (CRL), oxygenation (SaO2) at 30 min and survival time were recorded. The pup lungs were analyzed for phospholipid levels, surfactant protein A-D mRNA and the expression of the vitamin D receptor (VDR). S-25(OH)D was significantly lower in the VDL group at cesarean section (12 vs. 30nmol/L, plung weight (0.09 vs. 0.10g, p = 0.002), SaO2 (54% vs. 69%, p = 0.002) as well as reduced survival time (0.50 vs. 1.25h, plung weight and birth weight. Further studies of vitamin D depletion in respiratory insufficiency in preterm neonates are warranted.

  5. Instrumental variables estimation of exposure effects on a time-to-event endpoint using structural cumulative survival models.

    Science.gov (United States)

    Martinussen, Torben; Vansteelandt, Stijn; Tchetgen Tchetgen, Eric J; Zucker, David M

    2017-12-01

    The use of instrumental variables for estimating the effect of an exposure on an outcome is popular in econometrics, and increasingly so in epidemiology. This increasing popularity may be attributed to the natural occurrence of instrumental variables in observational studies that incorporate elements of randomization, either by design or by nature (e.g., random inheritance of genes). Instrumental variables estimation of exposure effects is well established for continuous outcomes and to some extent for binary outcomes. It is, however, largely lacking for time-to-event outcomes because of complications due to censoring and survivorship bias. In this article, we make a novel proposal under a class of structural cumulative survival models which parameterize time-varying effects of a point exposure directly on the scale of the survival function; these models are essentially equivalent with a semi-parametric variant of the instrumental variables additive hazards model. We propose a class of recursive instrumental variable estimators for these exposure effects, and derive their large sample properties along with inferential tools. We examine the performance of the proposed method in simulation studies and illustrate it in a Mendelian randomization study to evaluate the effect of diabetes on mortality using data from the Health and Retirement Study. We further use the proposed method to investigate potential benefit from breast cancer screening on subsequent breast cancer mortality based on the HIP-study. © 2017, The International Biometric Society.

  6. Incubation media affect the survival, pathway and time of embryo development in Neotropical annual fish Austrolebias nigrofasciatus (Rivulidae).

    Science.gov (United States)

    da Fonseca, A P; Volcan, M V; Robaldo, R B

    2018-01-01

    To analyse the survival, pathway and time of embryo development in the annual fish Austrolebias nigrofasciatus eggs were monitored in four liquid media and two damp media under experimental conditions for 130 days until their development was complete. Eggs kept in the same breeding water from oviposition remained in diapause I (DI) during all experiments. In constrast, up to the stage prior to entering diapause II (DII), the other media had no influence on development. Embryos at this stage (DII), however, show longer development time when treated in medium with water and powdered coconut shell so that about 80% of embryos remained in DII at 100 days. In contrast, all other treatments had a significantly lower proportion of embryos remaining in DII. When treated with Yamamoto's solution in humid media, embryos showed the fastest development. The first fully developed embryos (DIII) were seen at 27 days after oviposition. It took an average of 46-58 days for 50% of eggs in each treatment to reach DIII. Compared with other studies, survival in all incubation media was high at between 70 and 98%. Taken together, it can be concluded that all incubation media were found to be viable for maintaining embryos. Altering developmental trajectories through the manipulation of diapauses in different media makes this species a potential model organism for laboratory studies. © 2017 The Fisheries Society of the British Isles.

  7. A comparative study of machine learning methods for time-to-event survival data for radiomics risk modelling.

    Science.gov (United States)

    Leger, Stefan; Zwanenburg, Alex; Pilz, Karoline; Lohaus, Fabian; Linge, Annett; Zöphel, Klaus; Kotzerke, Jörg; Schreiber, Andreas; Tinhofer, Inge; Budach, Volker; Sak, Ali; Stuschke, Martin; Balermpas, Panagiotis; Rödel, Claus; Ganswindt, Ute; Belka, Claus; Pigorsch, Steffi; Combs, Stephanie E; Mönnich, David; Zips, Daniel; Krause, Mechthild; Baumann, Michael; Troost, Esther G C; Löck, Steffen; Richter, Christian

    2017-10-16

    Radiomics applies machine learning algorithms to quantitative imaging data to characterise the tumour phenotype and predict clinical outcome. For the development of radiomics risk models, a variety of different algorithms is available and it is not clear which one gives optimal results. Therefore, we assessed the performance of 11 machine learning algorithms combined with 12 feature selection methods by the concordance index (C-Index), to predict loco-regional tumour control (LRC) and overall survival for patients with head and neck squamous cell carcinoma. The considered algorithms are able to deal with continuous time-to-event survival data. Feature selection and model building were performed on a multicentre cohort (213 patients) and validated using an independent cohort (80 patients). We found several combinations of machine learning algorithms and feature selection methods which achieve similar results, e.g. C-Index = 0.71 and BT-COX: C-Index = 0.70 in combination with Spearman feature selection. Using the best performing models, patients were stratified into groups of low and high risk of recurrence. Significant differences in LRC were obtained between both groups on the validation cohort. Based on the presented analysis, we identified a subset of algorithms which should be considered in future radiomics studies to develop stable and clinically relevant predictive models for time-to-event endpoints.

  8. Two to Tango: Script Formulations, Dispositions, and Rhetorical Symmetry in Relationship Troubles Talk.

    Science.gov (United States)

    Edwards, Derek

    1995-01-01

    This study focuses on event descriptions in two couples' talks about relationship troubles in front of counselors, examining discursive patterns that have a recurring, predictable, sequential pattern. The relationship dynamics of couples' relationship troubles are discussed. (31 references) (MDM)

  9. Troubling Talk: Assembling the PhD Candidate

    Science.gov (United States)

    Mewburn, I.

    2011-01-01

    When PhD students complain it is assumed there are problems and that troubles talk is evidence of a "sick" research candidature or culture. This paper argues that such a one-dimensional reading fails to attend closely to the academic identity work that is done when students talk together. Identity work has become a useful way of thinking about the…

  10. A Program Based on Maslow's Hierarchy Helps Students in Trouble

    Science.gov (United States)

    Yates, Mary Ruth; Saunders, Ron; Watkins, J. Foster

    1980-01-01

    The article discusses the development of an "alternative school" in an urban school system for students having trouble in the regular secondary setting. The program was based upon "Maslow's Hierarchy of Needs" and is described in detail. The initial assessment of the program produced very positive results.

  11. Connecting the Dots: Threat Assessment, Depression and the Troubled Student

    Science.gov (United States)

    Harwood, Valerie

    2011-01-01

    One of the numerous responses to the mass shooting at Virginia Tech in April 2007 has been the call for higher education institutions in the United States to take an increased role in identifying troubled students. This has had widely felt effects, with educational institutions across the United States developing mechanisms such as Threat…

  12. Troubled Theory in the Debate between Hirst and Carr

    Science.gov (United States)

    Long, Fiachra

    2008-01-01

    When Paul Hirst and Wilfred Carr squared up to each other a few years ago on the issue of the role of philosophical theory in educational practice, it became clear that theory itself had become a troubled term. The very fact that Wilfred Carr could argue for the end of educational theory recalls Paul Feyerabend's fiery argument for the end of…

  13. A Family Affair: When School Troubles Come Home.

    Science.gov (United States)

    Dudley-Marling, Curt

    Little is known about the effects of schooling on parents, especially on those with children who struggle in school. Drawing on a series of interviews with parents, this book provides an insider's view of what happens at home when school goes wrong. The stories in this book reveal that school troubles threaten the happiness and self-esteem of…

  14. The "Quiet" Troubles of Low-Income Children

    Science.gov (United States)

    Weissbourd, Richard

    2009-01-01

    Most of the troubles poor at-risk children have are not "loud" problems like disruptive behavior or gang involvement. They are "quiet." The range of these problems is vast. Hunger, dehydration, asthma, obesity, and hearing problems can all insidiously trip children up in school. Some quiet problems are psychological--depression, anxiety, the fear…

  15. Ordering within Moral Orders to Manage Classroom Trouble

    Science.gov (United States)

    Doherty, Catherine; McGregor, Rowena; Shield, Paul

    2016-01-01

    This paper demonstrates how classroom trouble warranting teacher intervention can stem from transgressions in different layers of the complex moral order regulating classroom interactions. The paper builds from Durkheim's treatment of schooling as the institution responsible for the inculcation of a shared moral order, Bernstein's distinction…

  16. ENTREPRENEURSHIP IN TIMES OF ECONOMIC AND FINANCIAL CRISES, METHODS OF ADAPTATION AND SURVIVAL.

    Directory of Open Access Journals (Sweden)

    Radu Oprea

    2011-12-01

    Full Text Available This paper shows the main results of a research activity conducted in the South – East region of Romania during November 2009, over 117 small and medium-sized enterprises. The results help to better explain some of the social problems that have been generated in the region as a snow ball effect, due to the economic and financial crisis. The research has revealed the following:The majority of the employees of the companies that were interviewed do not participate in training courses related to project management and personal development. However, company administrators consider that such courses are useful to increase competitiveness in times of economic and financial crises. Personnel under 40 years of age suffer from a lack of professional training and dedication to job requirements. Companies have expressed an interest in accessing European Union funding. However, they do not have complete information that would allow them to start a project and finalize it. This lack of information is mainly due to lack of access to specialists who would write the projects and submit them. The majority of entrepreneurs consider they cannot write the projects themselves but on the other hand they do not have access to consulting companies or other organizations that could help them. Their main information source is the mass-media.As a result, companies have adjusted to the effects of the economic crisis, diminishing their activity and laying off people, decreasing the running expenses and stopping investing in their development.

  17. Effect of Migration Pathway on Travel Time and Survival of Acoustic-Tagged Juvenile Salmonids in the Columbia River Estuary

    Energy Technology Data Exchange (ETDEWEB)

    Harnish, Ryan A.; Johnson, Gary E.; McMichael, Geoffrey A.; Hughes, Michael S.; Ebberts, Blaine D.

    2012-02-01

    Off-channel areas (side channels, tidal flats, sand bars, and shallow-water bays) may serve as important migration corridors through estuarine environments for salmon and steelhead smolts. Relatively large percentages (21-33%) of acoustic-tagged yearling and subyearling Chinook salmon and steelhead smolts were detected migrating through off-channel areas of the Columbia River estuary in 2008. The probability of survival for off-channel migrants (0.78-0.94) was similar to or greater than the survival probability of main channel migrants (0.67-0.93). Median travel times were similar for all species or run types and migration pathways we examined, ranging from 1-2 d. The route used by smolts to migrate through the estuary may affect their vulnerability to predation. Acoustic-tagged steelhead that migrated nearest to avian predator nesting colonies experienced higher predation rates (24%) than those that migrated farthest from the colonies (10%). The use of multiple migration pathways may be advantageous to out-migrating smolts because it helps to buffer against high rates of mortality, which may occur in localized areas, and helps to minimize inter- and intraspecific competition.

  18. Epithelial ovarian cancer mortality among Hispanic women: Sub-ethnic disparities and survival trend across time: An analysis of SEER 1992-2013.

    Science.gov (United States)

    Chen, Chen; Markossian, Talar W; Silva, Abigail; Tarasenko, Yelena N

    2018-02-01

    Over the past half century the proportion of Hispanics in the US population has been steadily increasing, and groups of Hispanic origin have diversified. Despite notable racial and ethnic disparities in ovarian cancer (OC) mortality, population-based studies on OC among Hispanic females are lacking. To examine sub-ethnic disparities in OC mortality and survival trends using the Surveillance, Epidemiology, and End Results Program (SEER) 18 data on Hispanic women diagnosed with epithelial OC during 1992-2013. The disparities in OC 5 year survival and mortality were examined using log-rank tests and Cox proportional hazards models, adjusted for sociodemographic and pathological characteristics, time of diagnosis, receipt of resection surgery and county socioeconomic status. Trends in 5-year survival rates were examined using joinpoint regression models. The 5-year survival was lowest in Puerto Ricans (median survival: 33 months; survival rate: 31.07%) and was highest in the "Other" Hispanic subgroup (median survival: 59 months; survival rate: 49.14%) (log-rank test: P survival rates: from 43.37% to 48.94% (APC = 0.41, P = 0.40) and from 48.72% to 53.46% (APC = 0.29, P = 0.50), respectively. OC mortality in Hispanic patients varied by sub-ethnicity. This heterogeneity should be considered in future cancer data collection, reports and research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. The forecast of the postoperative survival time of patients suffered from non-small cell lung cancer based on PCA and extreme learning machine.

    Science.gov (United States)

    Han, Fei; Huang, De-Shuang; Zhu, Zhi-Hua; Rong, Tie-Hua

    2006-02-01

    In this paper, a new effective model is proposed to forecast how long the postoperative patients suffered from non-small cell lung cancer will survive. The new effective model which is based on the extreme learning machine (ELM) and principal component analysis (PCA) can forecast successfully the postoperative patients' survival time. The new model obtains better prediction accuracy and faster convergence rate which the model using backpropagation (BP) algorithm and the Levenberg-Marquardt (LM) algorithm to forecast the postoperative patients' survival time can not achieve. Finally, simulation results are given to verify the efficiency and effectiveness of our proposed new model.

  20. Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

    Directory of Open Access Journals (Sweden)

    Dahlqvist Vera

    2011-05-01

    Full Text Available Abstract Background This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection. The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care. Method A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology. Results The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made. Conclusion The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience

  1. Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

    Science.gov (United States)

    2011-01-01

    Background This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection. The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care. Method A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology. Results The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made. Conclusion The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a

  2. Feeling trapped and being torn: physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience.

    Science.gov (United States)

    Grönlund, Catarina E C Fischer; Dahlqvist, Vera; Söderberg, Anna I S

    2011-05-11

    This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care. A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology. The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made. The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups--to transform being burdened by a troubled conscience into using conscience as a guide--in situations where no way of

  3. The impact of pamidronate and chemotherapy on survival times in dogs with appendicular primary bone tumors treated with palliative radiation therapy.

    Science.gov (United States)

    Oblak, Michelle L; Boston, Sarah E; Higginson, Geraldine; Patten, Steven G; Monteith, Gabrielle J; Woods, J Paul

    2012-04-01

    To assess survival times in dogs that received palliative radiation therapy (RT) alone, and in combination with chemotherapy, pamidronate, or both for primary appendicular bone tumors and determine whether the addition of these adjunctive therapies affects survival. Retrospective case series. Dogs (n = 50) with primary appendicular bone tumors. Dogs were divided into the following treatment groups: RT alone, RT + chemotherapy, RT+ pamidronate, and RT+ chemotherapy + pamidronate. Dogs were considered for analysis if they had a known euthanasia date or follow-up data were available for at least 120 days from the time of diagnosis. Survival time was defined as the time from admission to euthanasia. Cox proportional hazard models and Kaplan-Meier survival functions were used. A P value of less than .05 was considered significant. Fifty dogs were considered for survival analysis. Median survival times (MSTs) were longest for dogs receiving RT and chemotherapy (307 days; 95% CI: 279, 831) and shortest in dogs receiving RT and pamidronate (69 days; 95% CI: 47, 112 days). The difference in MST between dogs who received pamidronate and those who did not in this population was statistically significant in a univariate (P = .039) and multivariate analysis (P = .0015). The addition of chemotherapy into any protocol improved survival (P Chemotherapy should be recommended in addition to a palliative RT protocol to improve survival of dogs with primary appendicular bone tumors. When combined with RT ± chemotherapy, pamidronate decreased MST and should not be included in a standard protocol. © Copyright 2012 by The American College of Veterinary Surgeons.

  4. Evaluation of clinical and histologic factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and adjuvant chemotherapy: 30 cases (2011-2014).

    Science.gov (United States)

    Moore, Antony S; Rassnick, Kenneth M; Frimberger, Angela E

    2017-09-01

    OBJECTIVE To determine histologic and clinical factors associated with survival time in dogs with stage II splenic hemangiosarcoma treated by splenectomy and a chemotherapy protocol in which an anthracycline was alternated with lomustine. DESIGN Retrospective case series. ANIMALS 30 dogs with stage II splenic hemangiosarcoma. PROCEDURES Medical records of 3 facilities were reviewed to identify dogs treated for stage II splenic hemangiosarcoma between June 2011 and October 2014. Information collected included signalment, disease staging data, whether anemia was present, date of splenectomy, chemotherapy protocol, adverse effects, and date of death or last follow-up. Histologic slides were reviewed and scored by pathologists. Associations between variables of interest and survival data were evaluated statistically. RESULTS Median survival time for all dogs was 158 days (range, 55 to 560 days), and the 1-year survival rate was 16%. On multivariate analysis, only the histologically determined mitotic score was significantly associated with survival time. The median survival time of 292 days for dogs with a mitotic score of 0 (hemangiosarcoma.

  5. Is Leptospira able to survive in raw milk? Study on the inactivation at different storage times and temperatures.

    Science.gov (United States)

    Fratini, Filippo; Turchi, Barbara; Ferrone, Martina; Galiero, Alessia; Nuvoloni, Roberta; Torracca, Beatrice; Cerri, Domenico

    2016-09-01

    The consumption of raw milk is currently increasing due to several beneficial aspects, such as nutritional qualities, taste, and health benefits. However, some authors highlight the potential risk associated with raw milk consumption. In Italy, while the absence of some pathogen microorganisms is set by the regional regulation DGR 381/2007, for other microorganisms, such as Leptospira, no recommendations are provided. Leptospira is not ascribed among classical milk pathogens; however, it can potentially be present in raw milk. The aim of this study was to evaluate the survival in raw milk of six serovars of Leptospira after storage at different temperatures (4 °C ± 2 °C, 20 °C ± 2 °C, and 30 °C ± 2 °C) for different incubation times (20 min, 45 min, 1 h, and 1 h and 30 min), in order to determine the potential risk for consumers. Moreover, the immediate effect of bovine, goat, and donkey raw milk on tested Leptospira serovars was visually evaluated. After incubation, all samples were subcultured in EMJH and incubated aerobically at 30 °C for 3 months. All inoculated media were weekly examined by dark-field microscope in order to assess Leptospira survival. Extemporary observation of strains' behavior in milk allowed to detect an almost immediate motility loss, and no leptospires were detected by microscopic observations carried out weekly during the trial period. According to our results, it could be possible to exclude raw milk as a source of Leptospira infection for consumers.

  6. Ostéopathie et troubles gastriques chez le chien

    OpenAIRE

    Agneray, François

    2003-01-01

    L'auteur se propose dans cette étude d'évaluer les possibilités thérapeutiques de l'ostéopathie (ou médecine manuelle) en cas de troubles gastriques chez le chien.Pour cela, il étudiera l'estomac et ses pathologies en insistant sur les points nécessaires à la compréhension du mode d'action de l'ostéopathie sur cet organe. L'ostéopathe, en agissant sur la structure, peut jouer sur la fonction : les troubles à dominante fonctionnelle seront donc traitées par ostéopathie avec le plus de profit, ...

  7. Troubling distinctions: a semiotics of the nursing/technology relationship.

    Science.gov (United States)

    Sandelowski, M

    1999-09-01

    I consider the discursive practices that have served conceptually and ontologically to trouble the boundaries between nursing and technology: between nurse/human/subject and machine/non-human/object. Nursing and technology have been semiotically related largely by two processes: (a) by the metaphor that depicts nursing as technology and (b) by opposition, or as not like and even in conflict with technology. Less frequently but no less significantly, nursing and technology have been semiotically linked (c) by the metaphor that depicts technology as nursing and (d) by metonymy, or by word or picture juxtapositions of nursing with technology. The troubling distinctions between nursing and technology suggest yet another reason why the construction of difference continues to elude nursing.

  8. Conditional Survival: An Assessment of the Prognosis of Patients at Time Points After Initial Diagnosis and Treatment of Locoregional Melanoma Metastasis.

    Science.gov (United States)

    Haydu, Lauren E; Scolyer, Richard A; Lo, Serigne; Quinn, Michael J; Saw, Robyn P M; Shannon, Kerwin F; Spillane, Andrew J; Stretch, Jonathan R; McCarthy, William H; Thompson, John F

    2017-05-20

    Purpose Standard cancer staging and prognostic estimates are determined at the time of the patient's initial disease presentation. Conditional survival is an alternative, dynamic assessment from follow-up time points after the initial disease diagnosis and is based on the condition of survivorship. Estimates of conditional survival can provide critical prognostic information for patients and clinicians, guide subsequent cancer follow-up schedules, and influence decisions regarding treatments. The current study presents conditional survival estimates developed from a cohort of 4,540 patients diagnosed with stage III melanoma treated at a single institution. Methods Patients with stage III disease at first melanoma diagnosis (initial; n = 2,042), or who developed locoregional metastasis as a first recurrence some time after primary diagnosis (recurrent; n = 2,498), were assessed. Conditional melanoma-specific survival (MSS) estimates up to 5 years after diagnosis were adjusted for age, sex, and 8th edition American Joint Committee on Cancer (AJCC) stage. Results Older age at diagnosis of stage III disease conveyed a worse prognosis at each conditional survival time point. Males had significantly worse MSS outcomes for up to 2 years of conditional survival, after which males and females had similar MSS. For patients with AJCC stage IIIB and stage IIIC disease, MSS outcomes were similar to those of patients with stage IIIA disease after 3 and 5 years of survivorship, respectively. Conclusion Adjuvant systemic treatments may have the greatest benefit when administered within the first 2 years of stage III melanoma diagnosis, during which period prognosis is significantly worse for male patients of increasing age and AJCC substage. Conditional survival estimates illustrate improved survival prospects for patients with cancer returning for follow-up and may define a finite period of increased risk after diagnosis.

  9. Seagrasses in northern Gulf of Mexico: An ecosystem in trouble

    Science.gov (United States)

    ,

    2000-01-01

    The USGS National Wetlands Research Center has documented that Seagrasses in the northern Gulf of Mexico constitute an ecosystem in trouble. From studies in St. Andrews Bay, Period Bay, the Chandeleur Islands, and the Gulf Islands National Seashore, scientists have discovered that declining seagrass acreage ranges from 12% to 66% in bays and estuaries of the Gulf of Mexico. Not only are seagrasses disappearing, but they are also changing in species composition, densities, and patchiness.

  10. Alcohol Toxicity in Diabetes and Its Complications: A Double Trouble?

    Science.gov (United States)

    Munukutla, Srikar; Pan, Guodong; Deshpande, Mandar; Thandavarayan, Rajarajan A; Krishnamurthy, Prasanna; Palaniyandi, Suresh S

    2016-04-01

    Eight percent of the U.S. population has been diagnosed with diabetes mellitus (DM), while another large percentage has gone undiagnosed. As the epidemiology of this disease constitutes a larger percentage of the American population, another factor presents a dangerous dilemma that can exacerbate the hazardous effects imposed by DM. Excessive alcohol consumption concerns the health of more than 50% of all adults. When this heavy-alcohol-drinking population overlaps with DM and its complications, the effects can be dangerous. In this review, we term it as "double trouble." We provide evidence of alcohol-induced exacerbation of organ damage in diabetic conditions. In certain cases, we have explained how diabetes and alcohol induce similar pathological effects. Known exacerbated complications include those related to heart diseases, liver damage, kidney dysfunction, as well as retinal and neurological impairment. Often, pathophysiological damage concludes with end-stage disorders and even mortality. The metabolic, cell signaling, and pathophysiological changes associated with "double trouble" would lead to the identification of novel therapeutic targets. This review summarizes the epidemiology, diagnosis, pathophysiology, metabolic, and cell signaling alterations and finally brushes upon issues and strategies to manage the "double trouble." Copyright © 2016 by the Research Society on Alcoholism.

  11. The Trouble with Teamwork: A Discursive Investigation

    Science.gov (United States)

    Barker, Dean M.; Rossi, Anthony

    2012-01-01

    Background: Teamwork sits comfortably within the vocabularies of most physical education teachers. It is used to both describe and prescribe student behaviour in a variety of physical and sport-related activities. Yet while supporters of sport and PE have readily employed the term, remarkably few pedagogues have taken the time to consider what…

  12. Ethiopian disaster management and its troubled history

    African Journals Online (AJOL)

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    integrate pre-disaster mitigation planning with post-disaster response and recovery. Recent times have witnessed a growing body of literature and a relatively new as well as systematic approach to DM. There are a number of key concepts that should warrant attention. Disaster, hazard, vulnerability, disaster management, ...

  13. Good news for a change: Hope for a troubled planet

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, D.; Dressel, H.

    2002-07-01

    This book by the noted Canadian environmentalists, David Suzuki and Holly Dressel, attempts to marshall arguments in favour of an affirmative answer to the question {sup I}s there any hope for this troubled planet?' The answer is a confident 'yes', notwithstanding the fact that along with social upheavals and terrorist attacks we daily read reports of yet another animal species on the brink of extinction, of ocean fisheries collapsing, and of how industrial activity is wreaking havoc with our soil, air and water. There appears to be no readily perceptible signs of a slowdown in this headlong rush to destroying the planet, despite the warnings of many credible scientists, telling us that our actions are suicidal. Despite this apparent rush to oblivion Suzuki and Dressel see some hopeful signs of common sense coming to the fore. They see thousands of individuals, groups and businesses slowly changing their ways. They see that despite the dire warnings of false prophets, a growing number of businesses are still making money while benefiting their local communities. They see anti-globalization activists who are learning to practice real participatory democracy and create real communities. They see farmers and ranchers who are sharing their land with other species, including predators and pests, while still prospering. They see even some governments, local and national, which are starting to base economic development strategies on humanity's collective dependency on nature, while decreasing large-scale interference with our ecosystems. In their search for hopeful signs Suzuki and Dressel have uncovered hundreds of working solutions and examples of how an increasing number of people are realizing the danger of our current life style and are attempting to come up with ways to change that allows us to live happily and contentedly while sharing the planet with other creatures and stop polluting the atmosphere. They describe farming methods that protect

  14. The trouble with de Sitter space

    Energy Technology Data Exchange (ETDEWEB)

    Goheer, Naureen [Department of Mathematics and Applied Mathematics, University of Cape Town, 7701 Rondebosch, Cape Town (South Africa); Kleban, Matthew [Department of Physics, Stanford University, Stanford, CA 94305-4060 (United States)]. E-mail: mkleban@itp.stanford.edu; Susskind, Leonard [Korea Institute for Advanced Study and Department of Physics, Stanford University Stanford, CA 94305-4060 (United States)

    2003-07-01

    In this paper we assume the de Sitter space version of black hole Complementarity which states that a single causal patch of de Sitter space is described as an isolated finite temperature cavity bounded by a horizon which allows no loss of information. We discuss the how the symmetries of de Sitter space should be implemented. Then we prove a no go theorem for implementing the symmetries if the entropy is finite. Thus we must either give up the finiteness of de Sitter space entropy or the exact symmetry of the classical space. Each has interesting implications for the very long time behavior. We argue that the lifetime of a de Sitter phase can not exceed the Poincare recurrence time. This is supported by recent results of Kachru, Kallosh, Linde and Trivedi. (author)

  15. Aprendiendo de la ficción televisiva. La recepción y los efectos socializadores de «Amar en tiempos revueltos» Learning from Television Fiction. The Reception and Socialization Effects from Watching «Loving in Troubled Times»

    Directory of Open Access Journals (Sweden)

    Mar Chicharro Merayo

    2011-03-01

    the viewer’s personal and social characteristics. This work examines the informational usefulness and significance for personal identity of a specific television genre, the telenovela, a fictional product which, despite focusing its narrative on romantic events and personal conflicts, can also provide the viewer with explanations and interpretations of society’s past and present. In particular, this analysis of the melodramatic format sets out to establish the meanings and representations in «Amar en tiempos revueltos» («Loving in Troubled Times» for its female viewers. Based on the analysis of in-depth interviews, the article will explore the female audience’s reception processes through variables such as age and education. This study concludes that the majority of female viewers use fiction in an explanatory sense, and that the telenovela is a genre in which women identify themselves individually and as a group.

  16. Damage of a Compressor Suction Valve Used in the Compact Refrigerator for Storage of Apples, and Measures to Settle the Trouble

    Science.gov (United States)

    Sudo, Atusi; Sudo, Akinari

    The air-cooled refrigerator for cold districts has been developed in response of the necessity of cold storage of apples over a long time of one year. The refrigerators have suffered the trouble of a compressor suction valve in practical use on the winter season, which is often caused by a pulsating flow of liquid refrigerant induced at sudden rise of condenser temperature. The trouble was settled by use of a large size dryer, which played additional roles of al iquid reservoir and an accumlator, in place of an old dryer.

  17. Effects of cadmium and a one-time drought stress on survival, growth, and yield of native plant species

    Energy Technology Data Exchange (ETDEWEB)

    Miles, L.J.; Parker, G.R.

    1980-04-01

    Andropogon scoparius, Monarda fistulosa, and Rudbeckia hirta were grown from seed for 6 weeks in an uncontaminated rural site soil and a heavy metal-contaminated urban site soil. The rural site soil was amended with cadmium chloride. Plants grown in both soils were subjected to a one-time drought stress. Survival, shoot weight, root weight, total weight, height, and weekly growth of Andropogon and Monarda were adversely affected by cadmium (Cd) addition and drought stress. Results were similar for Rudbeckia except that shoot, root, and total weight were not significantly affected by drought stress. Root weights of Monarda and Andropogon were more severely affected by Cd addition than were shoot weights. Root-shoot ratios were not significantly affected by drought stress for any species. Drought stress and Cd addition effects were found to be additive for Monarda and Andropogon. The effect of soil Cd addition on growth was found to be primarily due to an initial delay in growth rather than a reduction in the overall rate of growth. However, on the heavy metal contamination urban site soil the growth rate was found to be reduced. This was especially true for Andropogon which was found to be most tolerant of Cd addition to the rural site soil for the species tested. The reduction in growth rate of plants on the urban site soil was probably not due to Cd alone.

  18. Comparison of survival time of Hawley and Vacuum-formed retainers in orthhodontic patients– a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Seyed Hossein Moslemzadeh

    2017-01-01

    Full Text Available Background: Maintaining the results of orthodontic treatment and keeping the teeth in the corrected position is a great challenge in orthodontics. This study aimed to compare the survival time of three types of retainers including Hawley, 1-mm Vacuum-Formed (VF, and 1.5-mm VF within 6-month period. Methods: In this randomized clinical study, 152 patients were allocated into three groups to receive one type of the retainers. They were visited 1, 3, and 6 months after retainer delivery and checked for breakage, loss, local perforation, and discoloration from the patient's and clinician's point of view as indicators of failure. Chi-square and Fisher's exact tests were used as appropriated. Result: The results revealed that breakage was among the main reasons of failure of retainers within 6 months, which was statistically significantly different between Hawley and VF retainers, as well as between 1-mm and 1.5-mm VF retainers in the three intervals (p0.05. Assessing the discoloration from the patient's point of view revealed statistically significant differences between Hawley and VF retainers within the first month; however, the difference was not significant at the third and sixth months (p0.05. By the end of the sixth month, some of the VF retainers had perforation; while, perforation was not observed in Hawley retainers. Conclusion: Considering the higher breakage rate of 1-mm VF, 1.5-mm VF seems the retainer if choice.

  19. Transgenerational effects of parental nutritional status on offspring development time, survival, fecundity, and sensitivity to zinc in Chironomus tepperi midges.

    Science.gov (United States)

    Colombo, Valentina; Pettigrove, Vincent J; Golding, Lisa A; Hoffmann, Ary A

    2014-12-01

    Environmental stimuli can induce plastic changes in life history traits, and stimuli experienced by parents can be transmitted to the next generation ("transgenerational") through the inheritance of factors unrelated to changes in DNA sequences. Transgenerational effects are common in species living in habitats subjected to recurrent stressful events, such as fluctuating resource availability. In a previous study, the nutritional status of the midge Chironomus tepperi has been reported to influence life history traits of the offspring. In this study we investigated whether they also alter sensitivity of offspring to zinc. Offspring of parents reared under low food conditions had a shorter development time and lower reproductive output compared to offspring of parents raised under excess food. While zinc exposure decreased the survival of offspring generally, the interaction between parental food level and zinc exposure did not influence the relative sensitivity of offspring toward zinc. Parental nutritional stress therefore triggered transgenerational effects, potentially acting as confounding factors in ecotoxicological studies, but they did not directly affect the susceptibility of offspring to zinc. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt.

    Science.gov (United States)

    Kiely, Kim M; Butterworth, Peter

    2014-04-01

    The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.

  1. Single nucleotide polymorphisms in the D-loop region of mitochondrial DNA is associated with the kidney survival time in chronic kidney disease patients.

    Science.gov (United States)

    Xu, Jinsheng; Guo, Zhanjun; Bai, Yaling; Zhang, Junxia; Cui, Liwen; Zhang, Huiran; Zhang, Shenglei; Ai, Xiaolu

    2015-02-01

    The mitochondrial displacement loop (D-loop) is known to accumulate mutations and SNPs at a higher frequency than other regions of mitochondrial DNA (mtDNA). We had identified chronic kidney disease (CKD) risk-associated SNPs in the D-loop of CKD patients previously. In this study, we investigated the association of SNPs in the D-loop of mtDNA with the kidney survival of CKD. The D-loop region of mtDNA was sequenced for 119 CKD patients from the inpatient of the Fourth Hospital of Hebei Medical University. The Kaplan-Meier method was used to identify disease outcome-associated SNPs in the D-loop of CKD patients. The Cox proportional hazards model was used to identify risk factors for the kidney survival of CKD. In the present study, we identified 20 SNPs with a frequency higher than 5% and assessed the relationship of these SNPs with kidney survival time in CKD patients, a SNP of 146 was identified by log-rank test for statistically significant prediction of the kidney survival time. In an overall multivariate analysis, allele 146 was identified as an independent predictor of kidney survival time in CKD patients. The survival time of kidney in the CKD patients with 146C was significantly shorter than that of kidney in CKD patients with 146T (relative risk, 2.336; 95% CI, 1.319-3.923; p = 0.001). SNPs in the D-loop can predict the kidney survival of CKD patients. Analysis of genetic polymorphisms in the mitochondrial D-loop can help to identify CKD patient subgroup at high risk of a poor disease outcome.

  2. Treating troubled families: therapeutic scenario in India.

    Science.gov (United States)

    Thomas, Bino

    2012-04-01

    India, a country of diverse cultures, languages, life styles, and ethnicities, is becoming a land of economic change, political stability, technological advancement, and changing traditional structures of relationships as well as health consciousness. Being known for its ancient traditions, rituals, religious orientation, spiritual outlook and folk beliefs, Indian families attempt to continue certain healthy and traditional elements such as warmth, strong bond, hierarchy, extended support, cultural orientation, shared values and time, tolerance, respect for the aged and inculcation of religious teachings and traditions in families. These factors, or practices, in fact have strong therapeutic value in supplementing the growth and development of individuals in the family system in spite of its transitional position. This paper deals with the review of family-based mental health services and focuses on the changing trends of those practices in India and the advancement of Indian families in their engaging ability with mentally ill members as well as with the treating team.

  3. The relationship between annual survival rate and migration distance in mallards: an examination of the time-allocation hypothesis for the evolution of migration

    Science.gov (United States)

    Hestbeck, J.B.; Nichols, J.D.; Hines, J.E.

    1992-01-01

    Predictions of the time-allocation hypothesis were tested with several a posteriori analyses of banding data for the mallard (Anas platyrhynchos). The time-allocation hypothesis states that the critical difference between resident and migrant birds is their allocation of time to reproduction on the breeding grounds and survival on the nonbreeding grounds. Residents have higher reproduction and migrants have higher survival. Survival and recovery rates were estimated by standard band-recovery methods for banding reference areas in the central United States and central Canada. A production-rate index was computed for each reference area with data from the U.S. Fish and Wildlife Service May Breeding Population Survey and July Production Survey. An analysis of covariance was used to test for the effects of migration distance and time period (decade) on survival, recovery, and production rates. Differences in migration chronology were tested by comparing direct-recovery distributions for different populations during the fall migration. Differences in winter locations were tested by comparing distributions of direct recoveries reported during December and January. A strong positive relationship was found between survival rate, and migration distance for 3 of the 4 age and sex classes. A weak negative relationship was found between recovery rate and migration distance. No relationship was found between production rate and migration distance. During the fall migration, birds from the northern breeding populations were located north of birds from the southern breeding populations. No pattern could be found in the relative locations of breeding and wintering areas. Although our finding that survival rate increased with migration distance was consistent with the time-allocation hypothesis, our results on migration chronology and location of wintering areas were not consistent with the mechanism underlying the time-allocation hypothesis. Neither this analysis nor other recent

  4. Compost: Brown gold or toxic trouble?

    Science.gov (United States)

    Kovacic, D.A.; Cahill, R.A.; Bicki, T.J.

    1992-01-01

    Limited data are available regarding the occurrence of potentially hazardous constituents in raw, uncomposted yard wastes, partially composted yard wastes, and finished compost (15, 16). Environmental monitoring at composting operations or facilities is lacking, and currently published research on the environmental fate of composted yard waste constituents is extremely limited. The cost of thoroughly investigating the fate of toxicants in yard waste may seem needlessly expensive, but it is much less than the cost of cleaning up contaminated sites and groundwater. Could yard waste compost sites become Superfund sites? The cost of a thorough testing program throughout the United States may be several million dollars, but that is only a fraction of the funds spent initiating and developing yard waste composting facilities, let alone the potentially much greater cost of environmental remediation. There is still time to address these problems and to develop sound state and federal guidelines for siting and operating yard waste compost facilities. The rush to implement landfill alternatives such as composting should not be the major driving force in determining legislation governing solid waste management. ?? 1991 American Chemical Society.

