WorldWideScience

Sample records for surviving troubled times

  1. Building for success in troubled times

    International Nuclear Information System (INIS)

    Grandey, Gerald W.

    2009-01-01

    In spite of the dramatic decline of world financial markets and a looming global recession, Cameco CEO Jerry Grandey remains optimistic about the future for the uranium industry. Certainly prudent financial management is required in times of turmoil, but Grandey says it's equally important that those of us involved in the nuclear industry don't get swallowed up by the current culture of gloom, pessimism and fear. The long-term fundamentals of the industry remain strong. Worldwide demand for nuclear power continues to grow and we know that new uranium production will be needed to meet increasing demand. Utility customers are large, stable businesses that people depend on for electricity - in good times and bad - and we have yet to see any significant chill effect on plans for new reactors. Nuclear is still a growing industry, although Grandey expects the pace of growth may be more deliberate in the short term

  2. 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

  3. 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…

  4. Surviving Troubled Times: Five Best Practices for Training Professionals

    Science.gov (United States)

    Villachica, Steven W.; Stepich, Donald A.

    2010-01-01

    With the current economic downturn and signs of an emerging recovery, executives are trying to determine how to best use their organizations' funds and resources. This may mean downsizing human resource departments and eliminating positions for training personnel. The authors offer five strategies drawn from the professional literature to survive…

  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. 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

    2014-10-01

    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 significant increases in mean scores of the Behavioral Intent to Communicate with Important Others Regarding Emotional Health Issues subscale (p Teens program has a positive effect on help-seeking behaviors in troubled youth. © The Author(s) 2013.

  7. 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.

  8. Critical Literacy Can Help in These Troubled Times.

    Science.gov (United States)

    Sisk, Dorothy

    2002-01-01

    This article discusses how critical literacy can offer gifted students a way to research great leaders and their actions in times of crisis, enabling them to project the type of leadership that is called for in today's world. Reading activities, writing activities, and oral language activities are described. (Contains 1 reference.) (CR)

  9. Probabilistic Survivability Versus Time Modeling

    Science.gov (United States)

    Joyner, James J., Sr.

    2016-01-01

    This presentation documents Kennedy Space Center's Independent Assessment work completed on three assessments for the Ground Systems Development and Operations (GSDO) Program to assist the Chief Safety and Mission Assurance Officer during key programmatic reviews and provided the GSDO Program with analyses of how egress time affects the likelihood of astronaut and ground worker survival during an emergency. For each assessment, a team developed probability distributions for hazard scenarios to address statistical uncertainty, resulting in survivability plots over time. The first assessment developed a mathematical model of probabilistic survivability versus time to reach a safe location using an ideal Emergency Egress System at Launch Complex 39B (LC-39B); the second used the first model to evaluate and compare various egress systems under consideration at LC-39B. The third used a modified LC-39B model to determine if a specific hazard decreased survivability more rapidly than other events during flight hardware processing in Kennedy's Vehicle Assembly Building.

  10. 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.

  11. 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

  12. Running into trouble with the time-dependent propagation of a wavepacket

    International Nuclear Information System (INIS)

    Garriz, Abel E; Sztrajman, Alejandro; Mitnik, DarIo

    2010-01-01

    The propagation in time of a wavepacket is a conceptually rich problem suitable to be studied in any introductory quantum mechanics course. This subject is covered analytically in most of the standard textbooks. Computer simulations have become a widespread pedagogical tool, easily implemented in computer labs and in classroom demonstrations. However, we have detected issues raising difficulties in the practical effectuation of these codes which are especially evident when discrete grid methods are used. One issue-relatively well known-appears at high incident energies, producing a wavepacket slower than expected theoretically. The other issue, which appears at low wavepacket energies, does not affect the time evolution of the propagating wavepacket proper, but produces dramatic effects on its spectral decomposition. The origin of the troubles is investigated, and different ways to deal with these issues are proposed. Finally, we show how this problem is manifested and solved in the practical case of the electronic spectra of a metal surface ionized by an ultrashort laser pulse.

  13. Running into trouble with the time-dependent propagation of a wavepacket

    Energy Technology Data Exchange (ETDEWEB)

    Garriz, Abel E; Sztrajman, Alejandro; Mitnik, DarIo, E-mail: dmitnik@df.uba.a [Instituto de AstronomIa y Fisica del Espacio, C.C. 67, Suc. 28, (C1428EGA) Buenos Aires (Argentina)

    2010-07-15

    The propagation in time of a wavepacket is a conceptually rich problem suitable to be studied in any introductory quantum mechanics course. This subject is covered analytically in most of the standard textbooks. Computer simulations have become a widespread pedagogical tool, easily implemented in computer labs and in classroom demonstrations. However, we have detected issues raising difficulties in the practical effectuation of these codes which are especially evident when discrete grid methods are used. One issue-relatively well known-appears at high incident energies, producing a wavepacket slower than expected theoretically. The other issue, which appears at low wavepacket energies, does not affect the time evolution of the propagating wavepacket proper, but produces dramatic effects on its spectral decomposition. The origin of the troubles is investigated, and different ways to deal with these issues are proposed. Finally, we show how this problem is manifested and solved in the practical case of the electronic spectra of a metal surface ionized by an ultrashort laser pulse.

  14. Double Trouble

    NARCIS (Netherlands)

    Elsaesser, Thomas; Kievit, Robert; Simons, Jan

    1994-01-01

    Double Trouble highlights the career of Dutch scriptwriter and television producer Chiem van Houweninge, well-known for his long-running TV comedy series and as author of episodes for TV detective series. Double Trouble gives Van Houweninge's own views on writing and filming in television prime

  15. 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.

  16. 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.

  17. 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

  18. It Takes Two to Tango: Entrepreneurship and Creativity in Troubled Times – Vietnam 2012

    OpenAIRE

    Dang Le Nguyen, Vu; Napier, Nancy K.; Vuong, Quan-Hoang

    2012-01-01

    Strikingly, most literature suggests that market competition will push firms to take creativity/innovation seriously as matter of death or survival. Using the data, we examined creativity methods (Napier and Nilsson, 2008; Napier, 2010) in conjunction with three influential cultural values – namely risk tolerance, relationship, and dependence on resources – to assess how they influence decisions of entrepreneurs.The primary objective of this study focuses on perceived values of entrepreneursh...

  19. From Eyewitness Narratives to Retellings and Literary Adaptations: The Russian Time of Troubles in Early Modern Europe

    Directory of Open Access Journals (Sweden)

    George Prokhorov

    2017-12-01

    Full Text Available The article focuses on the adaptation strategies used by Lope de Vega in his play El Gran Duque de Moscovia y emperador perseguido (1617. This tragedy, built on material acquired from travelogues, represents the first depiction of the Russian Time of Troubles in fiction. In it, one can follow Lope de Vega’s shift from preserving the factual details collected from different travel sources to creating his own Baroque story placed within a purely Catholic world, as opposed to reality. In doing this, Lope de Vega creates a fictional space filled with mystery and miracles, where Heavens can intervene and punish the guilty party, whereby restoring the original status quo. Key situations turn from illustrations of an alien world into much more general depictions, namely, that of a tyrant versus a legal monarch, and the will of a ruler versus the law. The shift into tyranny provides the story with a new narrative centre and, by following Lope de Vega’s emphasis on the “Muscovian story,” discloses its universal spirit.

  20. The Philosopher's Stone: How Basic Skills Programs Fare in Troubled Financial Times

    Science.gov (United States)

    Ray, Thomas P.

    2012-01-01

    This mixed methods study examined the relative position of basic skills programs with transfer and career technical programs in a large suburban community college in California during the three-year period of budget reductions from 2009-2010 through 2011-2012. The budget line dedicated to part-time or non-contract instruction was analyzed along…

  1. Time allocated to mathematics in post-primary schools in Ireland: are we in double trouble?

    Science.gov (United States)

    O'Meara, Niamh; Prendergast, Mark

    2018-05-01

    Mathematics educators and legislators worldwide have begun placing a greater emphasis on teaching mathematics for understanding and through the use of real-life applications. Revised curricula have led to the time allocated to mathematics in effected countries being scrutinised. This has resulted in policy-makers and educationalists worldwide calling for the inclusion of double class periods on the mathematics timetable. Research from the United States suggests that the introduction of double or block periods allow for the objectives of revised curricula to be realized. The aim of this study, which is set in the school context, is first to ascertain if schools in Ireland are scheduling double periods for mathematics at both lower post-primary level (Junior Cycle) and upper post-primary level (Senior Cycle). It also seeks to determine if there is a link between teachers' levels of satisfaction with the time allocated to mathematics and the provision of double periods and to get insights from teachers in relation to their opinions on what can be achieved through the introduction of such classes. Questionnaires were sent to 400 post-primary schools (approximately 1600 teachers) which were selected using stratified sampling techniques. It was found that 8.7% of mathematics teachers reported the provision of double periods at Junior Cycle while 55% reported that double periods were included on their timetable at Senior Cycle. The study also identified a link between teachers' levels of satisfaction with the time allocated to mathematics and the provision of double periods. Finally, teachers felt that double periods allowed for new teaching methodologies, which were promoted by the revised curricula, to be implemented and teaching for understanding was also more feasible. In essence, it was found that double periods have an influence on the mathematical experience of post-primary students as well as the teaching approaches employed.

  2. Foam on troubled water: Capillary induced finite-time arrest of sloshing waves

    Science.gov (United States)

    Viola, Francesco; Brun, P.-T.; Dollet, Benjamin; Gallaire, François

    2016-09-01

    Interfacial forces exceed gravitational forces on a scale small relative to the capillary length—two millimeters in the case of an air-water interface—and therefore dominate the physics of sub-millimetric systems. They are of paramount importance for various biological taxa and engineering processes where the motion of a liquid meniscus induces a viscous frictional force that exhibits a sublinear dependence in the meniscus velocity, i.e., a power law with an exponent smaller than one. Interested in the fundamental implications of this dependence, we use a liquid-foam sloshing system as a prototype to exacerbate the effect of sublinear friction on the macroscopic mechanics of multi-phase flows. In contrast to classical theory, we uncover the existence of a finite-time singularity in our system yielding the arrest of the fluid's oscillations. We propose a minimal theoretical framework to capture this effect, thereby amending the paradigmatic damped harmonic oscillator model. Our results suggest that, although often not considered at the macroscale, sublinear capillary forces govern the friction at liquid-solid and liquid-liquid interfaces.

  3. 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

  4. 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.

  5. Fledgling survival increases with development time and adult survival across north and south temperate zones

    Science.gov (United States)

    Lloyd, Penn; Martin, Thomas E.

    2016-01-01

    Slow life histories are characterized by high adult survival and few offspring, which are thought to allow increased investment per offspring to increase juvenile survival. Consistent with this pattern, south temperate zone birds are commonly longer-lived and have fewer young than north temperate zone species. However, comparative analyses of juvenile survival, including during the first few weeks of the post-fledging period when most juvenile mortality occurs, are largely lacking. We combined our measurements of fledgling survival for eight passerines in South Africa with estimates from published studies of 57 north and south temperate zone songbird species to test three predictions: (1) fledgling survival increases with length of development time in the nest; (2) fledgling survival increases with adult survival and reduced brood size controlled for development time; and (3) south temperate zone species, with their higher adult survival and smaller brood sizes, exhibit higher fledgling survival than north temperate zone species controlled for development time. We found that fledgling survival was higher among south temperate zone species and generally increased with development time and adult survival within and between latitudinal regions. Clutch size did not explain additional variation, but was confounded with adult survival. Given the importance of age-specific mortality to life history evolution, understanding the causes of these geographical patterns of mortality is important.

  6. 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...

  7. 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...

  8. 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 ...

  9. Effect of fibrinolysis inhibitors on survival time of irradiated rats

    International Nuclear Information System (INIS)

    Smok, W.

    1988-01-01

    The possibilities of alleviation of the gastrointestinal syndrome of acute radiation sickness by modification of haemorrhagic diathesis using EACA and traskolan were studied. A significant prolongation of the mean survival time was obtained in the irradiated rats treated with EACA. 7 tabs., 10 refs. (author)

  10. 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 ...

  11. 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 suggest...

  12. 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

  13. 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 byfocusing on the mind/body relation (and often with the idea of the soul as a special kindof 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 “everlivingpresent.” The development of this intuition allows for a more integral or “complexholistic”theory of time, the soul, and the question of survival. Following the introductorymatter, the first section proposes a re-interpretation of Nietzsche’s doctrine of eternalrecurrence in terms of moments and lives as “eternally occurring.” The next section is atreatment of Julian Barbour’s neo-Machian model of instants of time as configurations inthe n-dimensional phase-space he calls “Platonia.” While rejecting his claim to have doneaway with time, I do find his model suggestive of the idea of moments and lives aseternally occurring. The following section begins with Fechner’s visionary ideas of thenature of the soul and its survival of bodily death, with particular attention to the notionof 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 ofactual occasions. From his epochal theory of time and certain ambiguities in hisreflections on the “divine antinomies,” we are brought to the threshold of a potentiallymore integral or “complex-holistic” theory of time and survival, which is treated in thelast 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’sinspired but cryptic description of the “Supramental Time Vision.” This interpretationleads to an alternative understanding of reincarnation—and to the possibility of itsreconciliation with the once-only view

  14. 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.

  15. Survival times of pre-1950 US women radium dial workers

    International Nuclear Information System (INIS)

    Stehney, A.F.

    1994-01-01

    Survival times of US women radium dial workers to the end of 1989 were examined by life table methods. Included were 1301 women rust employed before 1930 and 1242 first employed in 1930-1949. Expected numbers of deaths were estimated from age- and time-specific death rates for US white females. In the early group, 85 deaths from the well-known radium-induced cancers - bone sarcomas and head carcinomas - were observed, but only 724 deaths from aH other causes were observed vs 755 expected. Life shortening (±S.E.) of 1.8 ±0.5 y compared to the general population of US white females was calculated from the time distribution of all deaths in the pre-1930 group. In the 1930--1949 group, 350 deaths were observed vs 343 expected and no bone sarcomas or head carcinomas occurred. Among women who survived at least 2 y after rust measurement of body radium, a significant excess of observed vs expected deaths was found only for radium intakes greater than 1.85 MBq of 226 Ra + 228 Ra, and no trend of deaths or reduction of life expectancy was found with length of employment

  16. The "trouble" with salivary testosterone.

    Science.gov (United States)

    Granger, Douglas A; Shirtcliff, Elizabeth A; Booth, Alan; Kivlighan, Katie T; Schwartz, Eve B

    2004-11-01

    In a series of studies, we identify several specific issues that can limit the value of integrating salivary testosterone in biosocial research. Salivary testosterone measurements can be substantially influenced during the process of sample collection, are susceptible to interference effects caused by the leakage of blood (plasma) into saliva, and are sensitive to storage conditions when samples have been archived. There are gender differences in salivary testosterone levels and variance, the serum-saliva association, the relationship of salivary testosterone to age and pubertal development, and the stability of individual differences in salivary testosterone levels over time. The findings have important implications at several levels of analysis for research that aims to test biosocial models of testosterone--behavior relationships. Recommendations are provided to steer investigators around these "troubles" with salivary testosterone.

  17. Analysis of accidents and troubles of nuclear power plants in Japan

    International Nuclear Information System (INIS)

    Kobayashi, Kunio

    1980-01-01

    In Japan, electric power companies are obliged to report the accidents and troubles occurred in nuclear power stations to the MITI according to the relevant laws, and 166 cases in total have been reported as of the end of March, 1980. These accidents and troubles are all trivial, and do not cause problems from the viewpoint of the safety nuclear power stations. Regarding respective accidents and troubles, the causes have been sought thoroughly, and the sufficient countermeasures have been taken on all occasions. But in order to improve the reliability of nuclear power stations further, it is important to treat the accidents and troubles occurred so far statistically and grasp the general trend. Thereupon, 152 accidents and troubles occurred till September, 1979, were analyzed quantitatively, and the results are reported in this paper. From the results, the prospect hereafter is discussed. The number of the reported cases of accidents and troubles in each nuclear power plant in operation every year is tabulated. The accidents and troubles were relatively frequent in the initial two or three years of operation of respective new reactor types, but decreased thereafter. The systems to which troubled equipments belong and the troubled equipments are shown. Most troubles have occurred in reactor cooling systems and valves. The situations and causes of troubles, the operational conditions at the time of the accidents and troubles and the effects and others are reported. (Kako, I.)

  18. 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.

  19. Mean exit time and survival probability within the CTRW formalism

    Science.gov (United States)

    Montero, M.; Masoliver, J.

    2007-05-01

    An intense research on financial market microstructure is presently in progress. Continuous time random walks (CTRWs) are general models capable to capture the small-scale properties that high frequency data series show. The use of CTRW models in the analysis of financial problems is quite recent and their potentials have not been fully developed. Here we present two (closely related) applications of great interest in risk control. In the first place, we will review the problem of modelling the behaviour of the mean exit time (MET) of a process out of a given region of fixed size. The surveyed stochastic processes are the cumulative returns of asset prices. The link between the value of the MET and the timescale of the market fluctuations of a certain degree is crystal clear. In this sense, MET value may help, for instance, in deciding the optimal time horizon for the investment. The MET is, however, one among the statistics of a distribution of bigger interest: the survival probability (SP), the likelihood that after some lapse of time a process remains inside the given region without having crossed its boundaries. The final part of the manuscript is devoted to the study of this quantity. Note that the use of SPs may outperform the standard “Value at Risk" (VaR) method for two reasons: we can consider other market dynamics than the limited Wiener process and, even in this case, a risk level derived from the SP will ensure (within the desired quintile) that the quoted value of the portfolio will not leave the safety zone. We present some preliminary theoretical and applied results concerning this topic.

  20. Troubles in vacuum system and radiation exposure

    International Nuclear Information System (INIS)

    Konno, Osamu

    1978-01-01

    It is about eleven years since the LINAC of 300 MeV in Tohoku University has first accelerated electrons. The maintenance and improvement of the accelerator used more than 10 years now give the related personnel an important problem of radiation exposure. 40 days were required for the maintenance and checking-up in 1977, and other 26 days were used for other construction works. The troubles in the vacuum system occurred 81 times in total. The vacuum system is divided into two subsystems, each being provided with a leak detector. Either of them enables to detect and locate the leak. Silver-alloy brazing of a duct with a cooling water tube has deteriorated in the strength because of repeated baking temperature and/or the copper tubes for cooling have been eroded due to the large local cell action by purified water. The similar phenomena have occurred in RF windows, outside of which is cooled with water. Carbonaceous matter has stuck to the element of the ion pump, but successfully been cleaned. Though the energy compression system was installed for the efficient use of electrons, the troubles due to overheating of the current monitor have increased because of its limited space, and the change of location was made. Considerable surface residual radiation dose was found at some parts of transport system, and a few personnel have been exposed to radiation over 1000 mrem/year as a result of the troubles in vacuum system. (Wakatsuki, Y.)

  1. 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

  2. Association between time to disease progression end points and overall survival in patients with neuroendocrine tumors

    Directory of Open Access Journals (Sweden)

    Singh S

    2014-08-01

    Full Text Available Simron Singh,1 Xufang Wang,2 Calvin HL Law1 1Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada; 2Novartis Oncology, Florham Park, NJ, USA Abstract: Overall survival can be difficult to determine for slowly progressing malignancies, such as neuroendocrine tumors. We investigated whether time to disease progression is positively associated with overall survival in patients with such tumors. A literature review identified 22 clinical trials in patients with neuroendocrine tumors that reported survival probabilities for both time to disease progression (progression-free survival and time to progression and overall survival. Associations between median time to disease progression and median overall survival and between treatment effects on time to disease progression and treatment effects on overall survival were analyzed using weighted least-squares regression. Median time to disease progression was significantly associated with median overall survival (coefficient 0.595; P=0.022. In the seven randomized studies identified, the risk reduction for time to disease progression was positively associated with the risk reduction for overall survival (coefficient on −ln[HR] 0.151; 95% confidence interval −0.843, 1.145; P=0.713. The significant association between median time to disease progression and median overall survival supports the assertion that time to disease progression is an alternative end point to overall survival in patients with neuroendocrine tumors. An apparent albeit not significant trend correlates treatment effects on time to disease progression and treatment effects on overall survival. Informal surveys of physicians’ perceptions are consistent with these concepts, although additional randomized trials are needed. Keywords: neuroendocrine tumors, progression-free survival, disease progression, mortality

  3. School Trouble: A Mother's Burden.

    Science.gov (United States)

    Dudley-Marling, Curt

    2001-01-01

    Used interviews with a diverse group of parents of children who struggled academically in school to examine the effects of school troubles on mothers. Overall, the material and emotional burden for children's schoolwork fell to the mothers, many of whom felt overwhelmed and believed that the demands of schooling had diminished their quality of…

  4. Trouble Don't Last

    Science.gov (United States)

    Pearsall, Shelley

    2004-01-01

    Even as a child, Pearsall questioned social injustice and prejudice. In her own community in Ohio and, as she grew, all over the world, she saw social inequities she could neither understand nor accept. Her novel "Trouble Don't Last," takes place during the era of the Underground Railroad. The chapter included here pulls us in…

  5. Measuring survival time: a probability-based approach useful in healthcare decision-making.

    Science.gov (United States)

    2011-01-01

    In some clinical situations, the choice between treatment options takes into account their impact on patient survival time. Due to practical constraints (such as loss to follow-up), survival time is usually estimated using a probability calculation based on data obtained in clinical studies or trials. The two techniques most commonly used to estimate survival times are the Kaplan-Meier method and the actuarial method. Despite their limitations, they provide useful information when choosing between treatment options.

  6. What affects local community hospitals' survival in turbulent times?

    Science.gov (United States)

    Chiang, Hung-Che; Wang, Shiow-Ing

    2015-06-01

    Hospital closures became a prevalent phenomenon in Taiwan after the implementation of a national health insurance program. A wide range of causes contributes to the viability of hospitals, but little is known about the situation under universal coverage health systems. The purpose of present study is to recognize the factors that may contribute to hospital survival under the universal coverage health system. This is a retrospective case-control study. Local community hospitals that contracted with the Bureau of National Health Insurance in 1998 and remained open during the period 1998-2011 are the designated cases. Controls are local community hospitals that closed during the same period. Using longitudinal representative health claim data, 209 local community hospitals that closed during 1998-2011 were compared with 165 that remained open. Variables related to institutional characteristics, degree of competition, characteristics of patients and financial performance were analyzed by logistic regression models. Hospitals' survival was positively related to specialty hospital, the number of respiratory care beds, the physician to population ratio, the number of clinics in the same region, a highly competitive market and the occupancy rate of elderly patients in the hospital. Teaching hospitals, investor-owned hospitals, the provision of obstetrics services or home care, and the number of medical centers or other local community hospitals may jeopardize the chance of survival. Factors-enhanced local hospitals to survive under the universal coverage health system have been identified. Hospital managers could manipulate these findings and adapt strategies for subsistence. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  7. 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

    the influence of gender on post-stroke mortality, from the time of admission through the subsequent years until death or censoring ( mean follow-up time: 538 days). All patients underwent an evaluation including stroke severity, computed tomography and cardiovascular risk factors. Independent predictors......Background: Women live longer than men, yet most studies show that gender has no influence on survival after stroke. Methods: A registry was started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, and it now holds 39,484 patients of which 48% are female. We studied...... of death were identified by means of a survival model based on 22,222 individuals with a complete data set. Results: Females were older and had severer stroke. Interestingly, the risk of death between genders was time dependent. The female/male stroke mortality rate favoured women from the first day...

  8. The NSTX Trouble Reporting System

    International Nuclear Information System (INIS)

    Sengupta, S.; Oliaro, G.

    2002-01-01

    An online Trouble Reporting System (TRS) has been introduced at the National Spherical Torus Experiment (NSTX). The TRS is used by NSTX operators to report problems that affect NSTX operations. The purpose of the TRS is to enhance NSTX reliability and maintainability by identifying components, occurrences, and trends that contribute to machine downtime. All NSTX personnel have access to the TRS. The user interface is via a web browser, such as Netscape or Internet Explorer. This web-based feature permits any X-terminal, PC, or MAC access to the TRS. The TRS is based upon a trouble reporting system developed at the DIII-D Tokamak, at General Atomics Technologies. This paper will provide a detailed description of the TRS software architecture, user interface, MS SQL server interface and operational experiences. In addition, sample data from the TRS database will be summarized and presented

  9. 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.

  10. An Archaeology of the Troubles

    DEFF Research Database (Denmark)

    McAtackney, Laura

    Long Kesh / Maze prison was infamous as the major holding centre for paramilitary prisoners during the course of the Troubles in Northern Ireland. Some of the major events of the recent conflict centred on, emanated from, and were transformed by it, including the burning of the internment camp in...... society. Using a multitude of sources, McAtackney creatively provides a unique interpretation of the Northern Irish Troubles and the continuing destabilizing role of material remnants of the conflict in the peace process.......Long Kesh / Maze prison was infamous as the major holding centre for paramilitary prisoners during the course of the Troubles in Northern Ireland. Some of the major events of the recent conflict centred on, emanated from, and were transformed by it, including the burning of the internment camp...... contentious remnants of the conflict and has become central to debates about what we do with such sites, what they mean, and how they relate to contemporary rememberings of the difficult recent past. The only independent archaeological investigation of Long Kesh / Maze prior to its partial demolition...

  11. The Trouble with Zero

    Science.gov (United States)

    Lewis, Robert

    2015-01-01

    The history of the number zero is an interesting one. In early times, zero was not used as a number at all, but instead was used as a place holder to indicate the position of hundreds and tens. This article briefly discusses the history of zero and challenges the thinking where divisions using zero are used.

  12. Modelling the joint distribution of competing risks survival times using copula functions

    OpenAIRE

    Kaishev, V. K.; Haberman, S.; Dimitrova, D. S.

    2005-01-01

    The problem of modelling the joint distribution of survival times in a competing risks model, using copula functions is considered. In order to evaluate this joint distribution and the related overall survival function, a system of non-linear differential equations is solved, which relates the crude and net survival functions of the modelled competing risks, through the copula. A similar approach to modelling dependent multiple decrements was applied by Carriere (1994) who used a Gaussian cop...

  13. 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...

  14. On the troubles happened in nuclear power stations, 1995

    International Nuclear Information System (INIS)

    1996-01-01

    The troubles which happened at the nuclear power stations of Japan in the fiscal year of 1995 are described in this report. The number of troubles in those power stations reported from the corporations of electric industry to Nuclear Safety Commission according to The Law for Regulation of Nuclear Fertile Material, Nuclear Fuel Material and Reactors and Utility Industry Law were 14 in the year and so, the number per reactor was 0.3. The details of the trouble cases were as follows; one and nine cases for automatic and manual shutdowns in operation, respectively and 4 cases found during a down-time of the reactor. But, there was no influence on the environment surrounding those nuclear power stations by the radioactive materials in either of the cases. (M.N.)

  15. Surviving in a metastable de Sitter space-time

    International Nuclear Information System (INIS)

    Kashyap, Sitender Pratap; Mondal, Swapnamay; Sen, Ashoke; Verma, Mritunjay

    2015-01-01

    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.

  16. 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.

  17. 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…

  18. Enhancement of radiation effect on mouse intestinal crypt survival by timing of 5-fluorouracil administration

    International Nuclear Information System (INIS)

    Ho, E.; Coffey, C.; Maruyama, Y.

    1977-01-01

    There is a marked dependence of mouse crypt survival on the sequence of combined drug-radiation treatment and on the time lapse between irradiation and drug administration. When 5-fluorouracil is administered 6 hours after irradiation or later (up to 18 hours postirradiation), crypt survival drops significantly

  19. Survival and prognostic factors at time of diagnosis in high-grade appendicular osteosarcoma

    DEFF Research Database (Denmark)

    Colding-Rasmussen, Thomas; Thorn, Andrea Pohly; Horstmann, Peter

    2018-01-01

    BACKGROUND: Survival of patients with high-grade osteosarcoma (HOS), the most common primary bone cancer, has not improved significantly the last 30 years and the disease remains a major challenge. The purpose of this study is to evaluate survival in relation to prognostic factors at time of diag...

  20. Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems

    National Research Council Canada - National Science Library

    Zhao, Wei; Bettati, Riccardo; Vaidya, Nitin

    2005-01-01

    This document is the final report for Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems, a Texas A AND M project funded through the DARPA Fault Tolerant Networks Program...

  1. Russian and Soviet forensic psychiatry: troubled and troubling.

    Science.gov (United States)

    Healey, Dan

    2014-01-01

    Russian forensic psychiatry is defined by its troubled and troubling relationship to an unstable state, a state that was not a continuous entity during the modern era. From the mid-nineteenth century, Russia as a nation-state struggled to reform, collapsed, re-constituted itself in a bloody civil war, metastasized into a violent "totalitarian" regime, reformed and stagnated under "mature socialism" and then embraced capitalism and "managed democracy" at the end of the twentieth century. These upheavals had indelible effects on policing and the administration of justice, and on psychiatry's relationship with them. In Russia, physicians specializing in medicine of the mind had to cope with rapid and radical changes of legal and institutional forms, and sometimes, of the state itself. Despite this challenging environment, psychiatrists showed themselves to be active professionals seeking to guide the transformations that inevitably touched their work. In the second half of the nineteenth century debates about the role of psychiatry in criminal justice took place against a backdrop of increasingly alarming terrorist activity, and call for revolution. While German influence, with its preference for hereditarianism, was strong, Russian psychiatry was inclined toward social and environmental explanations of crime. When revolution came in 1917, the new communist regime quickly institutionalized forensic psychiatry. In the aftermath of revolution, the institutionalization of forensic psychiatry "advanced" with each turn of the state's transformation, with profound consequences for practitioners' independence and ethical probity. The abuses of Soviet psychiatry under Stalin and more intensively after his death in the 1960s-80s remain under-researched and key archives are still classified. The return to democracy since the late 1980s has seen mixed results for fresh attempts to reform both the justice system and forensic psychiatric practice. © 2013.

  2. On the Survival Time of a Duplex System: A Sokhotski-Plemelj Problem

    Directory of Open Access Journals (Sweden)

    Edmond J. Vanderperre

    2008-12-01

    Full Text Available We analyze the survival time of a renewable duplex system characterized by warm standby and subjected to a priority rule. In order to obtain the Laplace transform of the survival function, we employ a stochastic process endowed with time-dependent transition measures satisfying coupled partial differential equations. The solution procedure is based on the theory of sectionally holomorphic functions combined with the notion of dual transforms. Finally, we introduce a security interval related to a prescribed security level and a suitable risk criterion based on the survival function of the system. As an example, we consider the particular case of deterministic repair. A computer-plotted graph displays the survival function together with the security interval corresponding to a security level of 90%.

  3. Double trouble at high density:

    DEFF Research Database (Denmark)

    Gergs, André; Palmqvist, Annemette; Preuss, Thomas G

    2014-01-01

    Population size is often regulated by negative feedback between population density and individual fitness. At high population densities, animals run into double trouble: they might concurrently suffer from overexploitation of resources and also from negative interference among individuals...... regardless of resource availability, referred to as crowding. Animals are able to adapt to resource shortages by exhibiting a repertoire of life history and physiological plasticities. In addition to resource-related plasticity, crowding might lead to reduced fitness, with consequences for individual life...... history. We explored how different mechanisms behind resource-related plasticity and crowding-related fitness act independently or together, using the water flea Daphnia magna as a case study. For testing hypotheses related to mechanisms of plasticity and crowding stress across different biological levels...

  4. Median Survival Time of Endometrial Cancer Patients with Lymphovascular Invasion at the Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Asyikeen, Wan Adnan Wan Nor; Siti-Azrin, Ab Hamid; Jalil, Nur Asyilla Che; Zin, Anani Aila Mat; Othman, Nor Hayati

    2016-11-01

    Endometrial cancer is the most common gynaecologic malignancy among females worldwide. The purpose of this study was to determine the median survival time of endometrial cancer patients at the Hospital Universiti Sains Malaysia (USM). A list of 121 endometrial cancer cases registered at Hospital USM between 2000 until 2011 was retrospectively reviewed. The survival time of the endometrial cancer patients was estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare the survival of the patients based on socio-demographics and clinical presentation. Only 108 patients, 87.0%, were included who were of Malay ethnicity. Previous history included menopause in 67.6% of patients and diabetes mellitus in 39.8% of patients; additionally, 63.4% of patients were nulliparous. Tumour staging was as follows: 24.5% stage I, 10.8% stage II, 26.5% stage III and 38.2% stage IV. The overall median survival time of the endometrial cancer patients was 70.20 months (95% confidence interval (CI): 51.79, 88.61). The significant factors were age, the presence of lymphovascular invasion and treatment received. The overall survival of endometrial cancer was low. A prospective study needs to be carried out to discover more effective and accurate tests for the early detection of endometrial cancer.

  5. Median survival time of patients after transcatheter chemo-embolization for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Haider, Z.; Haq, T.; Munir, K.; Usman, M.U.; Azeemuddin, M.

    2006-01-01

    Objective: To determine the effect on survival after trans arterial chemo embolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). Design: Longitudinal cohort study. Place and Duration of Study: Radiology Department, The Aga Khan University Hospital, Stadium Road, Karachi, from December 1997 to September 2005. Patients and Methods: Patients undergoing TACE procedure for HCC were prospectively followed. Forty three patients were enrolled from December 1997 to March 2003 in the study and subjected to chemo embolization therapy. Eight out of 43 patients were excluded from the study, who lost to follow-up. All the patients were followed till their death. Median and mean survival were calculated. Results: The median survival of these 35 patients was 410 days (13.6 months), with 95% confidence interval (236 days lower bound and 536 days upper bound). Mean survival time was 603 days (20.1 months) with 95% confidence interval (394 days lower bound and 812 days upper bound). There was significant difference in mean survival time (in days) by Child's Pugh class (X2 = 12.384; df=2, p-value=0.002). Conclusion: The study showed that TACE is an effective palliative treatment. TACE increases the median survival time. (author)

  6. Helicopter crashes into water: warning time, final position, and other factors affecting survival.

    Science.gov (United States)

    Brooks, Christopher J; MacDonald, Conor V; Baker, Susan P; Shanahan, Dennis F; Haaland, Wren L

    2014-04-01

    According to 40 yr of data, the fatality rate for a helicopter crash into water is approximately 25%. Does warning time and the final position of the helicopter in the water influence the survival rate? The National Transportation Safety Board (NTSB) database was queried to identify helicopter crashes into water between 1981 and 2011 in the Gulf of Mexico and Hawaii. Fatality rate, amount of warning time prior to the crash, and final position of the helicopter were identified. There were 133 helicopters that crashed into water with 456 crew and passengers. Of these, 119 occupants (26%) did not survive; of those who did survive, 38% were injured. Twelve died after making a successful escape from the helicopter. Crashes with 1 min. However, more than half of fatalities (57%) came from crashes for which the warning time could not be determined. Lack of warning time and how to survive in the water after the crash should be a topic for study in all marine survival/aircraft ditching courses. Investigators should be trained to provide estimates of warning time when investigating helicopter crashes into water.

  7. 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.

  8. Human genetics in troubled times and places

    OpenAIRE

    Harper, Peter S.

    2017-01-01

    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 w...

  9. 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, P<0.001), with a survival half life (time taken for 50% of the chocolates 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.

  10. The Earth in energy troubles

    International Nuclear Information System (INIS)

    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.