  5. Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    James E Stahl

    2008-06-01

    Full Text Available The ability to preserve organs prior to transplant is essential to the organ allocation process.The purpose of this study is to describe the functional relationship between cold-ischemia time (CIT and primary nonfunction (PNF, patient and graft survival in liver transplant.To identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance.Twenty-six studies met criteria. Functionally, PNF% = -6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean-9.895352-0.0067663*(CIT Mean-9.895353, r2 = .625, , p<.0001. Mean patient survival: 93% (1 month, 88% (3 months, 83% (6 months and 83% (12 months. Mean graft survival: 85.9% (1 month, 80.5% (3 months, 78.1% (6 months and 76.8% (12 months. Maximum patient and graft survival occurred with CITs between 7.5-12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches.The results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ.

  6. Effect of time interval between capecitabine intake and radiotherapy on local recurrence-free survival in preoperative chemoradiation for locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeon Joo; Kim, Jong Hoon; Yu, Chang Sik; Kim, Tae Won; Jang, Se Jin; Choi, Eun Kyung; Kim, Jin Cheon [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Won Sik [University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2017-06-15

    The concentration of capecitabine peaks at 1–2 hours after administration. We therefore assumed that proper timing of capecitabine administration and radiotherapy would maximize radiosensitization and influence survival among patients with locally advanced rectal cancer. We retrospectively reviewed 223 patients with locally advanced rectal cancer who underwent preoperative chemoradiation, followed by surgery from January 2002 to May 2006. All patients underwent pelvic radiotherapy (50 Gy/25 fractions) and received capecitabine twice daily at 12-hour intervals (1,650 mg/m2/day). Patients were divided into two groups according to the time interval between capecitabine intake and radiotherapy. Patients who took capecitabine 1 hour before radiotherapy were classified as Group A (n = 109); all others were classified as Group B (n = 114). The median follow-up period was 72 months (range, 7 to 149 months). Although Group A had a significantly higher rate of good responses (44% vs. 25%; p = 0.005), the 5-year local recurrence-free survival rates of 93% in Group A and 97% in Group B did not differ significantly (p = 0.519). The 5-year disease-free survival and overall survival rates were also comparable between the groups. Despite the better pathological response in Group A, the time interval between capecitabine and radiotherapy administration did not have a significant effect on survivals. Further evaluations are needed to clarify the interaction of these treatment modalities.

  7. Synergistic Relationships Among Stress, Depression, and Troubled Relationships: Insights from Psychoneuroimmunology

    OpenAIRE

    Jaremka, Lisa M.; Lindgren, Monica E.; Kiecolt-Glaser, Janice K.

    2013-01-01

    Stress and depression consistently elevate inflammation. Stress and depression are often experienced simultaneously, which is exemplified by people in troubled relationships. Troubled relationships also elevate inflammation, which may be partially explained by their ability to engender high levels of stress and depression. People who are stressed, depressed, or in troubled relationships are also at greater risk for health problems than their less distressed counterparts. Inflammation, a risk ...

  8. Jointly modeling longitudinal proportional data and survival times with an application to the quality of life data in a breast cancer trial.

    Science.gov (United States)

    Song, Hui; Peng, Yingwei; Tu, Dongsheng

    2017-04-01

    Motivated by the joint analysis of longitudinal quality of life data and recurrence free survival times from a cancer clinical trial, we present in this paper two approaches to jointly model the longitudinal proportional measurements, which are confined in a finite interval, and survival data. Both approaches assume a proportional hazards model for the survival times. For the longitudinal component, the first approach applies the classical linear mixed model to logit transformed responses, while the second approach directly models the responses using a simplex distribution. A semiparametric method based on a penalized joint likelihood generated by the Laplace approximation is derived to fit the joint model defined by the second approach. The proposed procedures are evaluated in a simulation study and applied to the analysis of breast cancer data motivated this research.

  9. Alcohol use at time of injury and survival following traumatic brain injury: results from the National Trauma Data Bank.

    Science.gov (United States)

    Chen, Chiung M; Yi, Hsiao-Ye; Yoon, Young-Hee; Dong, Chuanhui

    2012-07-01

    Premised on biological evidence from animal research, recent clinical studies have, for the most part, concluded that elevated blood alcohol concentration levels are independently associated with higher survival or decreased mortality in patients with moderate to severe traumatic brain injury (TBI). This study aims to provide some counterevidence to this claim and to further future investigations. Incident data were drawn from the largest U.S. trauma registry, the National Trauma Data Bank, for emergency department admission years 2002-2006. TBI was identified according to the National Trauma Data Bank's definition using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes. To eliminate confounding, the exact matching method was used to match alcohol-positive with alcohol-negative incidents on sex, age, race/ethnicity, and facility. Logistic regression compared in-hospital mortality between 44,043 alcohol-positive and 59,817 matched alcohol-negative TBI incidents, with and without causes and intents of TBI and Injury Severity Score as covariates. A sensitivity analysis was performed within a subsample of isolated moderate to severe TBI incidents. Alcohol use at the time of injury was found to be significantly associated with an increased risk for TBI. Including varied causes and intents of TBI and Injury Severity Score as potential confounders in the regression model explained away the statistical significance of the seemingly protective effect of alcohol against TBI mortality for all TBIs and for isolated moderate to severe TBIs. The null finding shows that the purported reduction in TBI mortality attributed to positive blood alcohol likely is attributable to residual confounding. Accordingly, the risk of TBI associated with alcohol use should not be overlooked.

  10. The effects of ambient temperature and mixing time of glass ionomer cement material on the survival rate of proximal ART restorations in primary molars

    Directory of Open Access Journals (Sweden)

    Arthur M Kemoli

    2014-01-01

    Full Text Available Objective: Temperature fluctuations and material mixing times are likely to affect the consistency and integrity of the material mixture, and hence the restoration made out of it. The purpose of the present study was to determine the influence of the ambient temperature and the mixing time of glass ionomer cement (GIC restorative material on the survival rate of proximal atraumatic restorative treatment (ART restorations placed in primary molars. Materials and Methods: A total of 804 restorations were placed in the primary molars of 6-8-year-olds using the ART approach. The restorations were then followed for a period of 2 years and evaluated at given intervals. The data collected were analyzed using SPSS computer statistical program, and the results tested and compared using the Chi-square, Kaplan Meier survival analysis and Cox Proportional hazard statistical tests. Results: The cumulative survival rate of the restorations dropped from the initial 94.4% to 30.8% at the end of 2 years. The higher survival rate of the restorations was associated with the experienced operators and assistants when using the rubber dam isolation method. However, there was no statistically significant difference in the survival rate of the restorations when related to the room temperature and the mixing time of the GIC materials used in spite of the variations in the temperature recoded and the methods used in mixing the materials. Conclusion: The ambient temperature and mixing time of GIC did not have a significant effect on the survival of the proximal ART restorations.

  11. Survival of timber rattlesnakes (Crotalus horridus) estimated by capture-recapture models in relation to age, sex, color morph, time, and birthplace

    Science.gov (United States)

    Brown, W.S.; Kery, M.; Hines, J.E.

    2007-01-01

    Juvenile survival is one of the least known elements of the life history of many species, in particular snakes. We conducted a mark–recapture study of Crotalus horridus from 1978–2002 in northeastern New York near the northern limits of the species' range. We marked 588 neonates and estimated annual age-, sex-, and morph-specific recapture and survival rates using the Cormack-Jolly-Seber (CJS) model. Wild-caught neonates (field-born, n  =  407) and neonates produced by captive-held gravid females (lab-born, n  =  181) allowed comparison of the birthplace, or lab treatment effect, in estimated survival. Recapture rates declined from about 10–20% over time while increasing from young to older age classes. Estimated survival rates (S ± 1 SE) in the first year were significantly higher among field-born (black morph: S  =  0.773 ± 0.203; yellow morph: S  =  0.531 ± 0.104) than among lab-born snakes (black morph: S  =  0.411 ± 0.131; yellow morph: S  =  0.301 ± 0.081). Lower birth weights combined with a lack of field exposure until release apparently contributed to the lower survival rate of lab-born snakes. Subsequent survival estimates for 2–4-yr-old snakes were S  =  0.845 ± 0.084 for the black morph and S  =  0.999 (SE not available) for the yellow morph, and for ≥5-yr-old snakes S  =  0.958 ± 0.039 (black morph) and S  =  0.822 ± 0.034 (yellow morph). The most parsimonious model overall contained an independent time trend for survival of each age, morph, and lab-treatment group. For snakes of the first two age groups (ages 1 yr and 2–4 yr), survival tended to decline over the years for both morphs, while for adult snakes (5 yr and older), survival was constant or even slightly increased. Our data on survival and recapture are among the first rigorous estimates of these parameters in a rattlesnake and among the few yet available for any viperid snake. These data are useful for analyses of the life

  12. The association between timing of initiation of adjuvant therapy and the survival of early stage ovarian cancer patients - An analysis of NRG Oncology/Gynecologic Oncology Group trials.

    Science.gov (United States)

    Chan, John K; Java, James J; Fuh, Katherine; Monk, Bradley J; Kapp, Daniel S; Herzog, Thomas; Bell, Jeffrey; Young, Robert

    2016-12-01

    To determine the association between timing of adjuvant therapy initiation and survival of early stage ovarian cancer patients. Data were obtained from women who underwent primary surgical staging followed by adjuvant therapy from two Gynecologic Oncology Group trials (protocols # 95 and 157). Kaplan-Meier estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Of 497 stage I-II epithelial ovarian cancer patients, the median time between surgery and initiation of adjuvant therapy was 23days (25th-75th%: 12-33days). The time interval from surgery to initiation of adjuvant therapy was categorized into three groups: 4weeks. The corresponding 5-year recurrence-free survival rates were 72.8%, 73.9%, and 79.5% (p=0.62). The 5-year overall survival rates were 79.4%, 81.9%, and 82.8%, respectively (p=0.51; p=0.33 - global test). As compared to 4weeks. Age, stage, grade, and cytology were important prognostic factors. Timing of adjuvant therapy initiation was not associated with survival in early stage epithelial ovarian cancer patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Blockade of CD40-CD154 at the time of donor-specific blood transfusion does not lead to prolonged kidney allograft survival in nonhuman primates

    NARCIS (Netherlands)

    Ringers, J; Haanstra, KG; Kroczek, RA; Kliem, K; Kuhn, EM; Wubben, J; Ossevoort, MA; Volk, HD; Jonker, M

    2002-01-01

    Background. In rodents it has been demonstrated that blockade of the CD40-CD154 (CD40L) pathway at the time of donor-specific blood transfusion (DST) can result in indefinite graft survival. Because it has been reported in the past that DST in monkeys can have a favorable effect on graft outcome and

  14. Risk of Early Onset Substance Use among Students with and without Mild Academic Disabilities: Results of a Discrete-Time Survival Analysis

    Science.gov (United States)

    Kepper, Annelies; Koning, Ina; Vollebergh, Wilma; Monshouwer, Karin

    2014-01-01

    This study investigated the age of onset of substance use among 536 students with mild academic disabilities and 906 students without academic disabilities, and the extent to which emotional, conduct, and hyperactivity problems explain the differences between these two groups. Using discrete-time survival analysis, the results of this study showed…

  15. Surviving death-anxieties in liquid modern times: examining Zygmunt Bauman's cultural theory of death and dying.

    Science.gov (United States)

    Higo, Masa

    2012-01-01

    Despite his prominence as a leading contemporary social theorist, Zygmunt Bauman's long-term writing on the cultural theory of death and dying has largely been overlooked in the sociological literature of death and dying, particularly in the United States. Bauman uniquely theorizes how we survive death-anxieties today: Contemporary, liquid modern culture has engaged us in ceaseless pursuit of the unattainable consumer sensation of bodily fitness as a way to suppress and thus survive our death-anxieties. Bauman also argues that the prevalence of this cultural formula to survive death-anxieties has simultaneously increased, more than ever before in social history, the volume of individual responsibility for restlessly coping with existential anxieties in the societies of consumers. While unique and insightful, his theoretical argument has a limitation; largely succeeding Freud's classic view of mortality, Bauman's contemporary theory may lead us to neglect potentially important social, cultural, and historical variations in how mortality has been understood.

  16. Impact of marital status at diagnosis on survival and its change over time between 1973 and 2012 in patients with nasopharyngeal carcinoma: a propensity score-matched analysis.

    Science.gov (United States)

    Xu, Cheng; Liu, Xu; Chen, Yu-Pei; Mao, Yan-Ping; Guo, Rui; Zhou, Guan-Qun; Tang, Ling-Long; Lin, Ai-Hua; Sun, Ying; Ma, Jun

    2017-12-01

    The impact of marital status at diagnosis on survival outcomes and its change over time in patients with nasopharyngeal carcinoma (NPC) are unclear. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with NPC in the United States from 1973 to 2012. A primary comparison (married vs. unmarried) was implemented with 1:1 propensity score matching. Secondary comparisons were performed individually between three unmarried subgroups (single, separated/divorced, widowed) and married group. The effect of marital status on cause-specific survival (CSS) and overall survival (OS) were evaluated using univariate/multivariate analysis. Moreover, we investigated the change over time (1973-2012) in the effect of marital status on NPC survival. Married patients had better 5-year CSS/OS than unmarried patients (61.1% vs. 52.6%, P < 0.001; 55.6% vs. 45.3%, P < 0.001, respectively). In multivariate analysis, unmarried patients had significantly poorer CSS/OS than married patients (adjusted hazard ratio [aHR] = 1.35, P < 0.001; aHR = 1.40, P < 0.001, respectively). The survival benefit of being married was only detected in non-Hispanic white and Chinese American patients. Single, separated/divorced, and widowed patients had significantly poorer CSS/OS than married patients (aHR = 1.37 and 1.37; 1.46 and 1.42; 1.43 and 1.48, respectively; all P < 0.001). The change over time in the effect of marital status on survival was more stable in male than female. The strength of the negative effect of separated/divorced and widowed status showed a downward and upward trend, respectively. Gender difference in the adverse effect of single status on NPC survival became smaller over time. Only non-Hispanic white and Chinese American patients with NPC obtain survival benefits from married status. Single and widowed patients are regarded as high-risk population. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  17. 'Troubling' moments in health promotion: unpacking the ethics of empowerment.

    Science.gov (United States)

    Spencer, Grace

    2015-12-01

    Concepts of empowerment feature strongly in global health discourses. Empowerment is frequently advocated as a positive approach to addressing individual and community-level health needs. Despite its popularity, relatively little has been said about the unintended consequences of empowerment, which may give rise to some troubling ethical issues or, indeed, result in outcomes that may not be considered health promoting. Drawing on current uses of empowerment within health promotion, along with insights from an ethnographic study on young people's health, this paper raises some critical questions about the ethics of empowerment. By doing so, the paper troubles the idea that empowerment is a 'good thing' without some careful attention to the varying ways in which the ethics of empowerment may unfold in practice. Findings revealed young people's different perspectives on health and priorities for health promotion. The present analysis highlights how these alternative framings prompt a number of ethical tensions for understanding and operationalising empowerment. In conclusion, the findings underscore the importance of promoting ethical reflexivity in health promotion and, crucially, attending to the unintended and potentially ethically problematic consequences of empowerment. So what? This paper raises some critical questions about the ethics of empowerment and calls for a more thorough engagement with the unintended consequences of empowerment within health promotion.

  18. Race trouble: attending to race and racism in online interaction.

    Science.gov (United States)

    Durrheim, Kevin; Greener, Ross; Whitehead, Kevin A

    2015-03-01

    This article advocates the concept of race trouble as a way of synthesizing variation in racial discourse, and as a way of studying how social interaction and institutional life continue to be organized by conceptions of 'race' and 'racism'. Our analysis of an online discussion at a South African University about the defensibility of a characterization of (black) student protesters as 'savages' revealed a number of familiar strategies: participants avoided explicit racism, denied racism, and denied racism on behalf of others. However, the aim of this analysis was not to identify the 'real' racism, but to show how race and racism were used in the interaction to develop perspectives on transformation in the institution, to produce social division in the University, and to create ambivalently racialized and racializing subject positions. We demonstrate how, especially through uses of deracialized discourse, participants' actions were observably shaped by the potential ways in which others could hear 'race' and 'racism'. Race trouble thus became manifest through racial suggestion, allusion, innuendo, and implication. We conclude with a call to social psychologists to study the ways in which meanings of 'race' and 'racism' are forged and contested in relation to each other. © 2014 The British Psychological Society.

  19. 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…

  20. Time trends in incidence rates and survival of newly diagnosed stage IV breast cancer by tumor histology: a population-based analysis.

    Science.gov (United States)

    Di Meglio, Antonio; Freedman, Rachel A; Lin, Nancy U; Barry, William T; Metzger-Filho, Otto; Keating, Nancy L; King, Tari A; Sertoli, Mario Roberto; Boccardo, Francesco; Winer, Eric P; Vaz-Luis, Ines

    2016-06-01

    Few contemporary data are available that compare incidence and survival of metastatic breast cancer between ductal and lobular carcinomas. Using the Surveillance, Epidemiology, and End Results-9 registries, we identified 10,639 patients with de novo metastatic breast cancer diagnosed from 1990 to 2011. Annual age-adjusted incidence rates and annual percent changes (APCs) were analyzed. Multivariable Cox regression models were used to investigate the impact of year of diagnosis and histology on overall survival. 9250 (86.9 %) patients had ductal and 1389 (13.1 %) had lobular carcinomas. Metastatic breast cancer incidence increased slightly over time for ductal (APC = +1.7, 95 % confidence interval (CI) = +1.0 to +2.4) and lobular carcinomas (APC = +3.0, 95 % CI = +1.8 to +4.3). Median overall survival was 22 months among the whole cohort. More recent year of diagnosis was associated with better overall survival only for patients with ductal carcinomas (interaction p value = 0.006), with an adjusted hazard ratio of death for every five-year increment in the date of diagnosis of 0.93 (95 % CI =  0.91-0.95) among ductal carcinomas, compared with 1.05 (95 % CI = 0.95-1.10) among lobular carcinomas. Overall survival was longer for lobular versus ductal carcinomas (28 versus 21 months, respectively; adjusted hazard ratio of death = 0.93, 95 % CI = 0.87-0.99), but the magnitude of this effect was attenuated among the cohort restricted to hormone receptor-positive tumors. In this population-based analysis, incidence rates of metastatic breast cancer at presentation increased slightly over time for both histologies, and particularly for lobular tumors. A modest improvement in metastatic breast cancer median overall survival was observed, but was apparently limited to ductal carcinomas.

  1. Retrospective epidemiological study of canine epilepsy in Japan using the International Veterinary Epilepsy Task Force classification 2015 (2003-2013): etiological distribution, risk factors, survival time, and lifespan.

    Science.gov (United States)

    Hamamoto, Yuji; Hasegawa, Daisuke; Mizoguchi, Shunta; Yu, Yoshihiko; Wada, Masae; Kuwabara, Takayuki; Fujiwara-Igarashi, Aki; Fujita, Michio

    2016-11-09

    Epilepsy is the most common neurological disease in veterinary practice. However, contrary to human medicine, epilepsy classification in veterinary medicine had not been clearly defined until recently. A number of reports on canine epilepsy have been published, reflecting in part updated proposals from the human epilepsy organization, the International League Against Epilepsy. In 2015, the International Veterinary Epilepsy Task Force (IVETF) published a consensus report on the classification and definition of canine epilepsy. The purpose of this retrospective study was to investigate the etiological distribution, survival time of dogs with idiopathic epilepsy (IdE) and structural epilepsy (StE), and risk factors for survival time, according to the recently published IVETF classification. We investigated canine cases with epilepsy that were referred to our teaching hospital in Japan during the past 10 years, and which encompassed a different breed population from Western countries. A total of 358 dogs with epilepsy satisfied our etiological study criteria. Of these, 172 dogs (48 %) were classified as IdE and 76 dogs (21 %) as StE. Of these dogs, 100 dogs (consisting of 65 with IdE and 35 with StE) were included in our survival study. Median survival time from the initial epileptic seizure in dogs with IdE and StE was 10.4 and 4.5 years, respectively. Median lifespan of dogs with IdE and StE was 13.5 and 10.9 years, respectively. Multivariable analysis demonstrated that risk factors for survival time in IdE were high seizure frequency (≥0.3 seizures/month) and focal epileptic seizures. Focal epileptic seizures were identified as a risk factor for survival time in IdE. Clinicians should carefully differentiate seizure type as it is difficult to identify focal epileptic seizures. With good seizure control, dogs with IdE can survive for nearly the same lifespan as the general dog population. Our results using the IVETF classification are similar to previous

  2. Trouble at School: Understanding School Discipline Systems as Nets of Social Control

    Science.gov (United States)

    Irby, Decoteau J.

    2014-01-01

    Getting in trouble at school is often a student's first point of entry into the school-to-prison pipeline. What trouble entails is shaped by underlying and complex notions of justice that operate in a given school setting. These notions of justice shape the range of responses social actors use to address students who break school rules. These…

  3. Individual Characteristics of Adolescent Methamphetamine Users in Relation to Self-Reported Trouble with the Police

    Science.gov (United States)

    Gassman, Ruth; Nowicke, Carole E.; Jun, Mi Kung

    2010-01-01

    Survey responses by nonexperimental drug users in grades 6-12 were examined to determine whether MA users and nonusers with shared individual characteristics experience differential rates of police trouble, and whether specific factors place some users at greater risk than others. Findings showed that police trouble is pronounced for MA users,…

  4. [Effects of fuzheng jianpi decoction combined chemotherapy on the quality of life and the survival time of children with solid tumor].

    Science.gov (United States)

    Shi, Xue; Zhu, Xiu-Dan; Wang, Huan-Ming

    2012-09-01

    To study the effects of Fuzheng Jianpi Decoction (FJD) combined chemotherapy on the quality of life (QOL) and the survival time of children with solid tumor. Recruited were 167 solid tumor children patients at Department of Tumor, Beijing Children's Hospital from Jan. 2005 to Jan. 2008. They were randomly assigned to the treatment group (83 cases) and the control group (84 cases) according to the random digit table. All had chemotherapy. Those in the treatment group additionally took FJD, 50 -100 mL each time, twice daily. After chemotherapy those in the treatment group took modified FJD. The WBC, Hb, and PLT were detected in all patients before treatment, 6 months after treatment, and 1 year after treatment. The 1-, 2-, and 3-year QOL, 3-year survival rate, and the survival life of dead children patients were observed. Compared with the control group of the same period, the 6-month and 1-year WBC and Hb increased, the 1-year PLT increased in the treatment group, showing statistical difference (Pchildren was prolonged in the treatment group, showing statistical difference (Pchemotherapy could effectively improve the QOL of solid tumor children patients, elevate their survival rate, and prolong their life spans.

  5. Hemopathologic predisposition and survival time under continuous gamma irradiation: responses mediated by altered radiosensitivity of hemopoietic progenitors

    Energy Technology Data Exchange (ETDEWEB)

    Seed, T.M.; Kaspar, L.V.; Tolle, D.V.; Fritz, T.E.

    1982-01-01

    These marked differences in radiosensitivity of individual animals within a relatively homogeneous, healthy pure bred group, as manifested by varying survival patterns and pathologic tendencies, have stimulated studies concerning the cellular bases of these responses. In previous studies, as in this one, the authors have attempted to characterize the cellular processes of hemopoietic recovery, an early occurring event characteristically observed in a select subgroup of MPD dogs exhibiting prolonged course of survival and a tendency to myeloproliferative disorders (MPD). Hemopoietic recovery appears to be a broadly based process as indicated by: (a) increased concentrations of blood granulocytes; (b) expanded granulocyte reserves; and (c) increased concentration of hemopoietic progenitors in the marrow. The intent of the present study was to examine the possibility that the cellular basis of hemopoietic recovery resides in the acquisition of increased radioresistance by hemopoietic progenitors, i.e., the suspected cellular targets of the hemopathic effects of ionizing irradiation.

  6. From fun and excitement to joy and trouble. An explorative study of three Danish father's experiences around birth

    DEFF Research Database (Denmark)

    Hall, Elisabeth

    1995-01-01

    at the end of the pregnancy, love at first sight at the birth, at which they all attended and took an active part, awakening when the new family was united at home and when they came to realize how much effort is needed in caring for an infant, and joy and trouble three months later. It is suggested...... first-time fathers were interviewed at three different times: in the last month of pregnancy, two weeks after the birth of their child, and again three months later. Data were analyzed in several steps using a hermeneutical approach. The fathers' experiences were identified as fun and excitement...

  7. Spinal troubles in sewage workers: epidemiological data and work disability due to low back pain.

    Science.gov (United States)

    Friedrich, M; Cermak, T; Heiller, I

    2000-05-01

    To determine the prevalence of spinal troubles (i.e., neck, upper back and low back pain) in a population of sewage workers, and to establish the effect of sociodemographic, work-related, physical, and psychosocial factors on the reported work disability due to low back pain (LBP) during the previous 12 months. Data from 255 sewage workers were obtained by standardized questionnaire, structured interview, and standardized physical examination. Data on the prevalence of neck, upper back and low back pain were obtained with the use of the Nordic Questionnaire. The level of disability was assessed from a modified Low-Back Outcome Scale. Work history included physical factors and job perception based on a modified Work APGAR Score. Other questionnaires recorded the psychosocial aspects of the work environment. In addition, we compared the risk factors between sewage workers who had been prevented from doing their normal work, at any time during the preceding 12 months, as a result of LBP (n = 92), and those without any history of work disability during the previous 12 months (n = 157). The 12-month prevalence rates of neck, upper back and low back pain were 52.4%, 54.8%, and 72.8%, respectively. The prevalence of spinal troubles increased with age. Work disability during the preceding 12 months due to LBP was significantly positively associated with age, disability, the weekly duration of stooping and lifting 5 years previously and higher abnormal illness-behavior scores (odds ratio between 1.26 and 0.94). Moreover, when adjusted for age, the results showed that the subjects in the work disability group were more likely to report higher pain intensities, decreased participation in sports activities, higher levels of physical impairment, the belief that their LBP was related to the physical demands of their job, and a lack of drive (P < 0.05). This study revealed a high incidence of spinal troubles among sewage workers. In a multidisciplinary approach, we demonstrated

  8. Mercury and drought along the lower Carson River, Nevada: IV. Snowy egret post-fledging dispersal, timing of migration and survival, 2002–2004

    Science.gov (United States)

    Henny, Charles J.; Hill, Elwood F.; Grove, Robert A.; Chelgren, Nathan; Haggerty, Patricia K.

    2017-01-01

    This telemetry study is an extension of our 1997–2006 research on historical mercury contamination on snowy egrets (Egretta thula) up to ~ 20 days of age. Findings from initial studies at the mercury-contaminated Carson River colony at Lahontan Reservoir (LR) and a similar-sized reference (REF) colony on the Humboldt River included mercury-related physiological, biochemical, histopathological and reproductive effects up to ~20 days of age; with poor water years (2000–04), i.e., reduced prey availability, exacerbating effects. Herein, we compare timing of dispersal and migration at LR vs. REF, but the primary question now addressed is “whether survival of young mercury-exposed snowy egrets from LR would be further compromised beyond ~20 days of age? ” Based upon telemetry signals until 90–110 days of age (including dead bird counts and survival rate estimates), we conclude that mercury did not further compromise survival. Dead bird counts and survival rate estimates included time in the colony when fed by adults, plus the critical period when young dispersed from the colony to forage independently. The extended drought during this 3-year study was most critical in 2002 when production of ~20 d old egrets at LR was only 0.24 young/nest. In 2002, survival rates were low at both colonies and we documented the highest counts of dead egrets for both colonies. We suggest the losses in 2002 beyond 20 days of age were more a function of prey availability influenced by drought than exposure to mercury, especially at LR, because higher mercury concentrations, higher survival rates and fewer dead birds were documented at LR in 2003 when water conditions improved. Furthermore, total mercury (THg) in blood in 2003 was more than double 2002 (geometric mean, 3.39 vs 1.47 µg/g wet weight (ww). This higher THg exposure at LR in 2003 was associated with a redistribution of parent and post-dispersal feeding activities upstream (where there was higher mercury from historic

  9. Mercury and drought along the lower Carson River, Nevada: IV. Snowy egret post-fledging dispersal, timing of migration and survival, 2002-2004.

    Science.gov (United States)

    Henny, Charles J; Hill, Elwood F; Grove, Robert A; Chelgren, Nathan D; Haggerty, Patricia K

    2017-01-01

    This telemetry study is an extension of our 1997-2006 research on historical mercury contamination on snowy egrets (Egretta thula) up to ~ 20 days of age. Findings from initial studies at the mercury-contaminated Carson River colony at Lahontan Reservoir (LR) and a similar-sized reference (REF) colony on the Humboldt River included mercury-related physiological, biochemical, histopathological and reproductive effects up to ~20 days of age; with poor water years (2000-04), i.e., reduced prey availability, exacerbating effects. Herein, we compare timing of dispersal and migration at LR vs. REF, but the primary question now addressed is "whether survival of young mercury-exposed snowy egrets from LR would be further compromised beyond ~20 days of age? " Based upon telemetry signals until 90-110 days of age (including dead bird counts and survival rate estimates), we conclude that mercury did not further compromise survival. Dead bird counts and survival rate estimates included time in the colony when fed by adults, plus the critical period when young dispersed from the colony to forage independently. The extended drought during this 3-year study was most critical in 2002 when production of ~20d old egrets at LR was only 0.24 young/nest. In 2002, survival rates were low at both colonies and we documented the highest counts of dead egrets for both colonies. We suggest the losses in 2002 beyond 20 days of age were more a function of prey availability influenced by drought than exposure to mercury, especially at LR, because higher mercury concentrations, higher survival rates and fewer dead birds were documented at LR in 2003 when water conditions improved. Furthermore, total mercury (THg) in blood in 2003 was more than double 2002 (geometric mean, 3.39 vs 1.47µg/g wet weight (ww). This higher THg exposure at LR in 2003 was associated with a redistribution of parent and post-dispersal feeding activities upstream (where there was higher mercury from historic mining

  10. Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.

    Science.gov (United States)

    Sarkozy, Clémentine; Terré, Christine; Jardin, Fabrice; Radford, Isabelle; Roche-Lestienne, Catherine; Penther, Dominique; Bastard, Christian; Rigaudeau, Sophie; Pilorge, Sylvain; Morschhauser, Franck; Bouscary, Didier; Delarue, Richard; Farhat, Hassan; Rousselot, Philippe; Hermine, Olivier; Tilly, Hervé; Chevret, Sylvie; Castaigne, Sylvie

    2014-01-01

    Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. Copyright © 2013 Wiley Periodicals, Inc.

  11. Gray’s Time-Varying Coefficients Model for Posttransplant Survival of Pediatric Liver Transplant Recipients with a Diagnosis of Cancer

    Directory of Open Access Journals (Sweden)

    Yi Ren

    2013-01-01

    Full Text Available Transplantation is often the only viable treatment for pediatric patients with end-stage liver disease. Making well-informed decisions on when to proceed with transplantation requires accurate predictors of transplant survival. The standard Cox proportional hazards (PH model assumes that covariate effects are time-invariant on right-censored failure time; however, this assumption may not always hold. Gray’s piecewise constant time-varying coefficients (PC-TVC model offers greater flexibility to capture the temporal changes of covariate effects without losing the mathematical simplicity of Cox PH model. In the present work, we examined the Cox PH and Gray PC-TVC models on the posttransplant survival analysis of 288 pediatric liver transplant patients diagnosed with cancer. We obtained potential predictors through univariable (P<0.15 and multivariable models with forward selection (P<0.05 for the Cox PH and Gray PC-TVC models, which coincide. While the Cox PH model provided reasonable average results in estimating covariate effects on posttransplant survival, the Gray model using piecewise constant penalized splines showed more details of how those effects change over time.

  12. Long-term time trends in incidence, survival and mortality of lymphomas by subtype among adults in Manitoba, Canada: a population-based study using cancer registry data.

    Science.gov (United States)

    Ye, Xibiao; Mahmud, Salaheddin; Skrabek, Pamela; Lix, Lisa; Johnston, James B

    2017-07-17

    To examine 30-year time trends in incidence, survival and mortality of lymphomas by subtype in Manitoba, Canada. Lymphoma cases diagnosed between 1984 and 2013 were classified according to the 2008 WHO classification system for lymphoid neoplasms. Death data (1984-2014) were obtained from the Manitoba Vital Statistics Agency. To examine time trends in incidence and mortality, we used joinpoint regression to estimate annual percentage change and average annual percentage change. Age-period-cohort modelling was conducted to measure the effects of age, period and cohort on incidence and mortality time trends. We estimated age-specific and standardised 5-year relative survival and used Poisson regression model to test time trends in relative survival. Total Hodgkin lymphoma (HL) incidence in men and women was stable during the study period. Age-standardised total non-Hodgkin lymphoma (NHL) incidence increased by 4% annually until around 2000, and the trend varied by sex and NHL subtype. Total HL mortality continuously declined (by 2.5% annually in men and by 2.7% annually in women), while total NHL mortality increased (by 4.4% annually in men until 1998 and by 3.2% annually in women until 2001) and then declined (by 3.6% annually in men and by 2.5% annually in women). Age-standardised 5-year relative survival for HL improved from 72.6% in 1984-1993 to 85.8% in 2004-2013, and for NHL from 57.0% in 1984-1993 to 67.5% in 2004-2013. Survival improvement was also noted for NHL subtypes, although the extent varied, with the greatest improvement for follicular lymphoma (from 65.3% in 1984-1993 to 87.6% in 2004-2013). Time trends were generally consistent with those reported in other jurisdictions in total HL and NHL incidence, but were unique in incidence for HL and for NHL subtypes chronic/small lymphocytic leukaemia/lymphoma, diffuse large B cell lymphoma and follicular lymphoma. Survival improvements and mortality reductions were seen for HL and NHL in both sexes.

  13. A Growing Troubling Triad: Diabetes, Aging, and Falls

    Directory of Open Access Journals (Sweden)

    Ryan T. Crews

    2013-01-01

    Full Text Available There is a significant and troubling link between diabetes (DM and falls in the elderly. Individuals with DM are prone to fall for reasons such as decreased sensorimotor function, musculoskeletal/neuromuscular deficits, foot and body pain, pharmacological complications, and specialty (offloading footwear devices. Additionally, there is some concern that DM patients are prone to have more severe problems with falls than non-DM individuals. Fractures, poorer rehabilitation, and increased number of falls are all concerns. Fortunately, efforts to mitigate falls by DM patients show promise. A number of studies have shown that balance, strength, and gait training may be utilized to successfully reduce fall risk in this population. Furthermore, new technologies such as virtual reality proprioceptive training may be able to provide this reduced risk within a safe training environment.

  14. Living Kinship Trouble: Danish Sperm Donors' Narratives of Relatedness.

    Science.gov (United States)

    Mohr, Sebastian

    2015-01-01

    Danish sperm donors face a particular kind of kinship trouble: they find themselves in a cultural and organizational context that offers different and contrary ways of how to make connections to donor-conceived individuals meaningful. Whereas Danish sperm banks and Danish law want sperm donors to regard these connections as contractual issues, the dominant kinship narrative in Denmark asks sperm donors to also consider them as family and kinship relations. Based on interviews with Danish sperm donors and participant observation at Danish sperm banks, I argue that Danish sperm donors make sense of connections to donor-conceived individuals as a particular kind of relatedness that cannot be reduced to either contractual or kinship relations. Making sense of these connections, sperm donors negotiate their social significance and thereby participate in opening a space which offers avenues for new kinds of sociality.

  15. Les troubles endocriniens du furet (Mustela putorius furo)

    OpenAIRE

    Baudoin, Magalie

    2004-01-01

    De plus en plus populaire en Europe, le furet commence à prendre de l'importance en clientèle. Les troubles endocriniens sont de mieux en mieux étudiés et concernent essentiellement l'hyperadrénocorticisme, l'insulinome, l'hyperoestrogénisme ; et plus rarement l'hypocorticisme, le diabète sucré, le peptidome pancréatique, les tumeurs génitales de la femelle et du mâle, l'hyperthyroïdie, et enfin l'hypothyroïdie. Dans une première partie, l'auteur donne des règles générales pour la consulta...

  16. Survival time outcomes in randomized, controlled trials and meta-analyses: the parallel universes of efficacy and cost-effectiveness.

    Science.gov (United States)

    Guyot, Patricia; Welton, Nicky J; Ouwens, Mario J N M; Ades, A E

    2011-01-01

    Many regulatory agencies require that manufacturers establish both efficacy and cost-effectiveness. The statistical analysis of the randomized, controlled trial (RCT) outcomes should be the same for both purposes. The question addressed by this article is the following: for survival outcomes, what is the relationship between the statistical analyses used to support inference and the statistical model used to support decision making based on cost-effectiveness analysis (CEA)? We performed a review of CEAs alongside trials and CEAs based on a synthesis of RCT results, which were submitted to the National Institute for Health and Clinical Excellence (NICE) Technology Appraisal program and included survival outcomes. We recorded the summary statistics and the statistical models used in both efficacy and cost-effectiveness analyses as well as procedures for model diagnosis and selection. In no case was the statistical model for efficacy and CEA the same. For efficacy, relative risks or Cox regression was used. For CEA, the common practice was to fit a parametric model to the control arm, then to apply the hazard ratio from the efficacy analysis to predict the treatment arm. The proportional hazards assumption was seldom checked; the choice of model was seldom based on formal criteria, and uncertainty in model choice was seldom addressed and never propagated through the model. Both inference and decisions based on CEAs should be based on the same statistical model. This article shows that for survival outcomes, this is not the case. In the interests of transparency, trial protocols should specify a common procedure for model choice for both purposes. Further, the sufficient statistics and the life tables for each arm should be reported to improve transparency and to facilitate secondary analyses of results of RCTs. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Radiotherapy timing in the treatment of limited-stage small cell lung cancer: the impact of thoracic and brain irradiation on survival.

    Science.gov (United States)

    Scotti, Vieri; Meattini, Icro; Franzese, Ciro; Saieva, Calogero; Bertocci, Silvia; Meacci, Fiammetta; Furfaro, Ilaria; Scartoni, Daniele; Cecchini, Sara; Desideri, Isacco; Ferrari, Katia; Bruni, Alessio; De Luca Cardillo, Carla; Bastiani, Paolo; Agresti, Benedetta; Mangoni, Monica; Livi, Lorenzo; Biti, Giampaolo

    2014-01-01

    Small cell lung cancer is an aggressive histologic subtype of lung cancer in which the role of chemotherapy and radiotherapy has been well established in limited-stage disease. We retrospectively reviewed a series of limited-stage small cell lung cancers treated with chemotherapy and thoracic and brain radiotherapy. A total of 124 patients affected by limited-stage small cell lung cancer has been treated over 10 years in our Institute. Fifty-three patients (42.8%) had concomitant radio-chemotherapy treatment and 71 patients (57.2%) a sequential treatment. Eighty-eight patients (70.9%) underwent an association of a platinum-derived drug (cisplatinum or carboplatinum) and etoposide. Prophylactic cranial irradiation was planned in all patients with histologically proven complete response to primary radio-chemotherapy. With a mean follow-up of 2.2 years, complete response was obtained in 50.8% of cases. We found a significant difference between different radio-chemotherapy association approaches (P = 0.007): percentages of overall survival were respectively 10.0%, 12.9% and 5.6% in early, late concomitant and sequential radio-chemotherapy timing. Cranial prophylaxis did not seem to influence overall survival (P = 0.21) or disease-free survival for local relapse (P = 0.34). Concomitant radio-chemotherapy is the best approach according to our experience. Our results show a benefit of prophylactic cranial irradiation in distant metastasis-free survival.

  18. A race against time: can CO-OPs and provider start-ups survive in the health insurance marketplaces?

    Science.gov (United States)

    Eggbeer, Bill

    2015-12-01

    > The Affordable Care Act's state and federal health insurance marketplaces, designed to provide affordable insurance coverage to individuals and small groups, are proving hostile territory to new market entrants. Efforts to inject competition into the marketplaces are being challenged by the wide-scale withdrawal o consumer-operated and oriented plans (CO-OPs). Meanwhile, premiums appear likely to increase for consumers as plans seek to balance medical losses. Flaws in the "Three R's" (reinsurance, risk corridors, and risk-adjustment) program are viewed as a threat to the survival of CO-OPs and start-ups.

  19. Social familiarity reduces reaction times and enhances survival of group-living predatory mites under the risk of predation.

    Directory of Open Access Journals (Sweden)

    Markus Andreas Strodl

    Full Text Available Social familiarity, which is based on the ability to recognise familiar conspecific individuals following prior association, may affect all major life activities of group-living animals such as foraging, reproduction and anti-predator behaviours. A scarcely experimentally tested explanation why social familiarity is beneficial for group-living animals is provided by limited attention theory. Limited attention theory postulates that focusing on a given task, such as inspection and assessment of unfamiliar group members, has cognitive and associated physiological and behavioural costs with respect to the attention paid to other tasks, such as anti-predator vigilance and response. Accordingly, we hypothesised that social familiarity enhances the anti-predator success of group-living predatory mites, Phytoseiulus persimilis, confronted with an intraguild predator, the predatory mite Amblyseius andersoni.We videotaped and analysed the response of two P. persimilis larvae, held in familiar or unfamiliar pairs, to attacks by a gravid A. andersoni female, using the behavioural analyses software EthoVision Pro®. Familiar larvae were more frequently close together, reacted more quickly to predator attacks, survived more predator encounters and survived longer than unfamiliar larvae.In line with the predictions of limited attention theory, we suggest that social familiarity improves anti-predator behaviours because it allows prey to shift attention to other tasks rather than group member assessment.

  20. Eight-Year Retrospective Study of the Critical Time Lapse between Root Canal Completion and Crown Placement: Its Influence on the Survival of Endodontically Treated Teeth.

    Science.gov (United States)

    Pratt, Isaac; Aminoshariae, Anita; Montagnese, Thomas A; Williams, Kristin A; Khalighinejad, Navid; Mickel, Andre

    2016-11-01

    The purpose of this study was to investigate the effects of factors associated with various coronal restorative modalities after root canal treatment (RCT) on the survival of endodontically treated teeth (ETT) and to assess the effect of time lapse between RCT and crown placement after RCT to form a tooth loss hazard model. Computerized analysis was performed for all patients who received posterior RCT from 2008 to 2016 in the graduate endodontic department. Data collected included dates of RCT, type of post-endodontic restoration, and time of extraction if extracted. Teeth that received crown after RCT were also divided into 2 groups: receiving crown before 4 months and after 4 months after RCT. Data were analyzed by using Kaplan-Meier log-rank test and Cox regression model (α = 0.05) by using SPPS Statistic 21. Type of restoration after RCT significantly affected the survival of ETT (P = .001). ETT that received composite/amalgam buildup restorations were 2.29 times more likely to be extracted compared with ETT that received crown (hazard ratio, 2.29; confidence interval, 1.29-4.06; P = .005). Time of crown placement after RCT was also significantly correlated with survival rate of ETT (P = .001). Teeth that received crown 4 months after RCT were almost 3 times more likely to get extracted compared with teeth that received crown within 4 months of RCT (hazard ratio, 3.38; confidence interval, 1.56-6.33; P = .002). Patients may benefit by maintaining their natural dentition by timely placement of crown after RCT, which otherwise may have been extracted and replaced by implant because of any delay in crown placement. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Predicting treatment effect from surrogate endpoints and historical trials: an extrapolation involving probabilities of a binary outcome or survival to a specific time.

    Science.gov (United States)

    Baker, Stuart G; Sargent, Daniel J; Buyse, Marc; Burzykowski, Tomasz

    2012-03-01

    Using multiple historical trials with surrogate and true endpoints, we consider various models to predict the effect of treatment on a true endpoint in a target trial in which only a surrogate endpoint is observed. This predicted result is computed using (1) a prediction model (mixture, linear, or principal stratification) estimated from historical trials and the surrogate endpoint of the target trial and (2) a random extrapolation error estimated from successively leaving out each trial among the historical trials. The method applies to either binary outcomes or survival to a particular time that is computed from censored survival data. We compute a 95% confidence interval for the predicted result and validate its coverage using simulation. To summarize the additional uncertainty from using a predicted instead of true result for the estimated treatment effect, we compute its multiplier of standard error. Software is available for download. © 2011, The International Biometric Society No claim to original US government works.

  2. Effect of noise and detector sensitivity on a dynamical process: inverse power law and Mittag-Leffler interevent time survival probabilities.

    Science.gov (United States)

    Pramukkul, Pensri; Svenkeson, Adam; Grigolini, Paolo

    2014-02-01

    We study the combined effects of noise and detector sensitivity on a dynamical process that generates intermittent events mimicking the behavior of complex systems. By varying the sensitivity level of the detector we move between two forms of complexity, from inverse power law to Mittag-Leffler interevent time survival probabilities. Here fluctuations fight against complexity, causing an exponential truncation to the survival probability. We show that fluctuations of relatively weak intensity have a strong effect on the generation of Mittag-Leffler complexity, providing a reason why stretched exponentials are frequently found in nature. Our results afford a more unified picture of complexity resting on the Mittag-Leffler function and encompassing the standard inverse power law definition.

  3. Effect of noise and detector sensitivity on a dynamical process: Inverse power law and Mittag-Leffler interevent time survival probabilities

    Science.gov (United States)

    Pramukkul, Pensri; Svenkeson, Adam; Grigolini, Paolo

    2014-02-01

    We study the combined effects of noise and detector sensitivity on a dynamical process that generates intermittent events mimicking the behavior of complex systems. By varying the sensitivity level of the detector we move between two forms of complexity, from inverse power law to Mittag-Leffler interevent time survival probabilities. Here fluctuations fight against complexity, causing an exponential truncation to the survival probability. We show that fluctuations of relatively weak intensity have a strong effect on the generation of Mittag-Leffler complexity, providing a reason why stretched exponentials are frequently found in nature. Our results afford a more unified picture of complexity resting on the Mittag-Leffler function and encompassing the standard inverse power law definition.

  4. A geographic study of West Nile virus in humans, dead corvids and mosquitoes in Ontario using spatial scan statistics with a survival time application.

    Science.gov (United States)

    Thomas-Bachli, A L; Pearl, D L; Berke, O; Parmley, E J; Barker, I K

    2017-11-01

    Surveillance of West Nile virus (WNv) in Ontario has included passive reporting of human cases and testing of trapped mosquitoes and dead birds found by the public. The dead bird surveillance programme was limited to testing within a public health unit (PHU) until a small number of birds test positive. These dead corvid and mosquito surveillance programmes have not been compared for their ability to provide early warning in geographic areas where human cases occur each year. Spatial scan statistics were applied to time-to-event survival data based on first cases of WNv in found dead corvids, mosquitoes and humans. Clusters identified using raw data were compared to clusters based on model-adjusted survival times to evaluate whether geographic and sociodemographic factors influenced their distribution. Statistically significant (p space-time clusters of PHUs with faster time to detection were found using each surveillance data stream. During 2002-2004, the corvid surveillance programme outperformed the mosquito programme in terms of time to WNv detection, while the clusters of first-positive mosquito pools were more spatially similar to first human cases. In 2006, a cluster of first-positive dead corvids was located in northern PHUs and preceded a cluster of early human cases that was identified after controlling for the influence of geographic region and sociodemographic profile. © 2017 Blackwell Verlag GmbH.

  5. Endoscopic Ultrasound-Guided Direct Portal Pressure Measurement Using a Digital Pressure Wire with Real-Time Remote Display: A Survival Study.

    Science.gov (United States)

    Schulman, Allison R; Thompson, Christopher C; Ryou, Marvin

    2017-10-01

    Portal hypertension is necessary for the development of most clinical complications of cirrhosis. We recently reported a novel, endoscopic ultrasound (EUS)-guided technique for direct portal pressure measurements using a digital pressure wire. The aims of this study were to (1) evaluate safety in an animal survival model and (2) compare direct portal vein (PV) versus transhepatic access of a first-order venule. Yorkshire pigs, weighing 40-55 kg. Procedures were performed under general anesthesia. PV was identified using a linear array echoendoscope and accessed with a 22-G fine needle aspiration needle preloaded with a digital pressure wire. Access was confirmed by portal venography. Mean digital pressure measurements were recorded over 30 seconds, and again after accessing a first-order portal venule in a transhepatic manner. Procedure times and video logs were maintained throughout. Animals were survived for 2 weeks. Repeat portal pressure measurements were performed before euthanasia and necropsy. EUS-guided portal pressure measurements ranged from 3 to 11 mm Hg (mean 6.1) and were performed in a mean time of 214 seconds. There was no difference in measurement between the PV and first-order venule, or between baseline and 2-week follow-up. Five of 5 animals survived without incident. On necropsy, there was no evidence of thrombus or hemorrhage. This study represents the first survival study after EUS-guided direct portal pressure measurements using a digital pressure wire. This method appears safe, straightforward, and precise. Measurements of the PV and a first-order portal venule appear equivalent, and serial measurement seems feasible.

  6. Timing of therapeutic intervention determines functional and survival outcomes in a mouse model of late infantile batten disease.

    Science.gov (United States)

    Cabrera-Salazar, Mario A; Roskelley, Eric M; Bu, Jie; Hodges, Bradley L; Yew, Nelson; Dodge, James C; Shihabuddin, Lamya S; Sohar, Istvan; Sleat, David E; Scheule, Ronald K; Davidson, Beverly L; Cheng, Seng H; Lobel, Peter; Passini, Marco A

    2007-10-01

    Classical late infantile neuronal ceroid lipofuscinosis (cLINCL) is a monogenic disorder caused by the loss of tripeptidyl peptidase 1 (TPP1) activity as a result of mutations in CLN2. Absence of TPP1 results in lysosomal storage with an accompanying axonal degeneration throughout the central nervous system (CNS), which leads to progressive neurodegeneration and early death. In this study, we compared the efficacies of pre- and post-symptomatic injections of recombinant adeno-associated virus (AAV) for treating the cellular and functional abnormalities of CLN2 mutant mice. Intracranial injection of AAV1-hCLN2 resulted in widespread human TPP1 (hTPP1) activity in the brain that was 10-100-fold above wild-type levels. Injections before disease onset prevented storage and spared neurons from axonal degeneration, reflected by the preservation of motor function. Furthermore, the majority of CLN2 mutant mice treated pre-symptomatically lived for at least 330 days, compared with a median survival of 151 days in untreated CLN2 mutant controls. In contrast, although injection after disease onset ameliorated lysosomal storage, there was evidence of axonal degeneration, motor function showed limited recovery, and the animals had a median lifespan of 216 days. These data illustrate the importance of early intervention for enhanced therapeutic benefit, which may provide guidance in designing novel treatment strategies for cLINCL patients.

  7. Endogenous TSH levels at the time of {sup 131}I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality

    Energy Technology Data Exchange (ETDEWEB)

    Vrachimis, Alexis; Riemann, Burkhard [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Maeder, Uwe; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany)

    2016-02-15

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative {sup 131}I ablation in differentiated thyroid cancer (DTC) patients. We sought to determine whether endogenous TSH levels, i.e. after levothyroxine withdrawal, at the time of ablation influence ablation success rates, recurrence-free survival and DTC-related mortality. A total of 1,873 patients without distant metastases referred for postoperative adjuvant {sup 131}I therapy were retrospectively included from 1991 onwards. Successful ablation was defined as stimulated Tg <1 μg/l. Age, gender and the presence of lymph node metastases were independent determinants of TSH levels at the time of ablation. TSH levels were not significantly related to ablation success rates (p = 0.34), recurrence-free survival (p = 0.29) or DTC -elated mortality (p = 0.82), but established risk factors such as T-stage, lymph node metastases and age were. Ablation was successful in 230 of 275 patients (83.6 %) with TSH <30 mU/l and in 1,359 of 1,598 patients (85.0 %) with TSH ≥30 mU/l. The difference was not significant (p = 0.55). Of the whole group of 1,873 patients, 21 had recurrent disease. There were no significant differences in recurrence rates between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.16). Ten of the 1,873 patients died of DTC. There were no significant differences in DTC-specific survival between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.53). The precise endogenous TSH levels at the time of {sup 131}I ablation are not related to the ablation success rates, recurrence free survival and DTC related mortality. The established dogma that TSH levels need to be ≥30 mU/l at the time of {sup 131}I ablation can be discarded. (orig.)

  8. The influence of a covariate on optimal designs in longitudinal studies with discrete-time survival endpoints

    NARCIS (Netherlands)

    Safarkhani, Maryam; Moerbeek, Mirjam

    Longitudinal intervention studies on event occurrence can measure the timing of an event at discrete points in time. To design studies of this kind as inexpensively and efficiently as possible, researchers need to decide on the number of subjects and the number of measurements for each subject.

  9. Time-varying effects of aromatic oil constituents on the survival of aquatic species: Deviations between model estimates and observations

    NARCIS (Netherlands)

    Hoop, L. de; Viaene, K.P.; Schipper, A.M.; Huijbregts, M.A.; De Laender, F.; Hendriks, A.J.

    2017-01-01

    There is a need to study the time course of toxic chemical effects on organisms because there might be a time lag between the onset of chemical exposure and the corresponding adverse effects. For aquatic organisms, crude oil and oil constituents originating from either natural seeps or human

  10. 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.

  11. Exposure to "The Troubles" in Northern Ireland influences the clinical presentation of schizophrenia.

    Science.gov (United States)

    Mulholland, Ciaran; Boyle, Christine; Shannon, Ciaran; Huda, Uzma; Clarke, Linda; Meenagh, Ciaran; Dempster, Martin

    2008-07-01

    This study investigates the effect of exposure to "The Troubles" (the period of civil unrest from 1968 onwards) in Northern Ireland on symptomatology in people with schizophrenia. Eighty-two participants were assessed on a number of psychiatric rating scales and on measures of trauma, including an instrument designed to assess exposure to "Troubles"-related trauma. People with schizophrenia and a history of exposure to "The Troubles" had significantly higher levels of anxiety, depression, dissociative symptoms and number of admissions compared to those patients with no such exposure. "Troubles"-related trauma has a direct effect on the presentation of schizophrenia in Northern Ireland. Specific therapeutic intervention may be required in order to help patients come to terms with their experiences.

  12. DCE-MRI prediction of survival time for patients with glioblastoma multiforme: using an adaptive neuro-fuzzy-based model and nested model selection technique.

    Science.gov (United States)

    Dehkordi, Azimeh N V; Kamali-Asl, Alireza; Wen, Ning; Mikkelsen, Tom; Chetty, Indrin J; Bagher-Ebadian, Hassan

    2017-09-01

    This pilot study investigates the construction of an Adaptive Neuro-Fuzzy Inference System (ANFIS) for the prediction of the survival time of patients with glioblastoma multiforme (GBM). ANFIS is trained by the pharmacokinetic (PK) parameters estimated by the model selection (MS) technique in dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) data analysis, and patient age. DCE-MRI investigations of 33 treatment-naïve patients with GBM were studied. Using the modified Tofts model and MS technique, the following physiologically nested models were constructed: Model 1, no vascular leakage (normal tissue); Model 2, leakage without efflux; Model 3, leakage with bidirectional exchange (influx and efflux). For each patient, the PK parameters of the three models were estimated as follows: blood plasma volume (vp ) for Model 1; vp and volume transfer constant (K(trans) ) for Model 2; vp , K(trans) and rate constant (kep ) for Model 3. Using Cox regression analysis, the best combination of the estimated PK parameters, together with patient age, was identified for the design and training of ANFIS. A K-fold cross-validation (K = 33) technique was employed for training, testing and optimization of ANFIS. Given the survival time distribution, three classes of survival were determined and a confusion matrix for the correct classification fraction (CCF) of the trained ANFIS was estimated as an accuracy index of ANFIS's performance. Patient age, kep and ve (K(trans) /kep ) of Model 3, and K(trans) of Model 2, were found to be the most effective parameters for training ANFIS. The CCF of the trained ANFIS was 84.8%. High diagonal elements of the confusion matrix (81.8%, 90.1% and 81.8% for Class 1, Class 2 and Class 3, respectively), with low off-diagonal elements, strongly confirmed the robustness and high performance of the trained ANFIS for predicting the three survival classes. This study confirms that DCE-MRI PK analysis, combined with the MS technique and ANFIS

  13. Sotrastaurin (AEB071) alone and in combination with cyclosporine A prolongs survival times of non-human primate recipients of life-supporting kidney allografts.

    Science.gov (United States)

    Bigaud, Marc; Wieczorek, Grazyna; Beerli, Christian; Audet, Maxime; Blancher, Antoine; Heusser, Christoph; Morris, Randall E; Wagner, Jürgen

    2012-01-27

    Sotrastaurin (STN), a novel oral protein kinase C inhibitor that inhibits early T-cell activation, was assessed in non-human primate recipients of life-supporting kidney allografts. Cynomolgus monkey recipients of life-supporting kidney allografts were treated orally with STN alone or in combination with cyclosporine A (CsA). STN monotherapy at 50 mg/kg once daily prolonged recipient survival times to the predefined endpoint of 29 days (n=2); when given at 25 mg/kg twice daily, the median survival time (MST) was 27 days (n=4). Neither once-daily monotherapy of STN 20 mg/kg nor CsA 20 mg/kg was effective (MST 6 days [n=2] and 7 days [n=5], respectively). In combination, however, STN 20 mg/kg and CsA 20 mg/kg prolonged MST to more than 100 days (n=5). By combining lower once-daily doses of STN (7 or 2 mg/kg) with CsA (20 mg/kg), MST was more than 100 (n=3) and 22 days (n=2), respectively. Neither in single-dose pharmacokinetic studies nor the transplant recipients were STN or CsA blood levels for combined treatment greater than when either drug was administered alone. STN blood levels in transplant recipients during combination therapy were dose related (20 mg/kg, 30-182 ng/mL; 7 mg/kg, 7-41 ng/mL; and 2 mg/kg, 3-5 ng/mL). STN at a daily dose of up to 20 mg/kg was relatively well tolerated. STN prolonged survival times of non-human primate kidney allograft recipients both as monotherapy and most effectively in combination with CsA. Pharmacokinetic interactions were not responsible for the potentiation of immunosuppressive efficacy by coadministering STN and CsA.

  14. Mental health in Northern Ireland: have "the Troubles" made it worse?

    Science.gov (United States)

    O'Reilly, D; Stevenson, M

    2003-07-01

    To measure the effects of the civil unrest (the Troubles) on the mental health of the general population of Northern Ireland. A secondary analysis of a nationally representative population survey conducted in 1997. Northern Ireland. This is an analysis of the 1694 respondents (aged 16-64) who had their mental health assessed using the 12 question version of the General Health Questionnaire (GHQ). The effects of the Troubles was based on the responses to two survey questions; one asking about the impact on respondent's area; the second about the impact on the life of the respondent or their family. To model simultaneous effects, multiple logistic regression models were constructed with GHQ case as the dependent variable, the impact of the Troubles questions as independent variables, and the demographic, socioeconomic, and health related factors as covariates. 21.3% (361) of respondents said that the Troubles had either "quite a bit" or "a lot" of impact on their lives or the lives of their families and 25.1% (418) reported a similar impact on their area of residence. The likelihood of psychological morbidity increased the greater the extent to which the Troubles affected the respondent's area or life, the association being stronger for the second factor. Neither demographic nor socioeconomic factors significantly diminished this relation although adjusting for health related factors did attenuate the magnitude of the odd ratios especially for the effects of the Troubles on area of residence. It is probable that mental health of the population of Northern Ireland has been significantly affected by the Troubles. Whether this is attributable to the violence in itself or to other aspects of the Troubles is unclear and whether any additional inputs from psychiatric services are needed requires further study.

  15. Private security and military contractors: A troubling oversight

    DEFF Research Database (Denmark)

    Swed, Ori; Crosbie, Thomas Alexander

    2017-01-01

    Though private military and security companies (PMSCs) have been addressed extensively in the literature, little research has been done on the contractors themselves, leaving us in the dark as to who these individuals are. In this article, we focus on the critical case of the United States armed ...... the mesosocial to the microsocial level of inquiry. We conclude by reviewing the existing research on the demographics of the sector and then indicating the troubling gaps in our current understanding of this critical sector of the national security apparatus.......Though private military and security companies (PMSCs) have been addressed extensively in the literature, little research has been done on the contractors themselves, leaving us in the dark as to who these individuals are. In this article, we focus on the critical case of the United States armed...... and concomitant evolution of the security sector, while noting a new trend that points to the need for moving from the macrosocial to the microsocial level of inquiry. Second, we indicate the challenges contractors pose to the sociological paradigm of military professionalism: These suggest a need to move from...

  16. Using music as a therapy tool to motivate troubled adolescents.

    Science.gov (United States)

    Keen, Alexander W

    2004-01-01

    Children and adolescents with emotional disorders may often be characterized by having problems in peer and adult relations and in display of inappropriate behaviours. These include suicide attempts, anger, withdrawal from family, social isolation from peers, aggression, school failure, running away, and alcohol and/or drug abuse. A lack of self-concept and self-esteem is often central to these difficulties. Traditional treatment methods with young people usually includes cognitive- behavioural approaches with psychotherapy. Unfortunately these children often lack a solid communication base, creating a block to successful treatment. In my private clinical practice, I have endeavoured to break through these communication barriers by using music as a therapy tool. This paper describes and discusses my use of music as a therapy tool with troubled adolescents. Pre- and post-testing of the effectiveness of this intervention technique by using the Psychosocial Functioning Inventory for Primary School Children (PFI-PSC) has yielded positive initial results, lending support to its continued use. Music has often been successful in helping these adolescents engage in the therapeutic process with minimised resistance as they relate to the music and the therapist becomes a safe and trusted adult. Various techniques such as song discussion, listening, writing lyrics, composing music, and performing music.

  17. Smoking onset and the time-varying effects of self-efficacy, environmental smoking, and smoking-specific parenting by using discrete-time survival analysis

    NARCIS (Netherlands)

    Hiemstra, J.M.; Otten, R.; Engels, R.C.M.E.

    2012-01-01

    This study examined the timing of smoking onset during mid- or late adolescence and the time-varying effects of refusal self-efficacy, parental and sibling smoking behavior, smoking behavior of friends and best friend, and parental smoking-specific communication. We used data from five annual waves

  18. Relationship Between Radiation Treatment Time and Overall Survival After Induction Chemotherapy for Locally Advanced Head-and-Neck Carcinoma: A Subset Analysis of TAX 324

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: dsher@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, MA (United States); Posner, Marshall R. [Division of Hematology/Oncology, Mount Sinai School of Medicine, New York, NY (United States); Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, MA (United States); Sarlis, Nicholas J. [Sanofi-Aventis US, Bridgewater, NJ (United States); Haddad, Robert I. [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Holupka, Edward J. [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA (Israel); Devlin, Phillip M. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, MA (United States)

    2011-12-01

    Purpose: To analyze the relationship between overall survival (OS) and radiation treatment time (RTT) and overall treatment time (OTT) in a well-described sequential therapy paradigm for locally advanced head-and-neck carcinoma (LAHNC). Methods and Materials: TAX 324 is a Phase III study comparing TPF (docetaxel, cisplatin, and fluorouracil) with PF (cisplatin and fluorouracil) induction chemotherapy (IC) in LAHNC patients; both arms were followed by carboplatin-based chemoradiotherapy (CRT). Prospective radiotherapy quality assurance was performed. This analysis includes all patients who received three cycles of IC and a radiation dose of {>=} 70 Gy. Radiotherapy treatment time was analyzed as binary ({<=} 8 weeks vs. longer) and continuous (number of days beyond 8 weeks) functions. The primary analysis assessed the relationship between RTT, OTT, and OS, and the secondary analysis explored the association between treatment times and locoregional recurrence (LRR). Results: A total of 333 (of 501) TAX 324 patients met the criteria for inclusion in this analysis. There were no significant differences between the treatment arms in baseline or treatment characteristics. On multivariable analysis, PF IC, World Health Organization performance status of 1, non-oropharynx site, T3/4 stage, N3 status, and prolonged RTT (hazard ratio 1.63, p = 0.006) were associated with significantly inferior survival. Performance status, T3/4 disease, and prolonged RTT (odds ratio 1.68, p = 0.047) were independently and negatively related to LRR on multivariable analysis, whereas PF was not. Overall treatment time was not independently associated with either OS or LRR. Conclusions: In this secondary analysis of the TAX 324 trial, TPF IC remains superior to PF IC after controlling for radiotherapy delivery time. Even with optimal IC and concurrent chemotherapy, a non-prolonged RTT is a crucial determinant of treatment success. Appropriate delivery of radiotherapy after IC remains essential

  19. N-Acetylaspartate Synthase Deficiency Corrects the Myelin Phenotype in a Canavan Disease Mouse Model But Does Not Affect Survival Time.

    Science.gov (United States)

    Maier, Helena; Wang-Eckhardt, Lihua; Hartmann, Dieter; Gieselmann, Volkmar; Eckhardt, Matthias

    2015-10-28

    Canavan disease (CD) is a severe, lethal leukodystrophy caused by deficiency in aspartoacylase (ASPA), which hydrolyzes N-acetylaspartate (NAA). In the brains of CD patients, NAA accumulates to high millimolar concentrations. The pathology of the disease is characterized by loss of oligodendrocytes and spongy myelin degeneration in the CNS. Whether accumulating NAA, absence of NAA-derived acetate, or absence of any unknown functions of the ASPA enzyme is responsible for the pathology of the disease is not fully understood. We generated ASPA-deficient (Aspa(nur7/nur7)) mice that are also deficient for NAA synthase Nat8L (Nat8L(-/-)/Aspa(nur7/nur7)). These mice have no detectable NAA. Nevertheless, they exhibited normal myelin content, myelin sphingolipid composition, and full reversal of spongy myelin and axonal degeneration. Surprisingly, although pathology was fully reversed, the survival time of the mice was not prolonged. In contrast, Aspa(nur7/nur7) mice with only one intact Nat8L allele accumulated less NAA, developed a less severe pathology, phenotypic improvements, and, importantly, an almost normal survival time. Therefore, inhibition of NAA synthase is a promising therapeutic option for CD. The reduced survival rate of Nat8L(-/-)/Aspa(nur7/nur7) mice, however, indicates that complete inhibition of NAA synthase may bear unforeseeable risks for the patient. Furthermore, we demonstrate that acetate derived from NAA is not essential for myelin lipid synthesis and that loss of NAA-derived acetate does not cause the myelin phenotype of Aspa(nur7/nur7) mice. Our data clearly support the hypothesis that NAA accumulation is the major factor in the development of CD. Copyright © 2015 the authors 0270-6474/15/3514501-16$15.00/0.

  20. Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173,797 patients.

    Science.gov (United States)

    Saadatmand, Sepideh; Bretveld, Reini; Siesling, Sabine; Tilanus-Linthorst, Madeleine M A

    2015-10-06

    To assess the influence of stage at breast cancer diagnosis, tumour biology, and treatment on survival in contemporary times of better (neo-)adjuvant systemic therapy. Prospective nationwide population based study. Nationwide Netherlands Cancer Registry. Female patients with primary breast cancer diagnosed between 1999 and 2012 (n=173,797), subdivided into two time cohorts on the basis of breast cancer diagnosis: 1999-2005 (n=80,228) and 2006-12 (n=93,569). Relative survival was compared between the two cohorts. Influence of traditional prognostic factors on overall mortality was analysed with Cox regression for each cohort separately. Compared with 1999-2005, patients from 2006-12 had smaller (≤ T1 65% (n=60,570) v 60% (n=48,031); Page and tumour type, overall mortality was decreased by surgery (especially breast conserving), radiotherapy, and systemic therapies. Mortality increased with progressing tumour size in both cohorts (2006-12 T1c v T1a: hazard ratio 1.54, 95% confidence interval 1.33 to 1.78), but without a significant difference in invasive breast cancers until 1 cm (2006-12 T1b v T1a: hazard ratio 1.04, 0.88 to 1.22), and independently with progressing number of positive lymph nodes (2006-12 N1 v N0: 1.25, 1.17 to 1.32). Tumour stage at diagnosis of breast cancer still influences overall survival significantly in the current era of effective systemic therapy. Diagnosis of breast cancer at an early tumour stage remains vital. © Saadatmand et al 2015.

  1. Psychoanalysis and the early beginnings of residential treatment for troubled youth.

    Science.gov (United States)

    Cohler, Bertram J; Friedman, Daniel H

    2004-04-01

    One of the intentions of Aichhom, Redl, Wineman, Bettelheim, and Anna Freud in their writings about group care was to advocate for the need to simplify the lives of youths who had known only chaos, to create an atmosphere in which everything has a purpose and predictable positive responses were given unconditionally. Recent efforts, such as those by Greenberg et at, have focused on building community-wide early interventions to forestall later emergence of emotional or behavioral disorders. The efforts also mark a shift away from punishment and exclusion for troubled children at school to more inclusive systems of positive behavioral interventions and support by providing a place to achieve academic and social behavioral success. Contemporary social policy regarding residential care for troubled children reflects the belief that a child's development is inevitably enhanced by residence ina family environment. This belief in the value of home and family, so central to contemporary child welfare policy, has been challenged by the recognition that some family situations are not conducive for growth. Redl and Wineman observed that the children who ended up in residential treatment had used up all community treatment resources and soon became the children that nobody wants. Eventually, the homes that produced them, the communities in which they lived, the schools they attended, and the neighborhoods in which they played were unwilling to tolerate their disruptive and disturbing behavior. The chaotic lives of the parents of these children hindered effective monitoring and management,which limited the family's ability to spend time with children, teach conflict-resolution skills, or communicate consistent behavioral expectations. Walker suggested that divorce, abuse, poverty, drugs, and other forces that interfere with normal parenting increasingly disrupt advantaged and disadvantaged families. Vogel and Bell and Spiegel observed that some troubled young people become the

  2. Improvement of recurrence-free survival after radical prostatectomy for locally advanced prostate cancer in relation to the time of surgical intervention

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2016-01-01

    Full Text Available Objective: to comparatively estimate the frequency of a positive surgical margin and 5-year biochemical recurrent-free survival (BRFS rates in patients with locally advanced prostate cancer in relation to the time of radical retropubic prostatectomy.Subjects and methods. The investigation enrolled 274 patients with prostate cancer (pT3-4N0-1M0 who were divided into 2 groups of 68 and 20 patients operated on in 1997 to 2006 and 2007 to 2012, respectively. Two surgeons made surgical interventions by the standardized procedure. The 5-year BRFS rates were estimated using the Kaplan-Meier method and log-rank test. A biochemical recurrence was defined as a prostatespecific antigen level of t 0.2 ng / ml in 2 consecutive measurements or as the initiation of adjuvant therapy.Results. The detection rate of a positive surgical margin decreased from 55.9 % in 1997–2006 to 37.9 % in 2007–2012 (p = 0.01; the 5-year recurrence-free survival rates were 38.8 % versus 66.2 % (p < 0.001.Conclusion. These changes would probably be a result of surgeons» better experience and improved surgical techniques in the course of time.

  3. Effect of fish oil, arginine, and doxorubicin chemotherapy on remission and survival time for dogs with lymphoma: a double-blind, randomized placebo-controlled study.

    Science.gov (United States)

    Ogilvie, G K; Fettman, M J; Mallinckrodt, C H; Walton, J A; Hansen, R A; Davenport, D J; Gross, K L; Richardson, K L; Rogers, Q; Hand, M S

    2000-04-15

    Polyunsaturated n-3 fatty acids have been shown to inhibit the growth and metastasis of tumors. This double-blind, randomized study was designed to evaluate the hypothesis that polyunsaturated n-3 fatty acids can improve metabolic parameters, decrease chemical indices of inflammation, enhance quality of life, and extend disease free interval and survival time for dogs treated for lymphoblastic lymphoma with doxorubicin chemotherapy. Thirty-two dogs with lymphoma were randomized to receive one of two diets supplemented with menhaden fish oil and arginine (experimental diet) or an otherwise identical diet supplemented with soybean oil (control diet). Diets were fed before and after remission was attained with up to five dosages of doxorubicin. Parameters examined included blood concentrations of glucose, lactic acid, and insulin in response to glucose and diet tolerance tests; alpha-1 acid glycoprotein; tumor necrosis factor; interleukin-6; body weight; amino acid profiles; resting energy expenditure; disease free interval (DFI); survival time (ST); and clinical performance scores. Dogs fed the experimental diet had significantly (P diet tolerance testing. Increasing C22:6 levels were significantly (P dogs with Stage III lymphoma fed the experimental diet. Fatty acids of the n-3 series normalize elevated blood lactic acid in a dose-dependent manner, resulting in an increase in DFI and ST for dogs with lymphoma. Copyright 2000 American Cancer Society.

  4. Effects of Oral Administration of Fucoidan Extracted from Cladosiphon okamuranus on Tumor Growth and Survival Time in a Tumor-Bearing Mouse Model

    Directory of Open Access Journals (Sweden)

    Yoshiharu Okamoto

    2012-10-01

    Full Text Available We evaluated the anti-tumor activities of the oral administration of fucoidan extracted from Cladosiphon okamuranus using a tumor (colon 26-bearing mouse model. The materials used included low-molecular-weight fucoidan (LMWF: 6.5–40 kDa, intermediate-molecular-weight fucoidan (IMWF: 110–138 kDa and high-molecular-weight fucoidan (HMWF: 300–330 kDa. The IMWF group showed significantly suppressed tumor growth. The LMWF and HMWF groups showed significantly increased survival times compared with that observed in the control group (mice fed a fucoidan-free diet. The median survival times in the control, LMWF, IMWF and HMWF groups were 23, 46, 40 and 43 days, respectively. It was also found that oral administration of fucoidan increased the population of natural killer cells in the spleen. Furthermore, from the results of the experiment using Myd-88 knockout mice, it was found that these effects are related to gut immunity. These results suggest that fucoidan is a candidate anti-tumor functional food.

  5. Dynamic assessment of Capparis spinosa buds on survival of periodontal ligament cells using a real-time cell analysis method.

    Science.gov (United States)

    Ozan, F; Özan, Ü; Oktay, E A; Toptas, O; Özdemir, H; KürÞat, Er

    2015-01-01

    Tooth avulsion is the most severe type of traumatic dental injuries and it results in the complete displacement of the tooth out of its socket in alveolar bone. Reimplantation of the tooth is considered to be a best treatment modality due to its biological and psychological advantages. Its prognosis depends on the extra alveolar time, the storage medium, and the patient's general health. The aim of this study was to evaluate the effect of Capparis spinosa (C. spinosa) in maintaining the viability of human periodontal ligament (PDL) cells using a real-time cell analysis method. Periodontal ligament cells were obtained from healthy human third molars extracted for orthodontic purposes. The storage media tested were: Dulbecco's Modified Eagle Medium (DMEM), C. spinosa, Hank's Balanced Salt Solution (HBSS), and light milk. A real-time cell analyzer system was used to evaluate cell viability. After seeding cell suspensions into the wells of the E-plate 96, PDL cells were treated with each of tested media and monitored for every 5 min for 26 h. Statistical analysis of the data was accomplished using one-way analysis of variance complemented by the Tukey test. The level of significance was set at P spinosa groups had significantly higher cell index values compared with the HBSS and light milk (P spinosa showed better results than DMEM (control), but this difference was not found statistically significant. Capparis spinosa can be a suitable, alternative storage medium for avulsed teeth.

  6. Troubles du spectre de l'autisme et troubles de la fonction visuelle : revue critique, implications théoriques et cliniques

    National Research Council Canada - National Science Library

    Chokron, Sylvie; Pieron, Marie; Zalla, Tiziana

    2014-01-01

    ... et de la perception des visages chez des individus atteints d'un TSA. Dans cette revue de littérature, nous décrivons les troubles visuo-attentionnels, oculo-moteurs et neurovisuels dans l'autisme et nous discutons l'impact qu'une attente...

  7. Exploratory Analysis of Time from HIV Diagnosis to ART Start, Factors and effect on survival: A longitudinal follow up study at seven teaching hospitals in Ethiopia.