    2007-01-01

    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: global design

  11. 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…

  12. Childhood cancer survival in Switzerland (1976-2013): Time-trends and predictors.

    Science.gov (United States)

    Schindler, Matthias; Belle, Fabiën N; Grotzer, Michael A; von der Weid, Nicolas X; Kuehni, Claudia E

    2017-01-01

    Population-based studies on childhood cancer survival are key to monitor progress against cancer and to detect potential differences between regions and other subgroups in the population. We investigated time trends and factors associated with childhood cancer survival on a national level in Switzerland, from 1976 to 2013. We extracted data from the population-based Swiss Childhood Cancer Registry of 5,776 children (age 0-14 years) diagnosed with cancer from 1985 to 2014 in Switzerland. We calculated age-adjusted 5-year survival, defined the annual reduction in risk of death (ARR), and explored associations of survival with clinical and demographic factors. Overall, 5-year survival improved significantly, from 64% in 1976-1983 to 88% in 2004-2013. ARR over the whole period was 4% for all diagnostic groups, greatest for Hodgkin lymphomas (8%), ependymomas (6%), Burkitt's lymphomas (6%) and germ cell tumours (6%). Children treated in hospitals without specialised paediatric cancer centre for leukaemia (HR 12.9), lymphoma (HR 5.0) and neuroblastoma (HR 3.7) were at higher risk of death. In French-speaking Switzerland, risk of death was lower for lymphoma (HR 0.6), CNS tumours (HR 0.7) and neuroblastoma (HR 0.5). Children with migration background had a higher risk of death from all tumours except bone tumours. Childhood cancer survival significantly improved from 1976 to 2013, but there is room for further improvement. Survival rates varied by type of clinical treatment, language region and nationality. All paediatric cancer patients should be referred to a specialised paediatric cancer centre. Further research is needed to intervene and completely eliminate inequalities in survival. © 2016 UICC.

  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. 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.

  15. Modeling time-to-event (survival) data using classification tree analysis.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2017-12-01

    Time to the occurrence of an event is often studied in health research. Survival analysis differs from other designs in that follow-up times for individuals who do not experience the event by the end of the study (called censored) are accounted for in the analysis. Cox regression is the standard method for analysing censored data, but the assumptions required of these models are easily violated. In this paper, we introduce classification tree analysis (CTA) as a flexible alternative for modelling censored data. Classification tree analysis is a "decision-tree"-like classification model that provides parsimonious, transparent (ie, easy to visually display and interpret) decision rules that maximize predictive accuracy, derives exact P values via permutation tests, and evaluates model cross-generalizability. Using empirical data, we identify all statistically valid, reproducible, longitudinally consistent, and cross-generalizable CTA survival models and then compare their predictive accuracy to estimates derived via Cox regression and an unadjusted naïve model. Model performance is assessed using integrated Brier scores and a comparison between estimated survival curves. The Cox regression model best predicts average incidence of the outcome over time, whereas CTA survival models best predict either relatively high, or low, incidence of the outcome over time. Classification tree analysis survival models offer many advantages over Cox regression, such as explicit maximization of predictive accuracy, parsimony, statistical robustness, and transparency. Therefore, researchers interested in accurate prognoses and clear decision rules should consider developing models using the CTA-survival framework. © 2017 John Wiley & Sons, Ltd.

  16. Dry Eyes and Glaucoma: Double Trouble

    Science.gov (United States)

    ... Involved News About Us Donate In This Section Dry Eyes and Glaucoma: Double Trouble email Send this article ... eye disease bothers the patient more. What Causes Dry Eye Syndrome? Dry eye can be caused by many ...

  17. Factors associated with supermarket and convenience store closure: a discrete time spatial survival modelling approach.

    Science.gov (United States)

    Warren, Joshua L; Gordon-Larsen, Penny

    2018-06-01

    While there is a literature on the distribution of food stores across geographic and social space, much of this research uses cross-sectional data. Analyses attempting to understand whether the availability of stores across neighborhoods is associated with diet and/or health outcomes are limited by a lack of understanding of factors that shape the emergence of new stores and the closure of others. We used quarterly data on supermarket and convenience store locations spanning seven years (2006-2012) and tract-level census data in four US cities: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; San Francisco, California. A spatial discrete-time survival model was used to identify factors associated with an earlier and/or later closure time of a store. Sales volume was typically the strongest indicator of store survival. We identified heterogeneity in the association between tract-level poverty and racial composition with respect to store survival. Stores in high poverty, non-White tracts were often at a disadvantage in terms of survival length. The observed patterns of store survival varied by some of the same neighborhood sociodemographic factors associated with lifestyle and health outcomes, which could lead to confusion in interpretation in studies of the estimated effects of introduction of food stores into neighborhoods on health.

  18. 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

  19. Time to treatment as a quality metric in lung cancer: Staging studies, time to treatment, and patient survival

    International Nuclear Information System (INIS)

    Gomez, Daniel R.; Liao, Kai-Ping; Swisher, Stephen G.; Blumenschein, George R.; Erasmus, Jeremy J.; Buchholz, Thomas A.; Giordano, Sharon H.; Smith, Benjamin D.

    2015-01-01

    Purpose: Prompt staging and treatment are crucial for non-small cell lung cancer (NSCLC). We determined if predictors of treatment delay after diagnosis were associated with prognosis. Materials and methods: Medicare claims from 28,732 patients diagnosed with NSCLC in 2004–2007 were used to establish the diagnosis-to-treatment interval (ideally ⩽35 days) and identify staging studies during that interval. Factors associated with delay were identified with multivariate logistic regression, and associations between delay and survival by stage were tested with Cox proportional hazard regression. Results: Median diagnosis-to-treatment interval was 27 days. Receipt of PET was associated with delays (57.4% of patients with PET delayed [n = 6646/11,583] versus 22.8% of those without [n = 3908/17,149]; adjusted OR = 4.48, 95% CI 4.23–4.74, p < 0.001). Median diagnosis-to-PET interval was 15 days; PET-to-clinic, 5 days; and clinic-to-treatment, 12 days. Diagnosis-to-treatment intervals <35 days were associated with improved survival for patients with localized disease and those with distant disease surviving ⩾1 year but not for patients with distant disease surviving <1 year. Conclusion: Delays between diagnosing and treating NSCLC are common and associated with use of PET for staging. Reducing time to treatment may improve survival for patients with manageable disease at diagnosis

  20. [Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015].

    Science.gov (United States)

    Li, Y; Wang, J; He, S F; Chen, J; Lu, H Y

    2017-11-10

    Objective: To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods: A retrospective cohort study was conducted to analyze the data of 12 874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results: Among 12 874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9 346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95 %CI : 223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9% respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase ( HR =1.439, 95 %CI : 1.041-1.989), heterosexual transmission ( HR =1.646, 95 %CI : 1.184-2.289), being married ( HR =2.186, 95 %CI : 1.510-3.164); older age (≥60 years) at diagnosis ( HR =6.608, 95 %CI : 3.546-12.316); lower CD(4)(+)T cell counts at diagnosis (<350 cells/μl) ( HR =8.711, 95 %CI : 5.757-13.181); receiving no antiretroviral therapy (ART) ( HR =18.223, 95 %CI : 13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤30 years), higher CD(4)(+)T cell count (≥350 cell/μl) and receiving ART. Conclusion: The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD(4)(+)T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD(4)(+)T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.

  1. Increasing survival time decreases the cost-effectiveness of using "test & treat'' to eliminate HIV epidemics.

    Science.gov (United States)

    Wagner, Bradley G; Coburn, Brian J; Blower, Sally

    2013-01-01

    Treating HIV-infected individuals reduces their viral load, consequently increasing their survival time and decreasing their infectivity. It has been proposed that universal testing and treatment (i.e., universal "test & treat'') could lead to HIV elimination and would be extremely cost-effective. It is now being debated whether to use a universal "test & treat'' approach in the "real-world'' as a prevention strategy to control HIV epidemics. However current modeling predictions of the impact, and cost-effectiveness, of universal `"est & treat'' strategies are based on an unrealistically short survival time for treated individuals. Here we use mathematical modeling and a longer, more realistic, survival time. We model the potential impact of a universal "test & treat'' strategy in South Africa. Our results show that increasing the length of the survival time on treatment, although beneficial to individuals, reduces the probability of eliminating HIV and decreases the cost-effectiveness of using universal "test & treat'' strategies. Therefore our results show that individual-level benefits and public health benefits will conflict when using "test &treat'' strategies to reduce HIV transmission.

  2. Predicting survival time in noncurative patients with advanced cancer: a prospective study in China.

    Science.gov (United States)

    Cui, Jing; Zhou, Lingjun; Wee, B; Shen, Fengping; Ma, Xiuqiang; Zhao, Jijun

    2014-05-01

    Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.

  3. Palliative Sedation in Advanced Cancer Patients: Does it Shorten Survival Time? - A Systematic Review.

    Science.gov (United States)

    Barathi, B; Chandra, Prabha S

    2013-01-01

    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. This systematic review investigated the effect of palliative sedation on survival time in terminally ill cancer patients. 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. 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. 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.

  4. Mediation Analysis with Survival Outcomes: Accelerated Failure Time vs. Proportional Hazards Models.

    Science.gov (United States)

    Gelfand, Lois A; MacKinnon, David P; DeRubeis, Robert J; Baraldi, Amanda N

    2016-01-01

    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. 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. 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. 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.

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

    International Nuclear Information System (INIS)

    Yokokura, Teruo; Onoue, Masaharu; Mutai, Masahiko

    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. (Tsunoda, M.)

  6. 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.

  7. 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)

  8. Effect of antibiotic decontamination of the GI tract on survival time after neutron and gamma irradiation

    International Nuclear Information System (INIS)

    Geraci, J.P.; Jackson, K.L.; Mariano, M.S.

    1984-01-01

    Antibiotic decontaminated and conventional rats were whole-body irradiated with 8 MeV neutrons (1.5 to 13 Gy) or 137 Cs gamma radiation (9 to 20 Gy). The animals were checked for survival at four hour intervals from the second to the seventh day postirradiation and at eight hour intervals on other days. Decontamination of the GI tract increased median survival time 1 to 5 days in this range of dose dependency, whereas the effect of decontamination was negligible for doses that produced mostly intestinal death. These results suggest that sepsis and endotoxin produced by bacteria from the intestinal tract play little role in acute intestinal radiation death

  9. Causal inference for long-term survival in randomised trials with treatment switching: Should re-censoring be applied when estimating counterfactual survival times?

    OpenAIRE

    Latimer, N.R.; White, I.R.; Abrams, K.R.; Sieburt, U.

    2017-01-01

    Treatment switching often has a crucial impact on estimates of effectiveness and cost-effectiveness of new oncology treatments. Rank preserving structural failure time models (RPSFTM) and two-stage estimation (TSE) methods estimate ‘counterfactual’ (i.e. had there been no switching) survival times and incorporate re-censoring to guard against informative censoring in the counterfactual dataset. However, re-censoring causes a loss of longer term survival information which is problematic when e...

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

    International Nuclear Information System (INIS)

    Garzon, Benjamin; Emblem, Kyrre E.; Mouridsen, Kim; Nedregaard, Baard; Due-Toennessen, Paulina; Nome, Terje; Hald, John K.; Bjoernerud, Atle; Haaberg, Asta K.; Kvinnsland, Yngve

    2011-01-01

    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

  11. 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

  12. 33 CFR 150.503 - What are the time interval requirements for maintenance on survival craft falls?

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What are the time interval requirements for maintenance on survival craft falls? 150.503 Section 150.503 Navigation and Navigable Waters... maintenance on survival craft falls? (a) Each fall used in a launching device for survival craft or rescue...

  13. Automatic Detection of Electric Power Troubles (ADEPT)

    Science.gov (United States)

    Wang, Caroline; Zeanah, Hugh; Anderson, Audie; Patrick, Clint; Brady, Mike; Ford, Donnie

    1988-11-01

    Automatic Detection of Electric Power Troubles (A DEPT) is an expert system that integrates knowledge from three different suppliers to offer an advanced fault-detection system. It is designed for two modes of operation: real time fault isolation and simulated modeling. Real time fault isolation of components is accomplished on a power system breadboard through the Fault Isolation Expert System (FIES II) interface with a rule system developed in-house. Faults are quickly detected and displayed and the rules and chain of reasoning optionally provided on a laser printer. This system consists of a simulated space station power module using direct-current power supplies for solar arrays on three power buses. For tests of the system's ablilty to locate faults inserted via switches, loads are configured by an INTEL microcomputer and the Symbolics artificial intelligence development system. As these loads are resistive in nature, Ohm's Law is used as the basis for rules by which faults are located. The three-bus system can correct faults automatically where there is a surplus of power available on any of the three buses. Techniques developed and used can be applied readily to other control systems requiring rapid intelligent decisions. Simulated modeling, used for theoretical studies, is implemented using a modified version of Kennedy Space Center's KATE (Knowledge-Based Automatic Test Equipment), FIES II windowing, and an ADEPT knowledge base.

  14. Application of accelerated failure time models for breast cancer patients' survival in Kurdistan Province of Iran.

    Science.gov (United States)

    Karimi, Asrin; Delpisheh, Ali; Sayehmiri, Kourosh

    2016-01-01

    Breast cancer is the most common cancer and the second common cause of cancer-induced mortalities in Iranian women. There has been a rapid development in hazard models and survival analysis in the last decade. The aim of this study was to evaluate the prognostic factors of overall survival (OS) in breast cancer patients using accelerated failure time models (AFT). This was a retrospective-analytic cohort study. About 313 women with a pathologically proven diagnosis of breast cancer who had been treated during a 7-year period (since January 2006 until March 2014) in Sanandaj City, Kurdistan Province of Iran were recruited. Performance among AFT was assessed using the goodness of fit methods. Discrimination among the exponential, Weibull, generalized gamma, log-logistic, and log-normal distributions was done using Akaik information criteria and maximum likelihood. The 5 years OS was 75% (95% CI = 74.57-75.43). The main results in terms of survival were found for the different categories of the clinical stage covariate, tumor metastasis, and relapse of cancer. Survival time in breast cancer patients without tumor metastasis and relapse were 4, 2-fold longer than other patients with metastasis and relapse, respectively. One of the most important undermining prognostic factors in breast cancer is metastasis; hence, knowledge of the mechanisms of metastasis is necessary to prevent it so occurrence and treatment of metastatic breast cancer and ultimately extend the lifetime of patients.

  15. Survival time and effect of selected predictor variables on survival in owned pet cats seropositive for feline immunodeficiency and leukemia virus attending a referral clinic in northern Italy.

    Science.gov (United States)

    Spada, Eva; Perego, Roberta; Sgamma, Elena Assunta; Proverbio, Daniela

    2018-02-01

    Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are among the most important feline infectious diseases worldwide. This retrospective study investigated survival times and effects of selected predictor factors on survival time in a population of owned pet cats in Northern Italy testing positive for the presence of FIV antibodies and FeLV antigen. One hundred and three retrovirus-seropositive cats, 53 FIV-seropositive cats, 40 FeLV-seropositive cats, and 10 FIV+FeLV-seropositive cats were included in the study. A population of 103 retrovirus-seronegative age and sex-matched cats was selected. Survival time was calculated and compared between retrovirus-seronegative, FIV, FeLV and FIV+FeLV-seropositive cats using Kaplan-Meier survival analysis. Cox proportional-hazards regression analysis was used to study the effect of selected predictor factors (male gender, peripheral blood cytopenia as reduced red blood cells - RBC- count, leukopenia, neutropenia and lymphopenia, hypercreatininemia and reduced albumin to globulin ratio) on survival time in retrovirus-seropositive populations. Median survival times for seronegative cats, FIV, FeLV and FIV+FeLV-seropositive cats were 3960, 2040, 714 and 77days, respectively. Compared to retrovirus-seronegative cats median survival time was significantly lower (P<0.000) in FeLV and FIV+FeLV-seropositive cats. Median survival time in FeLV and FIV+FeLV-seropositive cats was also significant lower (P<0.000) when compared to FIV-seropositive cats. Hazard ratio of death in FeLV and FIV+FeLV-seropositive cats being respectively 3.4 and 7.4 times higher, in comparison to seronegative cats and 2.3 and 4.8 times higher in FeLV and FIV+FeLV-seropositive cats as compared to FIV-seropositive cats. A Cox proportional-hazards regression analysis showed that FIV and FeLV-seropositive cats with reduced RBC counts at time of diagnosis of seropositivity had significantly shorter survival times when compared to FIV and Fe

  16. Clinical findings and survival time in dogs with advanced heart failure.

    Science.gov (United States)

    Beaumier, Amelie; Rush, John E; Yang, Vicky K; Freeman, Lisa M

    2018-04-10

    Dogs with advanced heart failure are a clinical challenge for veterinarians but there are no studies reporting clinical features and outcome of this population. To describe clinical findings and outcome of dogs with advanced heart failure caused by degenerative mitral valve disease (DMVD). Fifty-four dogs with advanced heart failure because of DMVD. For study purposes, advanced heart failure was defined as recurrence of congestive heart failure signs despite receiving the initially prescribed dose of pimobendan, angiotensin-converting-enzyme inhibitor (ACEI), and furosemide >4 mg/kg/day. Data were collected for the time of diagnosis of Stage C heart failure and time of diagnosis of advanced heart failure. Date of death was recorded. At the diagnosis of advanced heart failure, doses of pimobendan (n = 30), furosemide (n = 28), ACEI (n = 13), and spironolactone (n = 4) were increased, with ≥1 new medications added in most dogs. After initial diagnosis of advanced heart failure, 38 (70%) dogs had additional medications adjustments (median = 2 [range, 0-27]), with the final total medication number ranging from 2-10 (median = 5). Median survival time after diagnosis of advanced heart failure was 281 days (range, 3-885 days). Dogs receiving a furosemide dose >6.70 mg/kg/day had significantly longer median survival times (402 days [range, 3-885 days] versus 129 days [range 9-853 days]; P = .017). Dogs with advanced heart failure can have relatively long survival times. Higher furosemide dose and non-hospitalization were associated with longer survival. Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  17. 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.

  18. The trouble with drink: why ideas matter.

    Science.gov (United States)

    Edwards, Griffith

    2010-05-01

    This paper builds upon the work of previous authors who have explored the evolution of ideas in the alcohol arena. With revisions in the relevant sections of ICD and DSM forthcoming, such matters are of considerable contemporary importance. The focus here will be upon the history of the last 200 years. The main themes to be explored include the flux of ideas on what, over time, has counted as the trouble with drink, ideas on the cause of the problem and the impact of this thinking on public action. Medical authorities of the late Enlightenment period made the revolutionary suggestion that habitual drunkenness constituted a disease, rather than a vice. The thread of that idea can be traced to the present day, but with an alternative perception of drink itself or alcohol-related problems generally, as cause for concern, also having a lineage. There are several inferences to be drawn from this history: the need for vigilance lest disease formulations become stalking-horses for moralism and social control, the need to integrate awareness of alcohol dependence as a dimensional individual-level problem, with a public health understanding of the vastly amorphous and at least equally important universe of alcohol-related problems; the dangers lurking in scientific reductionism when the problems at issue truly require a multi-disciplinary analysis; and the need for global consensus rather than cultural imposition of ideas on what counts as the problem with drink.

  19. 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.

  20. Systematic review of survival time in experimental mouse stroke with impact on reliability of infarct estimation

    DEFF Research Database (Denmark)

    Klarskov, Carina Kirstine; Klarskov, Mikkel Buster; Hasseldam, Henrik

    2016-01-01

    infarcts with more substantial edema. Purpose: This paper will give an overview of previous studies of experimental mouse stroke, and correlate survival time to peak time of edema formation. Furthermore, investigations of whether the included studies corrected the infarct measurements for edema...... of reasons for the translational problems from mouse experimental stroke to clinical trials probably exists, including infarct size estimations around the peak time of edema formation. Furthermore, edema is a more prominent feature of stroke in mice than in humans, because of the tendency to produce larger...... of the investigated process. Our findings indicate a need for more research in this area, and establishment of common correction methodology....

  1. The Application of Extended Cox Proportional Hazard Method for Estimating Survival Time of Breast Cancer

    Science.gov (United States)

    Husain, Hartina; Astuti Thamrin, Sri; Tahir, Sulaiha; Mukhlisin, Ahmad; Mirna Apriani, M.

    2018-03-01

    Breast cancer is one type of cancer that is the leading cause of death worldwide. This study aims to model the factors that affect the survival time and rate of cure of breast cancer patients. The extended cox model, which is a modification of the proportional hazard cox model in which the proportional hazard assumptions are not met, is used in this study. The maximum likelihood estimation approach is used to estimate the parameters of the model. This method is then applied to medical record data of breast cancer patient in 2011-2016, which is taken from Hasanuddin University Education Hospital. The results obtained indicate that the factors that affect the survival time of breast cancer patients are malignancy and leukocyte levels.

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Taraneh Movahhed

    2012-09-01

    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.

  4. Survivable architectures for time and wavelength division multiplexed passive optical networks

    Science.gov (United States)

    Wong, Elaine

    2014-08-01

    The increased network reach and customer base of next-generation time and wavelength division multiplexed PON (TWDM-PONs) have necessitated rapid fault detection and subsequent restoration of services to its users. However, direct application of existing solutions for conventional PONs to TWDM-PONs is unsuitable as these schemes rely on the loss of signal (LOS) of upstream transmissions to trigger protection switching. As TWDM-PONs are required to potentially use sleep/doze mode optical network units (ONU), the loss of upstream transmission from a sleeping or dozing ONU could erroneously trigger protection switching. Further, TWDM-PONs require its monitoring modules for fiber/device fault detection to be more sensitive than those typically deployed in conventional PONs. To address the above issues, three survivable architectures that are compliant with TWDM-PON specifications are presented in this work. These architectures combine rapid detection and protection switching against multipoint failure, and most importantly do not rely on upstream transmissions for LOS activation. Survivability analyses as well as evaluations of the additional costs incurred to achieve survivability are performed and compared to the unprotected TWDM-PON. Network parameters that impact the maximum achievable network reach, maximum split ratio, connection availability, fault impact, and the incremental reliability costs for each proposed survivable architecture are highlighted.

  5. Mediation Analysis with Survival Outcomes: Accelerated Failure Time vs. Proportional Hazards Models

    Science.gov (United States)

    Gelfand, Lois A.; MacKinnon, David P.; DeRubeis, Robert J.; Baraldi, Amanda N.

    2016-01-01

    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. PMID:27065906

  6. 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.

  7. Integration of RNA-Seq and RPPA data for survival time prediction in cancer patients.

    Science.gov (United States)

    Isik, Zerrin; Ercan, Muserref Ece

    2017-10-01

    Integration of several types of patient data in a computational framework can accelerate the identification of more reliable biomarkers, especially for prognostic purposes. This study aims to identify biomarkers that can successfully predict the potential survival time of a cancer patient by integrating the transcriptomic (RNA-Seq), proteomic (RPPA), and protein-protein interaction (PPI) data. The proposed method -RPBioNet- employs a random walk-based algorithm that works on a PPI network to identify a limited number of protein biomarkers. Later, the method uses gene expression measurements of the selected biomarkers to train a classifier for the survival time prediction of patients. RPBioNet was applied to classify kidney renal clear cell carcinoma (KIRC), glioblastoma multiforme (GBM), and lung squamous cell carcinoma (LUSC) patients based on their survival time classes (long- or short-term). The RPBioNet method correctly identified the survival time classes of patients with between 66% and 78% average accuracy for three data sets. RPBioNet operates with only 20 to 50 biomarkers and can achieve on average 6% higher accuracy compared to the closest alternative method, which uses only RNA-Seq data in the biomarker selection. Further analysis of the most predictive biomarkers highlighted genes that are common for both cancer types, as they may be driver proteins responsible for cancer progression. The novelty of this study is the integration of a PPI network with mRNA and protein expression data to identify more accurate prognostic biomarkers that can be used for clinical purposes in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.

    Science.gov (United States)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik; Hansen, Steen Møller; Gerds, Thomas A; Kragholm, Kristian; Hansen, Carolina Malta; Karlsson, Lena; Lippert, Freddy K; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

    2016-12-20

    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. 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 to examine the association between time from 911 call to emergency medical service arrival (response time) and survival according to whether bystander CPR was provided (yes or no). Reported are 30-day survival chances with 95% bootstrap confidence intervals. With increasing response times, adjusted 30-day survival chances decreased for both patients with bystander CPR and those without. However, the contrast between the survival chances of patients with versus without bystander CPR increased over time: within 5 minutes, 30-day survival was 14.5% (95% confidence interval [CI]: 12.8-16.4) versus 6.3% (95% CI: 5.1-7.6), corresponding to 2.3 times higher chances of survival associated with bystander CPR; within 10 minutes, 30-day survival chances were 6.7% (95% CI: 5.4-8.1) versus 2.2% (95% CI: 1.5-3.1), corresponding to 3.0 times higher chances of 30-day survival associated with bystander CPR. The contrast in 30-day survival became statistically insignificant when response time was >13 minutes (bystander CPR vs no bystander CPR: 3.7% [95% CI: 2.2-5.4] vs 1.5% [95% CI: 0.6-2.7]), but 30-day survival was still 2.5 times higher associated with bystander CPR. Based on the model and Danish 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

  9. 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

    2017-01-01

    Importance 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. Objective 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. Design, Setting, and Participants 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. Exposures 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. Main Outcomes and Measures 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. Results 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

  10. Timely disclosure of progress in long-term cancer survival: the boomerang method substantially improved estimates in a comparative study.

    Science.gov (United States)

    Brenner, Hermann; Jansen, Lina

    2016-02-01

    Monitoring cancer survival is a key task of cancer registries, but timely disclosure of progress in long-term survival remains a challenge. We introduce and evaluate a novel method, denoted "boomerang method," for deriving more up-to-date estimates of long-term survival. We applied three established methods (cohort, complete, and period analysis) and the boomerang method to derive up-to-date 10-year relative survival of patients diagnosed with common solid cancers and hematological malignancies in the United States. Using the Surveillance, Epidemiology and End Results 9 database, we compared the most up-to-date age-specific estimates that might have been obtained with the database including patients diagnosed up to 2001 with 10-year survival later observed for patients diagnosed in 1997-2001. For cancers with little or no increase in survival over time, the various estimates of 10-year relative survival potentially available by the end of 2001 were generally rather similar. For malignancies with strongly increasing survival over time, including breast and prostate cancer and all hematological malignancies, the boomerang method provided estimates that were closest to later observed 10-year relative survival in 23 of the 34 groups assessed. The boomerang method can substantially improve up-to-dateness of long-term cancer survival estimates in times of ongoing improvement in prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The role of donor age and ischemic time on survival following orthotopic heart transplantation.

    Science.gov (United States)

    Del Rizzo, D F; Menkis, A H; Pflugfelder, P W; Novick, R J; McKenzie, F N; Boyd, W D; Kostuk, W J

    1999-04-01

    The advances in immunotherapy, along with a liberalization of eligibility criteria have contributed significantly to the ever increasing demand for donor organs. In an attempt to expand the donor pool, transplant programs are now accepting older donors as well as donors from more remote areas. The purpose of this study is to determine the effect of donor age and organ ischemic time on survival following orthotopic heart transplantation (OHT). From April 1981 to December 1996 372 adult patients underwent OHT at the University of Western Ontario. Cox proportional hazards models were used to identify predictors of outcome. Variables affecting survival were then entered into a stepwise logistic regression model to develop probability models for 30-day- and 1-year-mortality. The mean age of the recipient population was 45.6 +/- 12.3 years (range 18-64 years: 54 56 years). The majority (329 patients, 86.1%) were male and the most common indications for OHT were ischemic (n = 180) and idiopathic (n = 171) cardiomyopathy. Total ischemic time (TIT) was 202.4 +/- 84.5 minutes (range 47-457 minutes). In 86 donors TIT was under 2 hours while it was between 2 and 4 hours in 168, and more than 4 hours in 128 donors. Actuarial survival was 80%, 73%, and 55% at 1, 5, and 10 years respectively. By Cox proportional hazards models, recipient status (Status I-II vs III-IV; risk ratio 1.75; p = 0.003) and donor age, examined as either a continuous or categorical variable ([age or = 35; risk ratio 1.98; p or = 50; risk ratio 2.20; p or = 50; risk ratio 1.83; p 50 years (p = 0.009). By stepwise logistic regression analysis, a probability model for survival was then developed based on donor age, the interaction between donor age and ischemic time, and patient status. Improvements in myocardial preservation and peri-operative management may allow for the safe utilization of donor organs with prolonged ischemic times. Older donors are associated with decreased peri-operative and long

  12. Main neuroendocrine features and therapy in primary sleep troubles.

    Science.gov (United States)

    Amihăesei, Ioana Cristina; Mungiu, O C

    2012-01-01

    Insomnia is a sleep trouble in which the patient has difficulties in falling or in staying asleep. There are patients who fall asleep easily, but wake up too early; others have troubles in falling asleep and a third category has troubles with both falling and staying asleep. Independent of the type of insomnia, the final result is a poor-quality sleep, responsible for depressive or irritable mood, loss in concentration, learning and memory capacities. Sleep is essential to emotional and physical health. Inadequate sleep over a period of time is increasing the risks for obesity, diabetes, heart disease and depression. People suffering of chronic insomnia show an increased predisposition for psychiatric problems. People who had sleep troubles reported impaired ability to fulfill tasks involving memory, learning, logical reasoning and mathematical operations. New studies show that insomnia might be a result of the decrease of gamma-aminobutyric acid (GABA), a neurochemical responsible for the decrease of activity in many brain areas. Lower brain GABA levels were also found in people with major depressive disorder and anxiety disorders. Hypnotics, such as benzodiazepines are acting increasing the activity of the GABA neurons. Exposure to stress is associated with a greater risk for insomnia, with individual differences. Stress activates the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Increased activity of HPA axis is stimulating the secretion of corticotropin-releasing hormone, further inducing sleep disruption. Insomnia is also associated with depression and anxiety disorders, in which the HPA axis is characteristically overactive. People who show predisposition to sleep troubles have a hyperactive sympathetic nervous system, they are usually suffering from hyperarousal and they have a more intense response to stressful events. Primary sleep troubles (insomnia) has no apparent causes, is lasting more than one month, and is affecting

  13. Pre-hospital transport times and survival for Hypotensive patients with penetrating thoracic trauma

    Directory of Open Access Journals (Sweden)

    Mamta Swaroop

    2013-01-01

    Full Text Available Background: Achieving definitive care within the "Golden Hour" by minimizing response times is a consistent goal of regional trauma systems . This study hypothesizes that in urban Level I Trauma Centers, shorter pre-hospital times would predict outcomes in penetrating thoracic injuries. Materials and Methods: A retrospective cohort study was performed using a statewide trauma registry for the years 1999-2003 . Total pre-hospital times were measured for urban victims of penetrating thoracic trauma. Crude and adjusted mortality rates were compared by pre-hospital time using STATA statistical software. Results: During the study period, 908 patients presented to the hospital after penetrating thoracic trauma, with 79% surviving . Patients with higher injury severity scores (ISS were transported more quickly. Injury severity scores (ISS ≥16 and emergency department (ED hypotension (systolic blood pressure, SBP <90 strongly predicted mortality (P < 0.05 for each . In a logistic regression model including age, race, and ISS, longer transport times for hypotensive patients were associated with higher mortality rates (all P values <0.05. This was seen most significantly when comparing patient transport times 0-15 min and 46-60 min (P < 0.001. Conclusion: In victims of penetrating thoracic trauma, more severely injured patients arrive at urban trauma centers sooner . Mortality is strongly predicted by injury severity, although shorter pre-hospital times are associated with improved survival . These results suggest that careful planning to optimize transport time-encompassing hospital capacity and existing resources, traffic patterns, and trauma incident densities may be beneficial in areas with a high burden of penetrating trauma.

  14. 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…

  15. Moral Markets for Troubling Youths: A Disruption!

    Science.gov (United States)

    Cousins, Linwood H.

    2001-01-01

    Maintains that public policy discourse with narrow views of morality and character are at the center of contemporary definitions and marketing of services for violent/troubled youth. Uses descriptive and ethnographic data on violence in urban and black schools/communities to argue that, left undisturbed, moral entrepreneurs pose as much risk as…

  16. Rational Emotive Behavior Therapy with Troubled Students.

    Science.gov (United States)

    Zionts, Paul; Zionts, Laura

    1997-01-01

    Based on the early work of Albert Ellis, seeks to identify and challenge irrational beliefs that underlie behavior problems. Outlines concepts and methods of Rational Emotive Behavior Theory and describes the application both in counseling and as a mental health curriculum for troubled children and youth. Offers classroom techniques. (RJM)

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

    International Nuclear Information System (INIS)

    McMillan, Matthew T.; Ojerholm, Eric; Roses, Robert E.; Plastaras, John P.; Metz, James M.; Mamtani, Ronac; Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A.; Stripp, Diana; Ben-Josef, Edgar; Datta, Jashodeep

    2015-01-01

    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

  18. 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.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    S B Dharap

    2017-01-01

    Full Text Available Background: 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. Materials and Methods: 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. Results: 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 <9, Injury Severity Score ≥16, need for intubation, and ventilatory support on arrival; but neither with 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. Conclusion: 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

  1. Parent-child communication and marijuana initiation: evidence using discrete-time survival analysis.

    Science.gov (United States)

    Nonnemaker, James M; Silber-Ashley, Olivia; Farrelly, Matthew C; Dench, Daniel

    2012-12-01

    This study supplements existing literature on the relationship between parent-child communication and adolescent drug use by exploring whether parental and/or adolescent recall of specific drug-related conversations differentially impact youth's likelihood of initiating marijuana use. Using discrete-time survival analysis, we estimated the hazard of marijuana initiation using a logit model to obtain an estimate of the relative risk of initiation. Our results suggest that parent-child communication about drug use is either not protective (no effect) or - in the case of youth reports of communication - potentially harmful (leading to increased likelihood of marijuana initiation). Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. 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

    30-day survival chances decreased for both patients with bystander CPR and those without. However, the contrast between the survival chances of patients with versus without bystander CPR increased over time: within 5 minutes, 30-day survival was 14.5% (95% confidence interval [CI]: 12.8-16.4) versus...... 6.3% (95% CI: 5.1-7.6), corresponding to 2.3 times higher chances of survival associated with bystander CPR; within 10 minutes, 30-day survival chances were 6.7% (95% CI: 5.4-8.1) versus 2.2% (95% CI: 1.5-3.1), corresponding to 3.0 times higher chances of 30-day survival associated with bystander...... CPR. The contrast in 30-day survival became statistically insignificant when response time was >13 minutes (bystander CPR vs no bystander CPR: 3.7% [95% CI: 2.2-5.4] vs 1.5% [95% CI: 0.6-2.7]), but 30-day survival was still 2.5 times higher associated with bystander CPR. Based on the model and Danish...

  3. 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.

  4. Biologically-equivalent dose and long-term survival time in radiation treatments

    International Nuclear Information System (INIS)

    Zaider, Marco; Hanin, Leonid

    2007-01-01

    Within the linear-quadratic model the biologically-effective dose (BED)-taken to represent treatments with an equal tumor control probability (TCP)-is commonly (and plausibly) calculated according to BED(D) = -log[S(D)]/α. We ask whether in the presence of cellular proliferation this claim is justified and examine, as a related question, the extent to which BED approximates an isoeffective dose (IED) defined, more sensibly, in terms of an equal long-term survival probability, rather than TCP. We derive, under the assumption that cellular birth and death rates are time homogeneous, exact equations for the isoeffective dose, IED. As well, we give a rigorous definition of effective long-term survival time, T eff . By using several sets of radiobiological parameters, we illustrate potential differences between BED and IED on the one hand and, on the other, between T eff calculated as suggested here or by an earlier recipe. In summary: (a) the equations currently in use for calculating the effective treatment time may underestimate the isoeffective dose and should be avoided. The same is the case for the tumor control probability (TCP), only more so; (b) for permanent implants BED may be a poor substitute for IED; (c) for a fractionated treatment schedule, interpreting the observed probability of cure in terms of a TCP formalism that refers to the end of the treatment (rather than T eff ) may result in a miscalculation (underestimation) of the initial number of clonogens

  5. Using Concurrent Cardiovascular Information to Augment Survival Time Data for Evaluating Orthostatic Tilt Test Performance

    Science.gov (United States)

    Feiveson, Alan H.; Fiedler, James; Lee, Stuart M. C.; Koslovsky, Matthew D.; Stenger, Michael B.; Platts, Steven H.