    Science.gov (United States)

    Teklu, Alula M; Delele, Kesetebirhan; Abraha, Mulu; Belayhun, Bekele; Gudina, Esayas Kebede; Nega, Abiy

    2017-02-01

    The HIV care in Ethiopia has reached 79% coverage. The timeliness of the care provided at the different levels in the course of the disease starting from knowing HIV positive status to ART initiation is not well known. This study intends to explore the timing of the care seeking, the care provision and associated factors. This is a longitudinal follow-up study at seven university hospitals. Patients enrolled in HIV care from September 2005 to December 2013 and aged ≥14 years were studied. Different times in the cascade of HIV care were examined including the duration from date HIV diagnosed to enrollment in HIV care, duration from enrollment to eligibility for ART and time from eligibility to initiation of ART. Ordinal logistic regression was used to investigate their determinants while the effect of these periods on survival of patients was determined using cox-proportional hazards regression. 4159 clients were studied. Time to enrollment after HIV test decreased from 39 days in 2005 to 1 day after 2008. It took longer if baseline CD4 was higher, and eligibility for ART was assessed late. Young adults, lower baseline CD4, HIV diagnosisART initiation. Male gender, advanced disease stage and lower baseline CD4 were consistent risk factors for mortality. Time to enrollment and duration of ART eligibility assessment as well as ART initiation time after eligibility is improving. Further study is required to identify why mortality is slightly increasing after 2010.

  8. The Art of Creating Attractive Consumer Experiences at the Right Time: Skills Marketers Will Need to Survive and Thrive

    Directory of Open Access Journals (Sweden)

    Lemon Katherine N.

    2016-11-01

    Full Text Available New technologies have made today’s marketing faster, more mobile, more location-based, more digital, more virtual, and more automatized than ever. In this new world, marketers need to be “real-time relevant” – to gain awareness, to change perceptions and to spur action. They need to have their content in the right channel, format, time and context – from a consumer’s perspective. Only then do they at least have a chance of the consumer attending to the information and being influenced by it. In such an environment new skills and competences are required. The amount of available data has virtually exploded. To gain any perspective or apparent “control” in these environments, successful managers must embrace the complexity and learn to analyze, integrate and interpret all this data. A critical skill for marketers will be to identify the metrics that best reflect the desired outcomes of the organization and that sufficiently reflect specific indicators of critical processes. Furthermore, insights from other disciplines such as architecture, design, information-processing, biology or engineering will be important for creating customer experiences. The marketer of the future will need to be supremely curious and creative and to balance and integrate different worlds. It will all come down to delivering memorable and lasting experiences in a constantly and fast changing environment.

  9. The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

    Directory of Open Access Journals (Sweden)

    Hyun Nam Choi

    2014-11-01

    Full Text Available BackgroundAdministration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection.MethodsA total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively.ResultsThe median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ×200 HPF in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group.ConclusionsThis study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

  10. Instrumental variables estimation of exposure effects on a time-to-event response using structural cumulative survival models

    DEFF Research Database (Denmark)

    Martinussen, T.; Vansteelandt, S.; Tchetgen, E. J. Tchetgen

    2016-01-01

    The use of instrumental variables for estimating the effect of an exposure on an outcome is popular in econometrics, and increasingly so in epidemiology. This increasing popularity may be attributed to the natural occurrence of instrumental variables in observational studies that incorporate...... elements of randomization, either by design or by nature (e.g., random inheritance of genes). Instrumental variables estimation of exposure effects is well established for continuous outcomes and to some extent for binary outcomes. It is, however, largely lacking for time-to-event outcomes because......-parametric variant of the instrumental variables additive hazards model. We propose a class of recursive instrumental variable estimators for these exposure effects, and derive their large sample properties along with inferential tools. We examine the performance of the proposed method in simulation studies...

  11. Effect of temperature and relative humidity on the development times and survival of Synopsyllus fonquerniei and Xenopsylla cheopis, the flea vectors of plague in Madagascar.

    Science.gov (United States)

    Kreppel, Katharina S; Telfer, Sandra; Rajerison, Minoarisoa; Morse, Andy; Baylis, Matthew

    2016-02-11

    Plague, a zoonosis caused by Yersinia pestis, is found in Asia, the Americas but mainly in Africa, with the island of Madagascar reporting almost one third of human cases worldwide. In the highlands of Madagascar, plague is transmitted predominantly by two flea species which coexist on the island, but differ in their distribution. The endemic flea, Synopsyllus fonquerniei, dominates flea communities on rats caught outdoors, while the cosmopolitan flea, Xenopsylla cheopis, is found mostly on rats caught in houses. Additionally S. fonquerniei seems restricted to areas above 800 m. Climatic constraints on the development of the two main vectors of plague could explain the differences in their distribution and the seasonal changes in their abundance. Here we present the first study on effects of temperature and relative humidity on the immature stages of both vector species. We examined the two species' temperature and humidity requirements under experimental conditions at five different temperatures and two relative humidities. By employing multivariate and survival analysis we established the impact of temperature and relative humidity on development times and survival for both species. Using degree-day analysis we then predicted the average developmental threshold for larvae to reach pupation and for pupae to complete development under each treatment. This analysis was undertaken separately for the two relative humidities and for the two species. Development times and time to death differed significantly, with the endemic S. fonquerniei taking on average 1.79 times longer to complete development and having a shorter time to death than X. cheopis under adverse conditions with high temperature and low humidity. Temperature had a significant effect on the development times of flea larvae and pupae. While humidity did not affect the development times of either species, it did influence the time of death of S. fonquerniei. Using degree-day analysis we estimated an

  12. Role functioning before start of adjuvant treatment was an independent prognostic factor for survival and time to failure. A report from the Nordic adjuvant interferon trial for patients with high-risk melanoma

    DEFF Research Database (Denmark)

    Brandberg, Yvonne; Johansson, Hemming; Aamdal, Steinar

    2013-01-01

    To investigate the role of health-related quality of life (HRQoL) at randomization as independent prognostic factors for survival and time to failure, and to explore associations between HRQoL and treatment effects....

  13. THE EFFECT OF CAROVERINE AND ITS COMBINATION WITH AMINOOXYACETIC ACID ON SURVIVAL TIME OF MICE WITH EXPERIMENTAL TETANUS

    Directory of Open Access Journals (Sweden)

    Indira Mujezinović

    2013-03-01

    Full Text Available Tetanus is a disease that occurs in humans and various animal species worldwide. Tetanus toxin, after binding itself to nerve structures in the spinal cord, blocking the release of inhibitory transmitors which results in predominance of excitatory transmitors, and this manifestes itself in skeletal muscle spasm. In theory, inhibition of excitatory transmission can try to antagonize a number of ways: by stimulating inhibitory transmission with application inhibitory transmitors, inhibition of excitatory transmission by application of antagonists of excitatory transmitors and combination of antagonists of excitatory transmitors. Bearing this in mind, we attempted to normalize the disorders by tetanus toxin with the use of caroverine, an antagonist of excitatory transmitors, alone and in combination with aminooxyacetic acid (substance that increases the level of GABA. Experiments were conducted on albino mice of both sexes, weight 20-25 g. The experimental tetanus was induced by application of tetanus toxin. The application of caroverine and combination with aminooxyacetic acid was carried out 24 hours after application of tetanus toxin, once per day, until the death. Caroverine, given alone in a dose of 1,2 mg/kg significantly prolonged the LD50 period of mice with experimental tetanus, so the obtained results can be said that its application only at this dose proved to be effective. The combination with aminooxyacetic acid was gave an insignificant extension of mice’s dying time with experimental tetanus in the trial, compared to the control group. Key words: tetanus, tetanus toxin, transmitors, caroverine, aminooxyacetic acid

  14. The Life and Times of Parasites: Rhythms in Strategies for Within-host Survival and Between-host Transmission.

    Science.gov (United States)

    Reece, Sarah E; Prior, Kimberley F; Mideo, Nicole

    2017-12-01

    Biological rhythms are thought to have evolved to enable organisms to organize their activities according to the earth's predictable cycles, but quantifying the fitness advantages of rhythms is challenging and data revealing their costs and benefits are scarce. More difficult still is explaining why parasites that live exclusively within the bodies of other organisms have biological rhythms. Rhythms exist in the development and traits of parasites, in host immune responses, and in disease susceptibility. This raises the possibility that timing matters for how hosts and parasites interact and, consequently, for the severity and transmission of diseases. Here, we take an evolutionary ecological perspective to examine why parasites exhibit biological rhythms and how their rhythms are regulated. Specifically, we examine the adaptive significance (evolutionary costs and benefits) of rhythms for parasites and explore to what extent interactions between hosts and parasites can drive rhythms in infections. That parasites with altered rhythms can evade the effects of control interventions underscores the urgent need to understand how and why parasites exhibit biological rhythms. Thus, we contend that examining the roles of biological rhythms in disease offers innovative approaches to improve health and opens up a new arena for studying host-parasite (and host-parasite-vector) coevolution.

  15. Methodology for lognormal modelling of malignant pleural mesothelioma survival time distributions: a study of 5580 case histories from Europe and USA

    Energy Technology Data Exchange (ETDEWEB)

    Mould, Richard F [41 Ewhurst Avenue, South Croydon, Surrey CR2 0DH (United Kingdom); Lahanas, Michael [Klinikum Offenbach, Strahlenklinik, 66 Starkenburgring, 63069 Offenbach am Main (Germany); Asselain, Bernard [Institut Curie, Biostatistiques, 26 rue d' Ulm, 75231 Paris Cedex 05 (France); Brewster, David [Director, Scottish Cancer Registry, Information Services (NHS National Services Scotland) Area 155, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB (United Kingdom); Burgers, Sjaak A [Department of Thoracic Oncology, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The (Netherlands); Damhuis, Ronald A M [Rotterdam Cancer Registry, Rochussenstraat 125, PO Box 289, 3000 AG Rotterdam, The (Netherlands); Rycke, Yann De [Institut Curie, Biostatistiques, 26 rue d' Ulm, 75231 Paris Cedex 05 (France); Gennaro, Valerio [Liguria Mesothelioma Cancer Registry, Etiology and Epidemiology Department, National Cancer Research Institute, Pad. Maragliano, Largo R Benzi, 10-16132 Genoa (Italy); Szeszenia-Dabrowska, Neonila [Department of Occupational and Environmental Epidemiology, National Institute of Occupational Medicine, PO Box 199, Swietej Teresy od Dzieciatka Jezus 8, 91-348 Lodz (Poland)

    2004-09-07

    A truncated left-censored and right-censored lognormal model has been validated for representing pleural mesothelioma survival times in the range 5-200 weeks for data subsets grouped by age for males, 40-49, 50-59, 60-69, 70-79 and 80+ years and for all ages combined for females. The cases available for study were from Europe and USA and totalled 5580. This is larger than any other pleural mesothelioma cohort accrued for study. The methodology describes the computation of reference baseline probabilities, 5-200 weeks, which can be used in clinical trials to assess results of future promising treatment methods. This study is an extension of previous lognormal modelling by Mould et al (2002 Phys. Med. Biol. 47 3893-924) to predict long-term cancer survival from short-term data where the proportion cured is denoted by C and the uncured proportion, which can be represented by a lognormal, by (1 - C). Pleural mesothelioma is a special case when C = 0.

  16. Joint analyses of longitudinal and time-to-event data in research on aging: Implications for predicting health and survival

    Directory of Open Access Journals (Sweden)

    Konstantin G. Arbeev

    2014-11-01

    Full Text Available Longitudinal data on aging, health and longevity provide a wealth of information to investigate different aspects of the processes of aging and development of diseases leading to death. Statistical methods aimed at analyses of time-to-event data jointly with longitudinal measurements became known as the joint models (JM. An important point to consider in analyses of such data in the context of studies on aging, health, and longevity is how to incorporate knowledge and theories about mechanisms and regularities of aging-related changes that accumulate in the research field into respective analytic approaches. In the absence of specific observations of longitudinal dynamics of relevant biomarkers manifesting such mechanisms and regularities, traditional approaches have a rather limited utility to estimate respective parameters that can be meaningfully interpreted from the biological point of view. A conceptual analytic framework for these purposes, the stochastic process model of aging (SPM, has been recently developed in the biodemographic literature. It incorporates available knowledge about mechanisms of aging-related changes which may be hidden in the individual longitudinal trajectories of physiological variables and this allows for analyzing their indirect impact on risks of diseases and death. Despite, essentially, serving similar purposes, JM and SPM developed in parallel in different disciplines with very limited cross-referencing. Although there were several publications separately reviewing these two approaches, there were no publications presenting both these approaches in some detail. Here we overview both approaches jointly and provide some new modifications of SPM. We discuss the use of stochastic processes to capture biological variation and heterogeneity in longitudinal patterns and important and promising (but still largely underused applications of JM and SPM to predictions of individual and population mortality and health

  17. L-carnitine is a survival factor for chilled storage of rooster semen for a long time.

    Science.gov (United States)

    Fattah, A; Sharafi, M; Masoudi, R; Shahverdi, A; Esmaeili, V

    2017-02-01

    Rooster sperm is sensitive to cooling, which restricts procedures to store sperms for extended periods of time for artificial insemination of commercial flocks. This study was conducted to evaluate the suitability of adding L-carnitine (LC) to chilled-storage of rooster sperm and its effects on sperm quality parameters and its fertility potential during storage at 5 °C. Pooled semen from roosters were divided into six equal aliquots and diluted with media supplemented with different concentrations of LC (0, 0.5, 1, 2, 4 and 8 mM LC). Diluted semen samples were cooled to 5 °C and stored over 48 h. Motility, viability, membrane functionality, lipid peroxidation and mitochondria activity of the sperm were assessed at 0, 24 and 48 h of storage. Moreover, fertility potential of chilled stored sperm was considered at 24 h of storage. While sperm quality was not affected by LC at the beginning of storage (0 h), supplementation of extender with 1 and 2 mM of LC significantly improved the percentage of sperm motility, viability, membrane integrity and mitochondria activity at 24 h and 48 h compared to other groups. Lipid peroxidation was significantly reduced in sperm samples diluted with 1 and 2 mM LC at 24 h (2.15 ± 0.52 nmol/ml and 2.21 ± 0.52 nmol/ml) and 48 h (3.42 ± 0.49 nmol/ml and 3.38 ± 0.49 nmol/ml) compared to other groups. Furthermore, fertility rates during artificial insemination using sperms cooled for 24 h in the presence of 1 and 2 mM LC were significantly higher (78%) than in the control group (64%). These findings suggest that optimum doses of LC could protect rooster sperm against cool storage-induced functional and structural damages. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Taming troubled teens: The social production of mental morbidity amongst young mothers in Pelotas, Brazil

    Science.gov (United States)

    Béhague, D.P.; Gonçalves, H.D.; Gigante, D.; Kirkwood, B.R.

    2012-01-01

    Explanations for the association between teen-childbearing and subsequent mental morbidity vary considerably, from those based on neurological theories of development to those investigating underlying social and economic determinants. Based on longitudinal epidemiological and ethnographic sub-studies of the 1982 Pelotas birth cohort study, this paper explores the hypothesis that teen childbearing and subsequent mental morbidity have become associated through the interplay of culture, society, and biology in situations where teen pregnancy has become a stigmatised object of scientific and public health attention. Results show that the effect of teen childbearing on subsequent mental morbidity remained significant in the multivariate analysis. Ethnographic analysis, together with epidemiological effect modification analyses, suggest that this association is partially accounted for by the fact that it is more pronounced amongst a specific subgroup of women of low socio-economic status who, being more politicised about societal injustice, were also more critically engaged with – and thus troubled by – the inequitable institutionalisation of life-cycle transitions. With time, these women became highly critical of the institutionalised identification of early childbearing as a key violation of life-cycle norms and the differential class-based application of scientific knowledge on its causes and consequences. Public health campaigns should consider how the age-based institutionalisation of developmental norms has enabled the stigmatisation of those identified as transgressors. PMID:22196249

  19. Synergistic relationships among stress, depression, and troubled relationships: insights from psychoneuroimmunology.

    Science.gov (United States)

    Jaremka, Lisa M; Lindgren, Monica E; Kiecolt-Glaser, Janice K

    2013-04-01

    Stress and depression consistently elevate inflammation and are often experienced simultaneously, which is exemplified by people in troubled relationships. Troubled relationships also elevate inflammation, which may be partially explained by their ability to engender high levels of stress and depression. People who are stressed, depressed, or in troubled relationships are also at greater risk for health problems than their less distressed counterparts. Inflammation, a risk factor for a variety of age-related diseases including cardiovascular disease, Type II diabetes, metabolic syndrome, and frailty, may be one key mechanistic pathway linking distress to poor health. Obesity may further broaden the health implications of stress and depression; people who are stressed or depressed are often overweight, and adipose tissue is a major source of proinflammatory cytokines. Stress, depression, and troubled relationships may have synergistic inflammatory effects: loneliness, subclinical depression, and major depression enhance inflammatory responses to an acute stressful event. The relationship between distress and inflammation is bidirectional; depression enhances inflammation and inflammation promotes depression. Interesting questions emerge from this literature. For instance, some stressors may be more potent than others and thus may be more strongly linked to inflammation. In addition, it is possible that psychological and interpersonal resources may buffer the negative inflammatory effects of stress. Understanding the links among stress, depression, troubled relationships, and inflammation is an exciting area of research that may provide mechanistic insight into the links between distress and poor health. © 2013 Wiley Periodicals, Inc.

  20. Nuclear morphometry in histological specimens of canine prostate cancer: Correlation with histological subtypes, Gleason score, methods of collection and survival time.

    Science.gov (United States)

    Di Donato, Guido; Laufer-Amorim, Renée; Palmieri, Chiara

    2017-10-01

    Ten normal prostates, 22 benign prostatic hyperplasia (BPH) and 29 prostate cancer (PC) were morphometrically analyzed with regard to mean nuclear area (MNA), mean nuclear perimeter (MNP), mean nuclear diameter (MND), coefficient of variation of the nuclear area (NACV), mean nuclear diameter maximum (MDx), mean nuclear diameter minimum (MDm), mean nuclear form ellipse (MNFe) and form factor (FF). The relationship between nuclear morphometric parameters and histological type, Gleason score, methods of sample collection, presence of metastases and survival time of canine PC were also investigated. Overall, nuclei from neoplastic cells were larger, with greater variation in nuclear size and shape compared to normal and hyperplastic cells. Significant differences were found between more (small acinar/ductal) and less (cribriform, solid) differentiated PCs with regard to FF (pnuclear morphometric analysis in combination with Gleason score can help in canine prostate cancer grading, thus contributing to the establishment of a more precise prognosis and patient's management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Impact of initial time to prostate-specific antigen nadir on survival in prostate cancer with bone metastasis initially treated with maximum androgen blockade therapy

    Directory of Open Access Journals (Sweden)

    Yamamoto Y

    2013-10-01

    Full Text Available Background: The objective of this study is to provide certain data on clinical outcomes and their predictors of traditional maximum androgen blockade (MAB in prostate cancer with bone metastasis. Methods: Subjects were patients with prostate adenocarcinoma with bone metastasis initiated to treat with MAB as a primary treatment without any local therapy at our hospital between January 2003 and December 2010. Time to prostate specific antigen (PSA progression, overall survival (OS time, and association of clinical factors and outcomes were retrospectively evaluated. Results: A total of 57 patients were evaluable. The median age was 70 years. The median primary PSA was 203 ng/ml. Luteinizing hormone-releasing hormone agonists had been administered in 96.5% of the patients. Bicalutamide had been chosen in 89.4 % of the patients as the initial antiandrogen. The median time to PSA progression with MAB was 11.3 months (95% confidence interval [CI], 10.4 to 13.0. The median OS was 47.3 months (95% CI, 30.7 to 81.0. Gleason score 9 or greater, decline of PSA level equal to or higher than 1.0 ng/ml with MAB, and time to PSA nadir equal to or shorter than six months after initiation of MAB were independent risk factors for time to PSA progression (P=0.010, P=0.005, and P=0.001; respectively. Time to PSA nadir longer than six months was the only independent predictor for longer OS (HR, 0.255 [95% CI, 0.109 to 0.597]; P=0.002. Conclusions: Initial time to PSA nadir should be emphasized for clinical outcome analyses in future studies on prostate cancer with bone metastasis.

  2. Timing of Whole Brain Radiotherapy on Survival of Patients with EGFR-mutated 
Non-small Cell Lung Cancer and Brain Metastases

    Directory of Open Access Journals (Sweden)

    Guimei LIU

    2016-08-01

    Full Text Available Background and objective There is no high-level evidence for the time of whole brain radiotherapy (WBRT for patients with epidermal growth factor receptor (EGFR-mutated non-small cell lung cancer (NSCLC and brain metastases. The aim of this study is to assess the appropriate timing of WBRT for patients with EGFR-mutated NSCLC and brain metastases (BM. Methods There were 78 patients diagnosed with EGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015. 48 untreated patients who received both WBRT and EGFR-tyrosine kinase inhibitors (TKIs therapy. Prognostic factors of intracranial progression-free survival (PFS and overall survival (OS were identified by Cox proportional hazards modeling. Results Intracranial objective response rate was 81.3% and disease control rate was 93.8%. Median intracranial PFS was 10 months. Median OS was 18 months. Multivariate analysis of intracranial PFS revealed that Eastern Cooperative Oncology Group (ECOG performance status (PS 0-1 (HR=30.436, 95%CI: 4.721-196.211, P<0.001 and early WBRT (HR=3.663, 95%CI: 1.657-8.098, P=0.001 had a better intracranial PFS. Multivariate analysis of OS revealed that PS 0-1 (HR=57.607, 95%CI: 6.135-540.953, P<0.001, early WBRT (HR=2.757, 95%CI: 1.140-6.669, P=0.024, and stereotactic radiosurgery (HR=5.964, 95%CI: 1.895-18.767, P=0.002 were independent prognostic factors of OS. Conclusion Early WBRT combined with EGFR-TKIs can improve outcomes of patients with EGFR-mutated NSCLC and BM, but it needs to be confirmed by large-sample-size and multicenter prospective clinical trials.

  3. Exploration for unknown substances in rapeseed oil that shorten survival time of stroke-prone spontaneously hypertensive rats. Effects of super critical gas extraction fractions.

    Science.gov (United States)

    Ohara, Naoki; Naito, Yukiko; Nagata, Tomoko; Tatematsu, Kenjiro; Fuma, Shin-Ya; Tachibana, Shigehiro; Okuyama, Harumi

    2006-07-01

    To identify the causative substances for the shortening of survival time by rapeseed (Canola) oil in stroke-prone spontaneously hypertensive rats (SHRSP), SHRSP were fed on a standard chow supplemented with 10 w/w% soybean oil (control), rapeseed oil, one of the fractions of rapeseed oil obtained by super critical gas extraction (SCE) under a pressure of 180-bar or 350-bar, at 40 degrees C, or the residue from the extraction (with 0.5% NaCl in drinking water). In another series of experiment, SHRSP were fed for 8 weeks on the above-mentioned diets without salt loading and autopsied. Fatty acid compositions in these diets were similar, except in the soybean oil diet, and phytosterol contents were: (diet containing) 180-bar fraction>residue>rapeseed oil>350-bar fraction>soybean oil. Survival times in the rapeseed oil, 350-bar fraction and residue groups were shorter than, whereas that in the 180-bar fraction was similar to in the soybean oil group. In the 8-week feeding experiment, chronic nephropathy was found frequently in the groups other than the soybean oil group. The heart weights were higher in the rapeseed oil and residue groups. Cerebral necrosis was found in the residue group. Taken together, the followings are concluded, (1) Neither the fatty acid composition, nor the amount of phytosterols in the diets appeared to be decisive in the shortening of life. (2) SCE appeared to produce a safe (180-bar) fraction, though it failed to separate clearly the causative substances into specific fractions. (3) The factors that facilitate the genetic disease of SHRSP appear to exist in rapeseed oil. However, they might not be identical to those responsible for the life-shortening, since there were no findings common across the rapeseed oil, 350-bar and residue groups, which showed similar life-shortening.

  4. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Seeing. Trouble Walking. Know Stroke, Know the Signs, Act in Time. Announcer: Most people know what to ... but you need to know the signs and act in time. Here are the signs to look ...

  5. Listening to the voices of important others: how adolescents make sense of troubled dating relationships.

    Science.gov (United States)

    Martsolf, Donna S; Draucker, Claire B; Bednarz, Lucy C; Lea, Joshua A

    2011-12-01

    Nearly one third of adolescents experience dating relationship maltreatment. Grounded theory methods were used to explicate a typology of ways by which adolescents incorporate views of others in making sense of their troubled dating relationships. Interviews with 90 young adults (ages 18-21 years) who had troubled adolescent dating relationships were analyzed using constant comparative techniques. A typology of ways in which adolescents "listen to the voices of important others" emerged. The six ways were "preventing challenging voices of important others," "deflecting irksome voices of important others," "succumbing to demanding voices of important others," "soliciting confirming voices of important others," "considering cautionary voices of important others," and "heeding knowing voices of important others." Professionals can use this model when deciding how to offer input about troubled adolescent dating relationships. 2011 Elsevier Inc. All rights reserved.

  6. Extension of the biotic ligand model of acute toxicity to a physiologically-based model of the survival time of rainbow trout (Oncorhynchus mykiss) exposed to silver.

    Science.gov (United States)

    Paquin, Paul R; Zoltay, Viktoria; Winfield, Richard P; Wu, Kuen Benjamin; Mathew, Rooni; Santore, Robert C; Di Toro, Dominic M

    2002-09-01

    Chemical speciation controls the bioavailability and toxicity of metals in aquatic systems and regulatory agencies are recognizing this as they develop updated water quality criteria (WQC) for metals. The factors that affect bioavailability may be quantitatively evaluated with the biotic ligand model (BLM). Within the context of the BLM framework, the 'biotic ligand' is the site where metal binding results in the manifestation of a toxic effect. While the BLM does account for the speciation and complexation of dissolved metal in solution, and competition among the free metal ion and other cations for binding sites at the biotic ligand, it does not explicitly consider either the physiological effects of metals on aquatic organisms, or the direct effect of water chemistry parameters such as pH, Ca(2+)and Na(+) on the physiological state of the organism. Here, a physiologically-based model of survival time is described. In addition to incorporating the effects of water chemistry on metal availability to the organism, via the BLM, it also considers the interaction of water chemistry on the physiological condition of the organism, independent of its effect on metal availability. At the same time it explicitly considers the degree of interaction of these factors with the organism and how this affects the rate at which cumulative damage occurs. An example application of the model to toxicity data for rainbow trout exposed to silver is presented to illustrate how this framework may be used to predict survival time for alternative exposure durations. The sodium balance model (SBM) that is described herein, a specific application of a more generic ion balance model (IBM) framework, adds a new physiological dimension to the previously developed BLM. As such it also necessarily adds another layer of complexity to this already useful predictive framework. While the demonstrated capability of the SBM to predict effects in relation to exposure duration is a useful feature of this

  7. Estimation of the probability of bacterial population survival: Development of a probability model to describe the variability in time to inactivation of Salmonella enterica.

    Science.gov (United States)

    Koyama, Kento; Hokunan, Hidekazu; Hasegawa, Mayumi; Kawamura, Shuso; Koseki, Shigenobu

    2017-12-01

    Despite the development of numerous predictive microbial inactivation models, a model focusing on the variability in time to inactivation for a bacterial population has not been developed. Additionally, an appropriate estimation of the risk of there being any remaining bacterial survivors in foods after the application of an inactivation treatment has not yet been established. Here, Gamma distribution, as a representative probability distribution, was used to estimate the variability in time to inactivation for a bacterial population. Salmonella enterica serotype Typhimurium was evaluated for survival in a low relative humidity environment. We prepared bacterial cells with an initial concentration that was adjusted to 2 × 10n colony-forming units/2 μl (n = 1, 2, 3, 4, 5) by performing a serial 10-fold dilution, and then we placed 2 μl of the inocula into each well of 96-well microplates. The microplates were stored in a desiccated environment at 10-20% relative humidity at 5, 15, or 25 °C. The survival or death of bacterial cells for each well in the 96-well microplate was confirmed by adding tryptic soy broth as an enrichment culture. The changes in the death probability of the 96 replicated bacterial populations were described as a cumulative Gamma distribution. The variability in time to inactivation was described by transforming the cumulative Gamma distribution into a Gamma distribution. We further examined the bacterial inactivation on almond kernels and radish sprout seeds. Additionally, we described certainty levels of bacterial inactivation that ensure the death probability of a bacterial population at six decimal reduction levels, ranging from 90 to 99.9999%. Consequently, the probability model developed in the present study enables us to estimate the death probability of bacterial populations in a desiccated environment over time. This probability model may be useful for risk assessment to estimate the amount of remaining bacteria in a given

  8. Effect of growth on the thermal resistance and survival of Salmonella Tennessee and Oranienburg in peanut butter, measured by a new thin-layer thermal death time device.

    Science.gov (United States)

    Keller, Susanne E; Grasso, Elizabeth M; Halik, Lindsay A; Fleischman, Gregory J; Chirtel, Stuart J; Grove, Stephen F

    2012-06-01

    In published data the thermal destruction of Salmonella species in peanut butter deviates from pseudo-first-order kinetics. The reasons for such deviation are unknown. This study examined both the method used to measure the thermal destruction rate and the method of growth of the microorganisms to explain variations in destruction kinetics. Growth on a solid matrix results in a different physiological state that may provide greater resistance to adverse environments. In this study, Salmonella Tennessee and Oranienburg were grown for 24 h at 37°C under aerobic conditions in broth and agar media to represent planktonic and sessile cell growth, respectively. Peanut butter was held at 25°C and tested for Salmonella levels immediately after inoculation and at various time intervals up to 2 weeks. Thermal resistance was measured at 85°C by use of a newly developed thin-layer metal sample holder. Although thermal heat transfer through the metal device resulted in longer tau values than those obtained with plastic bags (32.5 ± 0.9 versus 12.4 ± 1.9 s), the bags have a relative variability of about 15 % compared with about 3 % in the plates, allowing improved uniformity of sample treatment. The two serovars tested in the thin-layer device showed similar overall thermal resistance levels in peanut butter regardless of growth in sessile or planktonic states. However, thermal destruction curves from sessile cultures exhibited greater linearity than those obtained from planktonic cells (P = 0.0198 and 0.0047 for Salmonella Oranienburg and Salmonella Tennessee, respectively). In addition, both Salmonella serovars showed significantly higher survival in peanut butter at 25°C when originally grown on solid media (P = 0.001) with a survival of Salmonella at different temperatures in a low-water-activity environment such as peanut butter.

  9. Associations among self-perceived work and life stress, trouble sleeping, physical activity, and body weight among Canadian adults.

    Science.gov (United States)

    Sampasa-Kanyinga, Hugues; Chaput, Jean-Philippe

    2017-03-01

    We investigated the associations among self-perceived work and life stress, trouble sleeping, physical activity and body weight among Canadian adults, and tested whether trouble sleeping and physical activity moderated the relationship between work/life stress and body weight, and whether work/life stress and physical activity moderated the relationship between trouble sleeping and body weight. Data on 13,926 Canadian adults aged 20years and older were derived from the nationally representative 2012 Canadian Community Health Survey. After adjusting for age, sex, education level, household income, marital status and job insecurity, self-perceived work and life stress and trouble sleeping were associated with a higher BMI. The associations of work and life stress with higher BMI were independent of trouble sleeping and physical activity in addition to other covariates, while that of trouble sleeping and higher BMI was independent of work and life stress. Results further indicated that trouble sleeping among inactive participants was related to a higher BMI; however, this relationship was almost null for adults who self-reported being physically active for about 8h/week. These findings suggest that work and life stress are both associated with excess weight in adults, regardless of physical activity level, while the link of trouble sleeping with BMI varies by physical activity level. Future research is necessary to determine whether reducing work and life stress and improving sleep habits would benefit the prevention of weight gain and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The Transcriptional Response of Neurotrophins and Their Tyrosine Kinase Receptors in Lumbar Sensorimotor Circuits to Spinal Cord Contusion is Affected by Injury Severity and Survival Time

    Science.gov (United States)

    Hougland, M. Tyler; Harrison, Benjamin J.; Magnuson, David S. K.; Rouchka, Eric C.; Petruska, Jeffrey C.

    2013-01-01

    Traumatic spinal cord injury (SCI) results in changes to the anatomical, neurochemical, and physiological properties of cells in the central and peripheral nervous system. Neurotrophins, acting by binding to their cognate Trk receptors on target cell membranes, contribute to modulation of anatomical, neurochemical, and physiological properties of neurons in sensorimotor circuits in both the intact and injured spinal cord. Neurotrophin signaling is associated with many post-SCI changes including maladaptive plasticity leading to pain and autonomic dysreflexia, but also therapeutic approaches such as training-induced locomotor improvement. Here we characterize expression of mRNA for neurotrophins and Trk receptors in lumbar dorsal root ganglia (DRG) and spinal cord after two different severities of mid-thoracic injury and at 6 and 12 weeks post-SCI. There was complex regulation that differed with tissue, injury severity, and survival time, including reversals of regulation between 6 and 12 weeks, and the data suggest that natural regulation of neurotrophins in the spinal cord may continue for months after birth. Our assessments determined that a coordination of gene expression emerged at the 12-week post-SCI time point and bioinformatic analyses address possible mechanisms. These data can inform studies meant to determine the role of the neurotrophin signaling system in post-SCI function and plasticity, and studies using this signaling system as a therapeutic approach. PMID:23316162

  11. Modeling association between times to recurrence of the different polarities in bipolar disorder among service seekers in urban Nigeria: a survival analysis approach

    Directory of Open Access Journals (Sweden)

    Fagbamigbe AF

    2017-07-01

    Full Text Available Adeniyi Francis Fagbamigbe,1 Victor Adesola Makanjuola2 1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria; 2Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan Nigeria Introduction: Bipolar disorder (BD remains both a clinical and public health challenge worldwide, especially in developing countries such as Nigeria. Many studies have focused on prevalence and recurrences among BD service seekers but little has been documented on the nature, strength, direction, existence, and estimation of association between times to recurrence of the two possible polarities or mood episodes in BD. In this study, we explored the association between durations before recurrence of depression and manic episodes among people seeking treatment for BD.Methods: This analytical study used retrospective data of 467 persons who sought treatment for BD at the psychiatric clinic of University College Hospital, Ibadan, Nigeria between 2005 and 2014. Descriptive statistics were used to explore the data. We right-censored the data and obtained Kaplan–Meier estimates of the time to recurrence of the outcomes and transformed the estimates to standardized binormal data using quantile-quantile transformation. The likelihood was maximized to obtain the maximum likelihood estimate of the association parameter at 5% significance level.Results: The mean (± standard deviation age of the respondents was 32.9±12.9 years, this was lower among service seekers who were initially diagnosed with mania than among those initially diagnosed with depression (31.3±11.6, 33.2±11.9, respectively. The median survival time to recurrence of mania and depression among the patients was 1,120 and 745 days, respectively, whereas association between times to recurrence of mania and depression was maximized at 0.67 (95% confidence interval: 0.62–0.71.Conclusion: There exists a strong and positive

  12. Survival rate and expression of Heat-shock protein 70 and Frost genes after temperature stress in Drosophila melanogaster lines that are selected for recovery time from temperature coma.

    Science.gov (United States)

    Udaka, Hiroko; Ueda, Chiaki; Goto, Shin G

    2010-12-01

    In this study, we investigated the physiological mechanisms underlying temperature tolerance using Drosophila melanogaster lines with rapid, intermediate, or slow recovery from heat or chill coma that were established by artificial selection or by free recombination without selection. Specifically, we focused on the relationships among their recovery from heat or chill coma, survival after severe heat or cold, and survival enhanced by rapid cold hardening (RCH) or heat hardening. The recovery time from heat coma was not related to the survival rate after severe heat. The line with rapid recovery from chill coma showed a higher survival rate after severe cold exposure, and therefore the same mechanisms are likely to underlie these phenotypes. The recovery time from chill coma and survival rate after severe cold were unrelated to RCH-enhanced survival. We also examined the expression of two genes, Heat-shock protein 70 (Hsp70) and Frost, in these lines to understand the contribution of these stress-inducible genes to intraspecific variation in recovery from temperature coma. The line showing rapid recovery from heat coma did not exhibit higher expression of Hsp70 and Frost. In addition, Hsp70 and Frost transcription levels were not correlated with the recovery time from chill coma. Thus, Hsp70 and Frost transcriptional regulation was not involved in the intraspecific variation in recovery from temperature coma. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Placed Parenting, locating unrest: failed femininities, troubled mothers and rioting subjects

    Directory of Open Access Journals (Sweden)

    Kim Allen

    2012-07-01

    Full Text Available Critical attention has been given to the consolidation of classed forms of 'placed personhood', as compelling future-orientated and self-regulating subjects that 'fit' into contemporary economic and social formation. These forms of personhood, spoken of as moral character and behavioural 'traits', are increasingly attached to placed parenthood: as that which (selflocates in the right moral and material terrain. Good subjects – made through good parenting and in particular via 'good mothers' – are tasked with self-optimizing and bringing forward their own futures and those of their families (Allen and Osgood 2009; Armstrong 2010; Evans 2010, Gillies 2007; Lawler 2000; Taylor 2012a; Taylor and Addison 2011. A broader 'public' as concerned with equity, welfare and redistribution is dis-placed and entirely re-placed with a self-orientated 'enterprising' privatized response. This limited response is self-congratulating of its own 'responsibility' and condemning of those who 'fail' heightened efforts (in times of 'cutting back' parent-citizens are told simply to be more 'efficient'. 'Necessity' and 'austerity' are, as the editors of this special issue highlight, invoked to re-do all kind of classed and gendered violence, where the most privileged sections of society are evacuated from blame in times of economic crisis: in contrast, what re-circulates is a stated need for poor, 'failing mothers' to 'step-up' for all our sakes. Those who cannot bring themselves forward and propel into this neo-liberal future are increasingly condemned as the wrong kind of parents. This piece aims to chart some of the 'ugliness of parenting' (Taylor 2009, 2012b as placed parenthood attaches to specific classed locales and subjects as that which 'fails' and 'troubles' the future. This is witnessed in the example of and responses to the English Riots of 2011, which is placed as a case study casting light on intersections of class, race, gender and sexuality in forms

  14. The trouble with memes : Inference versus imitation in cultural creation.

    Science.gov (United States)

    Atran, S

    2001-12-01

    Memes are hypothetical cultural units passed on by imitation; although nonbiological, they undergo Darwinian selection like genes. Cognitive study of multimodular human minds undermines memetics: unlike in genetic replication, high-fidelity transmission of cultural information is the exception, not the rule. Constant, rapid "mutation" of information during communication generates endlessly varied creations that nevertheless adhere to modular input conditions. The sort of cultural information most susceptible to modular processing is that most readily acquired by children, most easily transmitted across individuals, most apt to survive within a culture, most likely to recur in different cultures, and most disposed to cultural variation and elaboration.

  15. Le trouble spécifique du langage oral chez les enfants bilingues

    NARCIS (Netherlands)

    Laloi, A.; Guedin-Dumont, M.; Céleste, B.

    2013-01-01

    Le trouble spécifique du langage oral chez les enfants bilingues De par la mobilité grandissante des populations, la proportion d’enfants grandissant dans un environnement plurilingue augmente en France. En région parisienne par exemple, la proportion d’enfants bilingues est estimée à 25%. Or le

  16. Murder-suicide involving BC doctor raises troubling questions about euthanasia.

    OpenAIRE

    Wilson, V

    1995-01-01

    The deaths last September of a British Columbia physician and his wife have raised troubling questions about euthanasia and Alzheimer's disease. Police described the deaths of Dr. Tom Powell and his wife Dr. Lorraine Miles, a retired dentist, as a murder-suicide. Friends of the couple wonder if more lenient laws concerning euthanasia and assisted suicide might have saved Miles' life.

  17. Group Cognitive Behavior Therapy Program with Troubled Adolescents: A Learning Experience

    Science.gov (United States)

    Edelman, Sarah; Remond, Louise

    2005-01-01

    Group CBT programs are widely used for assisting teenagers with anxiety, depression and other psychological problems. The majority of reported programs have targeted school or clinical populations however few have specifically targeted adolescents from highly troubled and disadvantaged backgrounds. This paper describes a group CBT program that was…

  18. Derrida, Foucault and Critical Pedagogies of Friendship in Conflict-Troubled Societies

    Science.gov (United States)

    Zembylas, Michalinos

    2015-01-01

    The aim of this paper is to place Derrida's and Foucault's ideas on friendship in conversation and then discuss how those ideas provide a pedagogical space in which critical educators in conflict-troubled societies can promote new modes of being and living with others. In particular, the notion of critical pedagogies of friendship is…

  19. Teachers' Understanding of Reconciliation and Inclusion in Mixed Schools of Four Troubled Societies

    Science.gov (United States)

    Zembylas, Michalinos; Bekerman, Zvi; McGlynn, Claire; Ferreira, Ana

    2009-01-01

    In this article, the authors examine how teachers in four troubled societies--Israel, Cyprus, Northern Ireland and South Africa--understand and implement reconciliation in light of the increasing diversity of these societies. The authors particularly pay attention to a dialogical encounter between reconciliation and inclusion, as they look for…

  20. A Critical Evaluation of the Literature of the Troubles Project: Philosophy, Methodology, Findings/Outcomes

    Science.gov (United States)

    Hanratty, Brian Robert

    2013-01-01

    The paper presents a critical evaluation of the Literature of the Troubles Project which was aimed at using literature in an educational context to help cement the process of peace and reconciliation between Northern Ireland's divided communities. The Project, funded by the Esmée Fairbairn Foundation, ran from September 2007 to August 2009. Its…

  1. "Staying with the Trouble" in Child-Insect-Educator Common Worlds

    Science.gov (United States)

    Nxumalo, Fikile; Pacini-Ketchabaw, Veronica

    2017-01-01

    Classroom pet programs have become extremely popular in urban North American early childhood classrooms. This article challenges anthropocentric child-pet pedagogies by proposing common world pedagogies of "staying with the trouble." Drawing from a common world multispecies ethnography in one early childhood centre, the authors engage…

  2. Supportive Devices in Language and Paralanguage in the Achievement of Affiliation in Troubles Talk.

    Science.gov (United States)

    Pritchard, C. Ruth

    1993-01-01

    Uses the methodology of conversational analysis to examine a case of "troubles talk" between a group of female survivors of rape. The conversational process of "affiliation" between interactants as it occurs within the structure of the conversation is examined as are the successfully utilized linguistic and paralinguistic…

  3. "That's Too Bad": Hedges and Indirect Complaints in "Troubles-Talk" Narrative.

    Science.gov (United States)

    Ouellette, Mark A.

    2001-01-01

    In many cultures, the "troubles-talk narrative" is a speech event which builds solidarity between interlocutors through the indirect speech act of complaining and through face-saving strategies such as speaker "hedges" and listener "commiserative responses" as backchannels. The manner in which speakers perform such…

  4. An Asset Protection Scheme for Banks Exposed to Troubled Loan Portfolios

    DEFF Research Database (Denmark)

    Grosen, Anders; Jessen, Pernille; Kokholm, Thomas

    2014-01-01

    We examine a specific portfolio credit derivative, an Asset Protection Scheme (APS), and its applicability as a discretionary regulatory tool to reduce asymmetric information and help restore the capital base of troubled banks. The APS can be a fair-valued contract with an appropriate structure...

  5. Methodological troubles as problems and phenomena: ethnomethodology and the question of 'method' in the social sciences.

    Science.gov (United States)

    Greiffenhagen, Christian; Mair, Michael; Sharrock, Wes

    2015-09-01

    Across the disciplinary frontiers of the social sciences, studies by social scientists treating their own investigative practices as sites of empirical inquiry have proliferated. Most of these studies have been retrospective, historical, after-the-fact reconstructions of social scientific studies mixing interview data with the (predominantly textual) traces that investigations leave behind. Observational studies of in situ work in social science research are, however, relatively scarce. Ethnomethodology was an early and prominent attempt to treat social science methodology as a topic for sociological investigations and, in this paper, we draw out what we see as its distinctive contribution: namely, a focus on troubles as features of the in situ, practical accomplishment of method, in particular, the way that research outcomes are shaped by the local practices of investigators in response to the troubles they encounter along the way. Based on two case studies, we distinguish methodological troubles as problems and methodological troubles as phenomena to be studied, and suggest the latter orientation provides an alternate starting point for addressing social scientists' investigative practices. © London School of Economics and Political Science 2015.

  6. A Chippewa Trouble-Case: Toward an Expended Model of Conflict Resolution.

    Science.gov (United States)

    Rohrl, Vivian

    1981-01-01

    This study employs the trouble-case method to explore the impact of a single breach of communal values in a Chippewa community. A brief theoretical legal framework and description of Chippewa culture serve as background to this analysis of community values and conflict management styles. (AM)

  7. A Pedagogy of Belonging: Troubling Encounters with Ethnic and Religious Difference

    Science.gov (United States)

    Edgeworth, Kathryn; Santoro, Ninetta

    2015-01-01

    Understanding the construction of belonging, and how unbelonging might be troubled, is critical work. For schools in many parts of the world one of the many challenges of globalisation is the task of teaching with, and for, ethnic and cultural diversity. This paper examines the exclusionary practices of teaching that construct ethnic and religious…

  8. 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

  9. Variations of motility and survival with storage time at 4°C of epididymal spermatozoa Ouled-Djellal breed rams in Eastern Algeria.

    Science.gov (United States)

    Safsaf, B; Belkadi, S; Belkacem, L; Mamache, B; Tlidjane, M

    2015-03-01

    The aim of this study was to evaluate some reproduction performances in Ouled-Djellal rams. This study involved genital organs removed after slaughter from 54 rams at the municipal slaughterhouse of Batna (East Algeria). The measurements of survival and mobility of epididymal sperm followed at 0, 24, 48 and 72 h after collection, revealed significant (p0.001) according to time. Thus, concerning the sperm motility the values were 91.00±2.40%, 89.20±2.40%, 77.00±6.20% and 62.60±1.20% at 0, 24, 48 and 72 h, respectively. Indeed, in live sperm, the viability rates were 82.15±1.48%, 77.67±1.74%, 66.56±1.95% and 52.30±1.46% at 0, 24, 48 and 72 h, respectively. This study revealed that epididymal spermatozoa stored at 04°C for 72 h kept their mobility and vitality at nearly a half of their the original parameters.

  10. Variations of motility and survival with storage time at 4°C of epididymal spermatozoa Ouled-Djellal breed rams in Eastern Algeria

    Directory of Open Access Journals (Sweden)

    B. Safsaf

    2015-03-01

    Full Text Available Aim: The aim of this study was to evaluate some reproduction performances in Ouled-Djellal rams. Materials and Methods: This study involved genital organs removed after slaughter from 54 rams at the municipal slaughterhouse of Batna (East Algeria. Results: The measurements of survival and mobility of epididymal sperm followed at 0, 24, 48 and 72 h after collection, revealed significant (p0.001 according to time. Thus, concerning the sperm motility the values were 91.00±2.40%, 89.20±2.40%, 77.00±6.20% and 62.60±1.20% at 0, 24, 48 and 72 h, respectively. Indeed, in live sperm, the viability rates were 82.15±1.48%, 77.67±1.74%, 66.56±1.95% and 52.30±1.46 at 0, 24, 48 and 72 h, respectively. Conclusion: This study revealed that epididymal spermatozoa stored at 04°C for 72 h kept their mobility and vitality at nearly a half of their the original parameters.

  11. Applied survival analysis using R

    CERN Document Server

    Moore, Dirk F

    2016-01-01

    Applied Survival Analysis Using R covers the main principles of survival analysis, gives examples of how it is applied, and teaches how to put those principles to use to analyze data using R as a vehicle. Survival data, where the primary outcome is time to a specific event, arise in many areas of biomedical research, including clinical trials, epidemiological studies, and studies of animals. Many survival methods are extensions of techniques used in linear regression and categorical data, while other aspects of this field are unique to survival data. This text employs numerous actual examples to illustrate survival curve estimation, comparison of survivals of different groups, proper accounting for censoring and truncation, model variable selection, and residual analysis. Because explaining survival analysis requires more advanced mathematics than many other statistical topics, this book is organized with basic concepts and most frequently used procedures covered in earlier chapters, with more advanced topics...

  12. The gendered trouble with alcohol: young people managing alcohol related violence.

    Science.gov (United States)

    Lindsay, Jo

    2012-05-01

    Alcohol related violence is a troubling backdrop to the social lives and relationships of many young people in post-industrial societies. The development of the night-time economy where young people are encouraged to drink heavily in entertainment precincts has increased the risk of violence. This paper reports on 60 individual structured in-depth interviews about the drinking biographies of young people (aged 20-24) living in Victoria, Australia. Twenty-six males and 34 females participated in the research. The participants discussed their experiences with alcohol over their life course to date. The material on alcohol related violence is analysed in this paper. Just over half of the participants (33/60) recounted negative experiences with alcohol related violence. The findings demonstrate the continuing gendered nature of experiences of perpetration and victimization. Participants reported that aggression and violence perpetrated by some men was fuelled by alcohol consumption and required ongoing management. Experiences of violence were also spatialized. Men were more likely to report managing and avoiding violence in particular public settings whilst more women than men discussed managing violence in domestic settings. The central argument of this paper is that incidents of alcohol related violence and reactions to it are specific gender performances that occur in specific socio-cultural contexts. In contrast to research which has found some young people enjoy the adventure and excitement of alcohol related violence the mainstream participants in this study saw violence as a negative force to be managed and preferably avoided. Understanding violence as a dynamic gender performance complicates the development of policy measures designed to minimize harm but also offers a more holistic approach to developing effective policy in this domain. There is a need for greater acknowledgement that alcohol related violence in public venues and in families is primarily about

  13. 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.

  14. 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...

  15. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... player... Video Transcript Weakness on one Side. Trouble Speaking. Trouble Seeing. Trouble Walking. Know Stroke, Know the ... side of the body Sudden confusion or trouble speaking or understanding, Sudden trouble seeing in one or ...

  16. Design and Analysis of Salmonid Tagging Studies in the Columbia Basin : Evaluating Wetland Restoration Projects in the Columbia River Estuary using Hydroacoustic Telemetry Arrays to Estimate Movement, Survival, and Residence Times of Juvenile Salmonids, Volume XXII (22).

    Energy Technology Data Exchange (ETDEWEB)

    Perry, Russell W.; Skalski, John R.

    2008-08-01

    Wetlands in the Columbia River estuary are actively being restored by reconnecting these habitats to the estuary, making more wetland habitats available to rearing and migrating juvenile salmon. Concurrently, thousands of acoustically tagged juvenile salmonids are released into the Columbia River to estimate their survival as they migrate through the estuary. Here, we develop a release-recapture model that makes use of these tagged fish to measure the success of wetland restoration projects in terms of their contribution to populations of juvenile salmon. Specifically, our model estimates the fraction of the population that enter the wetland, survival within the wetland, and the mean residence time of fish within the wetland. Furthermore, survival in mainstem Columbia River downstream of the wetland can be compared between fish that remained the mainstem and entered the wetland. These conditional survival estimates provide a means of testing whether the wetland improves the subsequent survival of juvenile salmon by fostering growth or improving their condition. Implementing such a study requires little additional cost because it takes advantage of fish already released to estimate survival through the estuary. Thus, such a study extracts the maximum information at minimum cost from research projects that typically cost millions of dollars annually.

  17. Larval food quantity affects development time, survival and adult biological traits that influence the vectorial capacity of Anopheles darlingi under laboratory conditions

    Directory of Open Access Journals (Sweden)

    Araújo Maisa

    2012-08-01

    Full Text Available Abstract Background The incidence of malaria in the Amazon is seasonal and mosquito vectorial capacity parameters, including abundance and longevity, depend on quantitative and qualitative aspects of the larval diet. Anopheles darlingi is a major malaria vector in the Amazon, representing >95% of total Anopheles population present in the Porto Velho region. Despite its importance in the transmission of the Plasmodium parasite, knowledge of the larval biology and ecology is limited. Studies regarding aspects of adult population ecology are more common than studies on larval ecology. However, in order develop effective control strategies and laboratory breeding conditions for this species, more data on the factors affecting vector biology is needed. The aim of the present study is to assess the effects of larval food quantity on the vectorial capacity of An. darling under laboratory conditions. Methods Anopheles darlingi was maintained at 28°C, 80% humidity and exposed to a daily photoperiod of 12 h. Larvae were divided into three experimental groups that were fed either a low, medium, or high food supply (based on the food amounts consumed by other species of culicids. Each experiment was replicated for six times. A cohort of adults were also exposed to each type of diet and assessed for several biological characteristics (e.g. longevity, bite frequency and survivorship, which were used to estimate the vectorial capacity of each experimental group. Results The group supplied with higher food amounts observed a reduction in development time while larval survival increased. In addition to enhanced longevity, increasing larval food quantity was positively correlated with increasing frequency of bites, longer blood meal duration and wing length, resulting in greater vectorial capacity. However, females had greater longevity than males despite having smaller wings. Conclusions Overall, several larval and adult biological traits were significantly

  18. General regression neural network and Monte Carlo simulation model for survival and growth of Salmonella on raw chicken skin as a function of serotype, temperature and time for use in risk assessment

    Science.gov (United States)

    A general regression neural network and Monte Carlo simulation model for predicting survival and growth of Salmonella on raw chicken skin as a function of serotype (Typhimurium, Kentucky, Hadar), temperature (5 to 50C) and time (0 to 8 h) was developed. Poultry isolates of Salmonella with natural r...

  19. Attenuation caused by infrequently updated covariates in survival analysis

    DEFF Research Database (Denmark)

    Andersen, Per Kragh; Liestøl, Knut

    2003-01-01

    Attenuation; Cox regression model; Measurement errors; Survival analysis; Time-dependent covariates......Attenuation; Cox regression model; Measurement errors; Survival analysis; Time-dependent covariates...

  20. Potential factors affecting survival differ by run-timing and location: linear mixed-effects models of Pacific salmonids (Oncorhynchus spp. in the Klamath River, California.

    Directory of Open Access Journals (Sweden)

    Rebecca M Quiñones

    Full Text Available Understanding factors influencing survival of Pacific salmonids (Oncorhynchus spp. is essential to species conservation, because drivers of mortality can vary over multiple spatial and temporal scales. Although recent studies have evaluated the effects of climate, habitat quality, or resource management (e.g., hatchery operations on salmonid recruitment and survival, a failure to look at multiple factors simultaneously leaves open questions about the relative importance of different factors. We analyzed the relationship between ten factors and survival (1980-2007 of four populations of salmonids with distinct life histories from two adjacent watersheds (Salmon and Scott rivers in the Klamath River basin, California. The factors were ocean abundance, ocean harvest, hatchery releases, hatchery returns, Pacific Decadal Oscillation, North Pacific Gyre Oscillation, El Niño Southern Oscillation, snow depth, flow, and watershed disturbance. Permutation tests and linear mixed-effects models tested effects of factors on survival of each taxon. Potential factors affecting survival differed among taxa and between locations. Fall Chinook salmon O. tshawytscha survival trends appeared to be driven partially or entirely by hatchery practices. Trends in three taxa (Salmon River spring Chinook salmon, Scott River fall Chinook salmon; Salmon River summer steelhead trout O. mykiss were also likely driven by factors subject to climatic forcing (ocean abundance, summer flow. Our findings underscore the importance of multiple factors in simultaneously driving population trends in widespread species such as anadromous salmonids. They also show that the suite of factors may differ among different taxa in the same location as well as among populations of the same taxa in different watersheds. In the Klamath basin, hatchery practices need to be reevaluated to protect wild salmonids.

  1. Family Relationships and Troubled Sleep among U.S. Adults: Examining the Influences of Contact Frequency and Relationship Quality*

    Science.gov (United States)

    Ailshire, Jennifer A.; Burgard, Sarah A.

    2013-01-01

    Sleep is essential for health and daily functioning, and social relationships may be a key social factor influencing sleep, yet sleep has been understudied in the literature on social relationships and health. This study used data from the National Survey of Midlife Development in the United States to examine associations between troubled sleep and family contact, social support, and strain. Results show that having strained family relationships is associated with more troubled sleep, while supportive family relationships are associated with less troubled sleep. Family strain is more consequential for sleep than support and sleep troubles are greatest when family relationships are highly strained and provide inadequate emotional support. Family strain is also more harmful to sleep among individuals who are in frequent contact with family members. These findings underscore the importance of focusing on both negative and positive aspects of relationships and highlight the significance of family relationships for sleep. PMID:22653715

  2. Family relationships and troubled sleep among U.S. adults: examining the influences of contact frequency and relationship quality.

    Science.gov (United States)

    Ailshire, Jennifer A; Burgard, Sarah A

    2012-01-01

    Sleep is essential for health and daily functioning, and social relationships may be a key social factor influencing sleep, yet sleep has been understudied in the literature on social relationships and health. This study used data from the National Survey of Midlife Development in the United States to examine associations between troubled sleep and family contact, social support, and strain. Results show that having strained family relationships is associated with more troubled sleep, while supportive family relationships are associated with less troubled sleep. Family strain is more consequential for sleep than support, and sleep troubles are greatest when family relationships are highly strained and provide inadequate emotional support. Family strain is also more harmful to sleep among individuals who are in frequent contact with family members. These findings underscore the importance of focusing on both negative and positive aspects of relationships and highlight the significance of family relationships for sleep.

  3. Flexible survival regression modelling

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Scheike, Thomas H; Martinussen, Torben

    2009-01-01

    Regression analysis of survival data, and more generally event history data, is typically based on Cox's regression model. We here review some recent methodology, focusing on the limitations of Cox's regression model. The key limitation is that the model is not well suited to represent time-varyi...

  4. Standing together in troubled times unpublished letters by Pauli, Einstein, Franck and others

    CERN Document Server

    2017-01-01

    This captivating book is a story of the friendship between a genius physicist Wolfgang Pauli and Charlotte Houtermans whose career in physics was not as glamorous. They met in the late 1920s in Germany, at the very onset of the quantum era and personally knew all the major players in the emergent quantum world that was very much part of central Europe: Germany, Austria, Hungary, Denmark and Switzerland. And Charlotte was a student at Göttingen that was right at the heart.Caught between two evils — Soviet Communism and German National Socialism — she would have probably perished if it were not for the brotherhood of physicists: Niels Bohr, Wolfgang Pauli, Albert Einstein, James Franck, Max Born, Robert Oppenheimer and many other noted scientists who tried to save friends and colleagues (either leftist sympathizers or Jews) who were in mortal danger of being entrapped in a simmering pre-WWII Europe.Using newly discovered documents from the Houtermans family archive: twenty three Pauli's letters to Charlott...

  5. The Arab Bed Spring? Sexual rights in troubled times across the Middle East and North Africa.

    Science.gov (United States)

    El Feki, Shereen

    2015-11-01

    In recent decades, attitudes in many parts of the Arab region have hardened towards non-conforming sexualities and gender roles, a shift fuelled in part by a rise in Islamic conservatism and exploited by authoritarian regimes. While political cultures have proved slow to change in the wake of the 'Arab Spring', a growing freedom of expression, and increasing activity by civil society, is opening space for discreet challenges to sexual taboos in a number of countries, part of wider debates over human rights and personal liberties in the emerging political and social order. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The Future of the Humanities in Primary Schools--Reflections in Troubled Times

    Science.gov (United States)

    Eaude, Tony; Butt, Graham; Catling, Simon; Vass, Peter

    2017-01-01

    This article reflects on the implications for practitioners, researchers and policy-makers of the future of the humanities in primary schools in the light of the challenges facing future generations. There is wide divergence in the four jurisdictions of the UK. The humanities are perceived as important, in principle, though curriculum frameworks…

  7. Troubled Times: The Role of Instructional Design in a Modern Dual-Mode University?

    Science.gov (United States)

    Fyle, Clifford Omodele; Moseley, Alexander; Hayes, Nichola

    2012-01-01

    Reduced higher education funding and other austerity measures imposed by governments and institutions have resulted in cascading cuts in resources for programme design, delivery and revision. The instructional design function is often the first casualty of these cuts in many universities. This paper considers the roles and functions of…

  8. Sang Froid in a time of trouble: is a vaccine against HIV possible?

    Directory of Open Access Journals (Sweden)

    Plotkin Stanley A

    2009-02-01

    Full Text Available Abstract Since the announcement of the STEP trial results in the past months, we have heard many sober pronouncements on the possibility of an HIV vaccine. On the other hand, optimistic quotations have been liberally used, from Shakespeare's Henry V's "Once more unto the breach, dear friends" to Winston Churchill's definition of success as "going from one failure to another with no loss of enthusiasm". I will forgo optimistic quotations for the phrase "Sang Froid", which translates literally from the French as "cold blood"; what it really means is to avoid panic when things look bad, to step back and coolly evaluate the situation. This is not to counsel easy optimism or to fly in face of the facts, but I believe that while the situation is serious, it is not desperate. I should stipulate at the outset that I am neither an immunologist nor an expert in HIV, but someone who has spent his life in vaccine development. What I will try to do is to provide a point of view from that experience. There is no doubt that the results of STEP were disappointing: not only did the vaccine fail to control viral load, but may have adversely affected susceptibility to infection. But HIV is not the only vaccine to experience difficulties; what lessons can we glean from prior vaccine development?

  9. 9/11 to the Iraq War: Using Books to Help Children Understand Troubled Times

    Science.gov (United States)

    Rycik, Mary Taylor

    2006-01-01

    Four years after the 9/11 attack on the United States, the country continues to be in considerable turmoil. Children have lived through the devastation of the September 11th attacks, the panic over the anthrax mailings, the hunt for terrorists in Afghanistan, elevated homeland security threat levels, the war in Iraq, the tsunami disaster, and…

  10. Murder-suicide involving BC doctor raises troubling questions about euthanasia.

    Science.gov (United States)

    Wilson, V

    1995-01-01

    The deaths last September of a British Columbia physician and his wife have raised troubling questions about euthanasia and Alzheimer's disease. Police described the deaths of Dr. Tom Powell and his wife Dr. Lorraine Miles, a retired dentist, as a murder-suicide. Friends of the couple wonder if more lenient laws concerning euthanasia and assisted suicide might have saved Miles' life. Images p1856-a PMID:7773902

  11. THE EFFECT OF KETAMINE AND ITS COMBINATION WITH INDOL-2-CARBOXYLIC ACID AND CAROVERINE ON SURVIVAL TIME OF MICE WITH EXPERIMENTAL TETANUS

    Directory of Open Access Journals (Sweden)

    Indira Mujezinović

    2017-12-01

    Full Text Available Tetanus, also known as lockjaw, is a very dangerous infectious acute, usually afebrile disease characterized by muscle spasms, affecting humans and various animal species. The causative agent of the disease is bacteria Clostridium tetani. This bacteria produces a specific neurotoxin known as Tetanus toxin, which consists of two components: tetanospasmin and tetanolysin. Light (L chains of tetanospamin cleavage synaptobrevin, an integral membrane component of the synaptic vesicles, which in turn prevent release of the inhibitory neurotransmitter γ-aminobutyric acid (GABA into the synaptic cleft. The α- motor neurons are, therefore, under no inhibitory control as a result of which they undergo sustained excitatory discharge causing the characteristic motor spasms of tetanus. In this research, we attempted to normalize the disorders caused by tetanus toxin by using ketamine, a non-competitive antagonist of aspartate (at doses of 5, 10, 44 and 100 mg/kg of body weight – b.w., alone and in combination with indol-2-carboxylic acid, a competitive antagonist of aspartate (at a dose of 10 mg/kg b.w. and caroverine, a non-competitive antagonist of glutamate (at a dose of 1.2 mg/kg b.w.. Experiments were conducted on the albino mice of both sexes, weighing around 20-25 g. Experimental tetanus was induced by application of tetanus toxin. The administration of ketamine, alone and in combination with indol-2-carboxylic acid and caroverine was carried out 24 hours after administration of tetanus toxin once per day, until the mice died. It was found that ketamine had an effect only at a dose of 10 mg/kg b.w., which slightly prolonged the LD50 periodin experimental group of mice, compared to the control group of mice with experimental tetanus. Thus, it can be concluded that administration of ketamine in this dose proved to be only slightly effective. On the other hand, combination of ketamine with indol-2-carboxylic acid slightly extended the survival time

  12. Differences in trouble per litre of different alcoholic beverages – A global comparison with the GENACIS dataset

    OpenAIRE

    Room, Robin; Ferris, Jason; Bond, Jason; Greenfield, Thomas K; Graham, Kathryn

    2011-01-01

    Different alcoholic beverages are seen as causing more or less trouble, with spirits historically often seen as the most troublesome. Differences in the “trouble per litre” could reflect differences in the beverages themselves (e.g., faster effect of stronger beverages, additives/contaminants in informal beverages), or could reflect characteristics of those drinking each beverage. Using two alternative definitions of beverage choice and measures of personal and of social consequences of drink...

  13. Family Relationships and Troubled Sleep among U.S. Adults: Examining the Influences of Contact Frequency and Relationship Quality*

    OpenAIRE

    Ailshire, Jennifer A.; Burgard, Sarah A.

    2012-01-01

    Sleep is essential for health and daily functioning, and social relationships may be a key social factor influencing sleep, yet sleep has been understudied in the literature on social relationships and health. This study used data from the National Survey of Midlife Development in the United States to examine associations between troubled sleep and family contact, social support, and strain. Results show that having strained family relationships is associated with more troubled sleep, while s...

  14. Correlation of [11C]choline PET-CT with time to treatment and disease-specific survival in men with recurrent prostate cancer after radical prostatectomy

    NARCIS (Netherlands)

    Breeuwsma, A.J.; Rybalov, M; Leliveld, AM; Pruim, J; de Jong, Igle Jan

    2012-01-01

    Aim: Radiotherapy following radical prostatectomy should be considered in men with high risk features who have a life expectancy of more than 10 years. So far no effect on prostate cancer specific survival has been proven by 3 randomized controlled trials (RCTs) on adjuvant radiotherapy. At present

  15. Long-Term Survival of Dental Implants with Different Prosthetic Loading Times in Healthy Patients: A 5-Year Retrospective Clinical Study.

    Science.gov (United States)

    Muelas-Jiménez, M Isabel; Olmedo-Gaya, Maria Victoria; Manzano-Moreno, Francisco J; Reyes-Botella, Candela; Vallecillo-Capilla, Manuel

    2017-02-01

    To compare survival rates among dental implants restored with immediate, early, and conventional loading protocols, also comparing between maxillary and mandibular implants, and to evaluate the influence of implant length and diameter and the type of prosthesis on treatment outcomes. This retrospective cohort study initially included all 52 patients receiving dental implants between July 2006 and February 2008 at a private oral surgery clinic in Granada (Southern Spain). Clinical and radiographic examinations were performed, including periapical or panoramic radiographs, and incidences during completion of the restoration were recorded at 1 week, 3 months, 6 months, and at 1, 2, 3, 4, and 5 years. After a 5-year follow-up, 1 patient had died, 3 were lost to follow-up, and 6 required grafting before implant placement; therefore, the final study sample comprised 42 patients with 164 implants. Variables associated with the survival/failure of the restoration were: number of implants (higher failure rate with fewer implants), bone type (higher failure rate in type III or IV bone), and type of prosthesis (higher failure rate with single crowns). No significant association was found in univariate or multivariate analyses between survival rate and the loading protocol, implant length or diameter, or maxillary/mandibular location. Immediate occlusal loading, immediate provisionalization without occlusal loading, and early loading are viable treatment options with similar survival rates to those obtained with conventional loading. Bone quality and number of implants per patient were the most influential factors. © 2015 by the American College of Prosthodontists.

  16. Counseling Centers Lack Resources to Help Troubled Students

    Science.gov (United States)

    Farrell, Elizabeth F.

    2008-01-01

    The fatal shootings at Northern Illinois University this month were shocking yet familiar. For the second time in 10 months, a student with a record of mental-health problems went on a killing spree at a large public university. Ever since a disturbed student fatally shot 32 students and professors at Virginia Tech last April, college…

  17. A Bridge over Troubled Water: Le tombeau de Couperin

    Directory of Open Access Journals (Sweden)

    Anne Morris

    2013-12-01

    Full Text Available Le tombeau de Couperin was composed during a turbulent time in the life of Ravel, a time when he had been emotionally scarred from the effects of war and had lost both his mother and many of his close friends. This composition may have served as the only friend whom Ravel felt comfortable enough to share with his innermost feelings. Autobiographical in nature, this piece follows the transition from Ravel’s carefully nurtured childhood and youth to serious maturity in his post-war adult life. There is personal emotional depth found in this piece, although at first it may appear somewhat hidden behind the classically ordered form and impressionistic harmony. Le tombeau, begun in 1914 and finished in 1917, serves as a bridge between Ravel’s pre- and post-war music.

  18. Body-conscious Shakespeare: sensory disturbances in troubled characters.

    Science.gov (United States)

    Heaton, Kenneth W

    2011-12-01

    It is widely accepted that Shakespeare was unique in the range of his insights into the human mind, but the way his characters reveal their mental states through bodily sensations has not been systematically explored. The author has searched for these phenomena in the 42 major works of Shakespeare and in 46 genre-matched works by his contemporaries, and in this paper the author focuses on sensory changes other than those involving vision, taste, the heart and the alimentary tract (all considered in other papers). Vertigo is experienced by five distressed Shakespearean characters, all men, but not at all by the other writers' characters. Breathlessness, probably representing hyperventilation, occurs eleven times in Shakespeare's works but only twice in the other writers' works. Fatigue, expressing grief, is articulated by several Shakespearean characters including Hamlet. It features less often in the others' works. Deafness at a time of high emotion is mentioned by Shakespeare several times but usually by a character 'turning a deaf ear', consciously or unconsciously. To the other writers, ears show emotion only by burning or itching. Blunting of touch and pain and their opposites of hypersensitivity to touch and pain are all to be found in Shakespeare's works when a character is distressed or excited, but not so with his contemporaries' works. Faint feelings and cold feelings are also more common in the works of Shakespeare. Overall, therefore, Shakespeare was exceptional in his use of sensory disturbances to express emotional upset. This may be a conscious literary device or a sign of exceptional awareness of bodily sensations.

  19. How Can Social Media Get Us in Trouble?

    Science.gov (United States)

    Langenfeld, Sean J; Batra, Rishi

    2017-09-01

    When utilized properly, social media offers several personal and professional benefits for the practicing surgeon, including peer networking, education, e-mentorship, marketing, recruitment, and patient outreach. However, unprofessional online behavior is common among surgeons, and this improper use of social media can be quite dangerous. This article reviews the dangers of social media and illustrates this with examples of unprofessional behavior and the associated consequences. It also provides recommendations for maintaining a professional and productive online persona. Surgeons must understand the various social media platforms and their target audience while upholding online professionalism at all times.

  20. Small islands awash in a sea of troubles.

    Science.gov (United States)

    Acharya, A

    1995-01-01

    The Caribbean islands contain an enormous ecological variety, and with the influx of people, they are left with denuded forests and disappearance of animals and people. Despite their limited size, these islands could sustain development with their own water, vegetation, soil, air, and wildlife resources. The Exclusive Economic Zones, approved by the UN Convention on the Law of the Sea, extends the coastline up to 200 miles, thus providing an increased amount of resource area. However, these natural resources are abused in various ways. Some of the white sand beaches are disappearing due to growing tourism. Furthermore, these islands are vulnerable to hazardous wastes and nuclear tests and other destructive natural forces that produce a dramatic change in the climate. To counteract this environmental degradation, the government implemented environmental initiatives that protect these natural resources with the aid of international agencies and organizations. These islands, though seen as a small capsule, represent the problems of the world magnified many times.

  1. Troubled waters: Environmental applications of electrical and electromagnetic methods

    Science.gov (United States)

    Nobes, David C.

    1996-07-01

    The relatively new subdiscipline of environmental geophysics has grown enormously in the last five years. The size and diversity of the field, and the associated literature, is such that it is extremely difficult to keep up with even a small portion of the field. Electrical and electromagnetic (E & EM) methods, including ground penetrating radar and time-domain reflectometry, play a central role in environmental geophysics. One reason for the utility of E & EM methods in groundwater studies is the similarity in the way that current flow and fluid flow depend on the connectivity and geometry of the pores in soils and rocks. Another reason is the influence of the pore water quality on the geophysical response. More than any other geophysical technique, E & EM methods are directly affected by the presence of conductive pore fluids in the subsurface, such as leachates from landfill sites and sea water invading a coastal groundwater supply that has been placed under stress because of population expansion. The chloride ion is one of the most electrically active of the naturally-occurring ions, and allows us to detect sea water incursion; leachates from landfill sites contain the by-products of organic decay, such as acetic acid, which are generally less conductive than chloride, but nonetheless enhance the pore water and formation electrical conductivities. Landfill leachate plumes are thus easily mapped. The shallow subsurface electrical and dielectric properties exhibit hysteresis due to seasonal changes in water content; the physical properties will be different for the same degree of saturation, depending on whether the water level is rising or falling. Topographic effects are also important; an empirical correction method works well to remove a background trend in the conductivity due to changes in elevation. Heterogeneity and anisotropy of the electric properties may be related to similar effects in the hydraulic properties. New technology and the adaptation of

  2. Semantic trouble sources and their repair in conversations affected by Parkinson's disease

    Science.gov (United States)

    Saldert, Charlotta; Ferm, Ulrika; Bloch, Steven

    2014-01-01

    Background It is known that dysarthria arising from Parkinson's disease may affect intelligibility in conversational interaction. Research has also shown that Parkinson's disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems. Aims To describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinson's disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding. Methods & Procedures Twelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinson's disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinson's disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis. Outcomes & Results In 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinson's disease. The problematic contributions were typically characterized by more or less explicit symptoms of word search or use of atypical wording. The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been. Conclusions & Implications In clinical work with people with Parkinson's disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics

  3. Artillery Survivability Model

    Science.gov (United States)

    2016-06-01

    experiment mode also enables users to set their own design of experiment by manipulating an editable CSV file. The second one is a real-time mode that...renders a 3D virtual environment of a restricted battlefield where the survivability movements of an artillery company are visualized . This mode...provides detailed visualization of the simulation and enables future experimental uses of the simulation as a training tool. 14. SUBJECT TERMS

  4. What are museums for? - Revisiting “Museums in a Troubled World”

    DEFF Research Database (Denmark)

    Søndergaard, Morten Karnøe; Janes, Robert

    2012-01-01

    World”, authored by Janes, a discussion between the authors is presented which focuses on the complexities of collaboration between museums and business. Finally a “hands on” section is included, in which different types of possible collaborations are examined. In this section, the topic of value......Focusing on the present situation in the Nordic museum scene, entailing economic pressures and restructuring, this article introduces the thoughts and ideas of Canadian museum expert and author, Robert R. Janes, to put things in perspective. After revisiting the 2009 book “Museums in a Troubled...

  5. Narratives of Public Health in Dickens's Journalism: The Trouble with Sanitary Reform.

    Science.gov (United States)

    Smith, Ralph F

    2015-01-01

    Although Dickens is still known as having been a highly visible supporter of England's well-known nineteenth-century sanitary movement, he became, in fact, deeply troubled by many of this movement's fundamental tenets, as evidenced by journal narratives on fever that he edited and wrote in the mid-nineteenth century. Rather than water and sewer engineering works and a sanitary regime policed by government agencies as envisaged by Edwin Chadwick and other sanitary reformers, Dickens's view by 1855 was that only a massive erasure of the existing social and political systems and their replacement by an utterly new infrastructure would suffice.