    2018-01-01

    Head-up tilt (HUT) tests often are used in research to measure orthostatic intolerance (OI) (inability to appropriately control blood pressure while upright) in clinical populations and otherwise healthy individuals after interventions. Post-space flight orthostatic intolerance is a well-known phenomenon, and countermeasures to its development has been an active area of research at NASA. In the NASA HUT protocol, subjects lie horizontally on an automatic tilt table for baseline measurements before being raised to 80deg head-up tilt for a defined period of time or until signs or symptoms of presyncope ensues (light-headedness, nausea, dizziness, sweating, weakness or fainting). Multiple measures are collected to evaluate the cardiovascular system's ability to respond appropriately to the orthostatic challenge. However if the intended duration of the HUT is short, the ability to detect changes in OI due to an intervention or its prevention by a countermeasure may be limited by a small number of failures to permit comparisons based on survival time alone. Thus, the time-trajectory of the cardiovascular data becomes an important additional source of information. In particular, we will show how various measures of trajectory variability can effectively augment survival analysis for the assessment of OI in a joint model when high censoring rates are present.

  6. Using Concurrent Cardiovascular Information to Augment Survival Time Data from Orthostatic Tilt Tests

    Science.gov (United States)

    Feiveson, Alan H.; Fiedler, James; Lee, Stuart M. M.; Westby, Christian M.; Stenger, Michael B.; Platts, Steven H.

    2014-01-01

    Orthostatic Intolerance (OI) is the propensity to develop symptoms of fainting during upright standing. OI is associated with changes in heart rate, blood pressure and other measures of cardiac function. Problem: NASA astronauts have shown increased susceptibility to OI on return from space missions. Current methods for counteracting OI in astronauts include fluid loading and the use of compression garments. Multivariate trajectory spread is greater as OI increases. Pairwise comparisons at the same time within subjects allows incorporation of pass/fail outcomes. Path length, convex hull area, and covariance matrix determinant do well as statistics to summarize this spread Missing data problems Time series analysis need many more time points per OTT session treatment of trend? how incorporate survival information?

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

    Science.gov (United States)

    Walsh, Daniel P; Dreitz, Victoria J; Heisey, Dennis M

    2015-02-01

    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 birth 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.

  8. 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 birth 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.

  9. Gene expression profiling of canine osteosarcoma reveals genes associated with short and long survival times

    Directory of Open Access Journals (Sweden)

    Rao Nagesha AS

    2009-09-01

    Full Text Available Abstract Background Gene expression profiling of spontaneous tumors in the dog offers a unique translational opportunity to identify prognostic biomarkers and signaling pathways that are common to both canine and human. Osteosarcoma (OS accounts for approximately 80% of all malignant bone tumors in the dog. Canine OS are highly comparable with their human counterpart with respect to histology, high metastatic rate and poor long-term survival. This study investigates the prognostic gene profile among thirty-two primary canine OS using canine specific cDNA microarrays representing 20,313 genes to identify genes and cellular signaling pathways associated with survival. This, the first report of its kind in dogs with OS, also demonstrates the advantages of cross-species comparison with human OS. Results The 32 tumors were classified into two prognostic groups based on survival time (ST. They were defined as short survivors (dogs with poor prognosis: surviving fewer than 6 months and long survivors (dogs with better prognosis: surviving 6 months or longer. Fifty-one transcripts were found to be differentially expressed, with common upregulation of these genes in the short survivors. The overexpressed genes in short survivors are associated with possible roles in proliferation, drug resistance or metastasis. Several deregulated pathways identified in the present study, including Wnt signaling, Integrin signaling and Chemokine/cytokine signaling are comparable to the pathway analysis conducted on human OS gene profiles, emphasizing the value of the dog as an excellent model for humans. Conclusion A molecular-based method for discrimination of outcome for short and long survivors is useful for future prognostic stratification at initial diagnosis, where genes and pathways associated with cell cycle/proliferation, drug resistance and metastasis could be potential targets for diagnosis and therapy. The similarities between human and canine OS makes the

  10. Gender trouble? On the gender constitution of clergymen's wives

    OpenAIRE

    Meurling, Birgitta

    1999-01-01

    When my informant Elisabeth told me: “You have to accept it, otherwise one cracks up”, my first thought was that I here was dealing with a serious kind of “gender trouble” or at minimum a serious kind of marital trouble. This because Elisabeth, on the one hand, claimed to be a “modern”, professional woman with a full-time job and yet, on the other hand, told me that she was subordinated under her husband’s occupation and that she was willing to accept this.

  11. Exposure to aged crumb rubber reduces survival time during a stress test in earthworms (Eisenia fetida).

    Science.gov (United States)

    Pochron, Sharon; Nikakis, Jacqueline; Illuzzi, Kyra; Baatz, Andrea; Demirciyan, Loriana; Dhillon, Amritjot; Gaylor, Thomas; Manganaro, Alexa; Maritato, Nicholas; Moawad, Michael; Singh, Rajwinder; Tucker, Clara; Vaughan, Daniel

    2018-04-01

    Solid waste management struggles with the sustainable disposal of used tires. One solution involves shredding used tires into crumb rubber and using the material as infill for artificial turf. However, crumb rubber contains hydrocarbons, organic compounds, and heavy metals, and it travels into the environment. Earthworms living in soil contaminated with virgin crumb rubber gained 14% less body weight than did earthworms living in uncontaminated soil, but the impact of aged crumb rubber on the earthworms is unknown. Since many athletic fields contain aged crumb rubber, we compared the body weight, survivorship, and longevity in heat and light stress for earthworms living in clean topsoil to those living in topsoil contaminated with aged crumb rubber. We also characterized levels of metals, nutrients, and micronutrients of both soil treatments and compared those to published values for soil contaminated with virgin crumb rubber. Consistent with earlier research, we found that contaminated soil did not inhibit microbial respiration rates. Aged crumb rubber, like new crumb rubber, had high levels of zinc. However, while exposure to aged crumb rubber did not reduce earthworm body weight as did exposure to new crumb rubber, exposure to aged crumb rubber reduced earthworm survival time during a stress test by a statistically significant 38 min (16.2%) relative to the survival time for worms that had lived in clean soil. Aged crumb rubber and new crumb rubber appear to pose similar toxic risks to earthworms. This study suggests an environmental cost associated with the current tire-recycling solution.

  12. Frozen in Time? Microbial strategies for survival and carbon metabolism over geologic time in a Pleistocene permafrost chronosequence

    Science.gov (United States)

    Mackelprang, R.; Douglas, T. A.; Waldrop, M. P.

    2014-12-01

    Permafrost soils have received tremendous interest due to their importance as a global carbon store with the potential to be thawed over the coming centuries. Instead of being 'frozen in time,' permafrost contains active microbes. Most metagenomic studies have focused on Holocene aged permafrost. Here, we target Pleistocene aged ice and carbon rich permafrost (Yedoma), which can differ in carbon content and stage of decay. Our aim was to understand how microbes in the permafrost transform organic matter over geologic time and to identify physiological and biochemical adaptations that enable long-term survival. We used next-generation sequencing to characterize microbial communities along a permafrost age gradient. Samples were collected from the Cold Regions Research and Engineering Laboratory (CRREL) Permafrost Tunnel near Fox, AK, which penetrates a hillside providing access to permafrost ranging in age from 12 to 40 kyr. DNA was extracted directly from unthawed samples. 16S rRNA amplicon (16S) and shotgun metagenome sequencing revealed significant age-driven differences. First, microbial diversity declines with permafrost age, likely due to long-term exposure to environmental stresses and a reduction in metabolic resources. Second, we observed taxonomic differences among ages, with an increasing abundance of Firmicutes (endospore-formers) in older samples, suggesting that dormancy is a common survival strategy in older permafrost. Ordination of 16S and metagenome data revealed age-based clustering. Genes differing significantly between age categories included those involved in lipopolysaccharide assembly, cold-response, and carbon processing. These data point to the physiological adaptations to long-term frozen conditions and to the metabolic processes utilized in ancient permafrost. In fact, a gene common in older samples is involved in cadaverine production, which could potentially explain the putrefied smell of Pleistocene aged permafrost. Coupled with soil

  13. Evaluating time to cancer recurrence as a surrogate marker for survival from an information theory perspective.

    Science.gov (United States)

    Alonso, Ariel; Molenberghs, Geert

    2008-10-01

    The last two decades have seen a lot of development in the area of surrogate marker validation. One of these approaches places the evaluation in a meta-analytic framework, leading to definitions in terms of trial- and individual-level association. A drawback of this methodology is that different settings have led to different measures at the individual level. Using information theory, Alonso et al. proposed a unified framework, leading to a new definition of surrogacy, which offers interpretational advantages and is applicable in a wide range of situations. In this work, we illustrate how this information-theoretic approach can be used to evaluate surrogacy when both endpoints are of a time-to-event type. Two meta-analyses, in early and advanced colon cancer, respectively, are then used to evaluate the performance of time to cancer recurrence as a surrogate for overall survival.

  14. Preoperative diffusion-weighted imaging of single brain metastases correlates with patient survival times.

    Directory of Open Access Journals (Sweden)

    Anna Sophie Berghoff

    Full Text Available BACKGROUND: MRI-based diffusion-weighted imaging (DWI visualizes the local differences in water diffusion in vivo. The prognostic value of DWI signal intensities on the source images and apparent diffusion coefficient (ADC maps respectively has not yet been studied in brain metastases (BM. METHODS: We included into this retrospective analysis all patients operated for single BM at our institution between 2002 and 2010, in whom presurgical DWI and BM tissue samples were available. We recorded relevant clinical data, assessed DWI signal intensity and apparent diffusion coefficient (ADC values and performed histopathological analysis of BM tissues. Statistical analyses including uni- and multivariate survival analyses were performed. RESULTS: 65 patients (34 female, 31 male with a median overall survival time (OS of 15 months (range 0-99 months were available for this study. 19 (29.2% patients presented with hyper-, 3 (4.6% with iso-, and 43 (66.2% with hypointense DWI. ADCmean values could be determined in 32 (49.2% patients, ranged from 456.4 to 1691.8*10⁻⁶ mm²/s (median 969.5 and showed a highly significant correlation with DWI signal intensity. DWI hyperintensity correlated significantly with high amount of interstitial reticulin deposition. In univariate analysis, patients with hyperintense DWI (5 months and low ADCmean values (7 months had significantly worse OS than patients with iso/hypointense DWI (16 months and high ADCmean values (30 months, respectively. In multivariate survival analysis, high ADCmean values retained independent statistical significance. CONCLUSIONS: Preoperative DWI findings strongly and independently correlate with OS in patients operated for single BM and are related to interstitial fibrosis. Inclusion of DWI parameters into established risk stratification scores for BM patients should be considered.

  15. Analyzing survival curves at a fixed point in time for paired and clustered right-censored data

    Science.gov (United States)

    Su, Pei-Fang; Chi, Yunchan; Lee, Chun-Yi; Shyr, Yu; Liao, Yi-De

    2018-01-01

    In clinical trials, information about certain time points may be of interest in making decisions about treatment effectiveness. Rather than comparing entire survival curves, researchers can focus on the comparison at fixed time points that may have a clinical utility for patients. For two independent samples of right-censored data, Klein et al. (2007) compared survival probabilities at a fixed time point by studying a number of tests based on some transformations of the Kaplan-Meier estimators of the survival function. However, to compare the survival probabilities at a fixed time point for paired right-censored data or clustered right-censored data, their approach would need to be modified. In this paper, we extend the statistics to accommodate the possible within-paired correlation and within-clustered correlation, respectively. We use simulation studies to present comparative results. Finally, we illustrate the implementation of these methods using two real data sets. PMID:29456280

  16. 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 ...

  17. Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis

    Science.gov (United States)

    Xu, Jianglin; Suri, Rita S.; Nesrallah, Gihad; Lindsay, Robert; Garg, Amit X.; Lester, Keith; Ofsthun, Norma; Lazarus, Michael; Hakim, Raymond M.

    2012-01-01

    Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score–matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61–0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score–matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials. PMID:22362905

  18. The NSTX Trouble Reporting System; TOPICAL

    International Nuclear Information System (INIS)

    S. Sengupta; G. Oliaro

    2002-01-01

    An online Trouble Reporting System (TRS) has been introduced at the National Spherical Torus Experiment (NSTX). The TRS is used by NSTX operators to report problems that affect NSTX operations. The purpose of the TRS is to enhance NSTX reliability and maintainability by identifying components, occurrences, and trends that contribute to machine downtime. All NSTX personnel have access to the TRS. The user interface is via a web browser, such as Netscape or Internet Explorer. This web-based feature permits any X-terminal, PC, or MAC access to the TRS. The TRS is based upon a trouble reporting system developed at the DIII-D Tokamak, at General Atomics Technologies. This paper will provide a detailed description of the TRS software architecture, user interface, MS SQL server interface and operational experiences. In addition, sample data from the TRS database will be summarized and presented

  19. Impact of latency time on survival for adolescents and young adults with a second primary malignancy.

    Science.gov (United States)

    Goldfarb, Melanie; Rosenberg, Aaron S; Li, Qian; Keegan, Theresa H M

    2018-03-15

    The adverse impact of second primary malignancies (SPMs) on survival is substantial for adolescents and young adults (AYAs; ie, those 15-39 years old). No studies have evaluated whether the latency time between the first malignancy (the primary malignancy [PM]) and the SPM affects cancer-specific survival (CSS). A multivariate Cox proportional hazards regression with Surveillance, Epidemiology, and End Results data for 13 regions from 1992 to 2008 was used to ascertain whether the latency time (1-5 vs ≥ 6 years) to the development of an SPM affected the CSS and overall survival with respect to either the PM or SPM for AYAs with common SPMs. The majority of 1515 AYAs with an SPM had their PM diagnosed between the ages of 26 and 39 years (74.2%) and an SPM diagnosed within 1 to 5 years (72.9%) of the PM's diagnosis. Overall, AYAs that developed an SPM 1 to 5 years after the diagnosis (vs ≥ 6 years) had an increased risk of death from cancer (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.92-3.29) as well as any cause (HR, 2.60; 95% CI, 2.04-3.32). Specifically, for AYAs with an SPM that was leukemia or a colorectal, breast, or central nervous system malignancy, a shorter latency time (1-5 years) from their PM diagnosis was associated with an overall significantly increased risk of death (2.6-fold) from either their PM or that particular SPM. However, latency did not appear to affect the CSS with respect to either the PM or SPM for AYA patients with a lymphoma or sarcoma SPM. Most AYAs who develop an SPM do so within 1 to 5 years of their primary cancer diagnosis, and they have an increased risk of death from cancer in comparison with AYAs with an SPM developing after longer survivorship intervals. Cancer 2018;124:1260-8. © 2017 American Cancer Society. © 2017 American Cancer Society.

  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. Troubles psychiatriques et psychopathologiques de la gravido

    African Journals Online (AJOL)

    3 patientes n'avaient pas respecté le rendez-vous de suivi qui leur avait été proposé (Tableau II). IV- DISCUSSION. En dépit du fait que ce travail a été réalisé dans un service spécialisé, nous avons constaté que les troubles psychiatriques et psychopathologiques chez les femmes enceintes ou accouchées représentaient ...

  2. Trend analysis of troubles caused by thermal-hydraulic phenomena at nuclear power plants

    International Nuclear Information System (INIS)

    Komatsu, Teruo

    2010-01-01

    The Institute of Nuclear Safety System (INSS) is promoting researches to improve the safety and reliability of nuclear power plants. In the present study, our attention was focused on troubles attributed to thermal-hydraulic phenomena in particular, trend analysis were carried out to learn lessons from these troubles and to prevent their recurrence. Through our survey, we found the following two points. First, many thermal-hydraulics related troubles can be attributed to design faults, since we found some events in foreign countries took place after inadequate facility renovation. To ensure appropriate design verification, it is important to take account of state-of-the-art science and technology and at the same time to pay attention to the compatibility with the initial design concept. Second point, thermal-hydraulic related troubles are common and recurrent to nuclear power plants worldwide. Japanese utilities are planning to introduce some of overseas experiences to their plants, such as power uprate and renovations of aged facilities. It is important to learn lessons from experiences paying close attention continuously to overseas trouble events, including thermal-hydraulics related events, and to use them to improve safety and reliability of nuclear power plants. (author)

  3. The Troubles of Templeless Judah

    DEFF Research Database (Denmark)

    Middlemas, Jill

    The time of the Babylonian captivity (c.587-539 BCE) is of seminal importance for the formation of the Hebrew Bible, as well as for the religious development of Judaism. Previous studies of this era have usually privileged the perspective of the community of exiles in Babylon (the Golah), and the......The time of the Babylonian captivity (c.587-539 BCE) is of seminal importance for the formation of the Hebrew Bible, as well as for the religious development of Judaism. Previous studies of this era have usually privileged the perspective of the community of exiles in Babylon (the Golah...

  4. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    The General Unified Threshold model for Survival (GUTS) integrates previously published toxicokinetic-toxicodynamic models and estimates survival with explicitly defined assumptions. Importantly, GUTS accounts for time-variable exposure to the stressor. We performed three studies to test...

  5. Survival time of bacteria on different plastics by application of ultraviolet rays and desinfectants

    International Nuclear Information System (INIS)

    Glueck, S.

    1975-01-01

    The survival times of four sorts of germs were studied (Staph. albus, Staph. aureus, E.coli and Clebsiella) on 28 different plastic surfaces under different ambient conditions, (darkness, daylight, UV-radiation) and after preceding disinfection of the surfaces. For these studies, a formaldehydecontaining, phenolic, and a surface-active preparation were used. No essential differences in the survival times of the 4 types of germs tested were found. Besides the chemical basic structure additional substances were found to play a substantial role for the autobactericides. The dark values which could help to obtain findings about auto-bactericides did not show significant correspondence within the groups of the plastics. Only for a few materials a safe auto-bactericide could be found (alkyd lake, phenol resin). In the case of some other substances (some preparations made of PVC, polystyrene, polyacetal) an effect on the germs could be seen which was, at least totally seen, unfavourable, if all test conditions (darkness, daylight, UV-radiation) are viewed as a total. As comparative values on glass had shown a lower lethal rate of the germs, a certain auto-bactericide is likely to exist in all plastics tested. A considerable antibacterial effect of daylight was found, even with low daylight quotients and clased windows. UV-rays also diminished the number of germs on the plastic surfaces considerably, even with only indirect irradiation. Delayed effects of desinfecting agents partially depend on the surface material. Thus the phenolic agent showed strong delayed effects on the acryl glas, polyethylene, phenol resin, polycarbonate, but less on PVC. Phormaldehyde showed a good long-term effect only on phenol resin. (orig.) [de

  6. [The meetings of the Société de Pharmacie de Paris during troubled periods (1803-1946)].

    Science.gov (United States)

    Storck, J

    1997-01-01

    With newly found archives and other already usable documents, it was possible to study the repercussions of several troubled periods in France on the meetings of the Société de Pharmacie de Paris (1803-1946). It seems that only three meetings were cancelled for 143 years. As a matter of fact, the number of attending members decreased widely in the troubled times. Allusions to contemporary events are not scarce in the minutes and have been reported.

  7. PSO-Based Robot Path Planning for Multisurvivor Rescue in Limited Survival Time

    Directory of Open Access Journals (Sweden)

    N. Geng

    2014-01-01

    Full Text Available Since the strength of a trapped person often declines with time in urgent and dangerous circumstances, adopting a robot to rescue as many survivors as possible in limited time is of considerable significance. However, as one key issue in robot navigation, how to plan an optimal rescue path of a robot has not yet been fully solved. This paper studies robot path planning for multisurvivor rescue in limited survival time using a representative heuristic, particle swarm optimization (PSO. First, the robot path planning problem including multiple survivors is formulated as a discrete optimization one with high constraint, where the number of rescued persons is taken as the unique objective function, and the strength of a trapped person is used to constrain the feasibility of a path. Then, a new integer PSO algorithm is presented to solve the mathematical model, and several new operations, such as the update of a particle, the insertion and inversion operators, and the rapidly local search method, are incorporated into the proposed algorithm to improve its effectiveness. Finally, the simulation results demonstrate the capacity of our method in generating optimal paths with high quality.

  8. Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis

    Directory of Open Access Journals (Sweden)

    François Niragire

    2017-05-01

    Full Text Available Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates. The results showed substantial district- level spatial variation in childhood mortality in Rwanda. District-specific spatial characteristics were particularly associated with higher death hazards in two districts: Musanze and Nyabihu. The model estimates showed that there were lower death rates among children from households of medium and high economic status compared to those from low-economic status households. Factors, such as four antenatal care visits, delivery at a health facility, prolonged breastfeeding and mothers younger than 31 years were associated with lower child death rates. Long preceding birth intervals were also associated with fewer hazards. For these reasons, programmes aimed at reducing child mortality gaps between districts in Rwanda should target maternal factors and take into consideration district-specific spatial characteristics. Further, child survival gains require strengthening or scaling-up of existing programmes pertaining to access to, and utilisation of maternal and child health care services as well as reduction of the household gap in the economic status.

  9. Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis.

    Science.gov (United States)

    Niragire, François; Achia, Thomas N O; Lyambabaje, Alexandre; Ntaganira, Joseph

    2017-05-11

    Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates. The results showed substantial district- level spatial variation in childhood mortality in Rwanda. District-specific spatial characteristics were particularly associated with higher death hazards in two districts: Musanze and Nyabihu. The model estimates showed that there were lower death rates among children from households of medium and high economic status compared to those from low-economic status households. Factors, such as four antenatal care visits, delivery at a health facility, prolonged breastfeeding and mothers younger than 31 years were associated with lower child death rates. Long preceding birth intervals were also associated with fewer hazards. For these reasons, programmes aimed at reducing child mortality gaps between districts in Rwanda should target maternal factors and take into consideration district-specific spatial characteristics. Further, child survival gains require strengthening or scaling-up of existing programmes pertaining to access to, and utilisation of maternal and child health care services as well as reduction of the household gap in the economic status.

  10. Wireless Sensors Pinpoint Rotorcraft Troubles

    Science.gov (United States)

    2013-01-01

    Helicopters present many advantages over fixed-wing aircraft: they can take off from and land in tight spots, they can move in any direction with relative ease, and they can hover in one area for extended periods of time. But that maneuverability comes with costs. For example, one persistent issue in helicopter maintenance and operation is that their components are subject to high amounts of wear compared to fixed-wing aircraft. In particular, the rotor drive system that makes flight possible undergoes heavy vibration during routine performance, slowly degrading components in a way that can cause failures if left unmonitored. The level of attention required to ensure flight safety makes helicopters very expensive to maintain. As a part of NASA s Fundamental Aeronautics Program, the Subsonic Rotary Wing Project seeks to advance knowledge about and improve prediction capabilities for rotorcraft, with the aim of developing technology that will meet future civilian requirements like higher efficiency and lower noise flights. One of the program s goals is to improve technology to detect and assess the health of critical components in rotorcraft drive systems.

  11. Timing of chemotherapy and survival in patients with resectable gastric adenocarcinoma

    Science.gov (United States)

    Arrington, Amanda K; Nelson, Rebecca; Patel, Supriya S; Luu, Carrie; Ko, Michelle; Garcia-Aguilar, Julio; Kim, Joseph

    2013-01-01

    AIM: To evaluate the timing of chemotherapy in gastric cancer by comparing survival outcomes in treatment groups. METHODS: Patients with surgically resected gastric adenocarcinoma from 1988 to 2006 were identified from the Los Angeles County Cancer Surveillance Program. To evaluate the population most likely to receive and/or benefit from adjunct chemotherapy, inclusion criteria consisted of Stage II or III gastric cancer patients > 18 years of age who underwent curative-intent surgical resection. Patients were categorized into three groups according to the receipt of chemotherapy: (1) no chemotherapy; (2) preoperative chemotherapy; or (3) postoperative chemotherapy. Clinical and pathologic characteristics were compared across the different treatment arms. RESULTS: Of 1518 patients with surgically resected gastric cancer, 327 (21.5%) received perioperative chemotherapy. The majority of these 327 patients were male (68%) with a mean age of 61.5 years; and they were significantly younger than non-chemotherapy patients (mean age, 70.7; P advanced gastric cancer. CONCLUSION: This study supports the implementation of a randomized trial comparing the timing of perioperative therapy in patients with locally advanced gastric cancer. PMID:24392183

  12. 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

  13. The Health Rationale for Family Planning: Timing of Births and Child Survival.

    Science.gov (United States)

    United Nations, New York, NY. Population Div.

    Among the most influential findings from the World Fertility Survey (WFS) were those linking fertility patterns to child survival, in particular the findings concerning the high infant and child mortality for children born after a short birth interval. This study examined the relations between fertility and child survival based on more recent data…

  14. 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 (Ptime. They also incurred lower costs compared to propensity score matched insured in routine care.

  15. Survival analysis

    International Nuclear Information System (INIS)

    Badwe, R.A.

    1999-01-01

    The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

  16. 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.

  17. End points for adjuvant therapy trials: has the time come to accept disease-free survival as a surrogate end point for overall survival?

    Science.gov (United States)

    Gill, Sharlene; Sargent, Daniel

    2006-06-01

    The intent of adjuvant therapy is to eradicate micro-metastatic residual disease following curative resection with the goal of preventing or delaying recurrence. The time-honored standard for demonstrating efficacy of new adjuvant therapies is an improvement in overall survival (OS). This typically requires phase III trials of large sample size with lengthy follow-up. With the intent of reducing the cost and time of completing such trials, there is considerable interest in developing alternative or surrogate end points. A surrogate end point may be employed as a substitute to directly assess the effects of an intervention on an already accepted clinical end point such as mortality. When used judiciously, surrogate end points can accelerate the evaluation of new therapies, resulting in the more timely dissemination of effective therapies to patients. The current review provides a perspective on the suitability and validity of disease-free survival (DFS) as an alternative end point for OS. Criteria for establishing surrogacy and the advantages and limitations associated with the use of DFS as a primary end point in adjuvant clinical trials and as the basis for approval of new adjuvant therapies are discussed.

  18. Effect of 153Sm-EDTMP on survival time in patients with nasopharyngeal carcinoma and multiple bone metastases

    International Nuclear Information System (INIS)

    Fan Wei; Zheng Zongyuan; Xu Guangpu

    2004-01-01

    Objective: To evaluate the effect on survival of Samarium-153-ethylene diamine tetramethylene phosphonate (153Sm-EDTMP) in patients with nasopharyngeal carcinoma (NPC) and multiple bone metastases. Methods: From 1993 to 1999, 160 patients (127 men, 33 women; median age 35 years) presented with NPC and multiple bone metastases. Of these, 40 patients had undergone chemotherapy, and 72 palliative radiotherapy. Patients were randomly divided into four groups: Group 1 (N = 20) received analgesics (control); Groups 2, 3 and 4 (N = 80, 40, and 20, respectively) received one, two or three courses, respectively, of 153Sm-EDTMP (77.7 MBq/kg/course; course interval, 4 wk). Results: Eight patients died of non-cancer-related causes, and 24 were lost to follow-up. The median survival time for Group 1 (7.8 months) was significantly less (p < 0.05) than that of Groups 2, 3 and 4 (11.6, 13.4 and 12.8 months, respectively). Patients given 153Sm-EDTMP who had had revious external radiation survived longer (p < 0.05) than those in the other treatment groups. Conclusions: Internal radiotherapy with 153Sm-EDTMP can extend survival time in patients with nasopharyngeal carcinoma and multiple bone metastases; when combined with external radiotherapy in appropriate patients, its effect on survival time is enhanced.. (authors)

  19. Correlation between the CT manifestations and post-operative survival time in patients with thymic epithelial tumor

    International Nuclear Information System (INIS)

    Chen Juan; Tan Ye; Wang Xiangyang; Du Jun; Pan Jishu; Wei Jiahu

    2011-01-01

    Objective: To describe the CT manifestations of thymic epithelial tumor and explore the correlation between CT findings and post-operative tumor-related survival time. Methods: Ninety-one patients who underwent CT scan before operation were reviewed retrospectively. All cases had operation and were classified according to the WHO classification. The size, contour, shape, density and enhancement of the tumors on CT were assessed. Presence of mediastinal lymphadenopathy, great vessel invasion, metastasis to the lung or plural, myasthenia gravis (MG) were also analyzed. The survival rate was obtained using, the Kaplan-Meier method. The Cox model was applied to determine the factors affecting the tumor-related survivals. Chi square test was used to analyze the relationship between CT findings and WHO classification. Results: Two patients were excluded because of dying of myocardial infarction and colon cancer. The total 5-year survival rate was 84.3% (n=75). Eighty-nine patients had total 91 tumors. Tumors with diameter larger than 5 cm, lobular contour, heterogenous density, and presence of great vessel invasion, mediastinal lymphadenopathy, and metastasis were adverse factors which could significantly affect the survival time. Five-year survival rates of these factors were 72.7%, 77.3%, 76.7%, 73.8%, 30.0%, and 68.8%, respectively. Presence of MG was a favorable factor which also significantly affected the survival time (P 0.05). The result of the Cox multivariate analysis was consistent with that of the Log-rank test. For different WHO classification, there were significant different among the size or contour of the tumors, presence of great vessel invasion, mediastinal lymphadenopathy, and metastasis (χ 2 value were 6.598, 5.737, 18.307, 8.465, and 15.608, respectively P<0.05). Conclusions: CT findings may be served as predictors of clinical prognosis of the thymic epithelial tumors. Adverse factors for survival time are the size of the tumors and presence of

  20. Differences in compliance with Surviving Sepsis Campaign recommendations according to hospital entrance time: day versus night.

    Science.gov (United States)

    Almeida, Mónica; Ribeiro, Orquídea; Aragão, Irene; Costa-Pereira, Altamiro; Cardoso, Teresa

    2013-04-23

    Higher compliance with Surviving Sepsis Campaign (SSC) recommendations has been associated with lower mortality. The authors evaluate differences in compliance with SSC 6-hour bundle according to hospital entrance time (day versus night) and its impact on hospital mortality. Prospective cohort study of all patients with community-acquired severe sepsis admitted to the intensive care unit of a large university tertiary care hospital, over 3.5 years with a follow-up until hospital discharge. Time to compliance with each recommendation of the SSC 6-hour bundle was calculated according to hospital entrance period: day (08:30 to 20:30) versus night (20:30 to 08:30). For the same periods, clinical staff composition and the number of patients attending the emergency department (ED) was also recorded. In this period 300 consecutive patients were included. Compliance rate was (night vs. day): serum lactate measurement 57% vs. 49% (P = 0.171), blood cultures drawn 59% vs. 37% (P 8 mmHg 45% vs. 29% (P = 0.021), and central venous oxygen saturation (SvcO₂) >70%, 7% vs. 2% (P = 0.082); fluids were administered in all patients with hypotension in both periods and vasopressors were administered in patients with hypotension not responsive to fluids in 100% vs. 99%. Time to get specific actions done was also different (night vs. day): serum lactate measurement (4.5 vs. 7 h, P = 0.018), blood cultures drawn (4 vs. 8 h, P night with a higher proportion of less differentiated doctors. The number of patients attending the Emergency Department was lower overnight. Hospital mortality rate was 34% in patients entering in the night period vs. 40% in those entering during the day (P = 0.281). Compliance with SSC recommendations was higher at night. A possible explanation might be the increased nurse to patient ratio in that period. Adjustment of the clinical team composition to the patients' demand is needed to increase compliance and improve prognosis.

  1. Information disclosure of troubles occurring at Rokkasho Reprocessing Plant

    International Nuclear Information System (INIS)

    Yamada, Tatsuya; Yoneyama, Mitsuru; Shinozaki, Yoshinori

    2005-01-01

    At Rokkasho Reprocessing Plant (RRP), efforts are made so that troubles occurred are promptly reported and announced publicly, and for minor troubles, etc., announcement to the society is made through the web-site and publicity magazines, so as to assure the transparency of the business. (author)

  2. 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…

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

    International Nuclear Information System (INIS)

    Shaikh, Talha; Handorf, Elizabeth A.; Murphy, Colin T.; Mehra, Ranee; Ridge, John A.; Galloway, Thomas J.

    2016-01-01

    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 49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ"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.

  4. Flow cytometric and radioisotopic determinations of platelet survival time in normal cats and feline leukemia virus-infected cats

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, R.M.; Boyce, J.T.; Kociba, G.J.

    1986-01-01

    This study demonstrates the potential usefulness of a flow cytometric technique to measure platelet survival time in cats utilizing autologous platelets labeled in vitro with fluorescein isothiocyanate (FITC). When compared with a 51Cr method, no significant differences in estimated survival times were found. Both the 51Cr and FITC-labeling procedures induced similar changes in platelet shape and collagen-induced aggregation. Platelets labeled with FITC had significantly greater volumes compared with those of glutaraldehyde-fixed platelets. These changes were primarily related to the platelet centrifugation and washing procedures rather than the labels themselves. This novel technique potentially has wide applicability to cell circulation time studies as flow cytometry equipment becomes more readily available. Problems with the technique are discussed. In a preliminary study of the platelet survival time in feline leukemia virus (FeLV)-infected cats, two of three cats had significantly reduced survival times using both flow cytometric and radioisotopic methods. These data suggest increased platelet turnover in FeLV-infected cats.

  5. Flow cytometric and radioisotopic determinations of platelet survival time in normal cats and feline leukemia virus-infected cats

    International Nuclear Information System (INIS)

    Jacobs, R.M.; Boyce, J.T.; Kociba, G.J.

    1986-01-01

    This study demonstrates the potential usefulness of a flow cytometric technique to measure platelet survival time in cats utilizing autologous platelets labeled in vitro with fluorescein isothiocyanate (FITC). When compared with a 51Cr method, no significant differences in estimated survival times were found. Both the 51Cr and FITC-labeling procedures induced similar changes in platelet shape and collagen-induced aggregation. Platelets labeled with FITC had significantly greater volumes compared with those of glutaraldehyde-fixed platelets. These changes were primarily related to the platelet centrifugation and washing procedures rather than the labels themselves. This novel technique potentially has wide applicability to cell circulation time studies as flow cytometry equipment becomes more readily available. Problems with the technique are discussed. In a preliminary study of the platelet survival time in feline leukemia virus (FeLV)-infected cats, two of three cats had significantly reduced survival times using both flow cytometric and radioisotopic methods. These data suggest increased platelet turnover in FeLV-infected cats

  6. Progression-free survival/time to progression as a potential surrogate for overall survival in HR+, HER2– metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Forsythe A

    2018-05-01

    Full Text Available Anna Forsythe,1 David Chandiwana,2 Janina Barth,3 Marroon Thabane,4 Johan Baeck,2 Gabriel Tremblay1 1Purple Squirrel Economics, New York, NY, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 3Novartis Pharma GmbH, Nuremberg, Germany; 4Novartis Pharmaceuticals Incorporated, Dorval, QC, Canada Background: Several recent randomized controlled trials (RCTs in hormone receptor-positive (HR+, human epidermal growth factor receptor 2-negative (HER2– metastatic breast cancer (MBC have demonstrated significant improvements in progression-free survival (PFS; however, few have reported improvement in overall survival (OS. The surrogacy of PFS or time to progression (TTP for OS has not been formally investigated in HR+, HER2– MBC.Methods: A systematic literature review of RCTs in HR+, HER2– MBC was conducted to identify studies that reported both median PFS/TTP and OS. The correlation between PFS/TTP and OS was evaluated using Pearson’s product–moment correlation and Spearman’s rank correlation. Subgroup analyses were performed to explore possible reasons for heterogeneity. Errors-in-variables weighted least squares regression (LSR was used to model incremental OS months as a function of incremental PFS/TTP months. An exploratory analysis investigated the impact of three covariates (chemotherapy vs hormonal/targeted therapy, PFS vs TTP, and first-line therapy vs second-line therapy or greater on OS prediction. The lower 95% prediction band was used to determine the minimum incremental PFS/TTP months required to predict OS benefit (surrogate threshold effect [STE].Results: Forty studies were identified. There was a statistically significant correlation between median PFS/TTP and OS (Pearson =0.741, P=0.000; Spearman =0.650, P=0.000. These results proved consistent for chemotherapy and hormonal/targeted therapy. Univariate LSR analysis yielded an R2 of 0.354 with 1 incremental PFS/TTP month corresponding to 1.13 incremental OS months

  7. The impact of chemotherapy and its timing on survival in malignant peritoneal mesothelioma treated with complete debulking.