  6. Troubling the family: Ongoing problems of coming out as lesbian or gay to families of origin

    OpenAIRE

    Nordqvist, Petra; Smart, Carol

    2014-01-01

    Legal and social attitudes towards gay men and lesbians have altered considerably in latter years and yet recent research suggests that ‘coming out’ as lesbian and gay may remain a troubled business, especially in one’s own family. Exploring this theme, we situate gay and lesbian identities in wider family networks and explore how gay men and women negotiate family relationships at particular and significant moments in their lives, such as weddings and child birth. In doing so, we draw ...

  7. Accidents, troubles and others in nuclear fuel facilities in fiscal year 1988

    Energy Technology Data Exchange (ETDEWEB)

    1990-03-01

    The number of the accidents, troubles and others reported on the basis of the 'Law concerning the regulation of nuclear raw material substances, nuclear fuel substances and nuclear reactors' in fiscal year 1988 was one. On February 23, 1989, in the controlled area of the plutonium waste treatment development facilities in Tokai Works. Power Reactor and Nuclear Fuel Development Corp., when one worker entered from a corridor into the material store, he fell down by mistake and broke the left collarbone, which required the hospitalization for about one month. (K.I.).

  8. Studies of Complex Behavior and Their Relation to Trouble Shooting in Electronic Equipment.

    Science.gov (United States)

    1957-06-01

    of problem solving to bear on trouble shooting in radio, .~id drew on the writings of such investigators as Duncker , Dewey, Bur ack , Maier, and...intell igence aid of the ability to form abstract concepts. I The effect of set on problem solution has re ceived mach attention. I or eiample, Duncker (13...19. ~ [ 12. Dsw~y, J. How us think. (Rev. ed. ) Boston: Heath, 1933.• 13. Duncker , D. On problem-solving. Psy’chol. Monogr., l915, 58, I Whol

  9. The present status of the foot trouble and its care in college students

    OpenAIRE

    米山, 美智代; 八塚, 美樹; 石田, 陽子; 新免, 望; 原, 元子; 松井, 文

    2007-01-01

    In this research, the present status of the foot trouble and its care was analyzed through the answers on college students questionnaires obtained from 447 healthy college students (270 and 177 students were female and male, respectively). Among the responders, as much as 321 students (71.8%) answered to have some symptom on their feet. As the foot symptoms cold senoation and swelling were cited most frequently (55.3% and 49.2%, respectively).Furthermore, 249 students (53.4%) also answered to...

  10. 'Hubble-bubble leads to trouble'--waterpipe smoking and oral health.

    Science.gov (United States)

    Shah, Savan B; Chestnutt, Ivor G; Lewis, Michael A O

    2013-12-01

    Waterpipes are used to smoke tobacco by more than 100 million people worldwide. Use is not restricted to any single racial, ethnic, or cultural group, and dentists are almost certain to encounter waterpipe users amongst their patients. This article describes what the practice involves and seeks to inform members of the dental team of the significantly detrimental impacts of waterpipe smoking on both general and oral health and how'hubble-bubble really can lead to trouble'. Advising patients on ceasing waterpipe use is also discussed. This paper explains what smoking a waterpipe involves, the associated misconceptions of safety amongst users and the dangers to health.

  11. Double Trouble.

    Science.gov (United States)

    AGB Reports, 1989

    1989-01-01

    The problem within almost all colleges and universities is not avarice but the fact that many of their practices run counter to two trends shaping the American economy: abandonment of cost-plus pricing and a willingness to reduce employment to make an enterprise more competitive and profitable. (Author/MSE)

  12. Troubled Talk.

    Science.gov (United States)

    Fleishman, Alfred; Meyer, William D.

    The importance of human communication is the focus of this guide for improving language habits, which explores both various communication problems and techniques for handling them. Topics discussed are as follows: bad language habits; words as symbols which do not dictate the nature of things in the real world; inaccurate communication which…

  13. Truth Troubles

    Science.gov (United States)

    Tullis Owen, Jillian A.; McRae, Chris; Adams, Tony E.; Vitale, Alisha

    2009-01-01

    "truth" is an issue of public discussion, research, and everyday performance. Processes of navigating truth, however, are obscure and often unknown. In this project, the authors highlight truth(s) of written life texts. They conceive of truth as "a" rather than "the" "rhetorical device" to use for evaluating personal research and believe that…

  14. Swallowing Trouble

    Science.gov (United States)

    ... it is important to seek treatment to avoid malnutrition and dehydration. How are swallowing disorders treated? Many ... causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of ...

  15. Troubling Diversity?

    DEFF Research Database (Denmark)

    Jæger, Kirsten; Jensen, Annie Aarup

    2009-01-01

    are related to recent contributions to diversity management theory and intercultural communication theory, calling for a strengthened focus on the historical, political, and social dimensions of intercultural contact. In continuation of these trends, an alternative, theoretical framework......Focussing on the cultural encounter between nurses and ethnic minority patients in Danish hospitals, this paper presents the results of a comprehensive analysis of nursing discourses on cultural difference and intercultural contact. Articles from the Danish professional journal ‘The Nurse......', published in the period from 2000 to 2008, pertaining to cultural contact and intercultural understanding have been analyzed in order to uncover nurses' experience of ethnic and cultural diversity and the ways, in which these experiences challenge their cultural and professional expertise. Results...

  16. Reducing Uncertainty: Predictors of Stopping Chemotherapy Early and Shortened Survival Time in Platinum Resistant/Refractory Ovarian Cancer-The GCIG Symptom Benefit Study.

    Science.gov (United States)

    Roncolato, Felicia T; Joly, Florence; O'Connell, Rachel; Lanceley, Anne; Hilpert, Felix; Buizen, Luke; Okamoto, Aikou; Aotani, Eriko; Pignata, Sandro; Donnellan, Paul; Oza, Amit; Avall-Lundqvist, Elisabeth; Berek, Jonathan S; Heitz, Florian; Feeney, Amanda; Berton-Rigaud, Dominique; Stockler, Martin R; King, Madeleine; Friedlander, Michael

    2017-09-01

    Clinicians and patients often overestimate the benefits of chemotherapy, and overall survival (OS), in platinum resistant/refractory ovarian cancer (PRROC). This study sought to determine aspects of health-related quality of life and clinicopathological characteristics before starting chemotherapy that were associated with stopping chemotherapy early, shortened survival, and death within 30 days of chemotherapy. This study enrolled women with PRROC before starting palliative chemotherapy. Health-related quality of life was measured with EORTC QLQ-C30/QLQ-OV28. Chemotherapy stopped within 8 weeks of starting was defined as stopping early. Logistic regression was used to assess univariable and multivariable associations with stopping chemotherapy early and death within 30 days of chemotherapy; Cox proportional hazards regression was used to assess associations with progression-free and OS. Low baseline global health status (GHS), role function (RF), physical function (PF), and high abdominal/gastrointestinal symptom (AGIS) were associated with stopping chemotherapy early (all p Women with low GHS, RF, or PF before starting chemotherapy were more likely to stop chemotherapy early, with short OS. Self-ratings of GHS, RF, and PF could improve patient-clinician communication regarding prognosis and help decision-making in women considering chemotherapy for PRROC. Measuring aspects of health-related quality of life when considering further chemotherapy in platinum resistant/refractory ovarian cancer (PRROC) could help identify women with a particularly poor prognosis who are unlikely to benefit from chemotherapy and could therefore be spared unnecessary treatment and toxicity in their last months of life. Self-ratings of global health status, role function, and physical function could improve patient-clinician communication regarding prognosis and help decision-making in women considering chemotherapy for PRROC. © AlphaMed Press 2017.

  17. Northern Ireland and 'The Troubles', outlining an innovative approach to nursing/midwifery student teaching and module evaluation.

    Science.gov (United States)

    McMullan, Johanna; Clarke, Susan A; O'Hagan, Marie Therese; O'Connor, Tony; Power, John J

    2016-02-01

    This discussion paper outlines an approach to developing and evaluating an educative programme primarily delivered by lay `citizen trainers' in educating student nurses, and student midwives to the impact of and experience of extended and extensive civil unrest within their communities (`the Troubles' ). This is drawn from experience within the Northern Ireland `Troubles' and all of the citizen trainers were directly affected physically/psychologically. The programme was intended to both educate but primarily to help facilitate student nurses and student midwives to better understanding to experience and context and to more effective care delivery to those affected by/damaged by `the Troubles'. Evaluation of the teaching and learning by the students was significantly positive. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Le trouble psychosomatique: poids du passe, trace traumatique en attente de subjectivation

    Directory of Open Access Journals (Sweden)

    Nathalie Dumet

    Full Text Available Le présent article propose de mettre en travail l'hypothèse selon laquelle le trouble psychosomatique constitue la trace traumatique d'une expérience passée en attente de subjectivation. Les cas de trois patientes, présentant chacune des manifestations somatiques spécifiques (obésité chez Mme Hera, douleurs physiques pour Christiane, somatisation gynécologique chez Philippa, permettent en effet de mettre en évidence la manière dont l'histoire subjective et surtout un vécu traumatique inélaboré prennent corps à travers leurs maux. Le trouble psychosomatique apparaît à ce titre chez ces sujets comme la rémanence d'une expérience vécue et non enregistrée psychiquement, mais susceptible de symbolisation à la faveur d'un dispositif d'invitation à la parole.

  19. Annual Decline in Pentraxin 3 Is a Risk of Vascular Access Troubles in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Kei Nagai

    2014-01-01

    Full Text Available Pentraxin 3 (PTX3, a multifunctional modulator of the innate immunoinflammatory response, is higher in patients undergoing hemodialysis than healthy control. Our study focused on annual change in PTX3 levels in patients with chronic hemodialysis, because regularly undergoing hemodialysis for many years modifies vascular inflammatory status. To demonstrate whether annual change in PTX3 is associated with vascular events, we measured blood levels of pentraxins (PTX3 and high-sensitivity C-reactive protein (hsCRP at baseline and in the next year in 76 hemodialysis patients and observed 20 patients with vascular access troubles during follow-up years. The annual decline in PTX3, but not hsCRP, is a significant risk of the incidence of vascular access trouble that is a critical and specific complication for hemodialysis patients (hazard ratio; 0.732 per +1 ng/mL/year in PTX3, *P=0.039. This study is the first to focus on the annual change of pentraxins in a hemodialysis cohort.

  20. Troubled social background of male anabolic-androgenic steroid abusers in treatment

    Directory of Open Access Journals (Sweden)

    Skarberg Kurt

    2007-07-01

    Full Text Available Abstract Background The aim of this study was to investigate the social background and current social situation of male abusers of anabolic-androgenic steroids (AAS. Methods We compared thirty-four AAS-abusing patients from an Addiction Centre (AC with two groups, 18 users and 259 non-users of AAS from a public gym in Orebro, Sweden. The study is based on semi-structured interviews and questionnaires. Results Histories of a troubled childhood as well as current social disadvantage were both more frequent among the AAS users. Users also reported poor relationships with their parents and almost half of them had experienced physical or mental abuse. The AC group's experiences from school were mostly negative, and included concentration problems, boredom and learning difficulties. Their current circumstance included abuse of other drugs, battering of spouses and other criminality such as assault, illegal possession of weapons and theft. Conclusion In conclusion, this study shows that abusers of AAS often have a troubled social background. This underlines the importance of making a thorough social assessment as a part of the treatment programme. The results of the study may help in directing appropriate questions relevant to the abuse of AAS.

  1. Meanings of troubled conscience and how to deal with it: expressions of Persian-speaking enrolled nurses in Sweden.

    Science.gov (United States)

    Mazaheri, Monir; Ericson-Lidman, Eva; Joakim, Öhlén; Norberg, Astrid

    2017-08-10

    A feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses. To illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian-speaking people with dementia who have emigrated from Iran. The study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one year's experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation. The meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to one's values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver. The enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context. © 2017 Nordic College of Caring Science.

  2. Survival After Relapse of Medulloblastoma.

    Science.gov (United States)

    Koschmann, Carl; Bloom, Karina; Upadhyaya, Santhosh; Geyer, J Russell; Leary, Sarah E S

    2016-05-01

    Survival after recurrence of medulloblastoma has not been reported in an unselected cohort of patients in the contemporary era. We reviewed 55 patients diagnosed with medulloblastoma between 2000 and 2010, and treated at Seattle Children's Hospital to evaluate patterns of relapse treatment and survival. Fourteen of 47 patients (30%) over the age of 3 experienced recurrent or progressive medulloblastoma after standard therapy. The median time from diagnosis to recurrence was 18.0 months (range, 3.6 to 62.6 mo), and site of recurrence was metastatic in 86%. The median survival after relapse was 10.3 months (range, 1.3 to 80.5 mo); 3-year survival after relapse was 18%. There were trend associations between longer survival and having received additional chemotherapy (median survival 12.8 vs. 1.3 mo, P=0.16) and radiation therapy (15.4 vs. 5.9 mo, P=0.20). Isolated local relapse was significantly associated with shorter survival (1.3 vs. 12.8 mo, P=0.009). Recurrence of medulloblastoma is more likely to be metastatic than reported in previous eras. Within the limits of our small sample, our data suggest a potential survival benefit from retreatment with cytotoxic chemotherapy and radiation even in heavily pretreated patients. This report serves as a baseline against which to evaluate novel therapy combinations.

  3. Clustered survival data with left-truncation

    DEFF Research Database (Denmark)

    Eriksson, Frank; Martinussen, Torben; Scheike, Thomas H.

    2015-01-01

    Left-truncation occurs frequently in survival studies, and it is well known how to deal with this for univariate survival times. However, there are few results on how to estimate dependence parameters and regression effects in semiparametric models for clustered survival data with delayed entry...

  4. Self-initiated and concentration-dependent degradation of tetracaine in neat standard solutions: A trouble-shooting story.

    Science.gov (United States)

    Tan, Aimin; Wu, Yanxin; Gu, Guifen; Fanaras, John C

    2016-10-15

    This paper presents the trouble-shooting for a very unusual stability case. Tetracaine was found unstable in neat solutions only at high concentrations, but not at low concentrations. Moreover, its stable-isotope labeled internal standard did not show similar behavior. A series of trouble-shooting experiments were conducted to uncover the root cause. Some generally applicable precautions/insights can be drawn from this investigation to avoid potential stability issues during bioanalytical method development and validation. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Minor regression and long-time survival (56 months) in a patient with malignant pleural mesothelioma under Viscum album and Helleborus niger extracts-a case report.

    Science.gov (United States)

    Werthmann, Paul G; Saltzwedel, Gerhard; Kienle, Gunver S

    2017-12-01

    Malignant pleural mesothelioma (MPM) is a rare cancer with a dismal prognosis. Viscum album extracts (VAE) have strong immune stimulatory properties, cytotoxic effects, can downregulate cancer genes and inhibit angiogenesis. VAE are often used as an adjunct treatment in cancer patients but have rarely been investigated in MPM. Helleborus niger extracts (HNE) have been used in anticancer therapy since antiquity, and also show tumor specific cytotoxic effects. We present a case of a 64-year old woman with epithelioid MPM of the right chest with node involvement (T2N1M0, stage III). Deciding against the recommended radio-chemotherapy, surgery and pleurodesis, she opted for an integrative treatment approach and was treated with VAE and HNE. After 6 weeks' treatment, the pleural and nodal MPM manifestations were reduced by about 15%. Subsequent tumor growth was slow, and the patient remained in good health, enabling her to remain physically active until shortly before her death 56 months after the initial diagnosis. This is a rare case of an MPM patient not receiving any standard anticancer treatment; it still shows an extraordinary long survival and good performance status. We presume that VAE and HNE might had an impact on this clinically relevant outcome and therefore should be further investigated in MPM.

  6. "I felt for a long time like everything beautiful in me had been taken out": Women's suffering, remembering, and survival following the loss of child custody.

    Science.gov (United States)

    Kenny, Kathleen S; Barrington, Clare; Green, Sherri L

    2015-11-01

    Child Protective Services' (CPS) placements of children in out-of-home care disproportionately impact families marginalized by poverty, racism and criminalization. CPS' mandate to protect children from neglect and abuse is frequently criticized as failing to address the multiple social and structural domains shaping parents' lives, especially mothers. We conducted a thematic narrative analysis of in-depth interviews to explore the impact of child custody loss on 19 women who use drugs residing in Toronto, Canada. We also assessed the potential roles of intersectional forms of violence and inequities in power that can both give rise to child custody loss and mediate its consequences. Trauma was identified as a key impact of separation, further exacerbated by women's cumulative trauma histories and ongoing mother-child apartness. Women described this trauma as unbearable and reported persistent symptoms of post-traumatic stress disorder and other mental health conditions. Practices of dissociation through increased use of drugs and alcohol were central in tending to the pain of separation, and were often synergistically reinforced by heightened structural vulnerability observed in increased exposure to housing instability, intimate partner violence, and initiation of injection drug use and sex work. Women's survival hinged largely on hopefulness of reuniting with children, a goal pivotal to their sense of future and day-to-day intentions toward ameliorated life circumstances. Findings highlight needs for strategies addressing women's health and structural vulnerability following custody loss and also direct attention to altering institutional processes to support community-based alternatives to parent-child separation. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Differential inequality trends over time in survival among U.S. children with acute lymphoblastic leukemia by race/ethnicity, age at diagnosis, and sex

    National Research Council Canada - National Science Library

    Wang, Linwei; Bhatia, Smita; Gomez, Scarlett Lin; Yasui, Yutaka

    2015-01-01

    ...) have changed over time in different race/ethnicity groups. Children diagnosed with a first primary malignant ALL at ages 0 to 19 years in 1975-2010 in the nine Surveillance, Epidemiology, and End Results cancer registries were included...

  8. Identifying Some Risk Factors for the Time to Death of the Elderly Using the Semi-Parametric Blended Model of Survival Analysis With Competing Risks

    Directory of Open Access Journals (Sweden)

    Samane Hajiabbasi

    2018-01-01

    Conclusion In single-variable fitting, age, history of myocardial infarction, history of stroke, and kidney problems were identified to have significant effects on the time to death of the elderly. Based on one-variable semi-parametric competing risk mixture fitted models, more significant risk factors for the time to death of elderly was identified when compared with a fitted multivariate mode to the data. This implies that the role of some independent variables can be explained by other independent variables.

  9. Les troubles alimentaires émergent-ils en milieu rural ?

    Directory of Open Access Journals (Sweden)

    Karine Tinat

    2008-05-01

    Full Text Available Ce texte constitue un premier état des lieux sur la question de l’émergence des troubles de la conduite alimentaire en milieu rural dans un pays en développement. Après une contextualisation du village (Michoacán, Mexique dans lequel est menée l’étude, sont exposés les résultats du questionnaire Eating Attitude Test et d’une série d’entretiens approfondis sur les représentations et les pratiques alimentaires et corporelles appliqués à douze jeunes âgés entre 15 et 26 ans. L’objectif principal est d’observer dans quelle mesure ces troubles alimentaires sont susceptibles d’émerger, et de voir si cette émergence est concomitante aux processus de modernisation sociale et économique vécus par le village. Notre propos est d’ouvrir une discussion sur les facteurs culturels qui, en milieu rural et dans les pays du Sud, peuvent fomenter l’éclosion des troubles alimentaires.The young, their bodies and foods. The emergence of eating disorders in rural areas (State of Michoacan, Mexico This paper is a first attempt at dealing with the question of the emergence of eating disorders in rural areas in a developed country. After contextualizing the village (in the state of Michoacán, Mexico where the study was carried out, we present the results of the Eating Attitude Test and a series of in-depth interviews with twelve young people between 15 and 26 years old about their food and body representations and practices. The main objective of the study is to observe to what extent eating disorders appear, and to see whether this is concomitant with the processes of social and economic modernization experienced in the village. The ultimate goal is to open up a discussion on the cultural factors which could generate the apparition of eating disorders in rural areas and in developed countries.

  10. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Â Loading the player... Video Transcript Weakness on one Side. Trouble Speaking. Trouble Seeing. Trouble Walking. Know ... in the face, arm, or leg, especially on one side of the body Sudden confusion or trouble ...

  11. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... Materials » Loading the player... Video Transcript Weakness on one Side. Trouble Speaking. Trouble Seeing. Trouble Walking. Know ... in the face, arm, or leg, especially on one side of the body Sudden confusion or trouble ...

  12. Reprint of: Trouble on takeoff: Crude oil on feathers reduces escape performance of shorebirds.

    Science.gov (United States)

    Maggini, Ivan; Kennedy, Lisa V; Elliott, Kyle H; Dean, Karen M; MacCurdy, Robert; Macmillan, Alexander; Pritsos, Chris A; Guglielmo, Christopher G

    2017-12-01

    The ability to takeoff quickly and accelerate away from predators is crucial to bird survival. Crude oil can disrupt the fine structure and function of feathers, and here we tested for the first time how small amounts of oil on the trailing edges of the wings and tail of Western sandpipers (Calidris mauri) affected takeoff flight performance. In oiled birds, the distance travelled during the first 0.4s after takeoff was reduced by 29%, and takeoff angle was decreased by 10° compared to unoiled birds. Three-axis accelerometry indicated that oiled sandpipers produced less mechanical power output per wingbeat during the initial phase of flight. Slower and lower takeoff would make oiled birds more likely to be targeted and captured by predators, reducing survival and facilitating the exposure of predators to oil. Whereas the direct mortality of heavily-oiled birds is often obvious and can be quantified, our results show that there are significant sub-lethal effects of small amounts crude oil on feathers, which must be considered in natural resource injury assessments for birds. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Trouble on takeoff: Crude oil on feathers reduces escape performance of shorebirds.

    Science.gov (United States)

    Maggini, Ivan; Kennedy, Lisa V; Elliott, Kyle H; Dean, Karen M; MacCurdy, Robert; Macmillan, Alexander; Pritsos, Chris A; Guglielmo, Christopher G

    2017-07-01

    The ability to takeoff quickly and accelerate away from predators is crucial to bird survival. Crude oil can disrupt the fine structure and function of feathers, and here we tested for the first time how small amounts of oil on the trailing edges of the wings and tail of Western sandpipers (Calidris mauri) affected takeoff flight performance. In oiled birds, the distance travelled during the first 0.4s after takeoff was reduced by 29%, and takeoff angle was decreased by 10° compared to unoiled birds. Three-axis accelerometry indicated that oiled sandpipers produced less mechanical power output per wingbeat during the initial phase of flight. Slower and lower takeoff would make oiled birds more likely to be targeted and captured by predators, reducing survival and facilitating the exposure of predators to oil. Whereas the direct mortality of heavily-oiled birds is often obvious and can be quantified, our results show that there are significant sub-lethal effects of small amounts crude oil on feathers, which must be considered in natural resource injury assessments for birds. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus

    2008-01-01

    of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... the SMR remained significantly 1.3-fold increased. CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion-transmitted disease...... as well as for cost-benefit estimation of new blood safety interventions....

  15. Design of survivable networks

    CERN Document Server

    Stoer, Mechthild

    1992-01-01

    The problem of designing a cost-efficient network that survives the failure of one or more nodes or edges of the network is critical to modern telecommunications engineering. The method developed in this book is designed to solve such problems to optimality. In particular, a cutting plane approach is described, based on polyhedral combinatorics, that is ableto solve real-world problems of this type in short computation time. These results are of interest for practitioners in the area of communication network design. The book is addressed especially to the combinatorial optimization community, but also to those who want to learn polyhedral methods. In addition, interesting new research problemsare formulated.

  16. Adenoviral vector-mediated gene transfer: timing of wild-type p53 gene expression in vivo and effect of tumor transduction on survival in a rat glioma brachytherapy model.

    Science.gov (United States)

    Bampoe, J; Glen, J; Hubbard, S L; Salhia, B; Shannon, P; Rutka, J; Bernstein, M

    2000-08-01

    This study sought to investigate modification of the radiation response in a rat 9L brain tumor model in vivo by the wild-type p53 gene (wtp53). Determination of the timing and dose of radiation therapy required the assessment of the duration of the effect of wtp53 expression on 9L tumors after in vivo transfection. Anesthetized male F-344 rats each were stereotactically inoculated with 4 x 10(4) 9L gliosarcoma cells through a skull screw into the cerebrum in the right frontal region. Twelve-day-old tumors were inoculated through the screw with recombinant adenoviral vectors under isoflurane anaesthesia: control rats with Ad5/RSV/GL2 (carrying the luciferase gene), and study rats with Ad5CMV-p53 (carrying the wtp53 gene). Brain tumors removed at specific times after transfection were measured, homogenized, and lysed and wtp53 expression determined by Western blot analysis. Four groups of nine rats were, subsequently, implanted with iodine-125 seeds 15 days post-tumor inoculation to give a minimum tumor dose of 40 or 60 Gy. We demonstrated transfer of wtp53 into rat 9L tumors in vivo using the Ad5CMV-p53 vector. The expression of wtp53 was demonstrated to be maximum between days 1 and 3 post-vector inoculation. Tumors expressing wtp53 were smaller than controls transfected with Ad5/RSV/GL2 but this difference was not statistically significant. Radiation made a significant difference to the survival of tumor-bearing rats. Moreover, wtp53 expression conferred a significant additional survival advantage. The expression of wtp53 significantly improves the survival of irradiated tumor-bearing rats in our model.

  17. Using Young Adult Realistic Literature to Help Troubled Teenagers: Something New, Tried and True, and Recommended Nonfiction (Young Adult Literature).

    Science.gov (United States)

    Kaywell, Joan F.

    1997-01-01

    Describes a seven-step process that uses young adult literature to help teenagers understand and deal with their troubles. Offers brief annotations of five young adult titles in each of nine areas: alienation and identity; divorce; dropouts, delinquency, and gangs; poverty; teenage pregnancy; abused children; alcohol and drugs; homosexuality; and…

  18. Human Rights and Religious Education in the Contentious Context of Conflict-Troubled Societies: Perspectives from Human Rights Education

    Science.gov (United States)

    Zembylas, Michalinos

    2014-01-01

    This article explores some of the tensions that are created from the entanglement of religion and human rights and offers a possible response to these tensions in the context of religious education in conflict-troubled societies. It is suggested that a historicised and politicised approach in religious education in conjunction with human rights…

  19. The Legacy of the Troubles on the Young People's Psychological and Social Development and Their School Life.

    Science.gov (United States)

    Muldoon, Orla T.; Trew, Karen; Kilpatrick, Rosemary

    2000-01-01

    Discusses the impact of the troubles in Northern Ireland on the psychological and social well-being and school lives of youth. Although some have suffered great trauma, recent research highlights the resilience of young people exposed to the stress of political conflict. For the majority of youth growing up in Northern Ireland, the future may be…

  20. Risk of early onset substance use among students with and without mild academic disabilities : Results of a discrete-time survival analysis

    NARCIS (Netherlands)

    Kepper, Annelies; Koning, Ina; Vollebergh, Wilma; Monshouwer, Karin

    2014-01-01

    This study investigated the age of onset of substance use among 536 students with mild academic disabilities and 906 students without academic disabilities, and the extent to which emotional, conduct, and hyperactivity problems explain the differences between these two groups. Using discrete-time

  1. Percutaneous coronary intervention-related time delay, patient's risk profile, and survival benefits of primary angioplasty vs lytic therapy in ST-segment elevation myocardial infarction.

    Science.gov (United States)

    De Luca, Giuseppe; Cassetti, Ettore; Marino, Paolo

    2009-07-01

    Previous reports have suggested an impact of patient's risk profile and percutaneous coronary intervention (PCI)-related time delay on the benefits of primary angioplasty as compared with fibrinolysis. However, several factors, such as inappropriate interpretation and definition of delays, missing currently available trials, and arguable risk-benefit analysis, limit the value of these reports. Thus, the aim of the current review is to assess whether the prognostic impact of PCI-related time delay may vary according to patient's risk profile, presentation delay, and type of lytic therapy. We obtained results from all randomized trials comparing fibrinolysis and primary angioplasty in ST-segment elevation myocardial infarction. The literature was scanned by formal searches of electronic databases (MEDLINE and CENTRAL) for papers published from January 1990 to April 2007. The following key words were used: randomized trial, myocardial infarction, reperfusion, primary angioplasty, rescue angioplasty, fibrinolysis, thrombolysis, duteplase, reteplase, tenecteplase, and alteplase. Major clinical end point assessed was mortality at 30-day follow-up. The relationship between mortality benefits from primary angioplasty, patient's risk profile, and PCI-related time delay was evaluated by using a weighted least-square regression in which results from each trial were weighted by the square root of the number of patients of each trial. A total of 27 trials were finally included, with 4399 patients randomized to primary angioplasty and 4474 patients randomized to fibrinolysis. The relationship between the benefits from primary angioplasty and PCI-related time changed according to risk profile. The higher the risk profile, the larger the reduction in mortality benefits from primary angioplasty as compared with fibrinolysis per each 10 minutes of PCI-related time delay (0.75%, 0.45%, and 0%, in high-, medium-, and low-risk patients, respectively). Furthermore, the impact was

  2. Evaluation et prise en charge des troubles phonologiques chez l'enfant

    OpenAIRE

    Maillart, Christelle

    2012-01-01

    Selon la nature et la sévérité du trouble phonologique, plusieurs approches peuvent être proposées. Nous distinguerons quatre profils de patients et présenterons les approches thérapeutiques ayant démontré leur efficacité dans ces cas précis. Il s’agira 1) d’enfants présentant très peu de production, et donc peu de pratiques des patterns moteurs ; 2) d’enfants présentant des déformations phonologiques stables ; 3) d’enfants présentant des déformations phonologiques instables ; et enfin, 4) d’...

  3. Decolonizing Straight Temporality Through Genre Trouble in Edwidge Danticat's The Farming of Bones

    Directory of Open Access Journals (Sweden)

    Eliana de Souza Ávila

    2014-12-01

    Full Text Available http://dx.doi.org/10.5007/2175-8026.2014n67p21 Framing genre trouble (McKenzie 2006 as a decolonial methodology, this paper considers the relevance of Edwidge Danticat’s The Farming of Bones (1998 for reading migrant texts against the grain of straight temporality which sustains the coloniality of power (Lugones 2007. Scrutinizing historiographic suppression, Danticat’s migrant text interrupts the chrononormative portrayal of the Trujillo genocide of Haitian workers in the Dominican Republic as a reality pertaining to an obsolete past and to the geocultural margins alone. Read in the aftermath of the testimonio controversy, it may thus decenter the ongoing deflection of attention from Rigoberta Menchú’s impact on the geocultural structures that sanction ongoing military intervention and genocide by refocusing on historiography as a terrain of relentless decolonial contestation rather than prescriptive narrative closure.

  4. Biais attentionnels et troubles émotionnels: De l’évaluation au changement clinique.

    OpenAIRE

    Heeren, Alexandre; Ceschi,Grazia; Philippot, Pierre

    2012-01-01

    De nombreux modèles cognitifs de l’anxiété font l’hypothèse que des biais sélectifs d’allocation de l’attention contribuent à l’installation et au maintien des troubles émotionnels. Afin de tester cette hypothèse, des procédures de réentrainement attentionnel ont récemment été développées. Cet article vise trois objectifs : (a) présenter les raisons sous-tendant le développement de telles interventions ; (b) décrire les tâches informatisées les plus couramment utilisées e...

  5. Modest associations between self-reported physical workload and neck trouble

    DEFF Research Database (Denmark)

    Holm, Jonas Winkel; Hartvigsen, Jan; Lings, Svend

    2013-01-01

    OBJECTIVES: To investigate the relationship between self-reported physical workload and neck trouble (NT) in twins. Additionally, to explore whether the relationship between physical workload and NT is influenced by genetic factors. METHODS: A twin control study was performed within a population......-based, cross-sectional questionnaire study using 3,208 monozygotic (MZ) and same-sexed dizygotic (DZ) twins aged 19-70. Twin pairs discordant for self-reported NT during the past year ("Any NT") were included. Self-reported physical workload in four categories was used as exposure ("sitting," "sitting...... physical" work was seen in DZ men (odds ratio 2.3, 95 % confidence intervals 1.3-4.0), but not in MZ men or the MZ or DZ women. CONCLUSIONS: The findings in some degree supported that "heavy physical" work is a determinant of NT, perhaps only in men, but hardly of any greater importance. The different...

  6. ʿHello! I'm behind you’: Warnings at trouble moments in forklift driving

    DEFF Research Database (Denmark)

    Nevile, Maurice Richard; Wagner, Johannes

    We are interested generally in the verbalized and embodied character of ’warnings’ at moments of potential ‘trouble’ in a flow of movement for collaborative work. Our participants are forklift truck drivers, whose primary occupation it is to handle and take objects from one place to another. Our...... of embodied conduct for activity and relative to presence within the physical surround (e.g. a change in driving –direction, speed – or in task activity). As forklift truck collisions can range from very minor to potentially dangerous or even catastrophic – if involving loss of load or impact with shelved...... competences constitutive of routine forklift work. Keywords collaboration, competence, forklift driving, multimodality, objects, training, transport, trouble, warning References De Rycker, Antoon / Mohd Don, Zuraidah (eds) 2013. Discourse and Crisis: Critical Perspectives. Amsterdam/Philadelphia: John...

  7. Hitting the Wall: Youth Perspectives on Boredom, Trouble, and Drug Use Dynamics in Rural New Mexico.

    Science.gov (United States)

    Willging, Cathleen E; Quintero, Gilbert A; Lilliott, Elizabeth A

    2014-01-01

    We examine the experience of boredom and its relationship to troublemaking and drug use among rural youth in southwestern New Mexico. We draw on qualitative research with area youth to describe what they think about drug use and how they situate it within their social circumstances. We then locate youth drug use within globalized processes affecting this setting, including a local economic environment with limited educational and employment opportunities for youth. Drug use emerges as a common social practice that enables youth to ameliorate boredom, yet only some youth become known as troublemakers. Study findings offer insight into how dominant social institutions-schools and juvenile justice authorities-shape the construction of trouble from the perspectives of youth. We contend that boredom and troublemaking among rural youth are not simply age-appropriate forms of self-expression but instead represent manifestations of social position, political economic realities, and assessments of possible futures.

  8. Just like my nanny: troubling teacher's social identities in the classroom

    Science.gov (United States)

    Tan, Edna

    2013-06-01

    Teacher-researcher narrative accounts are essential and insightful for the science education field, yet they are few and far-between. In this forum, I engage in dialogue with Nicole Grimes's auto-ethnographic narrative on the affordances her femme-Carribean identity allowed for some students to engage more deeply in science. While I agree with and applaud Grimes's reflection on how her perceived social identity had positive effects on some students' engagement in science, I trouble the notion of such a social identity being framed solely as an asset to student learning by examining the power dynamics inherent in the enacted nanny-child relationship. I also propose the need for deeper analyses on how a teacher's social identity can impact students' learning experiences in the science classroom by looking at how the boundaries of the science classroom are redefined and what additional resources are recruited that can foster deeper engagement.

  9. GUARANTEEING THE TROUBLE-FREE OPERATION OF CAPACITOR BANKS IN POWER-SUPPLY SYSTEMS OF INDUSTRIAL ENTERPRISES

    Directory of Open Access Journals (Sweden)

    D.A. Gapon

    2016-03-01

    Full Text Available Purpose. The problem of resonance phenomena in power systems of industrial enterprises using capacitor banks for reactive power compensation was detected. Circuit of the capacitor banks tier to downshift main substation tires is present. But there is no common algorithm to calculate and avoid such trouble. The main goal of this article is to introduce some basics for power supply systems with possible resonant circuits engineering. Methodology. At the first step the data on the change of the current in the chemical company network when changing capacitor banks value are received. For these purposes the oscilloscope function of digital protection relay was used. Current data samples were analyzed by spectrum detection software. Most significant levels of the 3rd and 5th harmonics were achieved. Comparison of harmonic distortion levels with and without capacitor bank is given. Results. Achieved data allow making conclusion about overloading reasons of capacitor banks while higher harmonics currents presence. A voltage and current harmonious composition measuring in the absence of power quality analyzers using digital protection relay terminals or emergencies registers are proposed. The necessity of power quality monitoring near capacitor banks connections to avoid resonance phenomena (current and voltage resonance in industrial power supply systems is proven. The control algorithm of capacitor banks to provide electromagnetic compatibility, while various modes of nonlinear load operation is given. Originality. Using of digital protection relay oscilloscoping for current resonant detection can allow to significally reduce time and cost of solution. Replacement parallel circuit comprising a branch and one active-inductive load to another branch network in the presence of higher harmonics source are proposed. Practical value. A sequence for measuring the levels of harmonic components at the connections of capacitor banks in the absence of specialized

  10. Quantitative real-time RT-PCR in sentinel lymph nodes from melanoma patients. Detection of melanocytic mRNA predicts disease-free survival

    DEFF Research Database (Denmark)

    Riber-Hansen, Rikke; Abrahamsen, Helene Nortvig; Sorensen, Boe Sandahl

    2008-01-01

    Quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) for specific melanoma markers is more sensitive than histology for detecting cells of melanocytic origin in sentinel lymph nodes (SLNs) in cutaneous melanoma. The clinical significance of a positive qRT-PCR analysis...... is unclear. We performed qRT-PCR for the presence of MART-1 and tyrosinase in SLNs from 93 melanoma patients, and then followed these patients clinically (median follow-up time 43.5 months). We found a significant correlation between disease progression and presence of MART-1 mRNA in SLNs (p=0.......02), but no correlation with the amount of MART-1 mRNA as measured by qRT-PCR. No correlation between histology and recurrence was detected, recurrence rates being low in both histology-negative (12%) and -positive (15%) patients. We found a significant difference in disease recurrence between patients positive by both...

  11. Effect of the radiation intensity, water turbidity and exposure time on the survival of Cryptosporidium during simulated solar disinfection of drinking water.