    Science.gov (United States)

    Naffouje, Samer A; Tulla, Kiara A; Salti, George I

    2018-04-12

    The current standard of treatment for malignant peritoneal mesothelioma (MPM) is cytoreductive surgery when the disease distribution is favorable. The role of chemotherapy, as an adjunct to surgery, remains unclear. The national database of mesothelioma was used to identify MPM patients who were treated with curative intent. Patients were divided into treatment groups: (1) chemotherapy only, (2) surgery only, (3) neoadjuvant chemotherapy + surgery, and (4) surgery + adjuvant chemotherapy. A negative control group of patients who did not receive any treatment was added (group 0). Totally, 1740 patients were included. Mean age was 63.04 ± 14.58 and 60.7% were males. The patients' distribution into the treatment groups was 604, 684, 169, 55, and 228 patients in groups 0-4, respectively, with a median survival of 3.61 ± 0.37, 11.10 ± 0.73, 57.41 ± 11.91, 52.30 ± 7.20, and 55.00 ± 9.19 months. The addition of chemotherapy, in any setting, to surgery provided an improved survival at 1 year (p = 0.006). This survival benefit ceased at the 2-, 3-, and 5-year checkpoints. The multivariate analysis identified age, sarcomatoid/biphasic histologies, nodal and distant metastasis, and offering no treatment or chemotherapy only as poor prognostic factors for overall survival. No difference in overall survival was noted with the addition of chemotherapy to complete debulking regardless of the timing. Complete debulking remains the standard treatment for MPM. The addition of systemic chemotherapy provides a short-term survival improvement at 1 year only and was similar whether given in the neoadjuvant or adjuvant setting. Nevertheless, it did not add a survival benefit beyond the 1-year time point.

  8. 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.

  9. Time to Thrive, Not Just Survive: Accumulating Advantage for Women in Science

    Science.gov (United States)

    Rolison, Debra

    2005-04-01

    Our departments of science, technology, mathematics, and engineering (STEM) need more women as faculty, and not only to show their undergraduates that a career in academia is a viable path. Their absence warns us that an unhealthy environment exists: unhealthy to those scientists who want fulfilling lives beyond academe and unhealthy to those women, who once they demonstrate productivity, scholarship, and mentorship, still reap less respect, space, salary, funding, and awards than their male colleagues. The recalcitrance of too many of our research universities toward diversifying their faculty is a national disgrace in that these universities covet a diversified student body, but do not reflect that pool of talent onto their faculty. Similar difficulties are apparent among the staff of National and Federal laboratories. Self-reform is not getting it done, and is especially frustrating in light of the historic opportunity to change the demographics as scientists and engineers hired in the 1960s retire. Is it time to apply the logic of Title IX--the loss of Federal funds--for the entrenched inability to increase the number of women represented on STEM faculties? Such a threat may be the impetus necessary for university administrators to create departmental environments that women are willing to call home. The July 2004 release of the GAO report on Women's Participation in the Sciences (which also surveyed DOE facilities) reminded those Federal agencies that fund scientific research that Title IX is the law and that these agencies must begin Title IX assessments of compliance in the STEM departments and institutions they fund. It is past time that women thrive, not just survive in their career homes. Using the mechanistic philosophy of Title IX--denial of resources to recalacitrant departments and laboratories--may be the start of a truly inclusive scientific enterprise in the United States. We must accept this opportunity to redirect the nature of the research

  10. 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

  11. Making Good Choices: How Autonomy Support Influences the Behavior Change and Motivation of Troubled and Troubling Youth

    Science.gov (United States)

    Harper, Elaine

    2007-01-01

    Autonomy is a basic human need having influence on motivation. Facilitating student autonomy is an essential ingredient of effective programs for maximizing internalized change and increasing motivation in troubled and troubling youth. This article examines the theoretical concepts of autonomy and control related to choices and considers their…

  12. KMWin--a convenient tool for graphical presentation of results from Kaplan-Meier survival time analysis.

    Science.gov (United States)

    Gross, Arnd; Ziepert, Marita; Scholz, Markus

    2012-01-01

    Analysis of clinical studies often necessitates multiple graphical representations of the results. Many professional software packages are available for this purpose. Most packages are either only commercially available or hard to use especially if one aims to generate or customize a huge number of similar graphical outputs. We developed a new, freely available software tool called KMWin (Kaplan-Meier for Windows) facilitating Kaplan-Meier survival time analysis. KMWin is based on the statistical software environment R and provides an easy to use graphical interface. Survival time data can be supplied as SPSS (sav), SAS export (xpt) or text file (dat), which is also a common export format of other applications such as Excel. Figures can directly be exported in any graphical file format supported by R. On the basis of a working example, we demonstrate how to use KMWin and present its main functions. We show how to control the interface, customize the graphical output, and analyse survival time data. A number of comparisons are performed between KMWin and SPSS regarding graphical output, statistical output, data management and development. Although the general functionality of SPSS is larger, KMWin comprises a number of features useful for survival time analysis in clinical trials and other applications. These are for example number of cases and number of cases under risk within the figure or provision of a queue system for repetitive analyses of updated data sets. Moreover, major adjustments of graphical settings can be performed easily on a single window. We conclude that our tool is well suited and convenient for repetitive analyses of survival time data. It can be used by non-statisticians and provides often used functions as well as functions which are not supplied by standard software packages. The software is routinely applied in several clinical study groups.

  13. KMWin – A Convenient Tool for Graphical Presentation of Results from Kaplan-Meier Survival Time Analysis

    Science.gov (United States)

    Gross, Arnd; Ziepert, Marita; Scholz, Markus

    2012-01-01

    Background Analysis of clinical studies often necessitates multiple graphical representations of the results. Many professional software packages are available for this purpose. Most packages are either only commercially available or hard to use especially if one aims to generate or customize a huge number of similar graphical outputs. We developed a new, freely available software tool called KMWin (Kaplan-Meier for Windows) facilitating Kaplan-Meier survival time analysis. KMWin is based on the statistical software environment R and provides an easy to use graphical interface. Survival time data can be supplied as SPSS (sav), SAS export (xpt) or text file (dat), which is also a common export format of other applications such as Excel. Figures can directly be exported in any graphical file format supported by R. Results On the basis of a working example, we demonstrate how to use KMWin and present its main functions. We show how to control the interface, customize the graphical output, and analyse survival time data. A number of comparisons are performed between KMWin and SPSS regarding graphical output, statistical output, data management and development. Although the general functionality of SPSS is larger, KMWin comprises a number of features useful for survival time analysis in clinical trials and other applications. These are for example number of cases and number of cases under risk within the figure or provision of a queue system for repetitive analyses of updated data sets. Moreover, major adjustments of graphical settings can be performed easily on a single window. Conclusions We conclude that our tool is well suited and convenient for repetitive analyses of survival time data. It can be used by non-statisticians and provides often used functions as well as functions which are not supplied by standard software packages. The software is routinely applied in several clinical study groups. PMID:22723912

  14. 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.

  15. KMWin--a convenient tool for graphical presentation of results from Kaplan-Meier survival time analysis.

    Directory of Open Access Journals (Sweden)

    Arnd Gross

    Full Text Available BACKGROUND: Analysis of clinical studies often necessitates multiple graphical representations of the results. Many professional software packages are available for this purpose. Most packages are either only commercially available or hard to use especially if one aims to generate or customize a huge number of similar graphical outputs. We developed a new, freely available software tool called KMWin (Kaplan-Meier for Windows facilitating Kaplan-Meier survival time analysis. KMWin is based on the statistical software environment R and provides an easy to use graphical interface. Survival time data can be supplied as SPSS (sav, SAS export (xpt or text file (dat, which is also a common export format of other applications such as Excel. Figures can directly be exported in any graphical file format supported by R. RESULTS: On the basis of a working example, we demonstrate how to use KMWin and present its main functions. We show how to control the interface, customize the graphical output, and analyse survival time data. A number of comparisons are performed between KMWin and SPSS regarding graphical output, statistical output, data management and development. Although the general functionality of SPSS is larger, KMWin comprises a number of features useful for survival time analysis in clinical trials and other applications. These are for example number of cases and number of cases under risk within the figure or provision of a queue system for repetitive analyses of updated data sets. Moreover, major adjustments of graphical settings can be performed easily on a single window. CONCLUSIONS: We conclude that our tool is well suited and convenient for repetitive analyses of survival time data. It can be used by non-statisticians and provides often used functions as well as functions which are not supplied by standard software packages. The software is routinely applied in several clinical study groups.

  16. 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.

  17. Correlation between the genetic diversity of nosocomial pathogens and their survival time in intensive care units.

    NARCIS (Netherlands)

    Gastmeier, P; Schwab, F; Bärwolff, S; Rüden, H; Grundmann, Hajo

    2006-01-01

    Bacteria differ in their ability to survive in the hospital environment outside the human host. Species remaining viable and infectious have a higher chance of being transmitted, giving them a fitness advantage in hospitals. This differential fitness could be expected to alter the genetic population

  18. Time-related survival effects of two gluconasturtiin hydrolysis products on the terrestrial isopod Porcellio scaber

    DEFF Research Database (Denmark)

    van Ommen Kloeke, A E Elaine; Jager, Tjalling; van Gestel, Cornelis A. M.

    2012-01-01

    Glucosinolates are compounds produced by commercial crops which can hydrolyse in a range of natural toxins that may exert detrimental effects on beneficial soil organisms. This study examined the effects of 2-phenylethyl isothiocyanate and 3-phenylpropionitrile on the survival and growth of the w...

  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. 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.

  1. Hyperthermic survival of Chinese hamster ovary cells as a function of cellular population density at the time of plating

    International Nuclear Information System (INIS)

    Highfield, D.P.; Holahan, E.V.; Holahan, P.K.; Dewey, W.C.

    1984-01-01

    The survival of synchronous G 1 or asynchronous Chinese hamster ovary cells in vitro to heat treatment may depend on the cellular population density at the time of heating and/or as the cells are cultured after heating. The addition of lethally irradiated feeder cells may increase survival at 10 -3 by as much as 10- to 100-fold for a variety of conditions when cells are heated either in suspension culture or as monolayers with or without trypsinization. The protective effect associated with feeder cells appears to be associated with close cell-to-cell proximity. However, when cells are heated without trypsinization about 24 hr or later after plating, when adaptation to monolayer has occurred, the protective effect is reduced; i.e., addition of feeder cells enhances survival much less, for example, about 2- to 3-fold at 10 -2 -10 -3 survival. Also, the survival of a cell to heat is independent of whether the neighboring cell in a microcolony is destined to live or die. Finally, if protective effects associated with cell density do occur and are not controlled, serious artifacts can result as the interaction of heat and radiation is studied; for example, survival curves can be moved upward, and thus changed in shape as the number of cells plated is increased with an increase in the hyperthermic treatment or radiation dose following hyperthermia. Therefore, to understand mechanisms and to obtain information relevant to populations of cells in close proximity, such as those in vivo, these cellular population density effects should be considered and understood

  2. 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.

  3. Rigorous bounds on survival times in circular accelerators and efficient computation of fringe-field transfer maps

    International Nuclear Information System (INIS)

    Hoffstaetter, G.H.

    1994-12-01

    Analyzing stability of particle motion in storage rings contributes to the general field of stability analysis in weakly nonlinear motion. A method which we call pseudo invariant estimation (PIE) is used to compute lower bounds on the survival time in circular accelerators. The pseudeo invariants needed for this approach are computed via nonlinear perturbative normal form theory and the required global maxima of the highly complicated multivariate functions could only be rigorously bound with an extension of interval arithmetic. The bounds on the survival times are large enough to the relevant; the same is true for the lower bounds on dynamical aperatures, which can be computed. The PIE method can lead to novel design criteria with the objective of maximizing the survival time. A major effort in the direction of rigourous predictions only makes sense if accurate models of accelerators are available. Fringe fields often have a significant influence on optical properties, but the computation of fringe-field maps by DA based integration is slower by several orders of magnitude than DA evaluation of the propagator for main-field maps. A novel computation of fringe-field effects called symplectic scaling (SYSCA) is introduced. It exploits the advantages of Lie transformations, generating functions, and scaling properties and is extremely accurate. The computation of fringe-field maps is typically made nearly two orders of magnitude faster. (orig.)

  4. 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.

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

    International Nuclear Information System (INIS)

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

    1981-01-01

    The effect of intestinal microflora on the survival time of mice exposed to 2-kR whole-body γ 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

  6. Double Trouble Foraminiferal Calcification in a Changing Ocean

    NARCIS (Netherlands)

    Van Dijk, I.E.Y.

    2017-01-01

    Within the project ‘Double Trouble: Foraminiferal Calcification in a Changing Ocean’, I tried to illuminate mechanisms determining element incorporation in foraminifera with different calcification strategies. In particular, I aimed to assess the interplay between ocean acidification and

  7. Double Trouble : Foraminiferal calcification in a changing ocean

    NARCIS (Netherlands)

    van Dijk, I.E.Y.

    2017-01-01

    Within the project ‘Double Trouble: Foraminiferal Calcification in a Changing Ocean’, I tried to illuminate mechanisms determining element incorporation in foraminifera with different calcification strategies. In particular, I aimed to assess the interplay between ocean acidification and

  8. Troubles in the teacher’s work

    Directory of Open Access Journals (Sweden)

    Nilson Rogério da Silva

    2017-12-01

    Full Text Available Introduction: The teacher’s work is permeated by a number of adverse factors including poor working conditions, inadequate wages, lack of teaching materials and resources, relationship problems with students, high workload, little or no interest in their work management. Such conditions end up being expressed by teachers through physical and emotional illnesses. Objective: To identify the perception of teachers about their work and their relation to health, considering physical, emotional and organizational. Method: The study included 110 elementary school teachers that are distance course members (EAD. For data collection, it was used a semi-structured questionnaire addressing personal and professional, physical, mental and organizational work. Data analysis was performed using non-parametric statistics, with mean and standard deviation calculations. Results: The results reveal that the bureaucratic activities are the most physically demanding and the mentally ones refer to the lack of interest of students and parents. The body region of biggest complaint was upper and lower limbs. As to working conditions, most teachers considered partially satisfactory, considering that these harms their health and can interfere with the student’s learning. Conclusion: The teacher’s work is permeated with troubles and requires prevention and intervention measures to develop confrontation strategies and reflection of the organizational context, with benefits also for students and schools.

  9. The comparison of proportional hazards and accelerated failure time models in analyzing the first birth interval survival data

    Science.gov (United States)

    Faruk, Alfensi

    2018-03-01

    Survival analysis is a branch of statistics, which is focussed on the analysis of time- to-event data. In multivariate survival analysis, the proportional hazards (PH) is the most popular model in order to analyze the effects of several covariates on the survival time. However, the assumption of constant hazards in PH model is not always satisfied by the data. The violation of the PH assumption leads to the misinterpretation of the estimation results and decreasing the power of the related statistical tests. On the other hand, the accelerated failure time (AFT) models do not assume the constant hazards in the survival data as in PH model. The AFT models, moreover, can be used as the alternative to PH model if the constant hazards assumption is violated. The objective of this research was to compare the performance of PH model and the AFT models in analyzing the significant factors affecting the first birth interval (FBI) data in Indonesia. In this work, the discussion was limited to three AFT models which were based on Weibull, exponential, and log-normal distribution. The analysis by using graphical approach and a statistical test showed that the non-proportional hazards exist in the FBI data set. Based on the Akaike information criterion (AIC), the log-normal AFT model was the most appropriate model among the other considered models. Results of the best fitted model (log-normal AFT model) showed that the covariates such as women’s educational level, husband’s educational level, contraceptive knowledge, access to mass media, wealth index, and employment status were among factors affecting the FBI in Indonesia.

  10. Unique protein expression signatures of survival time in kidney renal clear cell carcinoma through a pan-cancer screening.

    Science.gov (United States)

    Han, Guangchun; Zhao, Wei; Song, Xiaofeng; Kwok-Shing Ng, Patrick; Karam, Jose A; Jonasch, Eric; Mills, Gordon B; Zhao, Zhongming; Ding, Zhiyong; Jia, Peilin

    2017-10-03

    In 2016, it is estimated that there will be 62,700 new cases of kidney cancer in the United States, and 14,240 patients will die from the disease. Because the incidence of kidney renal clear cell carcinoma (KIRC), the most common type of kidney cancer, is expected to continue to increase in the US, there is an urgent need to find effective diagnostic biomarkers for KIRC that could help earlier detection of and customized treatment strategies for the disease. Accordingly, in this study we systematically investigated KIRC's prognostic biomarkers for survival using the reverse phase protein array (RPPA) data and the high throughput sequencing data from The Cancer Genome Atlas (TCGA). With comprehensive data available in TCGA, we systematically screened protein expression based survival biomarkers in 10 major cancer types, among which KIRC presented many protein prognostic biomarkers of survival time. This is in agreement with a previous report that expression level changes (mRNAs, microRNA and protein) may have a better performance for prognosis of KIRC. In this study, we also identified 52 prognostic genes for KIRC, many of which are involved in cell-cycle and cancer signaling, as well as 15 tumor-stage-specific prognostic biomarkers. Notably, we found fewer prognostic biomarkers for early-stage than for late-stage KIRC. Four biomarkers (the RPPA protein IDs: FASN, ACC1, Cyclin_B1 and Rad51) were found to be prognostic for survival based on both protein and mRNA expression data. Through pan-cancer screening, we found that many protein biomarkers were prognostic for patients' survival in KIRC. Stage-specific survival biomarkers in KIRC were also identified. Our study indicated that these protein biomarkers might have potential clinical value in terms of predicting survival in KIRC patients and developing individualized treatment strategies. Importantly, we found many biomarkers in KIRC at both the mRNA expression level and the protein expression level. These

  11. 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.

  12. Disparities in breast cancer tumor characteristics, treatment, time to treatment, and survival probability among African American and white women.

    Science.gov (United States)

    Foy, Kevin Chu; Fisher, James L; Lustberg, Maryam B; Gray, Darrell M; DeGraffinreid, Cecilia R; Paskett, Electra D

    2018-01-01

    African American (AA) women have a 42% higher breast cancer death rate compared to white women despite recent advancements in management of the disease. We examined racial differences in clinical and tumor characteristics, treatment and survival in patients diagnosed with breast cancer between 2005 and 2014 at a single institution, the James Cancer Hospital, and who were included in the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute Cancer Registry in Columbus OH. Statistical analyses included likelihood ratio chi-square tests for differences in proportions, as well as univariate and multivariate Cox proportional hazards regressions to examine associations between race and overall and progression-free survival probabilities. AA women made up 10.2% (469 of 4593) the sample. Average time to onset of treatment after diagnosis was almost two times longer in AA women compared to white women (62.0 days vs 35.5 days, p  triple negative and late stage breast cancer, and were less likely to receive surgery, especially mastectomy and reconstruction following mastectomy. After adjustment for confounding factors (age, grade, and surgery), overall survival probability was significantly associated with race (HR = 1.33; 95% CI 1.03-1.72). These findings highlight the need for efforts focused on screening and receipt of prompt treatment among AA women diagnosed with breast cancer.

  13. Nutrition management methods effective in increasing weight, survival time and functional status in ALS patients: a systematic review.

    Science.gov (United States)

    Kellogg, Jaylin; Bottman, Lindsey; Arra, Erin J; Selkirk, Stephen M; Kozlowski, Frances

    2018-02-01

    Poor prognosis and decreased survival time correlate with the nutritional status of patients with amyotrophic lateral sclerosis (ALS). Various studies were reviewed which assessed weight, body mass index (BMI), survival time and ALS functional rating scale revised (ALSFRS-R) in order to determine the best nutrition management methods for this patient population. A systematic review was conducted using CINAHL, Medline, and PubMed, and various search terms in order to determine the most recent clinical trials and observational studies that have been conducted concerning nutrition and ALS. Four articles met criteria to be included in the review. Data were extracted from these articles and were inputted into the Data Extraction Tool (DET) provided by the Academy of Nutrition and Dietetics (AND). Results showed that nutrition supplementation does promote weight stabilisation or weight gain in individuals with ALS. Given the low risk and low cost associated with intervention, early and aggressive nutrition intervention is recommended. This systematic review shows that there is a lack of high quality evidence regarding the efficacy of any dietary interventions for promoting survival in ALS or slowing disease progression; therefore more research is necessary related to effects of nutrition interventions.

  14. First recovery in anorexia nervosa patients in the long-term course: a discrete-time survival analysis.

    Science.gov (United States)

    Herzog, W; Schellberg, D; Deter, H C

    1997-02-01

    The results of a 12-year follow-up study of occurrence and timing of first recovery in 69 hospitalized patients with severe anorexia nervosa (AN) are presented. For the first time discrete-time survival analysis methods were used to determine the likelihood of recovery in AN patients. Furthermore, predictors gleaned from pretreatment-posttreatment studies of long-term outcome in AN could be evaluated as to their effect on a change in the time course structure of the likelihood of first recovery. Results show that AN condition did not improve until after 6 years after the first inpatient treatment in 50% of patients. However, a restricter-type AN and low serum creatinine levels were predictors for earlier recovery. One specific effect was that AN patients who show purging behavior in combination with additional social disturbances have a lower chance of recovering. The use of discrete-time survival analysis methodology in further prospective studies will contribute to the development of more tailored treatment of AN, which also takes the individual phase of illness and specific aspects of the symptomatology into account.

  15. Waiting Time from Diagnosis to Treatment has no Impact on Survival in Patients with Esophageal Cancer

    NARCIS (Netherlands)

    Visser, E.; Leeftink, Anne Greetje; van Rossum, P.S.N.; Siesling, Sabine; van Hillegersberg, R.; Ruurda, J.P.

    2016-01-01

    Background Waiting time from diagnosis to treatment has emerged as an important quality indicator in cancer care. This study was designed to determine the impact of waiting time on long-term outcome of patients with esophageal cancer who are treated with neoadjuvant therapy followed by surgery or

  16. 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....

  17. 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.

  18. 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.

  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

    Directory of Open Access Journals (Sweden)

    Justine B. Nasejje

    2017-07-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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. Diagnostics aid for mass spectrometer trouble-shooting

    International Nuclear Information System (INIS)

    Filby, E.E.; Rankin, R.A.; Webb, G.W.

    1987-01-01

    The ''MS Expert'' system provides problem diagnostics for instruments used in the Mass Spectrometry Laboratory (MSL). The most critical results generated on these mass spectrometers are the uranium concentration and isotopic content data used for process control and materials accountability at the Idaho Chemical Processing Plant. The two purposes of the system are: (1) to minimize instrument downtime and thereby provide the best possible support to the Plant, and (2) to improve long-term data quality. This system combines the knowledge of several experts on mass spectrometry to provide a diagnostic tool, and can make these skills avilable on a more timely basis. It integrates code written in the Pascal language with a knowledge base entered into a commercial expert system ''shell.'' The user performs some preliminary status checks, and then selects from among several broad diagnostic categories. These initial steps provide input to the rule base. The overall analysis provides the user with a set of possible solutions to the observed problems, graded as to their probabilities. Besides the trouble-shooting benefits expected from this system, it will also provide structures diagnostic training for lab personnel. In addition, development of the system knowledge base has already produced a better understanding of instrument behavior. Two key findings are that a good user interface is necessary for full acceptance of the tool, and a development system should include standard programming capabilities as well as the expert system shell. 22 refs., 5 figs

  1. 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.

  2. Diagnostics aid for mass spectrometer trouble-shooting

    International Nuclear Information System (INIS)

    Filby, E.E.; Rankin, R.A.; Webb, G.W.

    1987-01-01

    The MS Expert system provides problem diagnostics for instruments used in the Mass Spectrometry Laboratory (MSL). The most critical results generated on these mass spectrometers are the uranium concentration and isotopic content data used for process control and materials accountability at the Idaho General Processing Plant. The two purposes of the system are: (1) to minimize instrument downtime and thereby provide the best possible support to the Plant, and (2) to improve long-term data quality. This system combines the knowledge of several experts on mass spectrometry to provide a diagnostic tool, and can make these skills available on a more timely basis. It integrates code written in the Pascal language with a knowledge base entered into a commercial expert system shell. The user performs some preliminary status checks, and then selects from among several broad diagnostic categories. These initial steps provide input to the rule base. The overall analysis provides the user with a set of possible solutions to the observed problems, graded as to their probabilities. Besides the trouble-shooting benefits expected from this system, it also provides structured diagnostic training for lab personnel. In addition, development of the system knowledge base has already produced a better understanding of instrument behavior. Two key findings are that a good user interface is necessary for full acceptance of the tool, and, a development system should include standard programming capabilities as well as the expert system shell

  3. 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.

  4. 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.

  5. 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.

  6. Human umbilical-cord-blood mononucleated cells enhance the survival of lethally irradiated mice. Dosage and the window of time

    International Nuclear Information System (INIS)

    Kovalenko, Olga A.; Ende, Norman; Azzam, Edouard I.

    2013-01-01

    The purpose of this study was to evaluate the window of time and dose of human umbilical-cord-blood (HUCB) mononucleated cells necessary for successful treatment of radiation injury in mice. Female A/J mice (27-30 weeks old) were exposed to an absorbed dose of 9-10 Gy of 137 Cs γ-rays delivered acutely to the whole body. They were treated either with 1 × 10 8 or 2 × 10 8 HUCB mononucleated cells at 24-52 h after the irradiation. The antibiotic Levaquin was applied 4 h postirradiation. The increased dose of cord-blood cells resulted in enhanced survival. The enhancement of survival in animals that received 2 × 10 8 HUCB mononucleated cells relative to irradiated but untreated animals was highly significant (P < 0.01). Compared with earlier studies, the increased dose of HUCB mononucleated cells, coupled with early use of an antibiotic, extended the window of time for effective treatment of severe radiation injury from 4 to 24-52 h after exposure. (author)

  7. Survival of Lactobacillus plantarumU40 on the in vitro rumen fermentation quantified with real-time PCR

    Directory of Open Access Journals (Sweden)

    W.D. Astuti

    2018-05-01

    Full Text Available The objective of this study was to evaluate the survival of L. plantarumU40 quantified with real-time PCR during in vitro rumen fermentation. The experiment was arranged in a randomized block design with 3 treatments and 4 replications. Treatments were control, rumen fermentation inoculated with L. plantarumU40and L. plantarumU40 + glucose solution. Population of L. plantarum U40 was higher at inoculation treatment. After 8 hours incubation, glucose addition tended to decrease L. plantarum U40 population. Control treatment showed lowest population of L. plantarum U40 along in vitro fermentation compared with other treatment. Inoculation of L. plantarumU40 significantly (p<0.05 increased population of LAB until 12 hours incubation compared with control. Control treatment had highest pH at all incubation time. Glucose addition significantly (P<0.05 decreased final rumen pH (24 hours (6.30, compared with control treatment (6.85. Inoculation of L. plantarum U40 with glucose addition significantly (P<0.05increased propionic acid, decreased acetic acid and A/P ratio compared with other treatments. Lactobacillus plantarum U40 without glucose addition did not affect propionic acid production significantly. As conclusion, Lactobacillus plantarum U40 can survive in rumen fluid and changes rumen fermentation when glucose is added as carbon source.

  8. Slow Freezing or Vitrification of Oocytes: Their Effects on Survival and Meiotic Spindles, and the Time Schedule for Clinical Practice

    Directory of Open Access Journals (Sweden)

    Shee-Uan Chen

    2009-03-01

    Full Text Available Both the slow-freezing method with increased sucrose concentration and new vitrification techniques significantly improve the results of cryopreservation of human oocytes. The recent perfection for vitrification includes the concepts of increase of cooling and warming rates using minimum volume methods, and decrease of toxicity by reducing the concentration of cryoprotectants. In the recent literature, the survival of cryopreserved oocytes ranged from 74% to 90% using the slow-freezing method and from 84% to 99% by vitrification. Overall, the survival rate of oocytes from vitrification (95%, 899/948 appeared higher than that of the slow-freezing method (75%, 1,275/1,683. The microtubules of meiotic spindles are vulnerable to the thermal changes and will depolymerize. After incubation, the microtubules repolymerize. Spindle recovery is faster after vitrification than slow freezing. Even so, after 3 hours of incubation, spindle recuperation is similar between vitrification and slow freezing. Considering both aspects of spindle recovery and oocyte aging, the time schedule for oocyte cryopreservation program makes fertilization in the optimal time. Intracytoplasmic sperm injection is performed for oocytes at 3 hours of post-thaw incubation from the slow-freezing method and 2 hours from vitrification, with restoration of meiotic spindles. The pregnancy potential of cryopreserved oocytes is comparable to that of fresh oocytes or frozen embryos. Cryopreservation of oocytes would importantly contribute to oocyte donation and preservation of fertility for cancer patients.

  9. 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.

  10. 17th Environmental Quality Index: Troubling Times with Toxics.

    Science.gov (United States)

    National Wildlife, 1986

    1986-01-01

    Presents a subjective analysis of the status of United States' natural resources, reviewing 1985's key environmental events, problems, and successes. Reports current conditions and/or dilemmas concerning wildlife, air, water, energy, forests, and soils. Provides both a public rating of the quality of life and a priority ranking of environmental…

  11. The Campus Affiliates Program: Universities Respond to Troubled Times.

    Science.gov (United States)

    Kreutziger, Sarah Sloan; Ager, Richard; Harrell, Evelyn B.; Wright, James

    1999-01-01

    Presents a case study of the Campus Affiliates Program, a collaborative venture designed to revitalize the most severely impoverished sectors of New Orleans (Louisiana). Focuses on processes that created the program; organizing principles; obstacles encountered; and impacts of the program on faculty, students, staff, and institutions. (DSK)

  12. The M1 form of tumor-associated macrophages in non-small cell lung cancer is positively associated with survival time

    International Nuclear Information System (INIS)

    Ma, Junliang; Liu, Lunxu; Che, Guowei; Yu, Nanbin; Dai, Fuqiang; You, Zongbing

    2010-01-01

    Tumor-associated macrophages (TAMs) play an important role in growth, progression and metastasis of tumors. In non-small cell lung cancer (NSCLC), TAMs' anti-tumor or pro-tumor role is not determined. Macrophages are polarized into M1 (with anti-tumor function) and M2 (with pro-tumor function) forms. This study was conducted to determine whether the M1 and M2 macrophage densities in NSCLC are associated with patient's survival time. Fifty patients with an average of 1-year survival (short survival group) and 50 patients with an average of 5-year survival (long survival group) were included in this retrospective study. Paraffin-embedded NSCLC specimens and their clinicopathological data including up to 8-year follow-up information were used. Immunohistochemical double-staining of CD68/HLA-DR (markers for M1 macrophages) and CD68/CD163 (markers for M2 macrophages) was performed and evaluated in a blinded fashion. The M1 and M2 macrophage densities in the tumor islets, stroma, or islets and stroma were determined using computer-aided microscopy. Correlation of the macrophage densities and patient's survival time was analyzed using the Statistical Package for the Social Sciences. Approximately 70% of TAMs were M2 macrophages and the remaining 30% were M1 macrophages in NSCLC. The M2 macrophage densities (approximately 78 to 113 per mm 2 ) in the tumor islets, stroma, or islets and stroma were not significantly different between the long survival and short survival groups. The M1 macrophage densities in the tumor islets (approximately 70/mm 2 ) and stroma (approximately 34/mm 2 ) of the long survival group were significantly higher than the M1 macrophage densities in the tumor islets (approximately 7/mm 2 ) and stroma (13/mm 2 ) of the short survival group (P < 0.001 and P < 0.05, respectively). The M2 macrophage densities were not associated with patient's survival time. The M1 macrophage densities in the tumor islets, stroma, or islets and stroma

  13. Trouble in the second year: three questions about family interaction.

    Science.gov (United States)

    Belsky, J; Woodworth, S; Crnic, K

    1996-04-01

    3 questions regarding family interaction in the second year of life are addressed in this report on 69 families rearing firstborn sons. Question 1 concerns the identification, via cluster analysis, of families having difficulty managing their child, using codings of narrative records of family interaction when children were 15 and 21 months of age. Parents in families identified as "troubled" at each age tried to control their toddlers most often, were least likely to rely upon control-plus-guidance management strategies, had children who defied them most frequently, and experienced the greatest escalation of negative affect in these control encounters. Families identified as "troubled" at both 15 and 21 months had children who received the highest "externalizing" problem scores at 18 months and mothers who experienced the most daily hassles during the second year. Question 2 concerns the antecedents of "trouble in the second year." Discriminant function analyses indicated that membership in the groups of families that appeared troubled at both ages of measurement (n = 15), at only one age (n = 28), or never (n = 26) could be reliably predicted (hit rate = 71%) using a set of 9 measurements of parent personality, child emotionality/temperament, marital quality, work-family relations, and social support, suggested by Belsky's model of the determinants of parenting, and social class. Question 3 concerns the proposition that extensive nonmaternal care in the first year is a risk factor for troubled family functioning in the second year. As hypothesized, prediction analysis showed that families at moderate and high contextual risk (based on 10 antecedent variables pertaining to Question 2), were significantly more likely to experience trouble in the second year when children experienced 20 or more hours per week of nonmaternal care in their first year, and these results could not be attributed to "selection effects."

  14. Canada: trouble with two-legged bears

    International Nuclear Information System (INIS)

    Stauffer, Thomas

    1999-01-01

    The current low price of oil has serious implications for producers in Canada and the corporate survival of many of the smaller producers is now in danger. Oil production and exploration are themselves threatened. The advantages to OPEC in terms of reduced competition are discussed. The lesser impact on production of oil from tar sands and mitigation of the impact on many companies with interests in gas is also mentioned. (UK)

  15. The Impact of Timing and Graft Dysfunction on Survival and Cardiac Allograft Vasculopathy in Antibody Mediated Rejection

    Science.gov (United States)

    Clerkin, Kevin J.; Restaino, Susan W.; Zorn, Emmanuel; Vasilescu, Elena R.; Marboe, Charles C.; Mancini, Donna M.

    2017-01-01

    Background Antibody mediated rejection (AMR) has been associated with increased mortality and cardiac allograft vasculopathy (CAV). Early studies suggested that late AMR was rarely associated with graft dysfunction while recent reports have demonstrated an association with increased mortality. We sought to investigate the timing of AMR and its association with graft dysfunction, mortality, and CAV. Methods This retrospective cohort study identified all adult heart transplant recipients at Columbia University Medical Center from 2004–2013 (689 patients). There were 68 primary cases of AMR, which were stratified by early (1-year post-OHT) AMR. Kaplan-Meier survival analysis and modeling was performed with multivariable logistic regression and Cox proportional hazards regression. Results From January 1, 2004 through October 1, 2015 43 patients had early AMR (median 23 days post-OHT) and 25 had late AMR (median 1084 days post-OHT). Graft dysfunction was less common with early compared with late AMR (25.6% vs. 56%, p=0.01). Patients with late AMR had decreased post-AMR survival compared with early AMR (1-year 80% vs. 93%, 5-year 51% vs. 73%, p<0.05). When stratified by graft dysfunction, only those with late AMR and graft dysfunction had worse survival (30-day 79%, 1-year 64%, and 5-year 36%, p<0.006). The association remained irrespective of age, sex, DSA, LVAD use, reason for OHT, and recovery of graft function. Similarly, those with late AMR and graft dysfunction had accelerated development of de-novo CAV (50% at 1 year, HR 5.42, p=0.009), while all other groups were all similar to the general transplant population. Conclusion Late AMR is frequently associated with graft dysfunction. When graft dysfunction is present in late AMR there is an early and sustained increased risk of mortality and rapid development of de-novo CAV despite aggressive treatment. PMID:27423693

  16. Swedish National Registry of Urinary Bladder Cancer: No difference in relative survival over time despite more aggressive treatment.