    Science.gov (United States)

    Gómez-Couso, Hipólito; Fontán-Sainz, María; McGuigan, Kevin G; Ares-Mazás, Elvira

    2009-10-01

    The solar disinfection (SODIS) technique is a highly effective process that makes use of solar energy to inactivate pathogenic microorganisms in drinking water in developing countries. The pathogenic protozoan parasite Cryptosporidium parvum is often found in surface waters and is associated with waterborne outbreaks of cryptosporidiosis. In the present study, a complete multi-factorial mathematical model was used to investigate the combined effects of the intensity of solar radiation (200, 600 and 900W/m(2) in the 320nm to 10microm range), water turbidity (5, 100 and 300 NTU) and exposure time (4, 8 and 12h) on the viability and infectivity of C. parvum oocysts during simulated SODIS procedures at a constant temperature of 30 degrees C. All three factors had significant effects (p or =600W/m(2) and times of exposure between 8 and 12h were required to reduce the oocyst infectivity in water samples with different degrees of turbidity.

  12. Urinary arsenic, pesticides, heavy metals, phthalates, polyaromatic hydrocarbons, and polyfluoroalkyl compounds are associated with sleep troubles in adults: USA NHANES, 2005-2006.

    Science.gov (United States)

    Shiue, Ivy

    2017-01-01

    Links between environmental chemicals and human health have emerged, but the effects on sleep health were less studied. Therefore, the aim of the present study was to investigate the relationships of different sets of environmental chemicals and common sleep troubles in a national and population-based setting. Data were retrieved from the United States National Health and Nutrition Examination Surveys, 2005-2006 including demographics, serum measurements, lifestyle factors, self-reported sleep troubles, and urinary environmental chemical concentrations. Statistical analyses including descriptive statistics, t-test, chi-square test, and survey-weighted logistic regression models were performed. Of all 5563 Americans aged 18-85, 2331 (42.0%) had wake-up at night, 2914 (52.5%) felt unrested during the day, 740 (13.4%) had leg jerks while sleeping, and 1059 (19.1%) had leg cramps for 2+ times a month. Higher levels of urinary arsenic, phthalates, and polyfluoroalkyl compounds were associated with wake-up at night. Higher levels of urinary 4-tert-octylphenol and polyfluoroalkyl compounds were associated with being unrested during the day. Higher levels of urinary arsenic, polyaromatic hydrocarbons, and polyfluoroalkyl compounds were associated with leg jerks while sleeping. Higher levels of urinary pesticides, heavy metals, phthalates, and polyaromatic hydrocarbons were associated with leg cramps while sleeping. However, there were no significant associations with other environmental chemicals such as parabens, bisphenol A, benzophenone-3, triclosan, perchlorate, nitrate, or thiocyanate. Eliminating arsenic, heavy metals, phthalate, pesticides, polyaromatic hydrocarbons, and polyfluoroalkyl compounds to improve sleep health might be considered while understanding the biological pathway with a longitudinal or experimental approach in future research would be suggested.

  13. Foreign Ownership and Long-term Survival

    DEFF Research Database (Denmark)

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    Does foreign ownership enhance or decrease a firm's chances of survival? Over the 100 year period 1895-2001 this paper compares the survival of foreign subsidiaries in Denmark to a control sample matched by industry and firm size. We find that foreign-owned companies have higher survival...... probability. On average exit risk for domestic companies is 2.3 times higher than for foreign companies. First movers like Siemens, Philips, Kodak, Ford, GM or Goodyear have been active in the country for almost a century. Relative foreign survival increases with company age. However, the foreign survival...

  14. Survival of time-evolved quantum correlations depending on whether quenching is across a critical point in an X Y spin chain

    Science.gov (United States)

    Mishra, Utkarsh; Rakshit, Debraj; Prabhu, R.

    2016-04-01

    The time dynamics of quantum correlations in the quantum transverse anisotropic X Y spin chain of infinite length is studied at zero and finite temperatures. The evolution occurs due to the instantaneous quenching of the coupling constant between the nearest-neighbor spins of the model, which is performed either within the same phase or across the quantum phase-transition point connecting the order-disorder phases of the model. We characterize the time-evolved quantum correlations, viz., entanglement and quantum discord, which exhibit varying behavior depending on the initial state and the quenching scheme. We show that the system is endowed with enhanced nearest-neighbor bipartite quantum correlations compared to that of the initial state, when quenched from the ordered to the deep disordered phase. However, nearest-neighbor quantum correlations are almost washed out when the system is quenched from the disordered to the ordered phase with the initial state being at the zero temperature. We also identify the condition for the occurrence of enhanced bipartite correlations when the system is quenched within the same phase. Moreover, we investigate the bipartite quantum correlations when the initial state is a thermal equilibrium state with finite temperature, which reveals the effects of thermal fluctuation on the phenomena observed at zero temperature. Finally, an analogous analysis is carried out for zero-temperature next-nearest-neighbor quantum correlations.

  15. Immortal time bias in pharmacoepidemiological studies on cancer patient survival: empirical illustration for beta-blocker use in four cancers with different prognosis.

    Science.gov (United States)

    Weberpals, Janick; Jansen, Lina; van Herk-Sukel, Myrthe P P; Kuiper, Josephina G; Aarts, Mieke J; Vissers, Pauline A J; Brenner, Hermann

    2017-11-01

    Immortal time bias (ITB) is still seen frequently in medical literature. However, not much is known about this bias in the field of cancer (pharmaco-)epidemiology. In context of a hypothetical beneficial beta-blocker use among cancer patients, we aimed to demonstrate the magnitude of ITB among 9876 prostate, colorectal, lung and pancreatic cancer patients diagnosed between 1998 and 2011, which were selected from a database linkage of the Netherlands Cancer Registry and the PHARMO Database Network. Hazard ratios (HR) and 95% confidence intervals from three ITB scenarios, defining exposure at a defined point after diagnosis (model 1), at any point after diagnosis (model 2) and as multiple exposures after diagnosis (model 3), were calculated to investigate the association between beta-blockers and cancer prognosis using Cox proportional hazards regression. Results were compared to unbiased estimates derived from the Mantel-Byar model. Ignoring ITB led to substantial smaller HRs for beta-blocker use proposing a significant protective association in all cancer types [e.g. HR 0.18 (0.07-0.43) for pancreatic cancer in model 1], whereas estimates derived from the Mantel-Byar model were mainly suggesting no association [e.g. HR 1.10 (0.84-1.44)]. The magnitude of bias was consistently larger among cancer types with worse prognosis [overall median HR differences between all scenarios in model 1 and Mantel-Byar model of 0.56 (prostate), 0.72 (colorectal), 0.77 (lung) and 0.85 (pancreas)]. In conclusion, ITB led to spurious beneficial associations of beta-blocker use among cancer patients. The magnitude of ITB depends on the duration of excluded immortal time and the prognosis of each cancer.

  16. The Earth in energy troubles; La Planete en mal d'energie

    Energy Technology Data Exchange (ETDEWEB)

    Pierret, Ch.; Carroue, L.; Goodchild, M.F.; Charvet, J.P.; Simon, A.; Ane, J.M.; Auburtin, E.; Barre, B.; Bonin, S.; Fumey, G.; Daviet, S.; Goupil, Ph.; Helfer, M.; Raison, J.; Velut, S.; Vidal, D.; Radvanyi, J.; Tapia, St. de; Pourtier, R.; Sebille-Lopez, Ph.; Clairet, S.; Poirson, A.C.; Guillaume, J.; Collignon, B.; Bauquis, P.R.; Brunel, S.; Guillaume, J.; Hourcade, B.; Marchand-Vaguet, Y.; Pitte, J.R.; Marchand-Vaguet, Y.; Laherrere, J.; Letourneau, M.; Lemarchand, N.; Beltran, A.; Bret, B.; Feckoua, L.; Helfer, M.; Lacoste, R.; Manzagol, C.; Tessier, F.; Vanneph, A.; Claessens, M.; Berdevet, M.; Tabeaud, M.; Laherrere, J.; Arnould, P.; Berque, A.; Brucher, W.; Deshaies, M.; Douguedroit, A.; Husson, J.P.; Lemartinel, J.; Mancebo, F.; Baron-Yelles, N.; Pitte, J.R.; Sede Marceau, J.H. de; Vigneau, J.P.; Tabeaud, M.; Fremont, A.; Crozet, Y.; Maupu, J.L.; Orfeuil, J.P.; Savy, M.; Viel, D.; Hammer, A.; Sanjuan, Th.; Lagarec, D.; Raillon, F.; Koninck, R. de; Bailly, A.; Bruneau, M.; Boulanger, Ph.; Bret, B.; Fournet-Guerin, C.; Hourcade, J.Ch.; Pitte, J.R.; Sanjuan, Th.; Verdeil, E.; Butler, S. de; Saint Germain, F.; Bouette, N.; Detot, A.; Caracchioli, Ph.; Bouette, N.; Smaghue, N.; Pousin, J.; Buysse, Ph.; Riallant, Y.; Durand, H.; Genter, A.; Dieulin, C.; Pronier, O.; Badea, A.; Tetart, F.; Genevois, S.; Leobet, M.; Angsthelm, B.; Calugaru, C.; Domergue, Ph.; Iacu, C.; Muntele, L.; Goodchild, M.F.; Costa, P

    2007-07-01

    This document gathers the available presentations (articles and transparencies) given at this annual meeting, the 2007 topic of which was the technological, geopolitical, economical, environmental, societal and development stakes of energy. 1 - technological stakes - which energies for the future: new energies, illusion or solution of the future; the Lorraine region, an energy land: strategies and stakes for a sustainable development; from China to Brazil: understanding the nuclear energy revival; hydroelectric power: renewable and sustainable energy; renewable energies and environment protection: the contribution of biofuels; wind power in Germany between success and contestation; 2 - geopolitical stakes - energy levier of power: the Gulf of Guinea hydrocarbons: between development and geopolitics; the complex evaluation of resources and reserves between technology, market and geopolitics; the new Bakou-Tbilissi-Ceyhan pipeline: what impacts for Turkey and the European Union; 3 - economical stakes - are public energy policies possible: the pro-alcohol program in Brazil; the surprising development of coal in the 21. century; natural gas: geo-economical and geopolitical stakes; exploitation of offshore platforms in Newfoundland: the new future of codfish island; tar sands of Alberta: promises and stakes of a 'Northern Arabia'; 4 - environmental stakes - energies responsible for the global warming: energy transformation and work in human societies; lessons learnt from the pre-industrial era: the limits of modern renewable energy sources; the energy policies in Europe: environmental constraints and geopolitical risks; reducing our energy consumption: a stake of the future; global warming and energy troubles; a territorial approach of energy, an answer to the 21. century challenges; the climate in an energy consuming world, debate and precautions; the Kyoto protocol through the geographical critics; 5 - society stakes - what energies for tomorrow's city

  17. Long-term haemodialysis survival

    DEFF Research Database (Denmark)

    Heaf, James; Nielsen, Arne Høj; Hansen, Henrik Post

    2012-01-01

    Haemodialysis (HD) treatment for end-stage renal disease bears a poor prognosis. We present a case of a patient who, apart from two transplant periods lasting 8 months in all, was treated with conventional in-centre HD three times a week and who survived for 41 years. Patients should be aware tha...

  18. Le choix professionnel chez les jeunes présentant des troubles du langage écrit

    OpenAIRE

    Détraz, Charlène; Zittoun, Tania

    2017-01-01

    Ce travail de mémoire, dans une perspective psychosociale, aborde le choix professionnel de jeunes présentant des troubles du langage écrit. Le cadre théorique de cette recherche traite des troubles du langage écrit, de la période de l’adolescence, ainsi que de la structure et des spécificités du système éducatif suisse. En outre, il présente les différents éléments en jeu dans l’orientation scolaire et professionnelle, ainsi que la notion de transition. Dans l’optique de comprendre les multi...

  19. Development of a Competent and Trouble Free DNA Isolation Protocol for Downstream Genetic Analyses in Glycine Species

    Directory of Open Access Journals (Sweden)

    Muhammad Amjad Nawaz

    2016-08-01

    Full Text Available Extraction of deoxyribose nucleic acid (DNA from plants is preliminary step in molecular biology. Fast and cost effective genomic DNA isolation from Glycine species for downstream application is a major bottleneck. Here we report a high throughput and trouble free method for genomic DNA extraction from leaf and seeds of Glycine species with high quality and quantity. Protocol reports the optimization by employing different concentrations of CTAB and PVP in extraction buffer. Efficiency of optimized protocol was compared with frequently used DNA extraction methods. Wide adoptability and utility of this protocol was confirmed by DNA extraction from leaves as well as seeds of G. max, G. soja, G. tomentella and G. latifolia. Extracted DNA was successfully subjected to PCR amplification of five microsatellite markers and four putative glycosyltransferase genes. DNA extraction protocol is reproducible, trouble free, rapid and can be adopted for plant molecular biology applications.

  20. A Troubled Past? Reassessing Ethics in the History of Tissue Culture.

    Science.gov (United States)

    Wilson, Duncan

    2016-09-01

    Recent books, articles and plays about the 'immortal' HeLa cell line have prompted renewed interest in the history of tissue culture methods that were first employed in 1907 and became common experimental tools during the twentieth century. Many of these sources claim tissue cultures like HeLa had a "troubled past" because medical researchers did not seek informed consent before using tissues in research, contravening a long held desire for self-determination on the part of patients and the public. In this article, I argue these claims are unfair and misleading. No professional guidelines required informed consent for tissue culture during the early and mid twentieth century, and popular sources expressed no concern at the widespread use of human tissues in research. When calls for informed consent did emerge in the 1970s and 1980s, moreover, they reflected specific political changes and often emanated from medical researchers themselves. I conclude by arguing that more balanced histories of tissue culture can make a decisive contribution to public debates today: by refuting a false dichotomy between science and its publics, and showing how ethical concepts such as informed consent arise from a historically specific engagement between professional and social groups.

  1. MMPI profiles of troubled employees in relation to nuclear power plant personnel norms

    Energy Technology Data Exchange (ETDEWEB)

    Lavin, P.F.; Chardos, S.P.; Ford, T.W.; McGee, R.K.

    1987-01-01

    The psychological screening of nuclear power plant personnel is intended to reduce the risk of impaired worker judgment or behavior due to psychopathology. Despite inherent difficulties associated with the prediction of infrequent events, such efforts, mandated by industry standards (ANSI/ANS-3.3-1982 and -3.4-1983) and federal regulations (10CFR5 and 10CFR73), appear both reasonable and prudent. The Minnesota Multiphasic Personality Inventory (MMPI) has been used extensively to aid psychological screening evaluations of employees in the nuclear industry, as well as in other employment settings critical to public health and safety. Since traditional predictive validity study is not feasible in security screening, support for this use of the MMPI rests upon the large accumulated body of research indicating its construct validity as a measure of psychopathology. However, that research has been based predominantly upon clinical populations and a question has been raised as to the appropriateness of generalization to employment populations. The present study examines the MMPI as a measure of psychopathology in a nuclear plant employment population. In particular, it compares the MMPI results of troubled employees to normative base rates.

  2. 'Tell me about your troubles': description of patient-physiotherapist interaction during initial encounters.

    Science.gov (United States)

    Opsommer, Emmanuelle; Schoeb, Veronika

    2014-12-01

    Communication skills are essential for physiotherapy practice. It has been shown that patients, especially those with chronic pain problems, are more satisfied with services when therapists communicate adequately. The objective of this study was to explore how French-speaking physiotherapists and patients with low back pain explore and assess the patient's pain experience during initial encounters. The initial consultation of six consenting patients with low back pain and two physiotherapists was videotaped. Conversation analysis was used to describe and analyse the communication practices related to pain assessment. When physiotherapists explored patients' pain experience, they specifically focused on the impact of pain on function. The observed physiotherapists used the following communication strategies: 1) using yes/no questions and 'okay' as a resource to shift to a new topic; 2) following documentation quite stringently without allowing digression; 3) building the next question on the basis of the patient's discourse; 4) inviting the patient to talk using formulations such as 'tell me about your troubles?'; and 5) using gaze and nodding as continuers. The physiotherapists used two different approaches to close the encounter. While one therapist chose to summarize the consultation, including a prognostic assessment, the other one ended the consultation by organizing the follow-up consultation. This exploratory study examines the interaction between patients and physiotherapists during initial encounters and identifies assumptions underlying pain assessment that shape the therapists' exploration of patients' pain experience. It also shows evidence of the physiotherapists' difficulties to inquire about the patient's perspective. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Draining T-Tube Jejunostomy: A Technique to Get Out of Trouble.

    Science.gov (United States)

    Serrano, Oscar K; Solsky, Ian; Sandoval, Eduardo; Berlin, Arnold; Bellemare, Sarah

    2016-06-01

    A perforated viscus in the postpancreaticoduodenectomy setting is a rare phenomenon and a devastating complication. In this situation, adherence to damage-control principles demands minimizing the operative intervention while addressing the intestinal perforation as a way to mitigate the injurious effects on a complex gastrointestinal reconstruction. Herein, we describe our intraoperative decision-making with an unconventional approach in the management of a perforated viscus in the postpancreaticoduodenectomy setting using a draining T-tube jejunostomy. Our patient recovered remarkably well from this and was discharged from the hospital in six days with a controlled draining T-tube jejunostomy, which was subsequently removed on postoperative day 35. Our case illustrates an important option when dealing with a perforated viscus in the complex gastrointestinal surgery patient that has minimal morbidity, adequate source control, and the potential for an excellent clinical outcome. As surgical care continues to be delivered in a specialty-driven manner, a draining T-tube jejunostomy presents the ideal technique to get out of trouble for the general surgeon practicing in the community who may not be as experienced with complex gastrointestinal surgery.

  4. Cultivating a Troubled Consciousness: Compulsory sound-mindedness and complicity in oppression

    Directory of Open Access Journals (Sweden)

    C. Chapman

    2013-11-01

    Full Text Available Implicating oneself in oppression provokes uncertainty, shame and anxiety, and identity destabilizations. Yet anti-oppressive texts often denigrate these experiences, participating in forces I call “compulsory sound-mindedness.” Narratives of three women confronting their complicity illustrate the workings of compulsory sound-mindedness: a white Canadian recognizing the racism in her development work and both a white woman and a racialized Muslim reflecting on their complicity in ongoing Canadian colonization. The three narratives devalue affect, uncertainty, and destabilized identity. They also reveal these denigrated experiences as fundamental to personal-is-political ethical transformation. Compulsory sound-mindedness cannot consistently prevent people from journeying with pain, uncertainty, and coming undone. But when people undertake such journeys, compulsory sound-mindedness frames pain, identity destabilization, and uncertainty as regrettable and without value. I advocate that people cultivate a “troubled consciousness” by journeying with internalized accountability narratives, uncertainties, painful feelings, and destabilizations of a straightforwardly moral self.

  5. Trouble déficitaire de l’attention à l’université

    Directory of Open Access Journals (Sweden)

    Georgette Goupil

    2011-02-01

    Full Text Available Cet article présente un portrait du trouble déficitaire de l’attention avec ou sans hyperactivité (TDA/H chez les adultes et, plus particulièrement, chez les étudiants universitaires. Après avoir défini le TDA/H, le texte expose les défis de ces étudiants et la situation des universités québécoises sur cette question. La deuxième partie illustre un exemple d’intervention auprès de ces étudiants, soit un programme de tutorat appliqué à l’Université du Québec à Montréal.This article presents a descriptive portrait of Attention Deficit Hyperactivity Disorder (ADHD in adults, more particularly in university students. After describing ADHD, we will look at the many challenges those students may encounter during their university studies. Moreover, we will present a tutoring program that is currently taking place at the University of Québec in Montréal (UQAM.

  6. Migration depth and residence time of juvenile salmonids in the forebays of hydropower dams prior to passage through turbines or juvenile bypass systems: implications for turbine-passage survival.

    Science.gov (United States)

    Li, Xinya; Deng, Zhiqun D; Brown, Richard S; Fu, Tao; Martinez, Jayson J; McMichael, Geoffrey A; Skalski, John R; Townsend, Richard L; Trumbo, Bradly A; Ahmann, Martin L; Renholds, Jon F

    2015-01-01

    Little is known about the three-dimensional depth distributions in rivers of individually marked fish that are in close proximity to hydropower facilities. Knowledge of the depth distributions of fish approaching dams can be used to understand how vulnerable fish are to injuries such as barotrauma as they pass through dams. To predict the possibility of barotrauma injury caused by pressure changes during turbine passage, it is necessary to understand fish behaviour relative to acclimation depth in dam forebays as they approach turbines. A guiding study was conducted using high-resolution three-dimensional tracking results of salmonids implanted with Juvenile Salmon Acoustic Telemetry System transmitters to investigate the depth distributions of subyearling and yearling Chinook salmon (Oncorhynchus tshawytscha) and juvenile steelhead (Oncorhynchus mykiss) passing two dams on the Snake River in Washington State. Multiple approaches were evaluated to describe the depth at which fish were acclimated, and statistical analyses were performed on large data sets extracted from ∼28 000 individually tagged fish during 2012 and 2013. Our study identified patterns of depth distributions of juvenile salmonids in forebays prior to passage through turbines or juvenile bypass systems. This research indicates that the median depth at which juvenile salmonids approached turbines ranged from 2.8 to 12.2 m, with the depths varying by species/life history, year, location (which dam) and diel period (between day and night). One of the most enlightening findings was the difference in dam passage associated with the diel period. The amount of time that turbine-passed fish spent in the immediate forebay prior to entering the powerhouse was much lower during the night than during the day. This research will allow scientists to understand turbine-passage survival better and enable them to assess more accurately the effects of dam passage on juvenile salmon survival.

  7. Bidimensional measurements of right ventricular function for prediction of survival in patients with pulmonary hypertension: comparison of reproducibility and time of analysis with volumetric cardiac magnetic resonance imaging analysis

    Science.gov (United States)

    Kamel, Ihab R.; Rastegar, Neda; Damico, Rachel; Kolb, Todd M.; Boyce, Danielle M.; Sager, Ala-Eddin S.; Skrok, Jan; Shehata, Monda L.; Vogel-Claussen, Jens; Bluemke, David A.; Girgis, Reda E.; Mathai, Stephen C.; Hassoun, Paul M.; Zimmerman, Stefan L.

    2015-01-01

    Abstract We tested the hypothesis that bidimensional measurements of right ventricular (RV) function obtained by cardiac magnetic resonance imaging (CMR) in patients with pulmonary arterial hypertension (PAH) are faster than volumetric measures and highly reproducible, with comparable ability to predict patient survival. CMR-derived tricuspid annular plane systolic excursion (TAPSE), RV fractional shortening (RVFS), RV fractional area change (RVFAC), standard functional and volumetric measures, and ventricular mass index (VMI) were compared with right heart catheterization data. CMR analysis time was recorded. Receiver operating characteristic curves, Kaplan-Meier, Cox proportional hazard (CPH), and Bland-Altman test were used for analysis. Forty-nine subjects with PAH and 18 control subjects were included. TAPSE, RVFS, RVFAC, RV ejection fraction, and VMI correlated significantly with pulmonary vascular resistance and mean pulmonary artery pressure (all P < 0.05). Patients were followed up for a mean (± standard deviation) of 2.5 ± 1.6 years. Kaplan-Meier curves showed that death was strongly associated with TAPSE <18 mm, RVFS <16.7%, and RVFAC <18.8%. In CPH models with TAPSE as dichotomized at 18 mm, TAPSE was significantly associated with risk of death in both unadjusted and adjusted models (hazard ratio, 4.8; 95% confidence interval, 2.0–11.3; P = 0.005 for TAPSE <18 mm). There was high intra- and interobserver agreement. Bidimensional measurements were faster (1.5 ± 0.3 min) than volumetric measures (25 ± 6 min). In conclusion, TAPSE, RVFS, and RVFAC measures are efficient measures of RV function by CMR that demonstrate significant correlation with invasive measures of PAH severity. In patients with PAH, TAPSE, RVFS, and RVFAC have high intra- and interobserver reproducibility and are more rapidly obtained than volumetric measures. TAPSE <18 mm by CMR was strongly and independently associated with survival in PAH. PMID:26401254

  8. Stressed mothers - troubled offspring: a study of behavioural maternal effects in farmed Salmo salar.

    Science.gov (United States)

    Eriksen, M S; Faerevik, G; Kittilsen, S; McCormick, M I; Damsgård, B; Braithwaite, V A; Braastad, B O; Bakken, M

    2011-09-01

    Mature female Atlantic salmon Salmo salar were given intraperitoneal cortisol implants 1 week prior to stripping to examine the influence of simulated maternal stress on offspring boldness and social dominance. Behavioural tests originally designed to investigate stress responsiveness and coping styles in salmonids (i.e. feeding in isolation, dominance tests and acute confinement) were carried out on the offspring 1·5 years after hatching. In the feeding test, there were no differences between the two treatment groups in total feeding score or number of pellets eaten, but offspring from the cortisol-implanted females made more unsuccessful feeding attempts than offspring from control females. In dominance tests, there was no difference between controls and cortisol-treated fish regarding propensity to become socially dominant. A higher proportion of individuals with bite marks, however, was observed in the cortisol group when compared to controls. Cortisol-treated offspring that gained dominant rank in the dominance tests performed more aggressive acts after stable dominance-subordinate relationships were established compared to control winners. During acute confinement stress, offspring from cortisol-implanted females showed a reduction in the proportion of time they were moving compared to the controls. These results indicate that the maternal endocrine state at spawning affects several aspects of progeny behaviour potentially related to subsequent success and survival in farmed S. salar. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

  9. Overall survival in lower IPSS risk MDS by receipt of iron chelation therapy, adjusting for patient-related factors and measuring from time of first red blood cell transfusion dependence: an MDS-CAN analysis.

    Science.gov (United States)

    Leitch, Heather A; Parmar, Ambica; Wells, Richard A; Chodirker, Lisa; Zhu, Nancy; Nevill, Thomas J; Yee, Karen W L; Leber, Brian; Keating, Mary-Margaret; Sabloff, Mitchell; St Hilaire, Eve; Kumar, Rajat; Delage, Robert; Geddes, Michelle; Storring, John M; Kew, Andrea; Shamy, April; Elemary, Mohamed; Lenis, Martha; Mamedov, Alexandre; Ivo, Jessica; Francis, Janika; Zhang, Liying; Buckstein, Rena

    2017-10-01

    Analyses suggest iron overload in red blood cell (RBC) transfusion-dependent (TD) patients with myleodysplastic syndrome (MDS) portends inferior overall survival (OS) that is attenuated by iron chelation therapy (ICT) but may be biassed by unbalanced patient-related factors. The Canadian MDS Registry prospectively measures frailty, comorbidity and disability. We analysed OS by receipt of ICT, adjusting for these patient-related factors. TD International Prognostic Scoring System (IPSS) low and intermediate-1 risk MDS, at RBC TD, were included. Predictive factors for OS were determined. A matched pair analysis considering age, revised IPSS, TD severity, time from MDS diagnosis to TD, and receipt of disease-modifying agents was conducted. Of 239 patients, 83 received ICT; frailty, comorbidity and disability did not differ from non-ICT patients. Median OS from TD was superior in ICT patients (5·2 vs. 2·1 years; P MDS, adjusting for age, frailty, comorbidity, disability, revised IPSS, TD severity, time to TD and receiving disease-modifying agents. This provides additional evidence that ICT may confer clinical benefit. © 2017 John Wiley & Sons Ltd.

  10. Survival after in-hospital Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    M Adib Hajbaghery

    2005-05-01

    Full Text Available Background: During recent years, cardiopulmonary resuscitation (CPR in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran

  11. 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...

  12. Two Troubling Trends in the Conversation Over Whether Clinical Ethics Consultants Have Ethics Expertise.

    Science.gov (United States)

    Brummett, Abram; Ostertag, Christopher J

    2017-04-18

    In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical expertise on irresolvable meta-ethical debates as the reason for this move. We argue against this deflationary strategy because it ends up smuggling in meta-ethical assumptions it claims to avoid. Specifically, we critique Rasmussen's distinction between the ethical and normative features of clinical ethics cases. The second trend, exemplified in the work of Dien Ho, also attempts to avoid meta-ethics. However, unlike Rasmussen, Ho tries to articulate a notion of ethics expertise that does not rely upon meta-ethics. Specifically, we critique Ho's attempts to explain how clinical ethicists can resolve moral disputes using what he calls the "Default Principle" and "arguments by parity." We show that these strategies do not work unless those with the moral disagreement already share certain meta-ethical assumptions. Ultimately, we argue that the two trends of (1) attempting to avoid meta-ethics by denying that clinical ethicists have ethics expertise, and (2) attempting to articulate how ethics expertise can be used to resolve disputes without meta-ethics both fail because they do not, in fact, avoid doing meta-ethics. We conclude that these trends detract from what clinical ethics consultation was founded to do and ought to still be doing-provide moral guidance, which requires ethics expertise, and engagement with meta-ethics. To speak of ethicists without ethics expertise leaves their role in the clinic dangerously unclear and unjustified.

  13. Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma--results from a comprehensive multi-centre database (CORONA/SATURN-Project).

    Science.gov (United States)

    Brookman-May, Sabine D; May, Matthias; Shariat, Shahrokh F; Novara, Giacomo; Zigeuner, Richard; Cindolo, Luca; De Cobelli, Ottavio; De Nunzio, Cosimo; Pahernik, Sascha; Wirth, Manfred P; Longo, Nicola; Simonato, Alchiede; Serni, Sergio; Siracusano, Salvatore; Volpe, Alessandro; Morgia, Giuseppe; Bertini, Roberto; Dalpiaz, Orietta; Stief, Christian; Ficarra, Vincenzo

    2013-11-01

    To assess the prognostic impact of time to recurrence (TTR) on cancer-specific survival (CSS) after recurrence in patients with renal cell carcinoma (RCC) undergoing radical nephrectomy or nephron-sparing surgery. To analyse differences in clinical and histopathological criteria between patients with early and late recurrence. Of 13,107 patients with RCC from an international multicentre database, 1712 patients developed recurrence in the follow-up (FU), at a median (interquartile range) of 50.1 (25-106) months. In all, 1402 patients had recurrence at ≤5 years (Group A) and 310 patients beyond this time (Group B). Differences in clinical and histopathological variables between patients with early and late recurrence were analysed. The influence of TTR and further variables on CSS after recurrence was assessed by Cox regression analysis. Male gender, advanced age, tumour diameter and stage, Fuhrman grade 3-4, lymphovascular invasion (LVI), and pN + stage were significantly more frequent in patients with early recurrence, who had a significantly reduced 3-year CSS of 30% compared with patients in Group B (41%; P = 0.001). Age, gender, tumour histology, pT stage, and continuous TTR (hazard ratio 0.99, P = 0.006; monthly interval) independently predicted CSS. By inclusion of dichotomised TTR in the multivariable model, a significant influence of this variable on CSS was present until 48 months after surgery, but not beyond this time. Advanced age, male gender, larger tumour diameters, LVI, Fuhrman grade 3-4, pN + stage, and advanced tumour stages are associated with early recurrence. Up to 4 years from surgery, a shorter TTR independently predicts a reduced CSS after recurrence. © 2013 The Authors. BJU International © 2013 BJU International.

  14. Modeling Complex Time Limits

    Directory of Open Access Journals (Sweden)

    Oleg Svatos

    2013-01-01

    Full Text Available In this paper we analyze complexity of time limits we can find especially in regulated processes of public administration. First we review the most popular process modeling languages. There is defined an example scenario based on the current Czech legislature which is then captured in discussed process modeling languages. Analysis shows that the contemporary process modeling languages support capturing of the time limit only partially. This causes troubles to analysts and unnecessary complexity of the models. Upon unsatisfying results of the contemporary process modeling languages we analyze the complexity of the time limits in greater detail and outline lifecycles of a time limit using the multiple dynamic generalizations pattern. As an alternative to the popular process modeling languages there is presented PSD process modeling language, which supports the defined lifecycles of a time limit natively and therefore allows keeping the models simple and easy to understand.

  15. Statistical analysis of survival data.

    Science.gov (United States)

    Crowley, J; Breslow, N

    1984-01-01

    A general review of the statistical techniques that the authors feel are most important in the analysis of survival data is presented. The emphasis is on the study of the duration of time between any two events as applied to people and on the nonparametric and semiparametric models most often used in these settings. The unifying concept is the hazard function, variously known as the risk, the force of mortality, or the force of transition.

  16. School Drama and Representations of War and Terror--Some Theoretical Approaches to Understanding Learning in Drama in Troubled Times

    Science.gov (United States)

    Franks, Anton

    2008-01-01

    The argument here proceeds from an understanding that learning in drama is about participating in forms of cultural production whilst simultaneously engaging thought and feeling to make sense of aspects of contemporary life. In contemporary culture, acts of war and terror are mediated through television and digitised media and are thereby given…

  17. Troubles psychotiques précipités par le mariage : étude de trois observations

    Science.gov (United States)

    Jaweher, Masmoudi; Kammoun, Mohamed Faouzi; Inès, Feki; Imen, Baati; Rim, Sallami; Abdelaziz, Jaoua

    2013-01-01

    Le mariage est un évènement très investi dans notre culture arabo-musulmane. Il présente une situation à grande charge émotionnelle et ayant un vécu stressant. C'est ainsi qu'il peut être à l'origine de la décompensation de certains troubles psychiatriques. Ce moment particulier de déclenchement de la pathologie peut altérer significativement l'adaptation familiale et sociale du patient en question, le rendant dépendant en partie ou en totalité à une institution. Dans ce travail, nous proposons d’étudier certains facteurs psychiques, sociaux et culturels pouvant aboutir à la précipitation des manifestations psychotiques par le mariage. Il s'agit de l’étude de trois observations cliniques, deux hommes et une femme, hospitalisés dans le service de psychiatrie A du CHU Hédi Chaker de Sfax et qui ont développés des manifestations psychotiques de façon concomitante à leur mariage. La durée moyenne de survenue des crises a été de vingt ans, le diagnostic retenu a été celui de trouble bipolaire dans deux cas et d'une schizophrénie indifférenciée chez le troisième patient. L’évolution s'est faite vers une chronicisation de deux malades et une dépendance institutionnelle dans le troisième cas. La précipitation des troubles psychotiques par le mariage, reste un phénomène en relation intime avec les composantes culturelles, elles-mêmes sont déterminantes dans la prise en charge ultérieure de ces patients. PMID:23785551

  18. The trouble with physics the rise of string theory, the fall of a science, and what comes next

    CERN Document Server

    Smolin, Lee

    2006-01-01

    In this groundbreaking book, the renowned theoretical physicist Lee Smolin argues that physics - the basis for all other sciences - has lost its way. For more than two centuries, our understanding of the laws of nature expanded rapidly. But today, despite our best efforts, we know nothing more about these laws than we knew in the 1970s. Why is physics suddenly in trouble? And what can we do about it? One of the major problems, according to Smolin, is string theory: an ambitious attempt to formulate a "theory of everything" that explains all the particles and forces of nature and how the univer

  19. Survival and recovery of Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes on lettuce and parsley as affected by method of inoculation, time between inoculation and analysis, and treatment with chlorinated water.

    Science.gov (United States)

    Lang, Megan M; Harris, Linda J; Beuchat, Larry R

    2004-06-01

    The effects of method for applying inoculum and of drying time after inoculation on survival and recovery of foodborne pathogens on iceberg lettuce and parsley were studied. Five-strain mixtures of Escherichia coli O157:H7, Salmonella, or Listeria monocytogenes were applied to lettuce and parsley by dip, spot, or spray inoculation methods. Inocula were dried for 2 h at 22 degrees C or for 2 h at 22 degrees C and then 22 h at 4 degrees C before being treated with water (control) or chlorine (200 microg/ml). Significantly higher populations (CFU per lettuce or parsley sample) of E. coli O157:H7 and Salmonella (alpha = 0.05) were recovered from dip-inoculated produce than from spot- or spray-inoculated produce. This difference was attributed to larger numbers of cells adhering to lettuce and parsley subjected to dip inoculation. Populations of E. coli O157:H7 and Salmonella recovered from lettuce inoculated by spot and spray methods were not significantly different, but populations recovered from spot-inoculated parsley were significantly higher than those recovered from spray-inoculated parsley, even though the number of cells applied was the same. Significantly different numbers of L. monocytogenes were recovered from inoculated lettuce (dip > spray > spot); populations recovered from dip-inoculated parsley were significantly higher than those recovered from spot- or spray-inoculated parsley, which were not significantly different from each other. Populations of pathogens recovered from lettuce and parsley after drying inoculum for 2 h at 22 degrees C were significantly higher than or equal to populations recovered after drying for 2 h at 22 degrees C and then for 22 h at 4 degrees C. Significant differences (water > chlorine) were observed in populations of all pathogens recovered from treated lettuce and parsley, regardless of inoculation method and drying time. It is recommended that spot inoculation with a drying time of 2 h at 22 degrees C followed by 22 h at 4

  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. Aircraft Survivability: Rotorcraft Survivability. Summer 2010

    Science.gov (United States)

    2010-01-01

    protect those who serve to protect us?” The answer is a mixed bag. I am fortunate to have joined a group of dedicated men and women who represent this...and Service subject matter experts on rotorcraft safety and survivability to complete the study and report the results to the Joint Chiefs of...Operations and Support CDD TEMP DT DT/OT LUT IOT &E BLRIP TEMP TEMP LRIP Acquisition & LFT Strategies B C LFT&E Review Requirements Approve TEMPs

  2. ASSOCIATIONS BETWEEN MOTHERS’ EXPERIENCE WITH THE TROUBLES IN NORTHERN IRELAND AND MOTHERS’ AND CHILDREN’S PSYCHOLOGICAL FUNCTIONING: THE MODERATING ROLE OF SOCIAL IDENTITY

    Science.gov (United States)

    Merrilees, Christine E.; Cairns, Ed; Goeke-Morey, Marcie C.; Schermerhorn, Alice C.; Shirlow, Peter; Cummings, E. Mark

    2011-01-01

    Relatively little research has examined the relations between growing up in a community with a history of protracted violent political conflict and subsequent generations’ well-being. The current article examines relations between mothers’ self-report of the impact that the historical political violence in Northern Ireland (known as the Troubles) has on her and her child’s current mental health. These relations are framed within the social identity model of stress, which provides a framework for understanding coping responses within societies that have experienced intergroup conflict. Mother-child dyads (N = 695) living in Belfast completed interviews. Results suggest that the mother-reported impact of the Troubles continue to be associated with mothers’ mental health, which, in turn, is associated with her child’s adjustment. The strength of mothers’ social identity moderated pathways between the impact of the Troubles and her mental health, consistent with the social identity model of stress. PMID:21686048

  3. Cancer rehabilitation: a barometer for survival?

    Science.gov (United States)

    Saotome, Takako; Klein, Linda; Faux, Steven

    2015-10-01

    This pilot study was conducted to describe the clinical features and functional outcomes of patients attending inpatient rehabilitation for cancer-related deconditioning and neurological deficits and to explore factors associated with improved survival. Using a retrospective audit, demographic characteristics, discharge outcomes, survival time, and functional status as measured by Functional Independence Measure (FIM) were recorded for 73 patients. Clinical status was estimated by Karnofsky Performance Status Scale (KPS). Cox regression was used to assess factors associated with improved survival following discharge from rehabilitation. Significant functional gains following rehabilitation were observed in total FIM (p = 0.02), motor FIM (p = 0.001), and KPS (p = 0.003). Length of survival ranged from 9.0 to 25.0 months, with 26 cases surviving to the end of study (censored). Patients scoring a total FIM of ≥80 survived significantly longer than patients scoring <80 (p = 0.002). At discharge, motor FIM scores (p = 0.004), FIM Efficiency (p = 0.001), KPS scores (p = 0.022), ambulation ability (p = 0.026), return to home (p = 0.009), and receipt of in-home services (p = 0.045) were significantly associated with improved survival. Functional improvement achieved through inpatient rehabilitation was associated with prolonged survival among cancer patients. Rehabilitation leading to improved independence among cancer patients may act as a marker of those with greater likelihood of better prognosis.