    Science.gov (United States)

    Jahnson, Staffan; Hosseini Aliabad, Abolfazl; Holmäng, Sten; Jancke, Georg; Liedberg, Fredrik; Ljungberg, Börje; Malmström, Per-Uno; Rosell, Johan

    2016-01-01

    The aim of this study was to use the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) to investigate changes in patient and tumour characteristics, management and survival in bladder cancer cases over a period of 15 years. All patients with newly detected bladder cancer reported to the SNRUBC during 1997-2011 were included in the study. The cohort was divided into three groups, each representing 5 years of the 15 year study period. The study included 31,266 patients (74% men, 26% women) with a mean age of 72 years. Mean age was 71.7 years in the first subperiod (1997-2001) and 72.5 years in the last subperiod (2007-2011). Clinical T categorization changed from the first to the last subperiod: Ta from 45% to 48%, T1 from 21.6% to 22.4%, and T2-T4 from 27% to 25%. Also from the first to the last subperiod, intravesical treatment after transurethral resection for T1G2 and T1G3 tumours increased from 15% to 40% and from 30% to 50%, respectively, and cystectomy for T2-T4 tumours increased from 30% to 40%. No differences between the analysed subperiods were found regarding relative survival in patients with T1 or T2-T4 tumours, or in the whole cohort. This investigation based on a national bladder cancer registry showed that the age of the patients at diagnosis increased, and the proportion of muscle-invasive tumours decreased. The treatment of all tumour stages became more aggressive but relative survival showed no statistically significant change over time.

  17. Evidence for a time-dependent association between FOLR1 expression and survival from ovarian carcinoma

    DEFF Research Database (Denmark)

    Köbel, M; Madore, J; Ramus, S J

    2014-01-01

    BACKGROUND: Folate receptor 1 (FOLR1) is expressed in the majority of ovarian carcinomas (OvCa), making it an attractive target for therapy. However, clinical trials testing anti-FOLR1 therapies in OvCa show mixed results and require better understanding of the prognostic relevance of FOLR1...... stage I/II tumours, patients with FOLR1-positive HGSC showed increased OS during the first 2 years only (hazard ratio=0.44, 95% confidence interval=0.20-0.96) and patients with FOLR1-positive clear cell carcinomas (CCC) showed decreased PFS independent of follow-up time (HR=1.89, 95% CI=1.10-3.25, N=259...

  18. A flexible and coherent test/estimation procedure based on restricted mean survival times for censored time-to-event data in randomized clinical trials.

    Science.gov (United States)

    Horiguchi, Miki; Cronin, Angel M; Takeuchi, Masahiro; Uno, Hajime

    2018-04-22

    In randomized clinical trials where time-to-event is the primary outcome, almost routinely, the logrank test is prespecified as the primary test and the hazard ratio is used to quantify treatment effect. If the ratio of 2 hazard functions is not constant, the logrank test is not optimal and the interpretation of hazard ratio is not obvious. When such a nonproportional hazards case is expected at the design stage, the conventional practice is to prespecify another member of weighted logrank tests, eg, Peto-Prentice-Wilcoxon test. Alternatively, one may specify a robust test as the primary test, which can capture various patterns of difference between 2 event time distributions. However, most of those tests do not have companion procedures to quantify the treatment difference, and investigators have fallen back on reporting treatment effect estimates not associated with the primary test. Such incoherence in the "test/estimation" procedure may potentially mislead clinicians/patients who have to balance risk-benefit for treatment decision. To address this, we propose a flexible and coherent test/estimation procedure based on restricted mean survival time, where the truncation time τ is selected data dependently. The proposed procedure is composed of a prespecified test and an estimation of corresponding robust and interpretable quantitative treatment effect. The utility of the new procedure is demonstrated by numerical studies based on 2 randomized cancer clinical trials; the test is dramatically more powerful than the logrank, Wilcoxon tests, and the restricted mean survival time-based test with a fixed τ, for the patterns of difference seen in these cancer clinical trials. Copyright © 2018 John Wiley & Sons, Ltd.

  19. 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.

  20. 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.

  1. Thresholds and timing of pre-operative thrombocytosis and ovarian cancer survival: analysis of laboratory measures from electronic medical records

    International Nuclear Information System (INIS)

    Cozzi, Gabriella D.; Samuel, Jacob M.; Fromal, Jason T.; Keene, Spencer; Crispens, Marta A.; Khabele, Dineo; Beeghly-Fadiel, Alicia

    2016-01-01

    Thrombocytosis has been associated with poor ovarian cancer prognosis. However, comparisons of thresholds to define thrombocytosis and evaluation of relevant timing of platelet measurement has not been previously conducted. We selected Tumor Registry confirmed ovarian, primary peritoneal, and fallopian tube cancer cases diagnosed between 1995–2013 from the Vanderbilt University Medical Center. Laboratory measured platelet values from electronic medical records (EMR) were used to determine thrombocytosis at three thresholds: a platelet count greater than 350, 400, or 450 × 10 9 /liter. Timing was evaluated with 5 intervals: on the date of diagnosis, and up to 1, 2, 4, and 8 weeks prior to the date of diagnosis. Cox regression was used to calculate hazard ratios (HR) and confidence intervals (CI) for association with overall survival; adjustment included age, stage, grade, and histologic subtype of disease. Pre-diagnosis platelet measures were available for 136, 241, 280, 297, and 304 cases in the five intervals. The prevalence of thrombocytosis decreased with increasing thresholds and was generally consistent across the five time intervals, ranging from 44.8–53.2 %, 31.6–39.4 %, and 19.9–26.1 % across the three thresholds. Associations with higher grade and stage of disease gained significance as the threshold increased. With the exception of the lowest threshold on the date of diagnosis (HR 350 : 1.55, 95 % CI: 0.97–2.47), all other survival associations were significant, with the highest reaching twice the risk of death for thrombocytosis on the date of diagnosis (HR 400 : 2.01, 95 % CI: 1.25–3.23). Our EMR approach yielded associations comparable to published findings from medical record abstraction approaches. In addition, our results indicate that lower thrombocytosis thresholds and platelet measures up to 8 weeks before diagnosis may inform ovarian cancer characteristics and prognosis

  2. Does the benefit on survival from leisure time physical activity depend on physical activity at work? A prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Andreas Holtermann

    Full Text Available PURPOSE: To investigate if persons with high physical activity at work have the same benefits from leisure time physical activity as persons with sedentary work. METHODS: In the Copenhagen City Heart Study, a prospective cohort of 7,411 males and 8,916 females aged 25-66 years without known cardiovascular disease at entry in 1976-78, 1981-83, 1991-94, or 2001-03, the authors analyzed with sex-stratified multivariate Cox proportional hazards regression the association between leisure time physical activity and cardiovascular and all-cause mortality among individuals with different levels of occupational physical activity. RESULTS: During a median follow-up of 22.4 years, 4,003 individuals died from cardiovascular disease and 8,935 from all-causes. Irrespective of level of occupational physical activity, a consistently lower risk with increasing leisure time physical activity was found for both cardiovascular and all-cause mortality among both men and women. Compared to low leisure time physical activity, the survival benefit ranged from 1.5-3.6 years for moderate and 2.6-4.7 years for high leisure time physical activity among the different levels of occupational physical activity. CONCLUSION: Public campaigns and initiatives for increasing physical activity in the working population should target everybody, irrespective of physical activity at work.

  3. Does the benefit on survival from leisure time physical activity depend on physical activity at work? A prospective cohort study.

    Science.gov (United States)

    Holtermann, Andreas; Marott, Jacob Louis; Gyntelberg, Finn; Søgaard, Karen; Suadicani, Poul; Mortensen, Ole Steen; Prescott, Eva; Schnohr, Peter

    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. In the Copenhagen City Heart Study, a prospective cohort of 7,411 males and 8,916 females aged 25-66 years without known cardiovascular disease at entry in 1976-78, 1981-83, 1991-94, or 2001-03, the authors analyzed with sex-stratified multivariate Cox proportional hazards regression the association between leisure time physical activity and cardiovascular and all-cause mortality among individuals with different levels of occupational physical activity. During a median follow-up of 22.4 years, 4,003 individuals died from cardiovascular disease and 8,935 from all-causes. Irrespective of level of occupational physical activity, a consistently lower risk with increasing leisure time physical activity was found for both cardiovascular and all-cause mortality among both men and women. Compared to low leisure time physical activity, the survival benefit ranged from 1.5-3.6 years for moderate and 2.6-4.7 years for high leisure time physical activity among the different levels of occupational physical activity. Public campaigns and initiatives for increasing physical activity in the working population should target everybody, irrespective of physical activity at work.

  4. Bronchiolitis obliterans syndrome after single-lung transplantation: impact of time to onset on functional pattern and survival.

    Science.gov (United States)

    Brugière, Olivier; Pessione, Fabienne; Thabut, Gabriel; Mal, Hervé; Jebrak, Gilles; Lesèche, Guy; Fournier, Michel

    2002-06-01

    Among risk factors for the progression of bronchiolitis obliterans syndrome (BOS) after lung transplantation (LT), the influence of time to BOS onset is not known. The aim of the study was to assess if BOS occurring earlier after LT is associated with worse functional prognosis and worse graft survival. We retrospectively compared functional outcome and survival of all single-LT (SLT) recipients who had BOS develop during follow-up in our center according to time to onset of BOS ( or = 3 years after transplantation). Among the 29 SLT recipients with BOS identified during the study period, 20 patients had early-onset BOS and 9 patients had late-onset BOS. The mean decline of FEV(1) over time during the first 9 months in patients with early-onset BOS was significantly greater than in patients with of late-onset BOS (p = 0.04). At last follow-up, patients with early-onset BOS had a lower mean FEV(1) value (25% vs 39% of predicted, p = 0.004), a lower mean PaO(2) value (54 mm Hg vs 73 mm Hg, p = 0.0005), a lower 6-min walk test distance (241 m vs 414 m, p = 0.001), a higher Medical Research Council index value (3.6 vs 1.6, p = 0.0001), and a higher percentage of oxygen dependency (90% vs 11%, p = 0.001) compared with patients with late-onset BOS. In addition, graft survival of patients with early-onset BOS was significantly lower than that of patients with late-onset BOS (log-rank test, p = 0.04). There were 18 of 20 graft failures (90%) in the early-onset BOS group, directly attributable to BOS in all cases (deaths [n = 10] or retransplantation [n = 8]). In the late-onset BOS group, graft failure occurred in four of nine patients due to death from extrapulmonary causes in three of four cases. The median duration of follow-up after occurrence of BOS was not statistically different between patients with early-onset BOS and patients with late-onset BOS (31 +/- 28 months and 37 +/- 26 months, respectively; p = not significant). The subgroup of patients who had BOS develop

  5. Flipping SU(5) out of Trouble

    CERN Document Server

    Ellis, Jonathan Richard; Walker, J; Ellis, John

    2002-01-01

    Minimal supersymmetric SU(5) GUTs are being squeezed by the recent values of alpha_s, sin^2 theta_W, the lower limit on the lifetime for p to nubar K decay, and other experimental data. We show how the minimal flipped SU(5) GUT survives these perils, accommodating the experimental values of alpha_s and sin^2 theta_W and other constraints, while yielding a p to e/mu+ pi0 lifetime beyond the present experimental limit but potentially accessible to a further round of experiments. We exemplify our analysis using a set of benchmark supersymmetric scenarios proposed recently in a constrained MSSM framework.

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

    DEFF Research Database (Denmark)

    Lykkedegn, Sine; Sorensen, Grith Lykke; Beck-Nielsen, Signe Sparre

    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, p

  7. Abundance of early functional HIV-specific CD8+ T cells does not predict AIDS-free survival time.

    Directory of Open Access Journals (Sweden)

    Ingrid M M Schellens

    Full Text Available BACKGROUND: T-cell immunity is thought to play an important role in controlling HIV infection, and is a main target for HIV vaccine development. HIV-specific central memory CD8(+ and CD4(+ T cells producing IFNgamma and IL-2 have been associated with control of viremia and are therefore hypothesized to be truly protective and determine subsequent clinical outcome. However, the cause-effect relationship between HIV-specific cellular immunity and disease progression is unknown. We investigated in a large prospective cohort study involving 96 individuals of the Amsterdam Cohort Studies with a known date of seroconversion whether the presence of cytokine-producing HIV-specific CD8(+ T cells early in infection was associated with AIDS-free survival time. METHODS AND FINDINGS: The number and percentage of IFNgamma and IL-2 producing CD8(+ T cells was measured after in vitro stimulation with an overlapping Gag-peptide pool in T cells sampled approximately one year after seroconversion. Kaplan-Meier survival analysis and Cox proportional hazard models showed that frequencies of cytokine-producing Gag-specific CD8(+ T cells (IFNgamma, IL-2 or both shortly after seroconversion were neither associated with time to AIDS nor with the rate of CD4(+ T-cell decline. CONCLUSIONS: These data show that high numbers of functional HIV-specific CD8(+ T cells can be found early in HIV infection, irrespective of subsequent clinical outcome. The fact that both progressors and long-term non-progressors have abundant T cell immunity of the specificity associated with low viral load shortly after seroconversion suggests that the more rapid loss of T cell immunity observed in progressors may be a consequence rather than a cause of disease progression.

  8. The DIII-D Tokamak trouble report database

    International Nuclear Information System (INIS)

    Petersen, P.I.; Miller, S.M.

    1992-01-01

    Operation of the DIII-D tokamak at General Atomics involves many groups which work on the various subsystems. To overview and speed the solution to trouble or problem areas that limit machine availability, a common trouble report system was established. The TROUBLE database automates the recording of trouble reports and eases analysis of problem areas. It contains information on equipment affected, description of problem, cause of problem, solution to problem, and machine downtime (if any). It was created using S1032 from Compuserve Data Technologies and runs on a VAX 8650. The data is used to find the major problem areas so they can be solved and improve the tokamak availabilty. The data is available to Idaho National Engineering Laboratory (INEL). They are using the data with data from other tokamaks to develop a Fusion Failure Experience Data Collection. The authors' experience is that a few failures are often the cause of a major part of the downtime. In this paper, the authors will discuss these failures and the actions taken to correct them. The data base also will be used to determine the preventive maintenance schedule for different components

  9. 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…

  10. Kids in Crisis. He's Trouble with a Capital T.

    Science.gov (United States)

    Brodkin, Adele M.; Coleman, Melba

    1996-01-01

    Discusses what teachers can do to handle students with conduct disorders. After presenting a situation involving a troubled sixth grader, a child psychologist recommends avoiding labels, assuming underlying causes, advocating a full workup, and reaching out to his family; a school leader agrees and suggests pairing the child with a mentor. Four…

  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. 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…

  13. 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.

  14. Book review: Troubling possibility, hidden fires and secret drawers ...

    African Journals Online (AJOL)

    Book review: Troubling possibility, hidden fires and secret drawers: Tiyambe Zeleza's smouldering charcoal. H.F. Ross. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

  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. Polygenic Score × Intervention Moderation: an Application of Discrete-Time Survival Analysis to Model the Timing of First Marijuana Use Among Urban Youth.

    Science.gov (United States)

    Musci, Rashelle J; Fairman, Brian; Masyn, Katherine E; Uhl, George; Maher, Brion; Sisto, Danielle Y; Kellam, Sheppard G; Ialongo, Nicholas S

    2018-01-01

    The present study examines the interaction between a polygenic score and an elementary school-based universal preventive intervention trial and its effects on a discrete-time survival analysis of time to first smoking marijuana. Research has suggested that initiation of substances is both genetically and environmentally driven (Rhee et al., Archives of general psychiatry 60:1256-1264, 2003; Verweij et al., Addiction 105:417-430, 2010). A previous work has found a significant interaction between the polygenic score and the same elementary school-based intervention with tobacco smoking (Musci et al., in press). The polygenic score reflects the contribution of multiple genes and has been shown in prior research to be predictive of smoking cessation, tobacco use, and marijuana use (Uhl et al., Molecular Psychiatry 19:50-54, 2014). Using data from a longitudinal preventive intervention study (N = 678), we examined age of first marijuana use from sixth grade to age 18. Genetic data were collected during emerging adulthood and were genotyped using the Affymetrix 6.0 microarray (N = 545). The polygenic score was computed using these data. Discrete-time survival analysis was employed to test for intervention main and interaction effects with the polygenic score. We found main effect of the polygenic score approaching significance, with the participants with higher polygenic scores reporting their first smoking marijuana at an age significantly later than controls (p = .050). We also found a significant intervention × polygenic score interaction effect at p = .003, with participants at the higher end of the polygenic score benefiting the most from the intervention in terms of delayed age of first use. These results suggest that genetics may play an important role in the age of first use of marijuana and that differences in genetics may account for the differential effectiveness of classroom-based interventions in delaying substance use experimentation.

  17. The effect of timing and graft dysfunction on survival and cardiac allograft vasculopathy in antibody-mediated rejection.

    Science.gov (United States)

    Clerkin, Kevin J; Restaino, Susan W; Zorn, Emmanuel; Vasilescu, Elena R; Marboe, Charles C; Mancini, Donna M

    2016-09-01

    Antibody-mediated rejection (AMR) has been associated with increased death and cardiac allograft vasculopathy (CAV). Early studies suggested that late AMR was rarely associated with graft dysfunction, whereas recent reports have demonstrated an association with increased mortality. We investigated the timing of AMR and its association with graft dysfunction, death, and CAV. This retrospective cohort study identified all adult orthotopic heart transplant (OHT) recipients (N = 689) at Columbia University Medical Center from 2004 to 2013. There were 68 primary cases of AMR, which were stratified by early ( 1 year post-OHT) AMR. Kaplan-Meier survival analysis and modeling was performed with multivariable logistic regression and Cox proportional hazards regression. From January 1, 2004, through October 1, 2015, early AMR (median 23 days post-OHT) occurred in 43 patients and late AMR (median 1,084 days post-OHT) occurred in 25. Graft dysfunction was less common with early compared with late AMR (25.6% vs 56%, p = 0.01). Patients with late AMR had decreased post-AMR survival compared with early AMR (1 year: 80% vs 93%, 5 years: 51% vs 73%, p < 0.05). When stratified by graft dysfunction, only those with late AMR and graft dysfunction had worse survival (30 days: 79%, 1 year: 64%, 5 years: 36%; p < 0.006). The association remained irrespective of age, sex, donor-specific antibodies, left ventricular assist device use, reason for OHT, and recovery of graft function. Similarly, those with late AMR and graft dysfunction had accelerated development of de novo CAV (50% at 1 year; hazard ratio, 5.42; p = 0.009), whereas all other groups were all similar to the general transplant population. Late AMR is frequently associated with graft dysfunction. When graft dysfunction is present in late AMR, there is an early and sustained increased risk of death and rapid development of de novo CAV despite aggressive treatment. Copyright © 2016 International Society for Heart and Lung

  18. Studying DDT Susceptibility at Discriminating Time Intervals Focusing on Maximum Limit of Exposure Time Survived by DDT Resistant Phlebotomus argentipes (Diptera: Psychodidae): an Investigative Report.

    Science.gov (United States)

    Rama, Aarti; Kesari, Shreekant; Das, Pradeep; Kumar, Vijay

    2017-07-24

    Extensive application of routine insecticide i.e., dichlorodiphenyltrichloroethane (DDT) to control Phlebotomus argentipes (Diptera: Psychodidae), the proven vector of visceral leishmaniasis in India, had evoked the problem of resistance/tolerance against DDT, eventually nullifying the DDT dependent strategies to control this vector. Because tolerating an hour-long exposure to DDT is not challenging enough for the resistant P. argentipes, estimating susceptibility by exposing sand flies to insecticide for just an hour becomes a trivial and futile task.Therefore, this bioassay study was carried out to investigate the maximum limit of exposure time to which DDT resistant P. argentipes can endure the effect of DDT for their survival. The mortality rate of laboratory-reared DDT resistant strain P. argentipes exposed to DDT was studied at discriminating time intervals of 60 min and it was concluded that highly resistant sand flies could withstand up to 420 min of exposure to this insecticide. Additionally, the lethal time for female P. argentipes was observed to be higher than for males suggesting that they are highly resistant to DDT's toxicity. Our results support the monitoring of tolerance limit with respect to time and hence points towards an urgent need to change the World Health Organization's protocol for susceptibility identification in resistant P. argentipes.

  19. 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.

  20. 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

  1. Suspected survivor bias in case-control studies: stratify on survival time and use a negative control.

    Science.gov (United States)

    van Rein, Nienke; Cannegieter, Suzanne C; Rosendaal, Frits R; Reitsma, Pieter H; Lijfering, Willem M

    2014-02-01

    Selection bias in case-control studies occurs when control selection is inappropriate. However, selection bias due to improper case sampling is less well recognized. We describe how to recognize survivor bias (i.e., selection on exposed cases) and illustrate this with an example study. A case-control study was used to analyze the effect of statins on major bleedings during treatment with vitamin K antagonists. A total of 110 patients who experienced such bleedings were included 18-1,018 days after the bleeding complication and matched to 220 controls. A protective association of major bleeding for exposure to statins (odds ratio [OR]: 0.56; 95% confidence interval: 0.29-1.08) was found, which did not become stronger after adjustment for confounding factors. These observations lead us to suspect survivor bias. To identify this bias, results were stratified on time between bleeding event and inclusion, and repeated for a negative control (an exposure not related to survival): blood group non-O. The ORs for exposure to statins increased gradually to 1.37 with shorter time between outcome and inclusion, whereas ORs for the negative control remained constant, confirming our hypothesis. We recommend the presented method to check for overoptimistic results, that is, survivor bias in case-control studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. The number and microlocalization of tumor-associated immune cells are associated with patient's survival time in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Dai, Fuqiang; Liu, Lunxu; Che, Guowei; Yu, Nanbin; Pu, Qiang; Zhang, Shangfu; Ma, Junliang; Ma, Lin; You, Zongbing

    2010-01-01

    Tumor microenvironment is composed of tumor cells, fibroblasts, endothelial cells, and infiltrating immune cells. Tumor-associated immune cells may inhibit or promote tumor growth and progression. This study was conducted to determine whether the number and microlocalization of macrophages, mature dendritic cells and cytotoxic T cells in non-small cell lung cancer are associated with patient's survival time. Ninety-nine patients with non-small cell lung cancer (NSCLC) were included in this retrospective study. Paraffin-embedded NSCLC specimens and their clinicopathological data including up to 8-year follow-up information were used. Immunohistochemical staining for CD68 (marker for macrophages), CD83 (marker for mature dendritic cells), and CD8 (marker for cytotoxic T cells) was performed and evaluated in a blinded fashion. The numbers of immune cells in tumor islets and stroma, tumor islets, or tumor stroma were counted under a microscope. Correlation of the cell numbers and patient's survival time was analyzed using the Statistical Package for the Social Sciences (version 13.0). The numbers of macrophages, mature dendritic cells and cytotoxic T cells were significantly more in the tumor stroma than in the tumor islets. The number of macrophages in the tumor islets was positively associated with patient's survival time, whereas the number of macrophages in the tumor stroma was negatively associated with patient's survival time in both univariate and multivariate analyses. The number of mature dendritic cells in the tumor islets and stroma, tumor islets only, or tumor stroma only was positively associated with patient's survival time in a univariate analysis but not in a multivariate analysis. The number of cytotoxic T cells in the tumor islets and stroma was positively associated with patient's survival time in a univariate analysis but not in a multivariate analysis. The number of cytotoxic T cells in the tumor islets only or stroma

  3. An exploratory discrete-time multilevel analysis of the effect of social support on the survival of elderly people in China

    Science.gov (United States)

    Feng, Zhixin; Jones, Kelvyn; Wang, Wenfei Winnie

    2015-01-01

    This study undertakes a survival analysis of elderly persons in China using Chinese Longitudinal Healthy Longevity Survey 2002–2008. Employing discrete-time multilevel models, we explored the effect of social support on the survival of elderly people in China. This study focuses on objective (living arrangements and received support) and subjective activities (perceived support) of social support, finding that the effect of different activities of social support on the survival of elderly people varies according to the availability of different support resources. Specifically, living with a spouse, financial independence, perceiving care support from any resource is associated with higher survival rates for elderly people. Separate analysis focusing on urban elderly and rural elderly revealed broadly similar results. There is a larger difference between those perceiving care support from family or social service and not perceiving care support in urban areas comparing to those in rural areas. Those who cannot pay medical expenses are the least likely to survive. The higher level of economic development in province has no significant effect on the survival of elderly people for the whole sample model and the elderly people in urban areas; however, there is a negative influence on the survival of the rural elderly people. PMID:25703671

  4. Results of surgical excision and evaluation of factors associated with survival time in dogs with lingual neoplasia: 97 cases (1995-2008).

    Science.gov (United States)

    Culp, William T N; Ehrhart, Nicole; Withrow, Stephen J; Rebhun, Robert B; Boston, Sarah; Buracco, Paolo; Reiter, Alexander M; Schallberger, Sandra P; Aldridge, Charles F; Kent, Michael S; Mayhew, Philipp D; Brown, Dorothy C

    2013-05-15

    To describe the clinical characteristics, treatments, outcomes, and factors associated with survival time in a cohort of dogs with lingual neoplasia that underwent surgical excision. Retrospective case series. Animals-97 client-owned dogs. Medical records of dogs with a lingual tumor examined between 1995 and 2008 were reviewed. Records were included if a lingual tumor was confirmed by histologic examination and surgical excision of the mass was attempted. Data were recorded and analyzed to identify prognostic factors. Clinical signs were mostly related to the oral cavity. For 93 dogs, marginal excision, subtotal glossectomy, and near-total glossectomy were performed in 35 (38%), 55 (59%), and 3 (3%), respectively. Surgery-related complications were rare, but 27 (28%) dogs had tumor recurrence. The most common histopathologic diagnoses for the 97 dogs were squamous cell carcinoma (31 [32%]) and malignant melanoma (29 [30%]). Eighteen (19%) dogs developed metastatic disease, and the overall median survival time was 483 days. Median survival time was 216 days for dogs with squamous cell carcinoma and 241 days for dogs with malignant melanoma. Dogs with lingual tumors ≥ 2 cm in diameter at diagnosis had a significantly shorter survival time than did dogs with tumors melanoma predominate. A thorough physical examination to identify lingual tumors at an early stage and surgical treatment after tumor identification are recommended because tumor size significantly affected survival time.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

    In this study, the effectiveness of a 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 1 mice were injected intraperitoneally with 3.7 MBq (0.1mCi)/2mL of radiolabeled sulfur colloid ten days after intraperitoneal inoculation of 5x10 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∼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 ( 188 Re-sulfur colloid is an effective agent in controlling tumor cells in the abdominal cavity in animals

  6. 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.

  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. Expression of S1P metabolizing enzymes and receptors correlate with survival time and regulate cell migration in glioblastoma multiforme.

    Science.gov (United States)

    Bien-Möller, Sandra; Lange, Sandra; Holm, Tobias; Böhm, Andreas; Paland, Heiko; Küpper, Johannes; Herzog, Susann; Weitmann, Kerstin; Havemann, Christoph; Vogelgesang, Silke; Marx, Sascha; Hoffmann, Wolfgang; Schroeder, Henry W S; Rauch, Bernhard H

    2016-03-15

    A signaling molecule which is involved in proliferation and migration of malignant cells is the lipid mediator sphingosine-1-phosphate (S1P). There are hints for a potential role of S1P signaling in malignant brain tumors such as glioblastoma multiforme (GBM) which is characterized by a poor prognosis. Therefore, a comprehensive expression analysis of S1P receptors (S1P1-S1P5) and S1P metabolizing enzymes in human GBM (n = 117) compared to healthy brain (n = 10) was performed to evaluate their role for patient´s survival. Furthermore, influence of S1P receptor inhibition on proliferation and migration were studied in LN18 GBM cells. Compared to control brain, mRNA levels of S1P1, S1P2, S1P3 and S1P generating sphingosine kinase-1 were elevated in GBM. Kaplan-Meier analyses demonstrated an association between S1P1 and S1P2 with patient´s survival times. In vitro, an inhibitory effect of the SphK inhibitor SKI-II on viability of LN18 cells was shown. S1P itself had no effect on viability but stimulated LN18 migration which was blocked by inhibition of S1P1 and S1P2. The participation of S1P1 and S1P2 in LN18 migration was further supported by siRNA-mediated silencing of these receptors. Immunoblots and inhibition experiments suggest an involvement of the PI3-kinase/AKT1 pathway in the chemotactic effect of S1P in LN18 cells.In summary, our data argue for a role of S1P signaling in proliferation and migration of GBM cells. Individual components of the S1P pathway represent prognostic factors for patients with GBM. Perspectively, a selective modulation of S1P receptor subtypes could represent a therapeutic approach for GBM patients and requires further evaluation.

  9. The troubled relationship of state and religion in Eritrea

    OpenAIRE

    Mekonnen, Daniel R; Kidane, Selam

    2014-01-01

    Eritrea is a multi-ethnic, multi-lingual and multi-religion country. The country does not have an official state religion. However, since the country's independence in 1991, the relationship between state and religion has been a troubled one. At least four religions are officially recognised by the state: Islam, of the Sunni rite; the Eritrean Orthodox Tewahdo Church, part of the worldwide Coptic Orthodox Church of the eastern rite; the Eritrean Catholic Church, part of the worldwide Roman Ca...

  10. First off-time treatment prostate-specific antigen kinetics predicts survival in intermittent androgen deprivation for prostate cancer.

    Science.gov (United States)

    Sanchez-Salas, Rafael; Olivier, Fabien; Prapotnich, Dominique; Dancausa, José; Fhima, Mehdi; David, Stéphane; Secin, Fernando P; Ingels, Alexandre; Barret, Eric; Galiano, Marc; Rozet, François; Cathelineau, Xavier

    2016-01-01

    Prostate-specific antigen (PSA) doubling time is relying on an exponential kinetic pattern. This pattern has never been validated in the setting of intermittent androgen deprivation (IAD). Objective is to analyze the prognostic significance for PCa of recurrent patterns in PSA kinetics in patients undergoing IAD. A retrospective study was conducted on 377 patients treated with IAD. On-treatment period (ONTP) consisted of gonadotropin-releasing hormone agonist injections combined with oral androgen receptor antagonist. Off-treatment period (OFTP) began when PSA was lower than 4 ng/ml. ONTP resumed when PSA was higher than 20 ng/ml. PSA values of each OFTP were fitted with three basic patterns: exponential (PSA(t) = λ.e(αt)), linear (PSA(t) = a.t), and power law (PSA(t) = a.t(c)). Univariate and multivariate Cox regression model analyzed predictive factors for oncologic outcomes. Only 45% of the analyzed OFTPs were exponential. Linear and power law PSA kinetics represented 7.5% and 7.7%, respectively. Remaining fraction of analyzed OFTPs (40%) exhibited complex kinetics. Exponential PSA kinetics during the first OFTP was significantly associated with worse oncologic outcome. The estimated 10-year cancer-specific survival (CSS) was 46% for exponential versus 80% for nonexponential PSA kinetics patterns. The corresponding 10-year probability of castration-resistant prostate cancer (CRPC) was 69% and 31% for the two patterns, respectively. Limitations include retrospective design and mixed indications for IAD. PSA kinetic fitted with exponential pattern in approximately half of the OFTPs. First OFTP exponential PSA kinetic was associated with a shorter time to CRPC and worse CSS. © 2015 Wiley Periodicals, Inc.

  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. 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

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

    International Nuclear Information System (INIS)

    Suzuki, D.; Dressel, H.

    2002-01-01

    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 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 wolves and coyotes

  14. 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.

  15. 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.

  16. The trouble with H {sub 0}

    Energy Technology Data Exchange (ETDEWEB)

    Bernal, José Luis; Verde, Licia [ICC, University of Barcelona, IEEC-UB, Martí i Franquès, 1, E08028 Barcelona (Spain); Riess, Adam G., E-mail: joseluis.bernal@icc.ub.edu, E-mail: liciaverde@icc.ub.edu, E-mail: ariess@stsci.edu [Department of Physics and Astronomy, Johns Hopkins University, Baltimore, MD 21218 (United States)

    2016-10-01

    We perform a comprehensive cosmological study of the H {sub 0} tension between the direct local measurement and the model-dependent value inferred from the Cosmic Microwave Background. With the recent measurement of H {sub 0} this tension has raised to more than 3 σ. We consider changes in the early time physics without modifying the late time cosmology. We also reconstruct the late time expansion history in a model independent way with minimal assumptions using distance measurements from Baryon Acoustic Oscillations and Type Ia Supernovae, finding that at z < 0.6 the recovered shape of the expansion history is less than 5% different than that of a standard ΛCDM model. These probes also provide a model insensitive constraint on the low-redshift standard ruler, measuring directly the combination r {sub s} h where H {sub 0} = h × 100 Mpc{sup −1}km/s and r {sub s} is the sound horizon at radiation drag (the standard ruler), traditionally constrained by CMB observations. Thus r {sub s} and H {sub 0} provide absolute scales for distance measurements (anchors) at opposite ends of the observable Universe. We calibrate the cosmic distance ladder and obtain a model-independent determination of the standard ruler for acoustic scale, r {sub s}. The tension in H {sub 0} reflects a mismatch between our determination of r {sub s} and its standard, CMB-inferred value. Without including high-ℓ Planck CMB polarization data (i.e., only considering the ''recommended baseline' low-ℓ polarisation and temperature and the high ℓ temperature data), a modification of the early-time physics to include a component of dark radiation with an effective number of species around 0.4 would reconcile the CMB-inferred constraints, and the local H {sub 0} and standard ruler determinations. The inclusion of the ''preliminary' high-ℓ Planck CMB polarisation data disfavours this solution.

  17. 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.

  18. A retrospective analysis of survival outcomes for two different radiotherapy fractionation schedules given in the same overall time for limited stage small cell lung cancer

    International Nuclear Information System (INIS)

    Bettington, Catherine S.; Bryant, Guy; Hickey, Brigid; Tripcony, Lee; Pratt, Gary; Fay, Michael

    2013-01-01

    To compare survival outcomes for two fractionation schedules of thoracic radiotherapy, both given over 3 weeks, in patients with limited stage small cell lung cancer (LS-SCLC). At Radiation Oncology Mater Centre (ROMC) and the Royal Brisbane and Women's Hospital (RBWH), patients with LS-SCLC treated with curative intent are given radiotherapy (with concurrent chemotherapy) to a dose of either 40Gy in 15 fractions ('the 40Gy/15⧣group') or 45Gy in 30 fractions ('the 45Gy/30⧣group'). The choice largely depends on institutional preference. Both these schedules are given over 3 weeks, using daily and twice-daily fractionation respectively. The records of all such patients treated from January 2000 to July 2009 were retrospectively reviewed and survival outcomes between the two groups compared. Of 118 eligible patients, there were 38 patients in the 40Gy/15⧣ group and 41 patients in the 45Gy/30⧣ group. The median relapse-free survival time was 12 months in both groups. Median overall survival was 21 months (95% CI 2–37 months) in the 40Gy/15⧣ group and 26 months (95% CI 1–48 months) in the 45Gy/30⧣ group. The 5-year overall survival rates were 20% and 25%, respectively (P=0.24). On multivariate analysis, factors influencing overall survival were: whether prophylactic cranial irradiation (PCI) was given (P=0.01) and whether salvage chemotherapy was given at the time of relapse (P=0.057). Given the small sample size, the potential for selection bias and the retrospective nature of our study it is not possible to draw firm conclusions regarding the efficacy of hypofractionated thoracic radiotherapy compared with hyperfractionated accelerated thoracic radiotherapy however hypofractionated radiotherapy may result in equivalent relapse-free survival.

  19. Investigation of Growth and Survival of Transplanted Plane and Pine Trees According to IBA Application, Tree Age, Transplanting Time and Method

    Directory of Open Access Journals (Sweden)

    N. Etemadi

    2015-03-01

    Full Text Available The major problems in transplanting the landscape trees are high level of mortality and low establishment rate of transplanted trees, especially in the first year. In order to achieve the best condition for successful transplanting of pine and plane trees in Isfahan landscape, the present study was carried out based on a completely randomized block design with four replicates and three treatments including transplanting method (balled and burlapped and bare root, tree age (immature and mature and IBA application (0 and 150 mg/L. Trees were transplanted during 2009 and 2010 in three times (dormant season, early and late growing season. Survival rate and Relative Growth Rate index based on tree height (RGRH and trunk diameter (RGRD were measured during the first and second years. Trees transplanted early in the growing season showed the most survival percentage during the two years, as compared to other transplanting dates. Survival of Balled and burlapped and immature transplanted trees was significantly greater than bare root or mature trees. The significant effect of age treatment was continued in the second year. IBA treatment had no effect on survival rate of the studied species. Balled and burlapped and immature transplanted pine trees also had higher RGRH and RGRD compared to bare root or mature trees. According to the results of this study, early growing season is the best time for transplanting pine and plane trees. Also, transplanting of immature trees using balled and burlapped method is recommended to increase the survival and establishment rate.

  20. 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.

  1. The effect of the time interval between diagnosis of muscle-invasive bladder cancer and radical cystectomy on staging and survival: A Netherlands Cancer Registry analysis

    NARCIS (Netherlands)

    Bruins, H.M.; Aben, K.K.H.; Arends, T.J.; Heijden, A.G. van der; Witjes, J.A.

    2016-01-01

    INTRODUCTION: Data from single-center series suggest that a delay in time to radical cystectomy (RC) more than 3 months after diagnosis of muscle-invasive bladder cancer (MIBC) is associated with pathological upstaging and decreased survival. However, limited data is available from population-based

  2. PSA response to cabazitaxel is associated with improved progression-free survival in metastatic castration-resistant prostate cancer: the non-interventional QoLiTime study.

    Science.gov (United States)

    Hammerer, Peter; Al-Batran, Salah-Eddin; Windemuth-Kieselbach, Christine; Keller, Martin; Hofheinz, Ralf-Dieter

    2018-03-01

    To evaluate the association between prostate-specific antigen (PSA) response and progression-free and overall survival in men with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel. Men with mCRPC receiving cabazitaxel (25 mg/m 2 , every 3 weeks) plus oral prednis(ol)one (10 mg/day) were enrolled in the non-interventional, prospective QoLiTime study. Main outcome measures were progression-free survival and overall survival, in all patients and in those who showed a ≥ 50 or a ≥ 30% decrease in PSA relative to baseline after four cycles of cabazitaxel, as well as quality-of-life parameters. Of the 527 men (median age 72 years), 266 received ≥ 4 cycles of cabazitaxel and had PSA response data. After four cycles, 34.6% of men achieved a PSA decrease ≥ 50% and 49.6% a decrease ≥ 30%. Median progression-free survival was 7.7 (95% CI 6.2, 9.5) months, and overall survival was 19.5 (95% CI 16.0, 30.9) months, corresponding to 1-year event rates of 39.4 and 78.8%, respectively. Median progression-free survival was longer in PSA responders versus non-responders (15.7 vs 5.5 months at 50% cut-off; 15.7 vs 5.3 months for 30% cut-off; both P PSA response after four cycles of cabazitaxel is associated with improved progression-free survival in men with mCRPC treated with cabazitaxel plus prednis(ol)one.

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

    NARCIS (Netherlands)

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

    2017-01-01

    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

  4. Time-of-Day Dependent Neuronal Injury After Ischemic Stroke: Implication of Circadian Clock Transcriptional Factor Bmal1 and Survival Kinase AKT.

    Science.gov (United States)

    Beker, Mustafa Caglar; Caglayan, Berrak; Yalcin, Esra; Caglayan, Ahmet Burak; Turkseven, Seyma; Gurel, Busra; Kelestemur, Taha; Sertel, Elif; Sahin, Zafer; Kutlu, Selim; Kilic, Ulkan; Baykal, Ahmet Tarik; Kilic, Ertugrul

    2018-03-01

    Occurrence of stroke cases displays a time-of-day variation in human. However, the mechanism linking circadian rhythm to the internal response mechanisms against pathophysiological events after ischemic stroke remained largely unknown. To this end, temporal changes in the susceptibility to ischemia/reperfusion (I/R) injury were investigated in mice in which the ischemic stroke induced at four different Zeitgeber time points with 6-h intervals (ZT0, ZT6, ZT12, and ZT18). Besides infarct volume and brain swelling, neuronal survival, apoptosis, ischemia, and circadian rhythm related proteins were examined using immunohistochemistry, Western blot, planar surface immune assay, and liquid chromatography-mass spectrometry tools. Here, we present evidence that midnight (ZT18; 24:00) I/R injury in mice resulted in significantly improved infarct volume, brain swelling, neurological deficit score, neuronal survival, and decreased apoptotic cell death compared with ischemia induced at other time points, which were associated with increased expressions of circadian proteins Bmal1, PerI, and Clock proteins and survival kinases AKT and Erk-1/2. Moreover, ribosomal protein S6, mTOR, and Bad were also significantly increased, while the levels of PRAS40, negative regulator of AKT and mTOR, and phosphorylated p53 were decreased at this time point compared to ZT0 (06:00). Furthermore, detailed proteomic analysis revealed significantly decreased CSKP, HBB-1/2, and HBA levels, while increased GNAZ, NEGR1, IMPCT, and PDE1B at midnight as compared with early morning. Our results indicate that nighttime I/R injury results in less severe neuronal damage, with increased neuronal survival, increased levels of survival kinases and circadian clock proteins, and also alters the circadian-related proteins.

  5. Titration in the treatment of the more troubled patient.

    Science.gov (United States)

    Winer, J A; Ornstein, E D

    2001-01-01

    This article defines and discusses a modification of technique recommended by the authors in the psychoanalytic treatment of more troubled patients--a modification they call titration. Titration is defined as a conscious decision by the analyst to increase or decrease assistance (or gratification) gradually, in order to facilitate the analytic process. The authors emphasize the complexity of decisions in treatment by focusing on the decision-making processes that titration requires. Guidelines and a case vignette are presented. The authors conclude by considering some of the politics involved in the introduction of technique modifications, the salience of the titration concept, and directions for further exploration.

  6. Virtual system concept aiming at prevention of troubles and accidents

    International Nuclear Information System (INIS)

    Uchimoto, Tetsuya; Takagi, Toshiyuki

    2001-01-01

    A main impediment to optimization of the plant maintenance is the fact that we can not predict when and how troubles are introduced in a plant. Having regard to the point, the authors propose a 'virtual system' concept for prevention and prediction of accidents in plants. The virtual system is a system constructed in computers and it evaluates responses to various loads of the object system. The authors introduce the resistance to loads and the testing availability as key parameters characterizing object sub-systems and place their evaluation as the first step of construction of the virtual system. (author)

  7. The use of simple reparameterizations to improve the efficiency of Markov chain Monte Carlo estimation for multilevel models with applications to discrete time survival models.

    Science.gov (United States)

    Browne, William J; Steele, Fiona; Golalizadeh, Mousa; Green, Martin J

    2009-06-01

    We consider the application of Markov chain Monte Carlo (MCMC) estimation methods to random-effects models and in particular the family of discrete time survival models. Survival models can be used in many situations in the medical and social sciences and we illustrate their use through two examples that differ in terms of both substantive area and data structure. A multilevel discrete time survival analysis involves expanding the data set so that the model can be cast as a standard multilevel binary response model. For such models it has been shown that MCMC methods have advantages in terms of reducing estimate bias. However, the data expansion results in very large data sets for which MCMC estimation is often slow and can produce chains that exhibit poor mixing. Any way of improving the mixing will result in both speeding up the methods and more confidence in the estimates that are produced. The MCMC methodological literature is full of alternative algorithms designed to improve mixing of chains and we describe three reparameterization techniques that are easy to implement in available software. We consider two examples of multilevel survival analysis: incidence of mastitis in dairy cattle and contraceptive use dynamics in Indonesia. For each application we show where the reparameterization techniques can be used and assess their performance.

  8. 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 vs. 45.3%, P unmarried patients had significantly poorer CSS/OS than married patients (adjusted hazard ratio [aHR] = 1.35, P 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 married status. Single and widowed patients are regarded as high-risk population. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  9. Effect of timing and duration of a single chest compression pause on short-term survival following prolonged ventricular fibrillation.

    Science.gov (United States)

    Walcott, Gregory P; Melnick, Sharon B; Walker, Robert G; Banville, Isabelle; Chapman, Fred W; Killingsworth, Cheryl R; Ideker, Raymond E

    2009-04-01

    Pauses during chest compressions are thought to have a detrimental effect on resuscitation outcome. The Guidelines 2005 have recently eliminated the post-defibrillation pause. Previous animal studies have shown that multiple pauses of increasing duration decrease resuscitation success. We investigated the effect of varying the characteristics of a single pause near defibrillation on resuscitation outcome. Part A: 48 swine were anesthetized, fibrillated for 7min and randomized. Chest compressions were initiated for 90s followed by defibrillation and then resumption of chest compressions. Four groups were studied-G2000: 40s pause beginning 20s before, and ending 20s after defibrillation, A1: a 20s pause just before defibrillation, A2: a 20s pause ending 30s prior to defibrillation, and group A3: a 10s pause ending 30s prior to defibrillation. Part B: 12 swine (Group B) were studied with a protocol identical to Part A but with no pause in chest compressions. Primary endpoint was survival to 4h. The survival rate was significantly higher for groups A1, A2, A3, and B (5/12, 7/12, 5/12, and 5/12 survived) than for the G2000 group (0/12, p<0.05). Survival did not differ significantly among groups A1, A2, A3, and B. These results suggest that the Guidelines 2005 recommendation to omit the post-shock pulse check and immediately resume chest compressions may be an important resuscitation protocol change. However, these results also suggest that clinical maneuvers further altering a single pre-shock chest compression pause provide no additional benefit.

  10. Effect of timing and duration of a single chest compression pause on short-term survival following prolonged ventricular fibrillation☆

    Science.gov (United States)

    Walcott, Gregory P.; Melnick, Sharon B.; Walker, Robert G.; Banville, Isabelle; Chapman, Fred W.; Killingsworth, Cheryl R.; Ideker, Raymond E.

    2014-01-01

    Background Pauses during chest compressions are thought to have a detrimental effect on resuscitation outcome. The Guidelines 2005 have recently eliminated the post-defibrillation pause. Previous animal studies have shown that multiple pauses of increasing duration decrease resuscitation success. We investigated the effect of varying the characteristics of a single pause near defibrillation on resuscitation outcome. Methods Part A: 48 swine were anesthetized, fibrillated for 7 min and randomized. Chest compressions were initiated for 90 s followed by defibrillation and then resumption of chest compressions. Four groups were studied—G2000: 40 s pause beginning 20 s before, and ending 20 s after defibrillation, A1: a 20 s pause just before defibrillation, A2: a 20 s pause ending 30 s prior to defibrillation, and group A3: a 10 s pause ending 30 s prior to defibrillation. Part B: 12 swine (Group B) were studied with a protocol identical to Part A but with no pause in chest compressions. Primary endpoint was survival to 4 h. Results The survival rate was significantly higher for groups A1, A2, A3, and B (5/12, 7/12, 5/12, and 5/12 survived) than for the G2000 group (0/12, p < 0.05). Survival did not differ significantly among groups A1, A2, A3, and B. Conclusions These results suggest that the Guidelines 2005 recommendation to omit the post-shock pulse check and immediately resume chest compressions may be an important resuscitation protocol change. However, these results also suggest that clinical maneuvers further altering a single pre-shock chest compression pause provide no additional benefit. PMID:19185411

  11. Epstein-Barr virus ensures B cell survival by uniquely modulating apoptosis at early and late times after infection.

    Science.gov (United States)

    Price, Alexander M; Dai, Joanne; Bazot, Quentin; Patel, Luv; Nikitin, Pavel A; Djavadian, Reza; Winter, Peter S; Salinas, Cristina A; Barry, Ashley Perkins; Wood, Kris C; Johannsen, Eric C; Letai, Anthony; Allday, Martin J; Luftig, Micah A

    2017-04-20

    Latent Epstein-Barr virus (EBV) infection is causally linked to several human cancers. EBV expresses viral oncogenes that promote cell growth and inhibit the apoptotic response to uncontrolled proliferation. The EBV oncoprotein LMP1 constitutively activates NFκB and is critical for survival of EBV-immortalized B cells. However, during early infection EBV induces rapid B cell proliferation with low levels of LMP1 and little apoptosis. Therefore, we sought to define the mechanism of survival in the absence of LMP1/NFκB early after infection. We used BH3 profiling to query mitochondrial regulation of apoptosis and defined a transition from uninfected B cells (BCL-2) to early-infected (MCL-1/BCL-2) and immortalized cells (BFL-1). This dynamic change in B cell survival mechanisms is unique to virus-infected cells and relies on regulation of MCL-1 mitochondrial localization and BFL-1 transcription by the viral EBNA3A protein. This study defines a new role for EBNA3A in the suppression of apoptosis with implications for EBV lymphomagenesis.

  12. '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.

  13. 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.

  14. 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.

  15. The LDsub(50/30) and the survival time in whole-body gamma-irradiated conventional and germfree Minnesota miniature piglets

    International Nuclear Information System (INIS)

    Mandel, L.; Travnicek, J.; Talafantova, M.; Zahradnickova, M.

    1980-01-01

    The median lethal exposure causing the death in 30 days after single whole-body gamma-irradiation (the LD 50/30) was found to be 2731 MBq (73.8 mC/kg) for conventional piglets, but 3226 MBq (87.2 mC/kg) for germ-free piglets both irradiated 14 days after birth. After lethal exposures, the survival time in germ-free piglets was prolonged for 7 days in comparison with conventional piglets. (author)

  16. Randomized, placebo controlled study of the effect of propentofylline on survival time and quality of life of cats with feline infectious peritonitis.

    Science.gov (United States)

    Fischer, Y; Ritz, S; Weber, K; Sauter-Louis, C; Hartmann, K

    2011-01-01

    Currently there is no drug proven to effectively treat cats with feline infectious peritonitis (FIP). Propentofylline (PPF) can decrease vasculitis, and therefore prolong survival time in cats with FIP, and increase their quality of life. Twenty-three privately owned cats with FIP. Placebo-controlled double-blind trial. FIP was confirmed by histology or immunostaining of feline coronavirus (FCoV) antigen in effusion or tissue macrophages or both. The cats were randomly selected for treatment with either PPF or placebo. All cats received additional treatment with glucocorticoids, antibiotics, and low molecular weight heparin according to methods. There was no statistically significant difference in the survival time of cats treated with PPF (8 days, 95% CI 5.4-10.6) versus placebo (7.5 days, 95% CI 4.4-9.6). The median survival time of all cats was 8 days (4-36 days). There was neither a difference in quality of life (day 7, P = .892), in the amount of effusion (day 7, P = .710), the tumor necrosis factor-alpha (TNF-α) concentration (day 7, P = .355), nor in any other variable investigated in this study, including a complete blood count, and a small animal biochemistry profile. This study did not detect an effect of PPF on the survival time, the quality of life, or any clinical or laboratory parameter in cats with FIP. Therefore, PPF does not appear to be an effective treatment option in cats with a late stage of the disease FIP. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  17. 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

    OpenAIRE

    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

    2017-01-01

    Abstract 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 (sing...

  18. 77 FR 37399 - Policy Statement Concerning Assistance to Troubled Farm Credit System Institutions

    Science.gov (United States)

    2012-06-21

    ... assistance, the Corporation must evaluate the adequacy of managerial resources of the troubled System... control system to monitor on-going performance with measurable criteria. The plan must also include an... associations during a period of severe stress in agriculture. Temporary cash infusions to troubled associations...

  19. Les troubles gonadiques chez les hémodialysés chroniques à l ...

    African Journals Online (AJOL)

    étude montre une forte prévalence des manifestations cliniques des troubles gonadiques chez les patients en hémodialyse chronique. Aussi elles doivent être recherchées afin de mieux les prendre en charge, car ces troubles sont vécus par ...

  20. Human umbilical cord mesenchymal stromal cells suppress MHC class II expression on rat vascular endothelium and prolong survival time of cardiac allograft

    Science.gov (United States)

    Qiu, Ying; Yun, Mark M; Han, Xia; Zhao, Ruidong; Zhou, Erxia; Yun, Sheng

    2014-01-01

    Background: Human umbilical cord mesenchymal stromal cells (UC-MSCs) have low immunogenicity and immune regulation. To investigate immunomodulatory effects of human UC-MSCs on MHC class II expression and allograft, we transplanted heart of transgenic rats with MHC class II expression on vascular endothelium. Methods: UC-MSCs were obtained from human umbilical cords and confirmed with flow cytometry analysis. Transgenic rat line was established using the construct of human MHC class II transactivator gene (CIITA) under mouse ICAM-2 promoter control. The induced MHC class II expression on transgenic rat vascular endothelial cells (VECs) was assessed with immunohistological staining. And the survival time of cardiac allograft was compared between the recipients with and without UC-MSC transfusion. Results: Flow cytometry confirmed that the human UC-MSCs were positive for CD29, CD44, CD73, CD90, CD105, CD271, and negative for CD34 and HLA-DR. Repeated infusion of human UC-MSCs reduced MHC class II expression on vascular endothelia of transplanted hearts, and increased survival time of allograft. The UC-MSCs increased regulatory cytokines IL10, transforming growth factor (TGF)-β1 and suppressed proinflammatory cytokines IL2 and IFN-γ in vivo. The UC-MSC culture supernatant had similar effects on cytokine expression, and decreased lymphocyte proliferation in vitro. Conclusions: Repeated transfusion of the human UC-MSCs reduced MHC class II expression on vascular endothelia and prolonged the survival time of rat cardiac allograft. PMID:25126177

  1. Ensemble survival tree models to reveal pairwise interactions of variables with time-to-events outcomes in low-dimensional setting

    Science.gov (United States)

    Dazard, Jean-Eudes; Ishwaran, Hemant; Mehlotra, Rajeev; Weinberg, Aaron; Zimmerman, Peter

    2018-01-01

    Unraveling interactions among variables such as genetic, clinical, demographic and environmental factors is essential to understand the development of common and complex diseases. To increase the power to detect such variables interactions associated with clinical time-to-events outcomes, we borrowed established concepts from random survival forest (RSF) models. We introduce a novel RSF-based pairwise interaction estimator and derive a randomization method with bootstrap confidence intervals for inferring interaction significance. Using various linear and nonlinear time-to-events survival models in simulation studies, we first show the efficiency of our approach: true pairwise interaction-effects between variables are uncovered, while they may not be accompanied with their corresponding main-effects, and may not be detected by standard semi-parametric regression modeling and test statistics used in survival analysis. Moreover, using a RSF-based cross-validation scheme for generating prediction estimators, we show that informative predictors may be inferred. We applied our approach to an HIV cohort study recording key host gene polymorphisms and their association with HIV change of tropism or AIDS progression. Altogether, this shows how linear or nonlinear pairwise statistical interactions of variables may be efficiently detected with a predictive value in observational studies with time-to-event outcomes. PMID:29453930

  2. Troubling gifts of care: vulnerable persons and threatening exchanges in Chicago's home care industry.

    Science.gov (United States)

    Buch, Elana D

    2014-12-01

    By tracing the transformations of troubling exchanges in paid home care, this article examines how differently positioned individuals strive to build caring relations within potentially restrictive regimes of care. In paid home care in Chicago, older adults and their workers regularly participate in exchanges of money, time, and material goods. These gifts play a crucial role in building good care relationships that sustain participants' moral personhood. Amid widespread concern about vulnerable elders, home care agencies compete in a crowded marketplace by prohibiting these exchanges, even as they depend on them to strengthen relationships. Supervisors thus exercise discretion, sometimes reclassifying gift exchanges as punishable thefts. In this context, the commodification of care did not lead to the actual elimination of gift relations, but rather transformed gift relations into a suspicious and troublesome source of value. © 2014 by the American Anthropological Association.

  3. Troubling Gifts of Care: Vulnerable Persons and Threatening Exchanges in Chicago’s Home Care Industry

    Science.gov (United States)

    Buch, Elana

    2015-01-01

    By tracing the transformations of troubling exchanges in paid home care, this article examines how differently positioned individuals strive to build caring relations within potentially restrictive regimes of care. In paid home care in Chicago, older adults and their workers regularly participate in exchanges of money, time, and material goods. These gifts play a crucial role in building good care relationships that sustain participants’ moral personhood. Amid widespread concern about vulnerable elders, home care agencies compete in a crowded marketplace by prohibiting these exchanges, even as they depend on them to strengthen relationships. Supervisors thus exercise discretion, sometimes reclassifying gift exchanges as punishable thefts. In this context, the commodification of care did not lead to the actual elimination of gift relations, but rather transformed gift relations into a suspicious and troublesome source of value. PMID:25331658

  4. Minimally invasive surgical approaches offer earlier time to adjuvant chemotherapy but not improved survival in resected pancreatic cancer.

    Science.gov (United States)

    Mirkin, Katelin A; Greenleaf, Erin K; Hollenbeak, Christopher S; Wong, Joyce

    2018-05-01

    Pancreatic surgery encompasses complex operations with significant potential morbidity. Greater experience in minimally invasive surgery (MIS) has allowed resections to be performed laparoscopically and robotically. This study evaluates the impact of surgical approach in resected pancreatic cancer. The National Cancer Data Base (2010-2012) was reviewed for patients with stages 1-3 resected pancreatic carcinoma. Open approaches were compared to MIS. A sub-analysis was then performed comparing robotic and laparoscopic approaches. Of the 9047 patients evaluated, surgical approach was open in 7511 (83%), laparoscopic in 992 (11%), and robotic in 131 (1%). The laparoscopic and robotic conversion rate to open was 28% (n = 387) and 17% (n = 26), respectively. Compared to open, MIS was associated with more distal resections (13.5, 24.3%, respectively, p offered significantly shorter LOS in all types. Multivariate analysis demonstrated no survival benefit for any MIS approach relative to open (all, p > 0.05). When adjusted for patient, disease, and treatment characteristics, TTC was not an independent prognostic factor (HR 1.09, p = 0.084). MIS appears to offer comparable surgical oncologic benefit with improved LOS and shorter TTC. This effect, however, was not associated with improved survival.

  5. Social Familiarity Reduces Reaction Times and Enhances Survival of Group-Living Predatory Mites under the Risk of Predation

    Science.gov (United States)

    Strodl, Markus Andreas; Schausberger, Peter

    2012-01-01

    Background 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. Methodology/Principal Findings 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. Significance 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. PMID:22927997

  6. 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.

  7. The Glasgow Prognostic Score at the Time of Palliative Esophageal Stent Insertion is a Predictive Factor of 30-Day Mortality and Overall Survival.

    Science.gov (United States)

    Driver, Robert J; Handforth, Catherine; Radhakrishna, Ganesh; Bennett, Michael I; Ford, Alexander C; Everett, Simon M

    2018-03-01

    Optimizing the timing of esophageal stent insertion is a challenge, partly due to difficulty predicting survival in advanced malignancy. The Glasgow prognostic score (GPS) is a validated tool for predicting survival in a number of cancers. To assess the utility of the GPS in predicting 30-day mortality and overall survival postesophageal stent insertion. Patients at a tertiary referral center who had received an esophageal stent for palliation of dysphagia were included if they had a measurement of albumin and C-reactive protein (CRP) in the week preceding the procedure (n=209). Patients with both an elevated CRP (>10 mg/L) and hypoalbuminemia (L) were given a GPS score of 2 (GPS2). Patients with only one of these abnormalities were assigned as GPS1 and those with normal CRP and albumin were assigned as GPS0. Clinical and pathologic parameters were also collected to assess for potential confounding factors in the survival analysis. Increasing GPS was associated with 30-day mortality; for patients with GPS0, 30-day mortality was 5% (2/43), for GPS1 it was 23% (26/114), and for GPS2 it was 33% (17/52). The adjusted hazard ratio for overall poststent mortality was 1.6 (95% confidence interval, 1.1-2.4; P=0.02) for GPS1 and 2.4 (95% confidence interval, 1.5-3.8; PGPS2 patients compared with GPS0. GPS is an independent prognostic factor of 30-day mortality and overall survival after esophageal stent insertion. It is a potential adjunct to clinical assessment in identifying those patients at high-risk of short-term mortality poststent.

  8. Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study

    Science.gov (United States)

    Robinson, Emily J; Power, Geraldine S; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

    2016-01-01

    Background Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. Objective To describe IHCA demographics during three day/time periods—weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)—and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. Methods We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Results Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. Conclusions IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during

  9. Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study.

    Science.gov (United States)

    Robinson, Emily J; Smith, Gary B; Power, Geraldine S; Harrison, David A; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

    2016-11-01

    Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. To describe IHCA demographics during three day/time periods-weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)-and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes. Organisational or care differences at

  10. Times of analgesic efficacy of two drugs in the treatment of patients with renal-ureteral colic compared by survival models

    Directory of Open Access Journals (Sweden)

    Luis Reyes Velázquez

    2015-01-01

    Full Text Available Renourethral colic is a very painful clinical situation that requires a quick diagnosis and treatment. A study was done with patients who were administered two types of analgesics, and whose pain was measured through a visual analogue scale. Censored data results were obtained, considering the time when the pain disappeared as the random variable. Maximum likelihood and survival analysis give useful methods to estimate the distribution and parametric functions for this variable. This study will allow a more effective, timely, lower cost and suitable medical treatment for patients.

  11. 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.

  12. 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.

  13. Interaction of defibrillation waveform with the time to defibrillation or the number of defibrillation attempts on survival from out-of-hospital cardiac arrest.

    Science.gov (United States)

    Hagihara, Akihito; Onozuka, Daisuke; Ono, Junko; Nagata, Takashi; Hasegawa, Manabu

    2018-01-01

    Early biphasic defibrillation is effective in out-of-hospital cardiac arrest (OHCA) cases. In the resuscitation of patients with OHCA, it is not clear how the defibrillation waveform interacts with the time to defibrillation to influence patient survival. The second, and any subsequent, shocks need to be administered by an on-line physician in Japan. Thus, we investigated the interaction between the defibrillation waveform and time to or the number of defibrillation on resuscitation outcomes. This prospective observational study used data for all OHCAs that occurred between 2005 and 2014 in Japan. To investigate the interaction effect between the defibrillation waveform and the time to defibrillation or the number of defibrillations on the return to spontaneous circulation (ROSC), 1-month survival, and cerebral performance category (CPC) (1, 2), we assessed the modifying effects of the defibrillation waveform and the time to or the number of defibrillation on additive scale (i.e., the relative excessive risk due to interaction, RERI) and multiplicative scale (i.e., ratio of odds ratios (ORs)). In total, 71,566 cases met the inclusion criteria. For the measure of interaction between the defibrillation waveform and the time to defibrillation, ratio of ORs for ROSC was 0.84 (0.75-0.94), implying that the effect of time to first defibrillation on ROSC was negatively modified by defibrillation waveform. For the interaction between the defibrillation waveform and the number of defibrillations, RERI and ratio of ORs for CPC (1, 2) was -0.25 (-0.47 to -0.06) and 0.79 (0.67-0.93), respectively. It is implied that the effect of number of defibrillation on CPC (1, 2) was negatively modified by defibrillation waveform. An increased number of defibrillations was associated with a decreased ROSC in the case of biphasic and monophasic defibrillation, while an increased number of defibrillations was related to an increased 1-month survival rate and CPC (1, 2) only in the case of

  14. Differences in trouble per litre of different alcoholic beverages - A global comparison with the GENACIS dataset.

    Science.gov (United States)

    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 drinking, the paper examines trouble per litre among beer, wine and spirits drinkers in 19 different societies represented in the GENACIS dataset. There is no general pattern which holds across cultures of more or less trouble being associated with a particular beverage type. Wine seems to be less associated with trouble than beer or spirits in a number of societies, but there are counter-instances in other societies. There is no overall trend across cultures in comparing trouble associated with beer and with spirits. In a number of societies, drinkers with no predominant beverage report more problems than those mainly drinking beer or wine. Controlling for gender and age reduces the tilt towards less trouble from wine drinking, particularly for social consequences of drinking.

  15. HLA-A, -B, and -DR zero-mismatched kidneys shipped to the University of Wisconsin, Madison, 1993-2006: superior graft survival despite longer preservation time.

    Science.gov (United States)

    Burlingham, William J; Muñoz del Rio, Alejandro; Lorentzen, David; Sollinger, Hans W; Pirsch, John D; Jankowska-Gan, Ewa; D'Alessandro, Anthony

    2010-08-15

    To determine the impact at a single center of the United Network for Organ Sharing-mandated sharing program for human leukocyte antigen (HLA)-A/-B/-DR 0-mismatched (0MM) kidneys, we analyzed the results of 264 kidney transplants from 0MM distant donors between 1993 and 2006, with a follow-up through January 31, 2007. We compared these results with that of concurrent kidneys transplanted from HLA more than 0MM local donors and with shipped more than 0MM kidneys from "payback" donors. Despite a significantly longer preservation time, we found an 11% increase in 8-year graft survival (63% vs. 52%; P0MM donor kidneys. Graft survival of 0MM shipped kidneys at 8 years was significantly better in nonsensitized (or=20% panel reactive antibodies) recipients, who showed an early (2 years) but short-lived benefit. The benefit of receiving a HLA-A, -B, and -DR 0MM shipped kidney remained strong and statistically significant (0.71 relative risk of graft loss vs. local; POrgan Sharing policy restricting mandated sharing of 0MM kidneys to sensitized and pediatric recipients will give greater flexibility to the local organ procurement organization in allocating organs. However, the survival benefit to nonsensitized patients is real and long lasting and will be lost.

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

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Riemann, Burkhard; Maeder, Uwe; Reiners, Christoph; Verburg, Frederik A.

    2016-01-01

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative 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 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 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 131 I ablation can be discarded. (orig.)

  17. 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.)

  18. Study on information dissemination regarding trouble at a nuclear power plant

    International Nuclear Information System (INIS)

    Ueda, Yoshitaka

    2007-01-01

    We conducted a survey concerning how the general public perceived information regarding trouble that occurred at a nuclear power plant, and what kind of information people wished to obtain regarding such trouble. We then identified the points to be aware of in the future when disseminating such information. The results showed that people preferred such information to be disseminated not only via mass media, but also by governments and nuclear power plant companies. The results also revealed that terms used in explaining nuclear power plant troubles were not well known to the general public. Even some terms used to demonstrate safety to the public might only cause concern. We also learned that some information issued directly to the general public by electric power companies was difficult to understand, and that such information can give people a more serious image than the actual trouble. We therefore conducted interviews with the general public to collect opinions directly regarding points to be improved to ensure that information on nuclear power plant troubles is easy to understand and not misleading. We then actually prepared several patterns of trouble information by adding improvements on the basis of the collected opinions, and conducted a comparative review of these patterns. The results showed that ease of understanding of such information can be improved by providing a headline, simplifying the information and inserting illustrations, adding information supporting the fact that there is no effect of radiation, as well as information indicating the scale of trouble, and adding information on the effect of radiation within the power plant, on the safety impact of the trouble and on the state of trouble reporting to national and local governments. We also recognized that, to ensure that information is not misleading, we should include specific data on the effect of radiation within the nuclear power station. Moreover, we learned that making the above

  19. Mesenchymal stem cells increase skin graft survival time and up-regulate PD-L1 expression in splenocytes of mice.

    Science.gov (United States)

    Moravej, Ali; Geramizadeh, Bita; Azarpira, Negar; Zarnani, Amir-Hassan; Yaghobi, Ramin; Kalani, Mehdi; Khosravi, Maryam; Kouhpayeh, Amin; Karimi, Mohammad-Hossein

    2017-02-01

    Recently, mesenchymal stem cells (MSCs) have gained considerable interests as hopeful therapeutic cells in transplantation due to their immunoregulatory functions. But exact mechanisms underlying MSCs immunoregulatory function is not fully understood. Herein, in addition to investigate the ability of MSCs to prolong graft survival time, the effects of them on the expression of PD-L1 and IDO immunomodulatory molecules in splenocytes of skin graft recipient mice was clarified. To achieve this goal, full-thickness skins were transplanted from C57BL/6 to BALB/c mice. MSCs were isolated from bone marrow of BALB/c mice and injected to the recipient mice. Skin graft survival was monitored daily to determine graft rejection time. On days 2, 5 and 10 post skin transplantation, serum cytokine levels and expression of PD-L1 and IDO mRNA and protein in the splenocytes of recipient mice were evaluated. The results showed that administration of MSCs prolonged skin graft survival time from 11 to 14 days. On days 2 and 5 post transplantation, splenocytes PD-L1 expression and IL-10 serum level in MSCs treated mice were higher than those in the controls, while IL-2 and IFN-γ levels were lower. Rejection in MSCs treated mice was accompanied by an increase in IL-2 and IFN-γ, and decrease in PD-L1 expression and IL-10 level. No difference in the expression of IDO between MSCs treated mice and controls was observed. In conclusion, we found that one of the mechanisms underlying MSCs immunomodulatory function could be up-regulating PD-L1 expression. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  20. TH-E-BRF-05: Comparison of Survival-Time Prediction Models After Radiotherapy for High-Grade Glioma Patients Based On Clinical and DVH Features

    International Nuclear Information System (INIS)

    Magome, T; Haga, A; Igaki, H; Sekiya, N; Masutani, Y; Sakumi, A; Mukasa, A; Nakagawa, K

    2014-01-01

    Purpose: Although many outcome prediction models based on dose-volume information have been proposed, it is well known that the prognosis may be affected also by multiple clinical factors. The purpose of this study is to predict the survival time after radiotherapy for high-grade glioma patients based on features including clinical and dose-volume histogram (DVH) information. Methods: A total of 35 patients with high-grade glioma (oligodendroglioma: 2, anaplastic astrocytoma: 3, glioblastoma: 30) were selected in this study. All patients were treated with prescribed dose of 30–80 Gy after surgical resection or biopsy from 2006 to 2013 at The University of Tokyo Hospital. All cases were randomly separated into training dataset (30 cases) and test dataset (5 cases). The survival time after radiotherapy was predicted based on a multiple linear regression analysis and artificial neural network (ANN) by using 204 candidate features. The candidate features included the 12 clinical features (tumor location, extent of surgical resection, treatment duration of radiotherapy, etc.), and the 192 DVH features (maximum dose, minimum dose, D95, V60, etc.). The effective features for the prediction were selected according to a step-wise method by using 30 training cases. The prediction accuracy was evaluated by a coefficient of determination (R 2 ) between the predicted and actual survival time for the training and test dataset. Results: In the multiple regression analysis, the value of R 2 between the predicted and actual survival time was 0.460 for the training dataset and 0.375 for the test dataset. On the other hand, in the ANN analysis, the value of R 2 was 0.806 for the training dataset and 0.811 for the test dataset. Conclusion: Although a large number of patients would be needed for more accurate and robust prediction, our preliminary Result showed the potential to predict the outcome in the patients with high-grade glioma. This work was partly supported by the JSPS Core

  1. Predicting financial trouble using call data—On social capital, phone logs, and financial trouble

    Science.gov (United States)

    Lin, Chia-Ching; Chen, Kuan-Ta; Singh, Vivek Kumar

    2018-01-01

    An ability to understand and predict financial wellbeing for individuals is of interest to economists, policy designers, financial institutions, and the individuals themselves. According to the Nilson reports, there were more than 3 billion credit cards in use in 2013, accounting for purchases exceeding US$ 2.2 trillion, and according to the Federal Reserve report, 39% of American households were carrying credit card debt from month to month. Prior literature has connected individual financial wellbeing with social capital. However, as yet, there is limited empirical evidence connecting social interaction behavior with financial outcomes. This work reports results from one of the largest known studies connecting financial outcomes and phone-based social behavior (180,000 individuals; 2 years’ time frame; 82.2 million monthly bills, and 350 million call logs). Our methodology tackles highly imbalanced dataset, which is a pertinent problem with modelling credit risk behavior, and offers a novel hybrid method that yields improvements over, both, a traditional transaction data only approach, and an approach that uses only call data. The results pave way for better financial modelling of billions of unbanked and underbanked customers using non-traditional metrics like phone-based credit scoring. PMID:29474411

  2. Predicting financial trouble using call data-On social capital, phone logs, and financial trouble.

    Science.gov (United States)

    Agarwal, Rishav Raj; Lin, Chia-Ching; Chen, Kuan-Ta; Singh, Vivek Kumar

    2018-01-01

    An ability to understand and predict financial wellbeing for individuals is of interest to economists, policy designers, financial institutions, and the individuals themselves. According to the Nilson reports, there were more than 3 billion credit cards in use in 2013, accounting for purchases exceeding US$ 2.2 trillion, and according to the Federal Reserve report, 39% of American households were carrying credit card debt from month to month. Prior literature has connected individual financial wellbeing with social capital. However, as yet, there is limited empirical evidence connecting social interaction behavior with financial outcomes. This work reports results from one of the largest known studies connecting financial outcomes and phone-based social behavior (180,000 individuals; 2 years' time frame; 82.2 million monthly bills, and 350 million call logs). Our methodology tackles highly imbalanced dataset, which is a pertinent problem with modelling credit risk behavior, and offers a novel hybrid method that yields improvements over, both, a traditional transaction data only approach, and an approach that uses only call data. The results pave way for better financial modelling of billions of unbanked and underbanked customers using non-traditional metrics like phone-based credit scoring.