  4. SURVIVAL ANALYSIS AND LENGTH-BIASED SAMPLING

    Directory of Open Access Journals (Sweden)

    Masoud Asgharian

    2010-12-01

    Full Text Available When survival data are colleted as part of a prevalent cohort study, the recruited cases have already experienced their initiating event. These prevalent cases are then followed for a fixed period of time at the end of which the subjects will either have failed or have been censored. When interests lies in estimating the survival distribution, from onset, of subjects with the disease, one must take into account that the survival times of the cases in a prevalent cohort study are left truncated. When it is possible to assume that there has not been any epidemic of the disease over the past period of time that covers the onset times of the subjects, one may assume that the underlying incidence process that generates the initiating event times is a stationary Poisson process. Under such assumption, the survival times of the recruited subjects are called “lengthbiased”. I discuss the challenges one is faced with in analyzing these type of data. To address the theoretical aspects of the work, I present asymptotic results for the NPMLE of the length-biased as well as the unbiased survival distribution. I also discuss estimating the unbiased survival function using only the follow-up time. This addresses the case that the onset times are either unknown or known with uncertainty. Some of our most recent work and open questions will be presented. These include some aspects of analysis of covariates, strong approximation, functional LIL and density estimation under length-biased sampling with right censoring. The results will be illustrated with survival data from patients with dementia, collected as part of the Canadian Study of Health and Aging (CSHA.

  5. Exposure to Trauma and Mental Health Service Engagement Among Adults Who Were Children of the Northern Ireland Troubles of 1968 to 1998.

    Science.gov (United States)

    Ferry, Finola; Ennis, Edel; Bunting, Brendan; Murphy, Samuel; Bolton, David; O'Neill, Siobhan

    2017-12-01

    Northern Ireland is an appropriate region to examine the impact of traumatic experiences, owing to the many years of civil violence that have characterized its recent history, known colloquially as the "Troubles." Given the prominence of traumatic experiences among the aging population of Northern Ireland (NI), an evidence base is required to inform the planning and provision of effective mental health and other services. We analyzed the follow-up interviews (n = 225) of individuals from the Northern Ireland Study of Health and Stress (NISHS), aged 45 years and older, who experienced one or more conflict-related traumatic events. This study demonstrated that in NI traumatic events, such as being involved in an explosion, seeing someone killed or seriously injured, and living in a region of terror were most likely to be related to the Troubles. However, event types that we had not previously known to be related to conflict (such as the sudden death of a loved one), were also often related to the Troubles. Two-thirds of participants (67.1%) reported exposure to a Troubles-related event, and 57.8% reported being a civilian in a region of terror. The vast majority (85.9%) of participants who experienced a Troubles-related trauma never sought help, despite 59.1% meeting the criteria for a lifetime mental disorder. The reasons for not seeking help and sources of help are outlined. Policy makers must address Troubles-related mental health effects, in terms of how they carry forward into aging, and consider ways of improving engagement with services and treatments. Copyright © 2017 International Society for Traumatic Stress Studies.

  6. Evaluating survival model performance: a graphical approach.

    Science.gov (United States)

    Mandel, M; Galai, N; Simchen, E

    2005-06-30

    In the last decade, many statistics have been suggested to evaluate the performance of survival models. These statistics evaluate the overall performance of a model ignoring possible variability in performance over time. Using an extension of measures used in binary regression, we propose a graphical method to depict the performance of a survival model over time. The method provides estimates of performance at specific time points and can be used as an informal test for detecting time varying effects of covariates in the Cox model framework. The method is illustrated on real and simulated data using Cox proportional hazard model and rank statistics. Copyright 2005 John Wiley & Sons, Ltd.

  7. Relevance Vector Machine for Survival Analysis.

    Science.gov (United States)

    Kiaee, Farkhondeh; Sheikhzadeh, Hamid; Mahabadi, Samaneh Eftekhari

    2016-03-01

    An accelerated failure time (AFT) model has been widely used for the analysis of censored survival or failure time data. However, the AFT imposes the restrictive log-linear relation between the survival time and the explanatory variables. In this paper, we introduce a relevance vector machine survival (RVMS) model based on Weibull AFT model that enables the use of kernel framework to automatically learn the possible nonlinear effects of the input explanatory variables on target survival times. We take advantage of the Bayesian inference technique in order to estimate the model parameters. We also introduce two approaches to accelerate the RVMS training. In the first approach, an efficient smooth prior is employed that improves the degree of sparsity. In the second approach, a fast marginal likelihood maximization procedure is used for obtaining a sparse solution of survival analysis task by sequential addition and deletion of candidate basis functions. These two approaches, denoted by smooth RVMS and fast RVMS, typically use fewer basis functions than RVMS and improve the RVMS training time; however, they cause a slight degradation in the RVMS performance. We compare the RVMS and the two accelerated approaches with the previous sparse kernel survival analysis method on a synthetic data set as well as six real-world data sets. The proposed kernel survival analysis models have been discovered to be more accurate in prediction, although they benefit from extra sparsity. The main advantages of our proposed models are: 1) extra sparsity that leads to a better generalization and avoids overfitting; 2) automatic relevance sample determination based on data that provide more accuracy, in particular for highly censored survival data; and 3) flexibility to utilize arbitrary number and types of kernel functions (e.g., non-Mercer kernels and multikernel learning).

  8. La réalité virtuelle dans la rééducation des troubles de la marche et de l'équilibre du patient parkinsonien

    OpenAIRE

    Berthod, Coraline; Paccaud, Marine; Ferchichi-Barbey, Sylvie

    2013-01-01

    Introduction : Les troubles de la marche et de l’équilibre sont des facteurs de risque de chute importants dans la maladie de Parkinson. L’essentiel du traitement physiothérapeutique consiste en leur prise en charge. La réalité virtuelle étant de plus en plus utilisée, l’objectif de cette revue est d’identifier si son utilisation est efficace dans la rééducation des troubles de la marche et de l’équilibre chez le patient parkinsonien. Méthodologie : Notre recherche d’articles a été effectuée ...

  9. Foreign Ownership and long-term Survival

    OpenAIRE

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    Does foreign ownership enhance or decrease a firm’s chances of survival? Over the 100 year period 1895-2001 this paper compares the survival of foreign subsidiaries in Denmark to a control sample matched by industry and firm size. We find that foreign-owned companies have higher survival probability. On average exit risk for domestic companies is 2.3 times higher than for foreign companies. First movers like Siemens, Philips, Kodak, Ford, GM or Goodyear have been active in the country for alm...

  10. Ministerial Importance and Survival in Government

    DEFF Research Database (Denmark)

    Bright, Jonathan; Döring, Holger; Little, Conor

    2015-01-01

    Are holders of important ministerial positions more likely to survive in cabinet than their colleagues who hold less important positions? This study examines the relationship between the importance of a ministerial position and the length of time ministers are able to survive in government....... It is based on an original dataset of cabinet ministers in seven West European countries from 1945 to 2011. Employing a little-used measure of ministerial survival based on overall time in government, it is found that holders of important ministerial positions are more durable than their colleagues who hold...... less important ministerial positions. Age, prior government experience and the size of the party to which the minister belongs are also associated with consistently significant effects. Further, the study explores the determinants of survival for two types of risk – exiting government with one’s party...

  11. Fractional time stepping for unsteady engineering calculations on parallel computer systems

    Science.gov (United States)

    Molev, Sergey; Podaruev, Vladimir; Troshin, Alexey

    2017-11-01

    The tool for explicit scheme acceleration is described. Its essence is reducing arithmetic operations. Cells of the mesh are scattered by groups named levels. Each level has own time step. Coordination of levels is carried out. The method may be useful for great time scale scattering problems of aerodynamics. Reasons that produce deterioration of unsteady process modelling are revealed. Resolutions that correct the troubles are proposed. Example that demonstrates troubles rising conditions and successful abolition of them is presented. Limit of producing acceleration is denoted. Means that favor effective parallel computing with method are discussed.

  12. Seasonal survival of adult female mottled ducks

    Science.gov (United States)

    Moon, Jena A.; Haukos, David A.; Conway, Warren C.

    2017-01-01

    The mottled duck (Anas fulgivula) is a non-migratory duck dependent on coastal habitats to meet all of its life cycle requirements in the Western Gulf Coast (WGC) of Texas and Louisiana, USA. This population of mottled ducks has experienced a moderate decline during the past 2 decades. Adult survival has been identified as an important factor influencing population demography. Previous work based on band-recovery data has provided only annual estimates of survival. We assessed seasonal patterns of female mottled duck survival from 2009 to 2012 using individuals marked with satellite platform transmitter terminals (PTTs). We used temperature and movement sensors within each PTT to indicate potential mortality events. We estimated cumulative weekly survival and ranked factors influential in patterns of mortality using known-fate modeling in Program MARK. Models included 4 predictors: week; hunting and non-hunting periods; biological periods defined as breeding, brooding, molt, and pairing; and mass at time of capture. Models containing hunt periods, during and outside the mottled duck season, comprised essentially 100% of model weights where both legal and illegal harvest had a negative influence on mottled duck survival. Survival rates were low during 2009–2011 (12–38% annual rate of survival), when compared with the long-term banding average of 53% annual survival. During 2011, survival of female mottled ducks was the lowest annual rate (12%) ever documented and coincided with extreme drought. Management actions maximizing the availability of wetlands and associated upland habitats during hunting seasons and drought conditions may increase adult female mottled duck survival.

  13. Effects of larval crowding on development time, survival and weight at metamorphosis in Aedes aegypti (Diptera: Culicidae Efectos del hacinamiento larval en el tiempo de desarrollo, la supervivencia y el peso en la metamorfosis de Aedes aegypti (Diptera: Culicidae

    Directory of Open Access Journals (Sweden)

    Arnaldo Maciá

    2009-06-01

    Full Text Available The effects of larval crowding on survival, weight at metamorphosis and development time were assessed in the dengue mosquito, Aedes aegypti L., under a controlled environment. Larval cohorts were bred at 7 different densities (4, 8, 16, 32, 64, 128 and 256 larvae / 175 ml pot, while keeping constant water volume and food amount and quality, under controlled temperature and photoperiod. Natural detritus, mainly leaves, obtained from containers naturally colonized by A. aegypti, were used as a source of nutrients for larvae. Development time, mortality, mass at metamorphosis, and total biomass were recorded for each density. Development time ranged from 4 to 23 days in males, and from 5 to 24 in females, whereby larvae took longer to develop at 64 (females and 128 (males larvae per recipient. At high densities there was a male-biased sex proportion. At densities equal to or higher than 0.4 larvae/ml (0.32 larvae/cm² there was an increase of mortality. An inverse relationship between larval density and pupal weight was detected. Biomass per individual reached asymptotic values of about 1 mg/individual at a density of 128 individuals/pot (0.64 larvae/cm². This experiment shows that this southern strain of A. aegypti is sensitive to crowding in small containers.Los efectos del hacinamiento larval sobre el tiempo de desarrollo, la supervivencia y el peso en la metamorfosis fueron estudiados en el mosquito del dengue, Aedes aegypti L., en el laboratorio. Se criaron cohortes de larvas en 7 densidades (4, 8, 16, 32, 64, 128 y 256 larvas/ recipiente de 175 ml mientras se mantuvo constante el volumen de agua y la calidad y cantidad de alimento, bajo fotoperíodo y temperatura controlados. Se usaron detritos naturales, principalmente hojas, obtenidos de contenedores colonizados naturalmente por A. aegypti como fuente de nutrientes para las larvas. En cada densidad se registraron el tiempo de desarrollo, la mortalidad, el peso en la metamorfosis y la

  14. Proof-Carrying Survivability

    Science.gov (United States)

    2013-01-15

    pp.289-302 ( Impact factor : 2.09). 2. Julic, J. and Zuo, Y. (2012). “An RFID Survivability Impact Model in the Military Domain”, Proc. of 18 th...Availability, Reliability and Security, 40(4), pp. 406-418 ( Impact factor : 2.016). 10. Zuo, Y. (2010). “A Holistic Approach for Specification of Security... Impact factor : 1.596). 20. Zuo, Y., Pimple, M. and Lande, S. (2009). “A Framework for RFID Survivability Requirement Analysis and Specification”, Proc

  15. "small problems, Big Trouble": An Art and Science Collaborative Exhibition Reflecting Seemingly small problems Leading to Big Threats

    Science.gov (United States)

    Waller, J. L.; Brey, J. A.

    2014-12-01

    "small problems, Big Trouble" (spBT) is an exhibition of artist Judith Waller's paintings accompanied by text panels written by Earth scientist Dr. James A. Brey and several science researchers and educators. The text panels' message is as much the focus of the show as the art--true interdisciplinarity! Waller and Brey's history of art and earth science collaborations include the successful exhibition "Layers: Places in Peril". New in spBT is extended collaboration with other scientists in order to create awareness of geoscience and other subjects (i.e. soil, parasites, dust, pollutants, invasive species, carbon, ground water contaminants, solar wind) small in scale which pose significant threats. The paintings are the size of a mirror, a symbol suggesting the problems depicted are those we increasingly need to face, noting our collective reflections of shared current and future reality. Naturalistic rendering and abstract form in the art helps reach a broad audience including those familiar with art and those familiar with science. The goal is that gallery visitors gain greater appreciation and understanding of both—and of the sober content of the show as a whole. "small problems, Big Trouble" premiers in Wisconsin April, 2015. As in previous collaborations, Waller and Brey actively utilize art and science (specifically geoscience) as an educational vehicle for active student learning. Planned are interdisciplinary university and area high school activities linked through spBT. The exhibition in a public gallery offers a means to enhance community awareness of and action on scientific issues through art's power to engage people on an emotional level. This AGU presentation includes a description of past Waller and Brey activities: incorporating art and earth science in lab and studio classrooms, producing gallery and museum exhibitions and delivering workshops and other presentations. They also describe how walking the paths of several past earth science

  16. Evidence-based history taking under "time constraint"

    OpenAIRE

    Alireza Moayyeri; Akbar Soltani; Hamideh Moosapour; Mohsin Raza

    2011-01-01

    Physicians all through the world visit patients under time limitations. The most important troubled clinical skill under ?time constraint? is the diagnostic approach. In this situation, clinicians need some diagnostic approaches to reduce both diagnostic time and errors. It seems that highly experienced physicians utilize some special tactics in this regard. Evidence-based medicine (EBM) as a relatively new paradigm for clinical practice stresses on using research evidences in diagnostic eval...

  17. Child justice and the little daily drops of physical violence: a case of troubled waters

    Directory of Open Access Journals (Sweden)

    Maria del Mar Cabezas Hernandez

    2017-05-01

    Full Text Available This article addresses the debate on fuzzy cases concerning the so called ‘mild’ and sporadic instances of physical violence against children by caregivers. The end of violence toward children is a current goal in the international scenario. However, myths on the use of violence and the scope of parental rights still survive. Thus, I examine the main theoretical, ethical and political challenges regarding conceptual clear-cut boundaries and the burden of proof when justifying violence. Finally, I defend the role of a preventive approach on children’s wellbeing and family intervention as a fruitful way to surpass polarized debates on permissibility and criminalization.

  18. Marketing child survival.

    Science.gov (United States)

    Grant, J P

    1984-01-01

    Growth monitoring charts, packets of oral rehydration salts (ORS), and vaccines, are inexpensive, life-saving, growth-protecting technologies which can enable parents to protect their children against the worst effects of poverty. Similarly, a matrix of current and easily understandable information about pregnancy, breast feeding, weaning, feeding during and immediately after illness, child spacing, and preparing and using home-made oral rehydration solutions, also could empower parents to protect the lives and the health of their children. The question arises as to how can these technologies and this information be put at the disposal of millions of families in the low-income world. The initial task of the Child Survival and Development Revolution is the communication of what is now possible, yet little is known about how to communicate information whose principal value is to the poor. There are 2 large-scale precedents: the Green Revolution, which in many instances succeeded in putting into the hands of thousands of small and large farmers the techniques and the knowledge which enabled them to double and treble the yields from their lands; and the campaign to put the knowledge and the means of family planning at the disposal of many millions of people. There are 2 lessons to be learned from these precedents: they have shown that the way to promote a people's technology and to put information at the disposal of the majority is by mobilizing all possible resources and working through all possible channels both to create the demand and to meet it; and neither the Green Revolution nor the family planning movement rally took off until they were viewed as political and economic priorities and given the full support of the nation's political leadership. Nowhere are these 2 lessons more clearly illustrated than in present-day Indonesia. Because the campaign for family planning was given high personal and political priority by the President, and because 85% of all family

  19. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  20. Artists’ Survival Rate

    DEFF Research Database (Denmark)

    Bille, Trine; Jensen, Søren

    2017-01-01

    The literature of cultural economics generally finds that an artistic education has no significant impact on artists’ income and careers in the arts. In our research, we have readdressed this question by looking at the artists’ survival in the arts occupations. The results show that an artistic...... education has a significant impact on artists’ careers in the arts and we find important industry differences....

  1. Education for Survival

    Science.gov (United States)

    Aldrich, Richard

    2010-01-01

    This article provides a brief overview of current approaches to education and concludes that none of these is sufficient to meet the challenges that now face the human race. It argues instead for a new concept of education for survival. (Contains 1 note.)

  2. Seeds to survive

    NARCIS (Netherlands)

    Groot, S.P.C.

    2002-01-01

    Seeds are important for man, either as propagation material of crops or directly for the production of foods, fodder and drinks. The natural function of seeds is dispersal of its genes to successive generations. Survival mechanisms seed have evolved sometimes interfere with those preferred by

  3. Survival After Retirement.

    Science.gov (United States)

    Holloway, Clark; Youngblood, Stuart A.

    1986-01-01

    Examined survival rates after retirement in a large corporation. A regression analysis was performed to control for age, sex, job status, and type of work differences that may influence longevity. Short-term suvivors seemed to undergo a different adjustment process than long-term survivors. (Author/ABL)

  4. Associations between Mothers' Experience with the Troubles in Northern Ireland and Mothers' and Children's Psychological Functioning: The Moderating Role of Social Identity

    Science.gov (United States)

    Merrilees, Christine E.; Cairns, Ed; Goeke-Morey, Marcie C.; Schermerhorn, Alice C.; Shirlow, Peter; Cummings, E. Mark

    2011-01-01

    Relatively little research has examined the relations between growing up in a community with a history of protracted violent political conflict and subsequent generations' well-being. The current article examines relations between mothers' self-report of the impact that the historical political violence in Northern Ireland (known as the Troubles)…

  5. Survival during the Breeding Season: Nest Stage, Parental Sex, and Season Advancement Affect Reed Warbler Survival.

    Directory of Open Access Journals (Sweden)

    Kaja Wierucka

    Full Text Available Avian annual survival has received much attention, yet little is known about seasonal patterns in survival, especially of migratory passerines. In order to evaluate survival rates and timing of mortality within the breeding season of adult reed warblers (Acrocephalus scirpaceus, mark-recapture data were collected in southwest Poland, between 2006 and 2012. A total of 612 individuals (304 females and 308 males were monitored throughout the entire breeding season, and their capture-recapture histories were used to model survival rates. Males showed higher survival during the breeding season (0.985, 95% CI: 0.941-0.996 than females (0.869, 95% CI: 0.727-0.937. Survival rates of females declined with the progression of the breeding season (from May to August, while males showed constant survival during this period. We also found a clear pattern within the female (but not male nesting cycle: survival was significantly lower during the laying, incubation, and nestling periods (0.934, 95% CI: 0.898-0.958, when birds spent much time on the nest, compared to the nest building and fledgling periods (1.000, 95% CI: 1.00-1.000, when we did not record any female mortality. These data (coupled with some direct evidence, like bird corpses or blood remains found next to/on the nest may suggest that the main cause of adult mortality was on-nest predation. The calculated survival rates for both sexes during the breeding season were high compared to annual rates reported for this species, suggesting that a majority of mortality occurs at other times of the year, during migration or wintering. These results have implications for understanding survival variation within the reproductive period as well as general trends of avian mortality.

  6. Évaluer les risques dans le cas de troubles mentaux indifférenciés

    Science.gov (United States)

    Silveira, José; Rockman, Patricia; Fulford, Casey; Hunter, Jon

    2016-01-01

    Résumé Objectif Proposer aux médecins de soins primaires une approche novatrice pour la détermination des risques et la prise de décisions cliniques connexes dans la prise en charge de troubles mentaux indifférenciés. Sources de l’information Nous avons procédé à une recherche documentaire dans PubMed, CINAHL, PsycINFO et Google Scholar à l’aide des expressions de recherche suivantes, en anglais : diagnostic uncertainty, diagnosis, risk identification, risk assessment/methods, risk, risk factors, risk management/methods, cognitive biases and psychiatry, decision making, mental disorders/diagnosis, clinical competence, evidence-based medicine, interviews as topic, psychiatry/education, psychiatry/methods, documentation/methods, forensic psychiatry/education, forensic psychiatry/methods, mental disorders/classification, mental disorders/psychology, violence/prevention and control et violence/psychology. Message principal Les troubles mentaux constituent une grande part de la pratique en soins primaires; ils se présentent souvent de manière indifférenciée et ce, pendant de longues périodes. La difficile quête d’un diagnostic peut détourner l’attention de la détermination des risques, parce que nous présumons souvent qu’il faut un diagnostic avant d’amorcer un traitement. Cette situation peut avoir contribué par inadvertance à des événements indésirables. Il faudrait en priorité se concentrer sur les points saillants relatifs aux risques que présente le patient. Cet article propose une approche novatrice pour organiser les renseignements sur le patient afin d’aider à la détermination des risques et à la prise de décisions relativement à la prise en charge des patients souffrant de troubles mentaux indifférenciés. Conclusion Une approche structurée peut aider les médecins à gérer l’incertitude clinique fréquente dans la détermination des risques chez des patients souffrant de troubles mentaux, et à composer avec

  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. Traumatic events and their relative PTSD burden in Northern Ireland: a consideration of the impact of the 'Troubles'.

    Science.gov (United States)

    Ferry, Finola; Bunting, Brendan; Murphy, Samuel; O'Neill, Siobhan; Stein, Dan; Koenen, Karestan

    2014-03-01

    Over a 30-year period in its recent history, daily life in Northern Ireland (NI) was characterised by civil violence, colloquially termed as the 'Troubles'. The current report examines exposure to 29 traumatic event types and the associated conditional prevalence of post-traumatic stress disorder (PTSD) among the Northern Ireland population, with a focus on the impact of traumatic events that were characteristic of the NI 'Troubles'. Results presented are based on analysis of data from the Northern Ireland Study of Health and Stress (NISHS). The NISHS is a representative epidemiological study of mental health among the NI adult population (N = 4,340) and part of the World Mental Health Survey Initiative. Perpetration of violence, physical assault by a spouse or partner and private events were the event types associated with the highest conditional prevalence of PTSD. Despite this elevated risk, collectively these events accounted for just 16.8% of the overall public burden of PTSD, given their low prevalence among the general population. Events that were characteristic of civil conflict, including unexpected death of a loved one, witnessing death or a dead body or someone seriously injured and being mugged or threatened with a weapon accounted for the highest proportion of the overall public health burden of PTSD (18.6, 9.4 and 7.8%, respectively). These findings are a feature of the higher prevalence of these events among the general population coupled with their moderate to above average risk of PTSD. Despite the formal end to conflict in NI in 1999, a substantial proportion of the adult population continue to suffer the adverse mental health effects of chronic trauma exposure. Given rates of recovery of PTSD in the absence of evidence-based treatments, it is likely that the legacy of mental ill health associated with conflict, if not adequately addressed, will endure for many years.

  9. Survival of pneumococcus on hands and fomites

    Directory of Open Access Journals (Sweden)

    Beissbarth Jemima

    2008-11-01

    Full Text Available Abstract Background Pneumococcal hand contamination in Indigenous children in remote communities is common (37%. It is not clear whether this requires frequent inoculation, or if pneumococci will survive on hands for long periods of time. Thus the aim of this study was to determine the survival time of pneumococci on hands and fomites. Findings The hands of 3 adult volunteers, a glass plate and plastic ball were inoculated with pneumococci suspended in two different media. Survival at specified time intervals was determined by swabbing and re-culture onto horse blood agar. Pneumococci inoculated onto hands of volunteers were recovered after 3 minutes at 4% to 79% of the initial inoculum. Recovery from one individual was consistently higher. By one hour, only a small number of pneumococci were recovered and this was dependent on the suspension medium used. At subsequent intervals and up to 3 hours after inoculation, Conclusion The poor survival of pneumococci on hands suggests that the high prevalence of pneumococcal hand contamination in some populations is related to frequent inoculation rather than long survival. It is plausible that hand contamination plays a (brief role in transmission directly, and indirectly through contamination via fomites. Regular hand washing and timely cleansing or removal of contaminated fomites may aid control of pneumococcal transmission via these routes.

  10. Minding the body: psychotherapy and cancer survival.

    Science.gov (United States)

    Spiegel, David

    2014-09-01

    This article reviews evidence regarding effects of psychotherapy on overall cancer survival time. Special emphasis is given to research on adverse effects of depression on cancer survival, breast cancer, and mediating psychophysiological pathways linking psychosocial support to longer survival. It reviews all published clinical trials addressing effects of psychotherapy on cancer survival, emphasizing depression, breast cancer, and psychophysiological evidence linking stress, depression, and support to cancer survival. Systematic literature review and synthesis. Eight of 15 published trials indicate that psychotherapy enhances cancer survival time. No studies show an adverse effect of psychotherapy on cancer survival. Potential psychophysiological mechanisms linking stress to shorter survival include dysregulation of diurnal cortisol, increased pro-inflammatory cytokines, reduced natural killer cell activity, shorter telomeres and lower telomerase activity, glucocorticoid-mediated suppression of p53 and BrCA1 gene expression, and sympathetic nervous system activation of vascular endothelial growth factor. Stress and support affect the course of cancer progression. What is known? Stress and support have been thought to be related to cancer risk and progression, but evidence has been mixed. Depression is a natural co-morbid condition with cancer. It has not been clear how stress and support could physiologically affect the rate of cancer progression. Immune function was not thought to have much relevance to cancer progression. Few other physiological mechanisms linking stress to cancer progression were known. What does this paper add? There is evidence from 15 RCTs indicating that effective psychosocial support improves quantity as well as quality of life with cancer. There is evidence that chronic depression predicts poorer prognosis with cancer. Dysregulated circadian cortisol patterns predict more rapid cancer progression. Inflammatory processes affect cancer

  11. Learning to deal constructively with troubled conscience related to care providers' perceptions of deficient teamwork in residential care of older people--a participatory action research study.

    Science.gov (United States)

    Ericson-Lidman, Eva; Strandberg, Gunilla

    2015-06-01

    Conscience can be perceived as an asset that helps care providers to provide good care, but it can also be a burden that generates stress of conscience (stress related to a troubled conscience). Participatory action research (PAR) has been shown to be successful in supporting care providers in residential care of older people to learn to deal with their troubled conscience in challenging and demanding care situations. The aim of the study was to describe an intervention process to assist care providers in residential care of older people to constructively deal with their troubled conscience related to perceptions of deficient teamwork. The study design was grounded in PAR. Nine enrolled nurses (ENs), two nursing aids (NAs), one Registered Nurse (RN) and their manager participated in 12 PAR sessions. All sessions were tape-recorded, and a domain analysis of the transcriptions was performed. Findings show that a PAR-based intervention can support care providers to understand, handle and take measures against deficient teamwork. Using troubled conscience as a driving force can increase the opportunities to improve quality of care in residential care for older people. During the PAR process, participants raised their awareness of the need to view the team in a wider sense and that the manager and the Registered Nurse should also be members of the team to improve team outcome. To improve clinical practice, we suggest that teams in residential care of older people should be enabled to share and reflect on challenging situations that generate troubled conscience. However, as shown in this study, care providers might need support in order to facilitate and promote sharing and reflecting on what their conscience tells them. © 2014 Nordic College of Caring Science.

  12. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings......, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations...... of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality....

  13. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings......, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations...... of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality....

  14. Starvation-Survival in Haloarchaea

    Science.gov (United States)

    Winters, Yaicha D.; Lowenstein, Tim K.; Timofeeff, Michael N.

    2015-01-01

    Recent studies claiming to revive ancient microorganisms trapped in fluid inclusions in halite have warranted an investigation of long-term microbial persistence. While starvation-survival is widely reported for bacteria, it is less well known for halophilic archaea—microorganisms likely to be trapped in ancient salt crystals. To better understand microbial survival in fluid inclusions in ancient evaporites, laboratory experiments were designed to simulate growth of halophilic archaea under media-rich conditions, complete nutrient deprivation, and a controlled substrate condition (glycerol-rich) and record their responses. Haloarchaea used for this work included Hbt. salinarum and isolate DV582A-1 (genus Haloterrigena) sub-cultured from 34 kyear Death Valley salt. Hbt. salinarum and DV582A-1 reacted to nutrient limitation with morphological and population changes. Starved populations increased and most cells converted from rods to small cocci within 56 days of nutrient deprivation. The exact timing of starvation adaptations and the physical transformations differed between species, populations of the same species, and cells of the same population. This is the first study to report the timing of starvation strategies for Hbt. salinarum and DV582A-1. The morphological states in these experiments may allow differentiation between cells trapped with adequate nutrients (represented here by early stages in nutrient-rich media) from cells trapped without nutrients (represented here by experimental starvation) in ancient salt. The hypothesis that glycerol, leaked from Dunaliella, provides nutrients for the survival of haloarchaea trapped in fluid inclusions in ancient halite, is also tested. Hbt. salinarum and DV582A-1 were exposed to a mixture of lysed and intact Dunaliella for 56 days. The ability of these organisms to utilize glycerol from Dunaliella cells was assessed by documenting population growth, cell length, and cell morphology. Hbt. salinarum and DV582A-1

  15. Starvation-Survival in Haloarchaea

    Directory of Open Access Journals (Sweden)

    Yaicha D. Winters

    2015-11-01

    Full Text Available Recent studies claiming to revive ancient microorganisms trapped in fluid inclusions in halite have warranted an investigation of long-term microbial persistence. While starvation-survival is widely reported for bacteria, it is less well known for halophilic archaea—microorganisms likely to be trapped in ancient salt crystals. To better understand microbial survival in fluid inclusions in ancient evaporites, laboratory experiments were designed to simulate growth of halophilic archaea under media-rich conditions, complete nutrient deprivation, and a controlled substrate condition (glycerol-rich and record their responses. Haloarchaea used for this work included Hbt. salinarum and isolate DV582A-1 (genus Haloterrigena sub-cultured from 34 kyear Death Valley salt. Hbt. salinarum and DV582A-1 reacted to nutrient limitation with morphological and population changes. Starved populations increased and most cells converted from rods to small cocci within 56 days of nutrient deprivation. The exact timing of starvation adaptations and the physical transformations differed between species, populations of the same species, and cells of the same population. This is the first study to report the timing of starvation strategies for Hbt. salinarum and DV582A-1. The morphological states in these experiments may allow differentiation between cells trapped with adequate nutrients (represented here by early stages in nutrient-rich media from cells trapped without nutrients (represented here by experimental starvation in ancient salt. The hypothesis that glycerol, leaked from Dunaliella, provides nutrients for the survival of haloarchaea trapped in fluid inclusions in ancient halite, is also tested. Hbt. salinarum and DV582A-1 were exposed to a mixture of lysed and intact Dunaliella for 56 days. The ability of these organisms to utilize glycerol from Dunaliella cells was assessed by documenting population growth, cell length, and cell morphology. Hbt. salinarum

  16. Cracking the survival code

    Science.gov (United States)

    Füllgrabe, Jens; Heldring, Nina; Hermanson, Ola; Joseph, Bertrand

    2014-01-01

    Modifications of histones, the chief protein components of the chromatin, have emerged as critical regulators of life and death. While the “apoptotic histone code” came to light a few years ago, accumulating evidence indicates that autophagy, a cell survival pathway, is also heavily regulated by histone-modifying proteins. In this review we describe the emerging “autophagic histone code” and the role of histone modifications in the cellular life vs. death decision. PMID:24429873

  17. Le journalisme et les sciences sociales. Trouble ou problème ?

    Directory of Open Access Journals (Sweden)

    Gilles Bastin

    2017-01-01

    Full Text Available La sociologie et le journalisme, comme disciplines de factualisation du monde social (c’est-à-dire de transformation d’un réel continu en une série discontinue de faits susceptibles d’analyse causale et d’interprétation, présentent de nombreux points de convergence. Elles partagent certaines méthodes comme celle de l’entretien et ont connu des périodes d’échanges intenses dans certains pays comme les États-Unis. Il serait absurde de dire que sociologues et journalistes se ressemblent toujours. En revanche il n’est pas absurde de noter qu’un sociologue et un journaliste peuvent plus se ressembler dans leur façon de construire, de collecter et d’analyser des faits que deux sociologues entre eux ou deux journalistes entre eux. Malgré cela les sociologues partagent souvent de tenaces préjugés quant aux journalistes. Dans cet article on examine ces préjugés en relation aux deux principales formes prises par la « panique morale » diffuse qui s’est emparée des sociétés modernes à l’âge des médias de masse : la peur de l’imitation à la fin du XIXe siècle et la peur de la massification au milieu du XXe siècle. Le rejet par Émile Durkheim de l’idée que les journaux puissent avoir un rôle dans les phénomènes de suicide autour de 1895 et le rejet par Pierre Bourdieu et Jean-Claude Passeron de l’analyse des communications de masse au début des années 1960 servent de cas d’étude. En adoptant une telle stratégie de rupture, que nous assimilons à une forme de « boundary work », les sociologues prennent le risque d’alimenter la panique morale dont sont victimes les journalistes au lieu de la réduire, de rester au niveau du « trouble » personnel provoqué par les médias sans aller vers la construction d’un « problème » social à propos des médias. As factualization disciplines of the social world (in that they transform a continuous reality into a discontinuous series of facts open

  18. In-hospital resuscitation: opioids and other factors influencing survival

    Directory of Open Access Journals (Sweden)

    Karamarie Fecho

    2009-12-01

    Full Text Available Karamarie Fecho1, Freeman Jackson1, Frances Smith1, Frank J Overdyk21Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA; 2Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USAPurpose: “Code Blue” is a standard term used to alertt hospital staff that a patient requires resuscitation. This study determined rates of survival from Code Blue events and the role of opioids and other factors on survival.Methods: Data derived from medical records and the Code Blue and Pharmacy databases were analyzed for factors affecting survival.Results: During 2006, rates of survival from the code only and to discharge were 25.9% and 26.4%, respectively, for Code Blue events involving cardiopulmonary resuscitation (CPR; N = 216. Survival rates for events not ultimately requiring CPR (N = 77 were higher, with 32.5% surviving the code only and 62.3% surviving to discharge. For CPR events, rates of survival to discharge correlated inversely with time to chest compressions and defibrillation, precipitating event, need for airway management, location and age. Time of week, witnessing, postoperative status, gender and opioid use did not influence survival rates. For non-CPR events, opioid use was associated with decreased survival. Survival rates were lowest for patients receiving continuous infusions (P < 0.01 or iv boluses of opioids (P < 0.05.Conclusions: One-quarter of patients survive to discharge after a CPR Code Blue event and two-thirds survive to discharge after a non-CPR event. Opioids may influence survival from non-CPR events.Keywords: code blue, survival, opioids, cardiopulmonary resuscitation, cardiac arrest, patient safety

  19. Survival analysis models and applications

    CERN Document Server

    Liu, Xian

    2012-01-01

    Survival analysis concerns sequential occurrences of events governed by probabilistic laws.  Recent decades have witnessed many applications of survival analysis in various disciplines. This book introduces both classic survival models and theories along with newly developed techniques. Readers will learn how to perform analysis of survival data by following numerous empirical illustrations in SAS. Survival Analysis: Models and Applications: Presents basic techniques before leading onto some of the most advanced topics in survival analysis.Assumes only a minimal knowledge of SAS whilst enablin

  20. Survival analysis of mortality data among elderly patients in ...

    African Journals Online (AJOL)

    A study on the mortality among old patients 60 years or more, admitted at University of Ilorin Teaching Hospital (UITH), Ilorin was carried out using survival analysis approach. Results revealed that the median survival time, which is the time beyond which half of the patients are expected to stay in hospital before death was ...