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

    International Nuclear Information System (INIS)

    Sher, David J.; Posner, Marshall R.; Tishler, Roy B.; Sarlis, Nicholas J.; Haddad, Robert I.; Holupka, Edward J.; Devlin, Phillip M.

    2011-01-01

    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

  4. 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

  5. Relationship between radiation treatment time and overall survival after induction chemotherapy for locally advanced head-and-neck carcinoma: a subset analysis of TAX 324.

    Science.gov (United States)

    Sher, David J; Posner, Marshall R; Tishler, Roy B; Sarlis, Nicholas J; Haddad, Robert I; Holupka, Edward J; Devlin, Phillip M

    2011-12-01

    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). 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). 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. 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 for optimizing OS in LAHNC. Copyright © 2011 Elsevier Inc

  6. Survival analysis with covariates in combination with multinomial analysis to parametrize time to event for multi-state models

    NARCIS (Netherlands)

    Feenstra, T.L.; Postmus, D.; Quik, E.H.; Langendijk, H.; Krabbe, P.F.M.

    Objectives: Recent ISPOR Good practice guidelines as well as literature encourage to use a single distribution rather than the latent failure approach to model time to event for patient level simulation models with multiple competing outcomes. Aim was to apply the preferred method of a single

  7. Survival analysis with covariates in combination with multinomial analysis to parametrize time to event for multi-state models

    NARCIS (Netherlands)

    Feenstra, T.L.; Postmus, D.; Quik, E.H.; Langendijk, H.; Krabbe, P.F.M.

    2013-01-01

    Objectives: Recent ISPOR Good practice guidelines as well as literature encourage to use a single distribution rather than the latent failure approach to model time to event for patient level simulation models with multiple competing outcomes. Aim was to apply the preferred method of a single

  8. Effect of packaging and storage time on survival of Listeria monocytogenes on kippered beef steak and turkey tenders.

    Science.gov (United States)

    Uppal, Kamaldeep K; Getty, Kelly J K; Boyle, Elizabeth A E; Harper, Nigel M; Lobaton-Sulabo, April Shayne S; Barry, Bruce

    2012-01-01

    The objective of our study was to determine effect of packaging method and storage time on reducing Listeria monocytogenes in shelf-stable meat snacks. Commercially available kippered beef steak strips and turkey tenders were dipped into a 5-strain L. monocytogenes cocktail, and dried at 23 °C until a water activity of 0.80 was achieved. Inoculated samples were packaged with 4 treatments: (1) vacuum, (2) nitrogen flushed with oxygen scavenger, (3) heat sealed with oxygen scavenger, and (4) heat sealed without oxygen scavenger. Samples were stored at 23 °C and evaluated for L. monocytogenes levels at 0, 24, 48, and 72 h. Initial levels (time 0) of L. monocytogenes were approximately 5.7 log CFU/cm² for steak and tenders. After 24 h of storage time, a 1 log CFU/cm² reduction of L. monocytogenes was observed for turkey tenders for all packaging treatments. After 48 h, turkey tenders showed >1 log CFU/cm² reduction of L. monocytogenes for all packaging treatments except for vacuum, where only 0.9 log CFU/cm² reduction was observed. After 72 h, reductions for all packaging treatments for turkey tenders ranged from 1.5 to 2.4 log CFU/cm². For kippered beef steak, there was no interaction between the packaging treatments and all storage times (P > 0.05) whereas, time was different (P packaging treatments and a 2.1 log CFU/ cm² L. monocytogenes reduction at 72 h of storage time. Processors of kippered beef steak and turkey tenders could use a combination of vacuum or nitrogen-flushing or heat sealed with an oxygen scavenger packaging methods and a holding time of 24 h prior to shipping to reduce potential L. monocytogenes numbers by ≥1 log. However, processors should be encouraged to hold packaged product a minimum of 72 h to enhance the margin of safety for L. monocytogenes control. © 2011 Institute of Food Technologists®

  9. Application of tape unit in data acquisition system and its maintenance and trouble shoot

    International Nuclear Information System (INIS)

    Xing Jianping; Qian Xicheng

    1995-01-01

    Application of magnetic tape unit in data acquisition system of DEC computer imported from German and its maintenance as well as trouble shoot is described. The system is used for nuclear data acquisition and processing

  10. Intermedin A, a New Labdane Diterpene Isolated from Alpinia intermedia, Prolonged the Survival Time of P-388D1 Tumor-Bearing CDF1 Mice.

    Science.gov (United States)

    Chen, Lih-Geeng; Su, Pei-Jung; Tsai, Po-Wei; Yang, Ling-Ling; Wang, Ching-Chiung

    2017-01-01

    Eight ethanolic extracts of indigenous Taiwanese plants of the genus Alpinia were tested for tumor cytotoxicity against AGS, Hep G2, HeLa, KB, and HL-60 cells. Among the 50 % and 95 % EtOH extracts of eight Alpinia species, the cytotoxic effects of Alpinia intermedia leaves were the strongest. When the leaf extract of A. intermedia was partitioned using n -hexane and aqueous solvents, the n -hexane layer showed a greater cytotoxic effect and could prolong the survival time of P-388D 1 tumor-bearing CDF1 mice. Two new labdane diterpene derivatives, intermedin A ( 1 ) and intermedin B ( 2 ), and coronarin E ( 3 ) were isolated from the n -hexane layer of A. intermedia . Intermedin A induced apoptosis in HL-60 cells at 30 µg/mL and significantly prolonged the survival time of P-388D 1 tumor-bearing CDF 1 mice by 48.7 % at 20 mg/kg of body weight. We suggest that intermedin A is a major compound of A. intermedia and has a cytotoxic effect on HL-60 and P-388D 1 cells. Georg Thieme Verlag KG Stuttgart · New York.

  11. 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.

  12. 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.

  13. Troubling Muddy Waters: Problematizing Reflective Practice in Global Medical Education.

    Science.gov (United States)

    Naidu, Thirusha; Kumagai, Arno K

    2016-03-01

    The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself.

  14. Studies of Complex Behavior and Their Relation to Trouble Shooting in Electronic Equipment.

    Science.gov (United States)

    1957-06-01

    discussed. It has been concluded that the study of human problem • . solving, concept formation, probability learning, and so forth, has i. provided litt 1...five actions) used by men in trouble shooting radio problemson the MASTS , AUTOMI STS, arid a job—sample test . There were five L categories so defined...Defense Human Research Unit ’ s proposed Task MA INTRAIN• will be drawn upon as needed for the non—trouble —shooting topics. I

  15. Anemia in chronic renal failure. Ferrokinetic, erythrocytes-survival time and enzymes of erythrocytes on chronic dialysed patients

    Energy Technology Data Exchange (ETDEWEB)

    Junkers, K; Jontofson, R; Meuret, G; Blume, K G; Heinze, V [Freie Univ. Berlin (F.R. Germany). Nuklearmedizinische Abt.; Freiburg Univ. (F.R. Germany). Nuklearmedizinische Abt.; Freiburg Univ. (F.R. Germany). Medizinische Poliklinik)

    1975-12-01

    Radio-iron utilization was nearly normal in these patients, only bilateral nephrectomized patients showed a reduced radio-iron utilization. Red blood half-life span was shortened in all patients, well corresponding to the degree of anemia. Parameters of erythropoesis like plasma iron clearance, bone marrow transit time, erythron iron turnover, non-erythron iron turnover and hemolysis iron turnover failed to quantitate disorders of red blood cell regeneration in these patients. No defect in red blood cell enzyme activity could be demonstrated. Enzymes of glycolysis were increased corresponding to the reduced erythrocyte half-life span.

  16. 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.

  17. 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.

  18. 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.

  19. Survival after Abdominoperineal and Sphincter-Preserving Resection in Nonmetastatic Rectal Cancer: A Population-Based Time-Trend and Propensity Score-Matched SEER Analysis

    Directory of Open Access Journals (Sweden)

    Rene Warschkow

    2017-01-01

    Full Text Available Background. Abdominoperineal resection (APR has been associated with impaired survival in nonmetastatic rectal cancer patients. It is unclear whether this adverse outcome is due to the surgical procedure itself or is a consequence of tumor-related characteristics. Study Design. Patients were identified from the Surveillance, Epidemiology, and End Results database. The impact of APR compared to coloanal anastomosis (CAA on survival was assessed by Cox regression and propensity-score matching. Results. In 36,488 patients with rectal cancer resection, the APR rate declined from 31.8% in 1998 to 19.2% in 2011, with a significant trend change in 2004 at 21.6% (P<0.001. To minimize a potential time-trend bias, survival analysis was limited to patients diagnosed after 2004. APR was associated with an increased risk of cancer-specific mortality after unadjusted analysis (HR = 1.61, 95% CI: 1.28–2.03, P<0.01 and multivariable adjustment (HR = 1.39, 95% CI: 1.10–1.76, P<0.01. After optimal adjustment of highly biased patient characteristics by propensity-score matching, APR was not identified as a risk factor for cancer-specific mortality (HR = 0.85, 95% CI: 0.56–1.29, P=0.456. Conclusions. The current propensity score-adjusted analysis provides evidence that worse oncological outcomes in patients undergoing APR compared to CAA are caused by different patient characteristics and not by the surgical procedure itself.

  20. Trends and timing of cigarette smoking uptake among US young adults: survival analysis using annual national cohorts from 1976 to 2005.

    Science.gov (United States)

    Terry-McElrath, Yvonne M; O'Malley, Patrick M

    2015-07-01

    To measure changes over time in cigarette smoking uptake prevalence and timing during young adulthood (ages 19-26 years), and associations between time-invariant/-varying characteristics and uptake prevalence/timing. Discrete-time survival modeling of data collected from United States high school seniors (modal age 17/18) enrolled in successive graduating classes from 1976 to 2005 and participating in four follow-up surveys (to modal age 25/26). The longitudinal component of the Monitoring the Future study. A total of 10 758 individuals reporting no life-time smoking when first surveyed as high school seniors. Smoking uptake (any, experimental, occasional and regular); socio-demographic variables; marital, college and work status; time spent socializing. The percentage of young adults moving from non-smoker to experimental smoking [slope estimate 0.11, standard error (SE) = 0.04, P = 0.005] or occasional smoking (slope estimate 0.17, SE = 0.03, P age 19/20, but uptake prevalence at older ages increased over time [e.g. cohort year predicting occasional uptake at modal age 25/26 adjusted hazard odds ratio (AHOR) = 1.05, P = 0.002]. Time-invariant/-varying characteristics had unique associations with the timing of various forms of smoking uptake (e.g. at modal age 21/22, currently attending college increased occasional uptake risk (AHOR = 2.11, P age 19/20, but prevalence of uptake at older ages increased. © 2015 Society for the Study of Addiction.

  1. Accounting for Uncertainty in Decision Analytic Models Using Rank Preserving Structural Failure Time Modeling: Application to Parametric Survival Models.

    Science.gov (United States)

    Bennett, Iain; Paracha, Noman; Abrams, Keith; Ray, Joshua

    2018-01-01

    Rank Preserving Structural Failure Time models are one of the most commonly used statistical methods to adjust for treatment switching in oncology clinical trials. The method is often applied in a decision analytic model without appropriately accounting for additional uncertainty when determining the allocation of health care resources. The aim of the study is to describe novel approaches to adequately account for uncertainty when using a Rank Preserving Structural Failure Time model in a decision analytic model. Using two examples, we tested and compared the performance of the novel Test-based method with the resampling bootstrap method and with the conventional approach of no adjustment. In the first example, we simulated life expectancy using a simple decision analytic model based on a hypothetical oncology trial with treatment switching. In the second example, we applied the adjustment method on published data when no individual patient data were available. Mean estimates of overall and incremental life expectancy were similar across methods. However, the bootstrapped and test-based estimates consistently produced greater estimates of uncertainty compared with the estimate without any adjustment applied. Similar results were observed when using the test based approach on a published data showing that failing to adjust for uncertainty led to smaller confidence intervals. Both the bootstrapping and test-based approaches provide a solution to appropriately incorporate uncertainty, with the benefit that the latter can implemented by researchers in the absence of individual patient data. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. 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

  3. 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

  4. Lymphadenectomy extent and survival of patients with gastric carcinoma: a systematic review and meta-analysis of time-to-event data from randomized trials.

    Science.gov (United States)

    Mocellin, Simone; Nitti, Donato

    2015-05-01

    The extent of lymph node dissection in patients with resectable non-metastatic primary carcinoma of the stomach is still a controversial matter of debate, with special regard to its effect on survival. We conducted a systematic review and meta-analysis of time-to-event data from randomized controlled trials (RCTs) comparing the three main types of lymphadenectomy (D1, D2, and D3) for gastric cancer. Hazard ratio (HR) was considered the effect measure for both overall (OS), disease-specific (DSS) and disease-free survival (DFS). The quality of the available evidence was assessed using the GRADE system. Eight RCTs enrolling 2515 patients were eligible. The meta-analysis of four RCTs (n=1599) showed a significant impact of D2 versus D1 lymphadenectomy on DSS (summary HR=0.807, CI: 0.705-0.924, P=0.002), the corresponding number-to-treat being equal to ten. This effect remained clinically valuable even after adjustment for postoperative mortality. However, the quality of evidence was graded as moderate due to inconsistency issues. When OS and DFS were considered, the meta-analysis of respectively five (n=1653) and three RCTs (n=1332) found no significant difference between D2 and D1 lymph node dissection (summary HR=0.911, CI: 0.708-1.172, P=0.471, and summary HR=0.946, CI: 0.840-1.066, P=0.366, respectively). However, at subgroup analysis D2 type resulted superior to D1 type lymphadenectomy in terms of OS considering the two RCTs carried out in Eastern countries (summary HR=0.627, CI: 0.396-0.994, P=0.047). As regards the D3 vs D2 comparison, the meta-analysis of the three available RCTs (n=862) showed no significant impact of more extended lymphadenectomy on OS (summary HR=0.990, CI: 0.814-1.205, P=0.924). Our findings support the superiority of D2 versus D1 lymphadenectomy in terms of survival benefit. However, this advantage is mainly limited to DSS, the level of evidence is moderate, and the interaction with other factors affecting patient survival (such as

  5. The influence of age at time of exposure to 239Pu or 226Ra on retention, distribution, survival and tumor induction in Beagles

    International Nuclear Information System (INIS)

    Bruenger, F.W.; Miller, S.C.; Lloyd, R.D.

    1991-01-01

    The influence of age at injection of 226 Ra or 239 Pu on skeletal deposition and local distribution, the pattern of bone tumor formation and post-injection survival were studied in parallel short-term mechanistic and lifetime toxicity experiments. Beagles received a single intravenous injection of 226 Ra or 239 Pu at age 3 months (juveniles), 17-19 months (young adults) or 60 months (mature). Data from short-term mechanistic-dosimetric studies and from one dosage level (41 kBq 226 Ra/kg or 11 kBq 239 Pu/kg body mass) of each of the toxicity experiments were compared. Skeletal growth and turnover produced differential initial deposition and distribution patterns typical for each age group. The highest bone tumor incidence was seen in the young adult groups. Differences were observed in bone tumor location between dogs in the same age group given radium or plutonium and among age groups injected with either radionuclide, and some of these could be explained by differences in local dose distributions (e.g., trabecular vs. cortical bone). Cox regression indicated no significant differences in post-injection survivals (uncorrected for the different pre-injection periods) of Ra-injected groups, but there was a statistically significant difference among the Pu-injected groups. Neutron-induced autoradiography showed that differences in the effects of Pu in the three age groups were due primarily to the age- and time-dependent local distribution of the nuclide

  6. 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.

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

    International Nuclear Information System (INIS)

    Mould, Richard F; Lahanas, Michael; Asselain, Bernard; Brewster, David; Burgers, Sjaak A; Damhuis, Ronald A M; Rycke, Yann De; Gennaro, Valerio; Szeszenia-Dabrowska, Neonila

    2004-01-01

    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

  8. 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

  9. Denosumab and Bone Metastasis–Free Survival in Men With Nonmetastatic Castration-Resistant Prostate Cancer: Exploratory Analyses by Baseline Prostate-Specific Antigen Doubling Time

    Science.gov (United States)

    Smith, Matthew R.; Saad, Fred; Oudard, Stephane; Shore, Neal; Fizazi, Karim; Sieber, Paul; Tombal, Bertrand; Damiao, Ronaldo; Marx, Gavin; Miller, Kurt; Van Veldhuizen, Peter; Morote, Juan; Ye, Zhishen; Dansey, Roger; Goessl, Carsten

    2013-01-01

    Purpose Denosumab, an anti–RANK ligand monoclonal antibody, significantly increases bone metastasis–free survival (BMFS; hazard ratio [HR], 0.85; P = .028) and delays time to first bone metastasis in men with nonmetastatic castration-resistant prostate cancer (CRPC) and baseline prostate-specific antigen (PSA) ≥ 8.0 ng/mL and/or PSA doubling time (PSADT) ≤ 10.0 months. To identify men at greatest risk for bone metastasis or death, we evaluated relationships between PSA and PSADT with BMFS in the placebo group and the efficacy and safety of denosumab in men with PSADT ≤ 10, ≤ 6, and ≤ 4 months. Patients and Methods A total of 1,432 men with nonmetastatic CRPC were randomly assigned 1:1 to monthly subcutaneous denosumab 120 mg or placebo. Enrollment began February 2006; primary analysis cutoff was July 2010, when approximately 660 men were anticipated to have developed bone metastases or died. Results In the placebo group, shorter BMFS was observed as PSADT decreased below 8 months. In analyses by shorter baseline PSADT, denosumab consistently increased BMFS by a median of 6.0, 7.2, and 7.5 months among men with PSADT ≤ 10 (HR, 0.84; P = .042), ≤ 6 (HR, 0.77; P = .006), and ≤ 4 months (HR, 0.71; P = .004), respectively. Denosumab also consistently increased time to bone metastasis by PSADT subset. No difference in survival was observed between treatment groups for the overall study population or PSADT subsets. Conclusion Patients with shorter PSADT are at greater risk for bone metastasis or death. Denosumab consistently improves BMFS in men with shorter PSADT and seems to have the greatest treatment effects in men at high risk for progression. PMID:24043751

  10. Denosumab and bone metastasis-free survival in men with nonmetastatic castration-resistant prostate cancer: exploratory analyses by baseline prostate-specific antigen doubling time.

    Science.gov (United States)

    Smith, Matthew R; Saad, Fred; Oudard, Stephane; Shore, Neal; Fizazi, Karim; Sieber, Paul; Tombal, Bertrand; Damiao, Ronaldo; Marx, Gavin; Miller, Kurt; Van Veldhuizen, Peter; Morote, Juan; Ye, Zhishen; Dansey, Roger; Goessl, Carsten

    2013-10-20

    Denosumab, an anti-RANK ligand monoclonal antibody, significantly increases bone metastasis-free survival (BMFS; hazard ratio [HR], 0.85; P = .028) and delays time to first bone metastasis in men with nonmetastatic castration-resistant prostate cancer (CRPC) and baseline prostate-specific antigen (PSA) ≥ 8.0 ng/mL and/or PSA doubling time (PSADT) ≤ 10.0 months. To identify men at greatest risk for bone metastasis or death, we evaluated relationships between PSA and PSADT with BMFS in the placebo group and the efficacy and safety of denosumab in men with PSADT ≤ 10, ≤ 6, and ≤ 4 months. A total of 1,432 men with nonmetastatic CRPC were randomly assigned 1:1 to monthly subcutaneous denosumab 120 mg or placebo. Enrollment began February 2006; primary analysis cutoff was July 2010, when approximately 660 men were anticipated to have developed bone metastases or died. In the placebo group, shorter BMFS was observed as PSADT decreased below 8 months. In analyses by shorter baseline PSADT, denosumab consistently increased BMFS by a median of 6.0, 7.2, and 7.5 months among men with PSADT ≤ 10 (HR, 0.84; P = .042), ≤ 6 (HR, 0.77; P = .006), and ≤ 4 months (HR, 0.71; P = .004), respectively. Denosumab also consistently increased time to bone metastasis by PSADT subset. No difference in survival was observed between treatment groups for the overall study population or PSADT subsets. Patients with shorter PSADT are at greater risk for bone metastasis or death. Denosumab consistently improves BMFS in men with shorter PSADT and seems to have the greatest treatment effects in men at high risk for progression.

  11. 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.

  12. Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

    Science.gov (United States)

    Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

    1996-06-01

    Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

  13. 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.

  14. Analysis and Improvement of Control Algorithm for Operation Mode Transition due to Input Channel Trouble in Control Systems

    International Nuclear Information System (INIS)

    Ahn, Myunghoon; Kim, Woogoon; Yim, Hyeongsoon

    2016-01-01

    The PI (Proportional plus Integral) controller, which is the essential functional block in control systems, can automatically perform the stable control of an important plant process while reducing the steady state error and improving the transient response. However, if the received input PV (Process Variable) is not normal due to input channel trouble, it will be difficult to control the system automatically. For this reason, many control systems are implemented to change the operation mode from automatic to manual mode in the PI controller when the failed input PV is detected. If the PI controller is in automatic mode for all the time, the control signal varies as the change of the input PV is continuously reflected in the control algorithm. In the other cases, since the controller changes into the manual mode at t=0, the control signal is fixed at the last PI controller output and thus the feedback control is not performed anymore until the operator takes an action such as the operation mode change. As a result of analysis and simulations for the controller’s operation modes in all the cases of input channel trouble, we discovered that it is more appropriate to maintain the automatic mode despite the bad quality in the PV. Therefore, we improved the control system algorithm reflecting the analysis results for the operator’s convenience and the stability of a control system

  15. Analysis and Improvement of Control Algorithm for Operation Mode Transition due to Input Channel Trouble in Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Myunghoon; Kim, Woogoon; Yim, Hyeongsoon [KEPCO Engineering and Construction Co., Deajeon (Korea, Republic of)

    2016-10-15

    The PI (Proportional plus Integral) controller, which is the essential functional block in control systems, can automatically perform the stable control of an important plant process while reducing the steady state error and improving the transient response. However, if the received input PV (Process Variable) is not normal due to input channel trouble, it will be difficult to control the system automatically. For this reason, many control systems are implemented to change the operation mode from automatic to manual mode in the PI controller when the failed input PV is detected. If the PI controller is in automatic mode for all the time, the control signal varies as the change of the input PV is continuously reflected in the control algorithm. In the other cases, since the controller changes into the manual mode at t=0, the control signal is fixed at the last PI controller output and thus the feedback control is not performed anymore until the operator takes an action such as the operation mode change. As a result of analysis and simulations for the controller’s operation modes in all the cases of input channel trouble, we discovered that it is more appropriate to maintain the automatic mode despite the bad quality in the PV. Therefore, we improved the control system algorithm reflecting the analysis results for the operator’s convenience and the stability of a control system.

  16. Impact of Socioeconomic Status on Timing of Relapse and Overall Survival for Children Treated on Dana-Farber Cancer Institute ALL Consortium Protocols (2000-2010).

    Science.gov (United States)

    Bona, Kira; Blonquist, Traci M; Neuberg, Donna S; Silverman, Lewis B; Wolfe, Joanne

    2016-06-01

    Population-based evidence suggests that lower socioeconomic status (SES) negatively impacts the overall survival (OS) of children with leukemia; however, the relationships between SES and treatment-related mortality, relapse, and timing of relapse remain unclear. We examined OS, event-free survival (EFS) and cumulative incidence (CI) and timing of relapse by community-level poverty for 575 children aged 1-18 years with newly diagnosed acute lymphoblastic leukemia (ALL) treated on consecutive phase III multicenter Dana-Farber Cancer Institute ALL Consortium Protocols between 2000 and 2010. Children were categorized into high- and low-poverty areas for the analysis using aggregate U.S. Census data linked to zip code. Children living in high-poverty areas experienced a 5-year OS of 85% as compared with 92% for those in low-poverty areas (P = 0.02); poverty remained marginally significant (P = 0.07) after adjustment for immunophenotype, age, and white blood cell count. There were no differences detected in EFS or CI relapse by poverty area. However, 92% of the relapses observed in children from high-poverty areas occurred <36 months from complete remission, compared to 48% of those in children from low-poverty areas (P = 0.008). U.S. children with ALL living in high-poverty areas have a higher risk of early relapse when compared with those living in low-poverty areas despite uniform treatment. This may in part explain decreased OS observed in these children. This finding highlights disparities in childhood cancer outcomes by SES despite uniform treatment. Further investigations of the mechanistic pathways underlying this finding are needed. © 2016 Wiley Periodicals, Inc.

  17. Bias and precision of methods for estimating the difference in restricted mean survival time from an individual patient data meta-analysis

    Directory of Open Access Journals (Sweden)

    Béranger Lueza

    2016-03-01

    Full Text Available Abstract Background The difference in restricted mean survival time ( rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ , the area between two survival curves up to time horizon t ∗ $$ {t}^{\\ast } $$ , is often used in cost-effectiveness analyses to estimate the treatment effect in randomized controlled trials. A challenge in individual patient data (IPD meta-analyses is to account for the trial effect. We aimed at comparing different methods to estimate the rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ from an IPD meta-analysis. Methods We compared four methods: the area between Kaplan-Meier curves (experimental vs. control arm ignoring the trial effect (Naïve Kaplan-Meier; the area between Peto curves computed at quintiles of event times (Peto-quintile; the weighted average of the areas between either trial-specific Kaplan-Meier curves (Pooled Kaplan-Meier or trial-specific exponential curves (Pooled Exponential. In a simulation study, we varied the between-trial heterogeneity for the baseline hazard and for the treatment effect (possibly correlated, the overall treatment effect, the time horizon t ∗ $$ {t}^{\\ast } $$ , the number of trials and of patients, the use of fixed or DerSimonian-Laird random effects model, and the proportionality of hazards. We compared the methods in terms of bias, empirical and average standard errors. We used IPD from the Meta-Analysis of Chemotherapy in Nasopharynx Carcinoma (MAC-NPC and its updated version MAC-NPC2 for illustration that included respectively 1,975 and 5,028 patients in 11 and 23 comparisons. Results The Naïve Kaplan-Meier method was unbiased, whereas the Pooled Exponential and, to a much lesser extent, the Pooled Kaplan-Meier methods showed a bias with non-proportional hazards. The Peto-quintile method underestimated the rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ , except with non-proportional hazards at t ∗ $$ {t}^{\\ast } $$ = 5 years. In the presence of treatment effect

  18. Substitution time of natural food by artificial diet on survival rate and growth of pacific white shrimp (Litopenaeus vannamei postlarvae during rearing in low salinity media

    Directory of Open Access Journals (Sweden)

    Ferdinand Hukama Taqwa

    2011-01-01

    Full Text Available This research was conducted to determine natural food substitution time by artificial diet   after salinity acclimatization from 20 ppt until 2 ppt, which can increase survival and growth of (Litopenaeus vannamei postlarvae during rearing period. Design experiment was completely randomized design with five treatments and three replications of natural food Chironomus sp.  (60% of crude protein substitution time by artificial diet (40% of crude protein at day: 1 (A, 7 (B, 14 (C, 21 (D and full natural food without artificial diet (E during 28 days rearing period. White shrimp postlarvae and rearing media in this experiment based from best result of earlier research that is PL25 from acclimatization in media 2 ppt with addition of potassium 25 ppm to freshwater media.  The densities of PL25 white shrimp were 20 PLs/50 liters of 2 ppt media. The result of this experiment showed that the use of artificial diet as soon as after salinity acclimatization (PL25 gave best performance production compared to which only that was given natural food Chironomus sp. during experiment or with treatment by artificial diet substitution at day-7, day-14 or day-21, shown with the highest value of food consumption level, protein retention, energy retention, daily growth rate and food efficiency. Survival rate of PL54 was above 80% and not significant different between treatment. That is supported by chemical-physical value of water quality still in range appropriate to survival rate of white shrimp post larvae during a rearing period. The result of this experiment indicated that requirement nutrient of PL25 in low salinity did not fulfilled if only rely on natural food, so that require artificial diet with nutrition content to support growth and survival rate of white shrimp post larvae more maximal. Key words: salinity, natural food, artificial diet, Pacific white shrimp   ABSTRAK Tujuan penelitian ini adalah untuk menentukan waktu penggantian pakan alami oleh

  19. Human papilloma virus 16/18: Fabricator of trouble in oral squamous cell carcinoma.

    Science.gov (United States)

    Zil-E-Rubab; Baig, Saeeda; Zaman, Uzma; Lucky, Mohammad Haris

    2018-04-01

    To find out the association between Human Papilloma Virus (HPV) genotypes 16/18 in Pakistani patients with oral squamous cell carcinoma (OSCC). DNA from oral rinse of 300 subjects was taken. The subjects included 100 cases with OSCC and 200 controls. Samples were analyzed by both conventional and real time PCR using "HPV consensus Gp5+/Gp6+ and HPV 16, 18 specific primers". Out of 300 persons, 74/300 (25%) were found to be infected with HPV: "46/100(46%) from cases and 74/200(14%) from controls". The distribution was: HPV16, 6/300 (8%): 4/100 (9%) from OSCC group and 2/200 (8%) from controls while HPV 18 was 9/300(12%): 5/100(11%) from cases and 4/200(16%) from controls. Out of 300 subjects, 26(35%) were infected by "both HPV 16/18 (23(50%) from cases and 3(12%) from controls". Persons who were infected with HPV 16&18 had higher chances to develop OSCC as compared to those who didn't have HPV 16/18 (AOR: 21.4, 95% CI: 5.73 - 80.8). The exposure to high risk strains of Human papilloma virus (16/18) in combination can be fabricotor of trouble (p<0.001, Adjusted odds ratio; 21.42) in OSCC. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. 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.

  1. 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

    The role of the father has undergone considerable change in the West. Fathers of today are expected to take a more active part in birth preparation, birth and childcare than their predecessors were. The purpose of the present study is to describe some Danish fathers' experiences around birth. Three...... 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...... 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...

  2. 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.

  3. 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.

  4. 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...

  5. Time to Let Go of the Illusion that Psychotherapy Extends the Survival of Cancer Patients: Reply to Kraemer, Kuchler, and Spiegel (2009)

    Science.gov (United States)

    Coyne, James C.; Thombs, Brett D.; Stefanek, Michael; Palmer, Steven C.

    2009-01-01

    Replies to comments from Kraemer, Kuchler, and Spiegel on the authors original article Psychotherapy and survival in cancer: The conflict between hope and evidence. The authors recently reviewed evidence related to the notion that psychotherapy extends survival in cancer patients (J. C. Coyne, M. Stefanek, & S. C. Palmer, 2007). The authors found…

  6. Tumultos de género: os efeitos de Gender trouble em Portugal

    OpenAIRE

    de Oliveira, João Manuel

    2015-01-01

    A publicação da obra Gender trouble – feminism and the subversion of identity, por Judith Butler, constitui um tumulto nas teorias do género existentes e futuras. Este texto visa traçar o rastro dessa passagem no quadro dos estudos de género em Portugal, analisando a recepção da obra. Este artigo debruça-se também no rastro de Gender trouble na criação contemporânea, mostrando o encontro estranhamente familiar do coreógrafo Francisco Camacho com esse tumulto de género.

  7. Deleuze and the teenage mother: trouble makers for education and transition

    OpenAIRE

    Kamp, Annelies

    2014-01-01

    The title of this chapter is doing some work, albeit in a somewhat awkward fashion. Giles Deleuze appears, philosopher of a “bastard kind” (Massumi 1992, 1). Deleuze opens the work because he, and his concepts, do something they are rather good at: a bit of troubling, a bit of “prying open” of habitual ways of thinking (Massumi 1987, xv). In this chapter that bit of troubling and prying open is directed toward a rethinking of youth transition and the role of schools in that particular form of...

  8. Trouble in paradise: The crime and health outcomes of the Surfers Paradise licensed venue lockout.

    Science.gov (United States)

    de Andrade, Dominique; Homel, Ross; Townsley, Michael

    2016-09-01

    The lockout intervention has become embedded in Australian alcohol policy with little scientific evidence of its effectiveness in reducing violence and disorder. This paper reports an evaluation of the Queensland lockout pilot in Surfers Paradise. Patrons could not enter or re-enter licensed venues after 3 am, while patrons inside at this time could stay until close. Using police and ambulance data, time series analyses examined the impact of tourism seasons and the lockout on rates of crime, violence, injury and intoxication. Additional analyses were also conducted to show spatial and temporal changes in crime over time. Both police and ambulance data showed that the lockout introduction had no statistically significant impact on rates of crime, violence, head and neck injuries, and intoxication over the 2 years following lockout. Hot spot maps indicated limited spatial shift of crime within Surfers Paradise following the lockout introduction, with evidence of a temporary intensification of crime in already established hot spots. We found a moderate statistically significant change in the 24 h distribution of crime after the lockout implementation, suggesting temporal displacement of crime. Results support the small existing body of evidence on lockouts that indicates they are largely ineffective in reducing crime and injuries in entertainment districts. As multi-pronged strategies that include a lockout gain in popularity, further investigation should focus on identifying the key drivers of successful interventions such as the Newcastle strategy, to better refine these interventions for replication and evaluation elsewhere. [De Andrade D, Homel R, Townsley M. Trouble in paradise: The crime and health outcomes of the Surfers Paradise licensed venue lockout. Drug Alcohol Rev 2016;35:564-572]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  9. 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

  10. The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. A 15-year follow-up study of risk indicators for self-reported sick-listing caused by low back trouble.

    Science.gov (United States)

    Müller, C F; Monrad, T; Biering-Sørensen, F; Darre, E; Deis, A; Kryger, P

    1999-08-01

    A 15-year follow-up study. To find risk indicators for self-reported sick-listing because of low back trouble and to evaluate which variables were the most important indicators of work incapacity resulting from low back trouble during the follow-up period of 15 years. The initial data were obtained from a health survey conducted in a general population from the Municipality of Glostrup, Denmark. The follow-up data included information from the Central Person Register, the Early Retirement Pension Register, and a postal questionnaire regarding self-reported sick-listing because of low back trouble. An epidemiologic study, in which logistic regression analyses were used for evaluation of the data. The model used consisted of the variable in question, age, gender, and previous experience of low back trouble, along with interactions. It was found that 22 of 37 variables were risk indicators for later self-reported sick-listing because of low back trouble during the preceding year or the 7 years before the date of follow-up evaluation. In analyzing the most significant variables simultaneously, it was found that information from the initial investigation about sick-listing in general during the previous 10 years, sciatic pain, use of analgesics for low back trouble, previous sick-listing because of low back trouble, and occupation were the most important risk indicators for self-reported work incapacity resulting from low back trouble during the follow-up period of 15 years. Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.

  11. 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 ...

  12. 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.

  13. 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.

  14. Lactobacillus rhamnosus R11 consumed in a food supplement survived human digestive transit without modifying microbiota equilibrium as assessed by real-time polymerase chain reaction.

    Science.gov (United States)

    Firmesse, Olivier; Mogenet, Agnès; Bresson, Jean-Louis; Corthier, Gérard; Furet, Jean-Pierre

    2008-01-01

    The aim of this study was to evaluate the survival of Lactobacillus rhamnosus R11 and Lactobacillus acidophilus R52 in the human digestive tract and their effects on the microbiota homeostasis. We designed an open human trial including 14 healthy volunteers. A 3-week exclusion period of fermented products was followed by a 12-day consumption period of 4 capsules daily containing 2 x 10(9)L. rhamnosus R11 and 1 x 10(8)L. acidophilus R52, and a 12-day wash-out period. The 2 strains and dominant bacterial groups of the microbiota were quantified by real-time polymerase chain reaction. At the end of the capsule consumption period, high levels of L. rhamnosus R11 were detected in faecal samples from all volunteers, reaching a mean value of 7.1 log(10) colony-forming unit (CFU) equivalents/g of stool. L. acidophilus R52 was detected in the stools of only 1 volunteer, reaching a maximum level of 6.1 log(10) CFU equivalents/g of stool. Dilution plating enumerations performed in parallel provided less consistent and generally lower levels. No significant effect of capsule consumption was observed on microbiota homeostasis for the dominant faecal populations. Mean values of 8.8, 9.2, 9.9 and 10.6 log(10) CFU equivalents/g of stool were obtained for the Clostridium coccoides, Bifidobacterium sp., Bacteroides sp. and Clostridium leptum groups, respectively.

  15. Time-related improvement of survival in resectable gastric cancer: the role of Japanese-style gastrectomy with D2 lymphadenectomy and adjuvant chemotherapy

    Directory of Open Access Journals (Sweden)

    Vidal Oscar

    2006-08-01

    Full Text Available Abstract Background We investigated the change of prognosis in resected gastric cancer (RGC patients and the role of radical surgery and adjuvant chemotherapy. Methods We retrospectively analyze the outcome of 426 consecutive patients from 1975 to 2002, divided into 2 time-periods (TP cohort: Before 1990 (TP1, n = 207 and 1990 or after (TP2; n= 219. Partial gastrectomy and D1-lymphadenetomy was predominant in TP1 and total gastrectomy with D2-lymphadenectomy it was in TP2. Adjuvant chemotherapy consisted of mitomycin C (MMC, 10–20 mg/m2 iv 4 courses or MMC plus Tegafur 500 mg/m2 for 6 months. Results Positive nodes were similar in TP2/TP1 patients with 56%/59% respectively. Total gastrectomy was done in 56%/45% of TP2/TP1 respectively. Two-drug adjuvant chemotherapy was administered in 65%/18% of TP2/TP1 respectively. Survival at 5 years was 66% for TP2 versus 42% for TP1 patients (p Conclusion The global prognosis and that of some stages have improved in recent years with case RGC patients treated with surgery and adjuvant chemotherapy.

  16. 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.

  17. Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study.

    Science.gov (United States)

    Gebremichael, Delelegn Yilma

    2015-12-21

    Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high. A retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors. Nutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1-1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3-2.4), weight (AHR = 1.5, 95 % CI: 1.2-1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1-1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4-3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1-4.8). The findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia.

  18. 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

  19. Procedure times, complication rates, and survival times associated with single-chamber versus dual-chamber pacemaker implantation in dogs with clinical signs of bradyarrhythmia: 54 cases (2004-2009).

    Science.gov (United States)

    Genovese, David W; Estrada, Amara H; Maisenbacher, Herbert W; Heatwole, Bonnie A; Powell, Melanie A

    2013-01-15

    To compare procedure times and major and minor complication rates associated with single-chamber versus dual-chamber pacemaker implantation and with 1-lead, 2-lead, and 3-lead pacemaker implantation in dogs with clinical signs of bradyarrhythmia. Retrospective case series. 54 dogs that underwent pacemaker implantation because of clinical signs of bradyarrhythmia. Medical records of dogs that received pacemakers between July 2004 and December 2009 were reviewed for information regarding signalment, diagnosis, pacemaker implantation, pacemaker type, complications, and survival time. Analyses were performed to determine significant differences in anesthesia time, procedure time, and outcome for dogs on the basis of pacing mode and number of pacing leads. 28 of 54 (51.9%) dogs received single-chamber pacemakers and 26 (48.1%) received dual-chamber pacemakers. Mean ± SD procedural time was significantly longer for patients with dual-chamber pacemakers (133.5 ± 51.3 minutes) than for patients with single-chamber pacemakers (94.9 ± 37.0 minutes), and procedure time increased significantly as the number of leads increased (1 lead, 102.3 ± 51.1 minutes; 2 leads, 114.9 ± 24.8 minutes; 3 leads, 158.2 ± 8.5 minutes). Rates of major and minor complications were not significantly different between dogs that received single-chamber pacemakers and those that received dual-chamber pacemakers or among dogs grouped on the basis of the number of pacing leads placed. Although dual-chamber pacemaker implantation did result in increased procedural and anesthesia times, compared with single-chamber pacemaker implantation, this did not result in a higher complication rate.

  20. 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.

  1. Low temperature and dust favour in vitro survival of Mycoplasma hyopneumoniae: time to revisit indirect transmission in pig housing.

    Science.gov (United States)

    Browne, C; Loeffler, A; Holt, H R; Chang, Y M; Lloyd, D H; Nevel, A

    2017-01-01

    Porcine enzootic pneumonia (EP) caused by Mycoplasma hyopneumoniae adversely affects pig welfare and is associated with major economic losses in the pig industry worldwide. Transmission is predominantly by direct contact, but the role of indirect transmission remains poorly understood. This study examined survival of six M. hyopneumoniae isolates dried onto five different surfaces encountered in pig units and exposed to temperatures of 4, 25 and 37°C for up to 12 days. Survival of the organisms was determined by recovering the organism from the surface material and culturing in Friis broth. Data were analysed by logistic regression to identify factors influencing survival of M. hyopneumoniae. Maximum survival was 8 days for all isolates on at least one surface (except stainless steel) at 4°C and was limited to 2 days at 25 and 37°C. Overall, dust and polypropylene copolymer supported M. hyopneumoniae survival the longest when compared with other surface materials. In conclusion, we have demonstrated that M. hyopneumoniae can survive outside the host for at least 8 days. Understanding the transmission of Mycoplasma hyopneumoniae and optimizing biosecurity practices are keys to reducing the use of antimicrobial agents to control this pathogen. Direct transmission of the pathogen between pigs is the main route of spread and its lack of cell wall may compromise its resilience outside the host. The results from our study show that M. hyopneumoniae can survive for up to several days on dry surfaces and therefore may have the potential to infect pigs by indirect transmission. Factors influencing the survival of M. hyopneumoniae outside the host are further elucidated. © 2016 The Society for Applied Microbiology.

  2. 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…

  3. Teaching Feminist Theory via Philosophy: Political Implications of an Ontological Inquiry in Judith Butler's "Gender Trouble."

    Science.gov (United States)

    Artese, Brian

    Rather than begin an undergraduate class in feminist theory with the assertion that such theory is important because of its social implications--and then attempt to prove it--it is more effective to begin with a more neutral philosophical discussion that will act as a foundation for its premises. Judith Butler's essay "Gender Trouble"…

  4. What Troubles Clerks in Psychiatry? A Strategy to Explore the Question

    Science.gov (United States)

    Pessar, Linda F.; Pristach, Cynthia A.; Leonard, Kenneth E.

    2008-01-01

    Objective: The psychiatric clerkship is a stressful experience that influences attitudes toward patients with psychiatric illnesses and influences recruitment into the field. This study focused on medical students' encounters with patients they found troubling or difficult, and whether specific themes regarding their emotional responses could be…

  5. Troubling the Politics of Engagement, Ethics, and Educational Research: Reframing Our Work

    Science.gov (United States)

    Kumashiro, Kevin K.

    2014-01-01

    This reflective essay draws on the personal experiences of the author in negotiating various tensions of engaged research and raises several troubling questions about research with immigrant populations, particularly concerning engagement, ethics, and educational contexts. Three "lenses" (or, three theoretical framings) serve as…

  6. Free Choice and Free Play in Early Childhood Education: Troubling the Discourse

    Science.gov (United States)

    Wood, Elizabeth Ann

    2014-01-01

    This article troubles the established discourse of free choice and free play in early childhood education, and develops post-structural approaches to theorising children's agency in the context of institutional and relational power structures. It is widely accepted that planning a curriculum based on children's needs, interests and patterns of…

  7. 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…

  8. Why Competent Persons Have Meltdowns Working with Troubled Students: A Personal Essay

    Science.gov (United States)

    Long, Nicholas J.

    2010-01-01

    How do otherwise competent helpers "lose it" in work with certain troubled children and youth? Drawing on extensive research and practice expertise, this article identifies four causes of these predictable professional "meltdowns"--(1) Caught in the Conflict Cycle; (2) Violation of cherished values and beliefs; (3) Tap-in issues; and (4) Carry-in…

  9. Wuzzit Trouble: The Influence of a Digital Math Game on Student Number Sense

    Directory of Open Access Journals (Sweden)

    Holly Pope

    2015-12-01

    Full Text Available This study sought to determine if playing a digital math game could increase student number sense (mathematical proficiency in numeracy. We used a pre- and post-assessment to measure the number sense of two groups of third grade students with the same mathematics teacher. One group played the game Wuzzit Trouble and the other did not. Overall, the group who played Wuzzit Trouble showed a significant increase in number sense between the pre- and post-assessment, compared to the other group who did not. A qualitative analysis of a novel problem revealed differences between the treatment and comparison groups from pre- to post-. A discussion of these findings and features of the game are addressed. Namely, two features inherent in Wuzzit Trouble are associated with the learners’ increased number sense. First, Wuzzit Trouble promoted mathematical proficiency by requiring learners to attend to several mathematical constraints at once. Second, the game engaged learners in an iterative process of decision-making by calling for students to try, check, and revise their strategy as they played.

  10. 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.

  11. The influence of age at time of exposure to 226Ra or 239Pu on distribution, retention, postinjection survival, and tumor induction in beagle dogs

    International Nuclear Information System (INIS)

    Bruenger, F.W.; Lloyd, R.D.; Miller, S.C.

    1991-01-01

    The influence of age at injection of 226Ra or 239Pu on skeletal deposition and local distribution, the pattern of bone tumor formation, and postinjection survival was assessed in parallel short-term studies of mechanisms and lifetime toxicity. Beagles received a single intravenous injection of 226Ra or 239Pu at 3 months (juveniles), 17-19 months (young adults) or 60 months (mature). Data from short-term studies of mechanisms and dosimetry and from one dosage level of each of the toxicity experiments were compared. Skeletal growth and turnover produced differential initial deposition and distribution patterns typical for each age group. At 1 week after injection, skeletal retention of 226Ra or 239Pu was 68 and 68%, respectively, in the juveniles, 32 and 46% in the young adults, and 31 and 43% in the mature dogs. Comparing individual bones in the juveniles, gradients in the concentration of 239Pu were small since all bones were actively growing, but substantial gradients, corresponding to centers of ossification, were present within individual bones. In other age groups, local concentration gradients were less pronounced, but much larger differences were present among the various bones. In the toxicity study all animals injected with either 41 kBq 226Ra/kg or 11 kBq 239Pu/kg have died. The cumulative average skeletal doses to the presumed time of start of tumor growth (1 year before death) were 25 and 4 Gy, respectively, for the juveniles, 22 and 5 Gy for the young adults, and 15 and 4 Gy for the mature dogs. The highest bone tumor incidence was seen in the young adult groups. Differences were observed in location of bone tumors between dogs in the same age group given radium or plutonium and among age groups injected with either radionuclide, some of which could be explained by differences in local dose distributions

  12. Adjusting survival time estimates to account for treatment switching in randomized controlled trials--an economic evaluation context: methods, limitations, and recommendations.

    Science.gov (United States)

    Latimer, Nicholas R; Abrams, Keith R; Lambert, Paul C; Crowther, Michael J; Wailoo, Allan J; Morden, James P; Akehurst, Ron L; Campbell, Michael J

    2014-04-01

    Treatment switching commonly occurs in clinical trials of novel interventions in the advanced or metastatic cancer setting. However, methods to adjust for switching have been used inconsistently and potentially inappropriately in health technology assessments (HTAs). We present recommendations on the use of methods to adjust survival estimates in the presence of treatment switching in the context of economic evaluations. We provide background on the treatment switching issue and summarize methods used to adjust for it in HTAs. We discuss the assumptions and limitations associated with adjustment methods and draw on results of a simulation study to make recommendations on their use. We demonstrate that methods used to adjust for treatment switching have important limitations and often produce bias in realistic scenarios. We present an analysis framework that aims to increase the probability that suitable adjustment methods can be identified on a case-by-case basis. We recommend that the characteristics of clinical trials, and the treatment switching mechanism observed within them, should be considered alongside the key assumptions of the adjustment methods. Key assumptions include the "no unmeasured confounders" assumption associated with the inverse probability of censoring weights (IPCW) method and the "common treatment effect" assumption associated with the rank preserving structural failure time model (RPSFTM). The limitations associated with switching adjustment methods such as the RPSFTM and IPCW mean that they are appropriate in different scenarios. In some scenarios, both methods may be prone to bias; "2-stage" methods should be considered, and intention-to-treat analyses may sometimes produce the least bias. The data requirements of adjustment methods also have important implications for clinical trialists.

  13. High Numbers of Stromal Cancer-Associated Fibroblasts Are Associated With a Shorter Survival Time in Cats With Oral Squamous Cell Carcinoma.

    Science.gov (United States)

    Klobukowska, H J; Munday, J S

    2016-11-01

    Cancer-associated fibroblasts (CAFs) are fibroblastic cells that express α-smooth muscle actin and have been identified in the stroma of numerous epithelial tumors. The presence of CAFs within the tumor stroma has been associated with a poorer prognosis in some human cancers, including oral squamous cell carcinomas (SCCs). Cats frequently develop oral SCCs, and although these are generally highly aggressive neoplasms, there is currently a lack of prognostic markers for these tumors. The authors investigated the prognostic value of the presence of CAFs within the stroma of oral SCC biopsy specimens from 47 cats. In addition, several epidemiologic, clinical, and histologic variables were also assessed for prognostic significance. A CAF-positive stroma was identified in 35 of 47 SCCs (74.5%), and the median survival time (ST) of cats with CAF-positive SCCs (35 days) was significantly shorter than that of cats with CAF-negative SCCs (48.5 days) (P = .031). ST was also associated with the location of the primary tumor (P = .0018): the median ST for oropharyngeal SCCs (179 days) was significantly longer than for maxillary (43.5 days; P = .047), mandibular (42 days; P = .022), and sublingual SCCs (22.5 days; P = .0005). The median ST of sublingual SCCs was also shorter compared with maxillary SCCs (P = .0017). Furthermore, a significant association was identified between site and the presence of stromal CAFs (P = .025). On the basis of this retrospective study, evaluating the tumor stroma for CAFs in feline oral SCC biopsy specimens may be of potential prognostic value. © The Author(s) 2016.

  14. Survivability of porcine epidemic diarrhea virus (PEDV) in bovine plasma submitted to spray drying processing and held at different time by temperature storage conditions.

    Science.gov (United States)

    Pujols, Joan; Segalés, Joaquim

    2014-12-05

    Bovine plasma was inoculated with porcine epidemic diarrhea virus (PEDV) at an average final titer of 4.2 log10 TCID50/mL to determine the effect of spray drying on viral inactivation. Using a laboratory scale drier, inoculated plasma was spray dried at 200 °C inlet temperature and either 70 or 80 °C throughout substance. Both liquid and dried samples were subjected to three passages on VERO cell monolayers to determine PEDV infectivity. Results indicated liquid samples contained infective virus, but none of the spray dried samples were infectious. Also, survivability of PEDV inoculated on spray dried bovine plasma (SDBP) and stored at 4, 12 or 22 °C was determined for 7, 14 and 21 days. Commercial SDBP powder was inoculated with PEDV to an average final titer of 2.8 log10 TCID50/g. Five samples per time and temperature conditions were subjected to three passages on VERO cell monolayers to determine PEDV infectivity. The virus was non-infectious for all samples stored at 22 °C at 7, 14 and 21 days. PEDV was infective in 1 out of 5 samples stored at 12 °C at 7 days, but none of the samples stored for 14 and 21 days were infectious in cell culture. For samples stored at 4 °C, 4 out of 5 samples were infectious at 7 days, 1 out of 5 samples were infectious at 14 days, but none were infectious at 21 days. In summary, PEDV was not infectious on cell culture within 7 days when stored at room temperature and within 21 days when stored at refrigerated temperature. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. 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

  16. Hanford's Battle with Nuclear Waste Tank SY-101: Bubbles, Toils, and Troubles

    International Nuclear Information System (INIS)

    Stewart, Charles W.

    2006-01-01

    Radioactive waste tank SY-101 is one of 177 big underground tanks that store waste from decades of plutonium production at the Hanford Nuclear Reservation in central Washington State. The chemical reactions and radioactivity in all the tanks make bubbles of flammable gas, mainly hydrogen along with a little methane and ammonia. But SY-101 was the most potent gas producer of all. Every few months the gas built up in the million gallons of extra-thick slurry until it suddenly came up in great rushing ''burps''. A few of the tank's larger burps let off enough gas to make the air space at the top of the tank flammable for a few hours. This flammable gas hazard became a dominating force in DOE nuclear waste management politics in the last two decades of the 20th century. It demanded the toil of scientists, managers, and officials from the time it was filled in 1980, until it was finally declared safe in January 2001. The tank seemed almost a personality--acting with violence and apparent malice, hiding information about itself, deceiving us with false indications, and sometimes lulling us into complacency only to attack in a new way. From 1990 through 1993, SY-101's flammable gas troubles were acknowledged as the highest priority safety issue in the entire DOE complex. Uncontrolled crust growth demanded another high-priority remedial effort from 1998 through April 2000. The direct cost of the bubbles, toils, and troubles was high. Overall, the price of dealing with the real and imagined hazards in SY-101 may have reached $250 million. The indirect cost was also high. Spending all this money fighting SY-101?s safety issues only stirred radioactive waste up and moved it around, but accomplished no cleanup whatever. Worse yet, the flammable gas problem spawned suspicions of a much wider danger that impeded and complicated cleanup in other 176 waste tanks for a decade. The real cleanup job has yet to be done. The SY-101 story is really about the collective experience of

  17. Larval food quantity affects development time, survival and adult biological traits that influence the vectorial capacity of Anopheles darlingi under laboratory conditions.

    Science.gov (United States)

    Araújo, Maisa da-Silva; Gil, Luiz Herman S; e-Silva, Alexandre de-Almeida

    2012-08-02

    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. 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. 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. Overall, several larval and adult biological traits were significantly affected by larval food availability. Greater larval food supply

  18. 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.

  19. Radioprotective effects of miso (fermented soy bean paste) against radiation in B6C3F1 mice. Increased small intestinal crypt survival, crypt lengths and prolongation of average time to death

    International Nuclear Information System (INIS)

    Ohara, Masayuki; Lu, Huimei; Shiraki, Katsutomo; Ishimura, Yoshimasa; Uesaka, Toshihiro; Katoh, Osamu; Watanabe, Hiromitsu

    2001-01-01

    The radioprotective effect of miso, a fermentation product from soy bean, was investigated with reference to the survival time, crypt survival and jejunum crypt length in male B6C3F1 mice. Miso at three different fermentation stages (early-, medium- and long-term fermented miso) was mixed in MF diet into biscuits at 10% and was administered from 1 week before irradiation. Animal survival in the long-term fermented miso group was significantly prolonged as compared with the short-term fermented miso and MF cases after 8 Gy of 60 Co-γ-ray irradiation at a dose rate of 2 Gy min -1 . Delay in mortality was evident in all three miso groups, with significantly increased survival. At doses of 10 and 12 Gy X-irradiation at a dose rate of 4 Gy min -1 , the treatment with long-term fermented miso significantly increased crypt survival. Also the protective influence against irradiation in terms of crypt lengths in the long-term fermented miso group was significantly greater than in the short-term or medium-term fermented miso and MF diet groups. Thus, prolonged fermentation appears to be very important for protection against radiation effects. (author)

  20. Radioprotective effects of miso (fermented soy bean paste) against radiation in B6C3F1 mice: increased small intestinal crypt survival, crypt lengths and prolongation of average time to death.

    Science.gov (United States)

    Ohara, M; Lu, H; Shiraki, K; Ishimura, Y; Uesaka, T; Katoh, O; Watanabe, H

    2001-12-01

    The radioprotective effect of miso, a fermentation product from soy bean, was investigated with reference to the survival time, crypt survival and jejunum crypt length in male B6C3F1 mice. Miso at three different fermentation stages (early-, medium- and long-term fermented miso) was mixed in MF diet into biscuits at 10% and was administered from 1 week before irradiation. Animal survival in the long-term fermented miso group was significantly prolonged as compared with the short-term fermented miso and MF cases after 8 Gy of 60Co-gamma-ray irradiation at a dose rate of 2Gy min(-1). Delay in mortality was evident in all three miso groups, with significantly increased survival. At doses of 10 and 12 Gy X-irradiation at a dose rate of 4 Gy min(-1), the treatment with long-term fermented miso significantly increased crypt survival. Also the protective influence against irradiation in terms of crypt lengths in the long-term fermented miso group was significantly greater than in the short-term or medium-term fermented miso and MF diet groups. Thus, prolonged fermentation appears to be very important for protection against radiation effects.

  1. Surviving Sengstaken.

    Science.gov (United States)

    Jayakumar, S; Odulaja, A; Patel, S; Davenport, M; Ade-Ajayi, N

    2015-07-01

    To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis. Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). 19 children [10 male, age 1 (0.4-16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula. Varices were secondary to: biliary atresia (n=8), portal vein thrombosis (n=5), alpha-1-anti-trypsin deficiency (n=1), cystic fibrosis (n=1), intrahepatic cholestasis (n=1), sclerosing cholangitis (n=1) and nodular hyperplasia with arterio-portal shunt (n=1). Three children deteriorated rapidly and did not survive to have post-SBT endoscopy. The child with an aortooesophageal fistula underwent aortic stent insertion and subsequently oesophageal replacement. Complications included gastric mucosal ulceration (n=3, 16%), pressure necrosis at lips and cheeks (n=6, 31%) and SBT dislodgment (n=1, 6%). Six (31%) children died. The remaining 13 have been followed up for 62 (2-165) months; five required liver transplantation, two underwent a mesocaval shunt procedure and 6 have completed endoscopic variceal obliteration and are under surveillance. SBT can be an effective, albeit temporary, life-saving manoeuvre in children with catastrophic haematemesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. "Heart trouble" and religious involvement among older white men and women.

    Science.gov (United States)

    Thompson, Edward H; Killgore, Leslie; Connors, Heather

    2009-09-01

    Objective Few studies examine how older adults' health status affects spiritual and religious involvement. This study examined the effects of gender and poor cardiac health on older adults' ends, means, and quest religious motivations and frequency of private devotion. Method Longitudinal data (12 months between the T1 and T2 interviews) with 182 older adults sampled from a Northeast city were used to examine in a multivariate analysis of covariance whether gender and the existence of cardiac health problems at T1 affected older adults' spiritual and religious involvement at T2. Findings A gender and cardiac health condition interaction showed older men with heart trouble had more changes in religious involvement-they engaged in more religious doubt, prayed less, and were not as intrinsically oriented at T2. Discussion The findings strongly suggest that older men with heart trouble may maintain a masculine style and shun seeking divine help.

  3. Method of extracting significant trouble information of nuclear power plants using probabilistic analysis technique

    International Nuclear Information System (INIS)

    Shimada, Yoshio; Miyazaki, Takamasa

    2005-01-01

    In order to analyze and evaluate large amounts of trouble information of overseas nuclear power plants, it is necessary to select information that is significant in terms of both safety and reliability. In this research, a method of efficiently and simply classifying degrees of importance of components in terms of safety and reliability while paying attention to root-cause components appearing in the information was developed. Regarding safety, the reactor core damage frequency (CDF), which is used in the probabilistic analysis of a reactor, was used. Regarding reliability, the automatic plant trip probability (APTP), which is used in the probabilistic analysis of automatic reactor trips, was used. These two aspects were reflected in the development of criteria for classifying degrees of importance of components. By applying these criteria, a simple method of extracting significant trouble information of overseas nuclear power plants was developed. (author)

  4. Étude des perturbations du sommeil dans le trouble bipolaire en phase euthymique

    OpenAIRE

    St-Amand, Julie

    2012-01-01

    L'objectif de la présente étude est de décrire la nature et la sévérité des difficultés de sommeil et les problèmes de fonctionnement diurne des individus qui ont un trouble bipolaire lorsqu'ils sont dans la phase euthymique de la maladie. Quatorze participants avec un trouble bipolaire sont comparés à 13 participants avec insomnie primaire et à 13 individus sans problème de santé mentale et sans insomnie sur différents paramètres du sommeil et du fonctionnement diurne provenant de l'agenda d...

  5. A protocol for storage and long-distance shipment of Mediterranean fruit fly (Diptera: Tephritidae) eggs. 1. Effect of temperature, embryo age , and storage time on survival and quality

    International Nuclear Information System (INIS)

    Caceres, C.; Wornoayporn, V.; Islam, S.M.; Ahmad, S.; Ramirez, E.

    2007-01-01

    The operational use of Mediterranean fruit fly (medfly) Ceratitis capitata (Wiedemann), genetic sexing strains in Sterile Insect Technique applications can be maximized by developing methods for effective shipment of eggs. This would enable a central production facility to maintain the relevant mother stocks and large colonies to supply eggs to satellite centers that would mass produce only males for irradiation and release. In order to achieve this, the survival of medfly embryos of different ages was assessed after storage at 5, 10, 15, 20, and 25 deg. C in water for different periods of time. Survival was affected by all 3 variables, i.e., embryo age, water temperature, and length of storage. Storage of embryos at any temperature for 120 h resulted in almost no survival. Controlling the age of the embryo at the time of the temperature treatment is crucial for the success of this procedure. Embryos collected between 0 to 12 h after oviposition and pre-incubated at 25 deg. C for 12 h provide a suitable 72 h window for shipment when maintained between 10 to 15 deg. C. Under these conditions, no significant reductions in survival during all the developmental stages were observed. (author) [es

  6. Born analytical or adopted over time? a study investigating if new analytical tools can ensure the survival of market oriented startups.

    OpenAIRE

    Skogen, Hege Janson; De la Cruz, Kai

    2017-01-01

    Masteroppgave(MSc) in Master of Science in Strategic Marketing Management - Handelshøyskolen BI, 2017 This study investigates whether the prevalence of technological advances within quantitative analytics moderates the effect market orientation has on firm performance, and if startups can take advantage of the potential opportunities to ensure their own survival. For this purpose, the authors review previous literature in marketing orientation, startups, marketing analytics, an...

  7. 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

  8. Class and narrative accrual: personal troubles and public issues in five vignettes.

    OpenAIRE

    Spokes, Matthew

    2017-01-01

    This paper develops Bruner’s (1991) notion of narrative accrual, in conjunction with ‘life-stories’ and ‘event-stories’, to focus on the accumulation of experiences as a contributor to working class identity. Situated between Mills’ (1959) personal troubles and public issues, and framed by Nouri and Helterline (1998) argument that identity is framed by social interaction with signification systems and other people, the author’s own experiences as an early career academic in two different Brit...

  9. Born of the Troubles: Lessons in Trust and Legitimacy from the Police Service of Northern Ireland

    Science.gov (United States)

    2017-12-01

    89  3.  Pillar 3: Technology and Social Media ......................................91  4.  Pillar 4: Community Policing and Crime Reduction...effectively, it was necessary to understand the circumstances surrounding calls for American police reform and the history of police reform in...The period known as “the Troubles,” a 30-year armed conflict with deep roots in Irish history , was a key historical factor in the loss of confidence

  10. The impact of time between staging PET/CT and definitive chemo-radiation on target volumes and survival in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Everitt, Sarah; Plumridge, Nikki; Herschtal, Alan; Bressel, Mathias; Ball, David; Callahan, Jason; Kron, Tomas; Schneider-Kolsky, Michal; Binns, David; Hicks, Rodney J.

    2013-01-01

    Background and purpose: To investigate the impact of treatment delays on radiation therapy (RT) target volumes and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) who underwent two baseline FDG PET/CT scans. Material and methods: Patients underwent a staging (PET1) and RT planning (PET2) FDG PET/CT scan. At PET1 all patients were eligible for radical chemo-RT. OS and progression-free survival (PFS) were compared for patients remaining eligible for radical RT and those treated palliatively because PET2 showed progression. RT target volumes were contoured using PET1 and PET2. Normal tissue doses were compared for patients remaining eligible for radical RT. Results: Eighty-two patients underwent PET2 scans between October 2004 and February 2007. Of these, 21 had a prior PET1 scan, median 23 days apart (range 8–176 days). Six patients (29%) were unsuitable for radical RT after PET2; five received palliative treatment and one received no treatment. Patients treated palliatively had significantly worse OS and PFS than patients treated radically p < 0.001. Mean RT tumour volume increased from 105cc to 198cc (p < 0.005) between scans. Conclusions: Disease progression while awaiting initiation of curative RT in NSCLC is associated with larger treatment volumes and worse survival

  11. TROUBLING TIMES-THE GFC AND ITS IMPLICATIONS FOR REGIONAL PERFORMANCE. PART TWO: AUSTRALIA

    OpenAIRE

    Robert J. Stimson

    2013-01-01

    The Global Financial Crisis (GFC) was a profound exogenous shock which has had profound impacts the performance of national economies and the regions within them. The differential outcomes are vast. In many parts of the world there is evidence of what is being referred to as the ‘two-speed’ economy - or even a ‘multi-speed’ - economy. This has implications for regional economic development theory in which, over the last two to three decades, there has been an increasing emphasis on endogenous...

  12. 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.

  13. Public Policy Towards the Sale of State Assets in Troubled Times: Lessons from the Irish Experience

    NARCIS (Netherlands)

    Gorecki, P. K.; Lyons, S.; Tol, R.S.J.

    2011-01-01

    The sale of state assets, both tangible (e.g. commercial firms) and intangible (e.g. radio spectrum), can address budgetary shortfalls. However, drawing on the Irish experience to inform this important issue, it becomes clear that much more is involved in selling state assets in electricity, gas,

  14. "Inspired and Assisted", or "Berated and Destroyed"? Research Leadership, Management and Performativity in Troubled Times

    Science.gov (United States)

    Saltmarsh, Sue; Sutherland-Smith, Wendy; Randell-Moon, Holly

    2011-01-01

    Research leadership in Australian universities takes place against a backdrop of policy reforms concerned with measurement and comparison of institutional research performance. In particular, the Excellence in Research in Australian initiative undertaken by the Australian Research Council sets out to evaluate research quality in Australian…

  15. 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...

  16. Current status and future plan of INSS's analysis of overseas trouble information

    International Nuclear Information System (INIS)

    Akazawa, Takashi; Okumoto, Masaru

    2017-01-01

    In order to enhance safety of nuclear power stations, it is important to analyze trouble information of both domestic and overseas to understand the causes, so as to prevent similar troubles which may be caused by the ones at our own nuclear power stations, by carrying out countermeasures beforehand. At Institute of Nuclear Safety System (INSS), we mainly collect and analyze overseas trouble information. So far, we have accumulated about 130,000 of such data, making analysis on about 4,000 of event reports every year, and presenting suggestions to PWR utilities from which we recognized needs of countermeasures in Japan. For example, we submitted 5 suggestions to PWR utilities last year. Moreover, we are learning about similar activities which are carried out by Institut de Radioprotection et de Sûreté Nucléaire (IRSN) in France to help us further improve our analyzing skills. As our plan for further improvement, we have started our effort to share knowledge and co-operate between PWR and BWR for deepening analysis. Our activity of Operating Experience (OE) analysis is to be consolidated in the fiscal year of 2019 under the structure of JANSI including BWR OE analysis, to effectively follow additional activities such as suggestions co-operating with JANSI's peer reviews. (author)

  17. Probability of Survival Decision Aid (PSDA)

    National Research Council Canada - National Science Library

    Xu, Xiaojiang; Amin, Mitesh; Santee, William R

    2008-01-01

    A Probability of Survival Decision Aid (PSDA) is developed to predict survival time for hypothermia and dehydration during prolonged exposure at sea in both air and water for a wide range of environmental conditions...

  18. 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…

  19. 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.

  20. 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.

  1. ACL Surgical Technique — Staying Out of Trouble

    Directory of Open Access Journals (Sweden)

    Predescu Vlad

    2016-11-01

    Full Text Available The incidence of ACL tear and reconstruction has increased over time, and failure of ACL reconstruction is not perfectly defined among surgeons. Atraumatic failure of ACL surgery represents approximately 70% of causes, and occurs in diagnostic errors, technical errors and problems of ACL graft integrations. Regarding surgical technique, we should answer certain questions about our choice of surgery, tunnel position, graft type, graft suture, tensioning the graft, and how we deal with certain incidents or intraoperative accidents. The purpose of this article is to review the current information and trends of ACL reconstruction, and presents some tips and tricks we use in our current practice.

  2. Financially troubled El Paso discontinues more nonutility operations

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    As part of a plan to phase out its nonutility businesses, El Paso Electric Company will discontinue its remaining PascoTex Corporation operations, consisting of the manufacture of specialty steel products, and company management released revised estimates of losses to be incurred during the disposal period. Recently El Paso announced it would also bow out of most of its nonutility real estate operations. Increased operating expenses, principally at El Paso's Palo Verde station nuclear facility, have also impacted the bottom line. All three units at Palo Verde were out of service at the time of this writing. The good news was that energy sales have increased

  3. 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.

  4. [Impact of the chemotherapy protocols for metastatic breast cancer on the treatment cost and the survival time of 371 patients treated in three hospitals of the Rhone-Alpes region].

    Science.gov (United States)

    Paviot, B Trombert; Bachelot, T; Clavreul, G; Jacquin, J-P; Mille, D; Rodrigues, J-M

    2009-10-01

    The chemotherapy of the metastatic breast cancer is characterized by the diversity of the treatment protocols and the utilisation of new expensive molecules posing the double problem of outcomes for the patients and financial effects for the hospitals. This survey describes the different chemotherapy treatments prescribed in the metastatic breast cancer and the direct costs supported by the hospitals according to the patient survival time. A cohort of 371 patients treated for a metastatic breast cancer was followed in three hospitals of the Rhone-Alpes region between 2001 and 2006. The detail of their different antineoplasic treatments, as well as the purchase cost of the drugs and their cost of hospital administration, the cost of the other hospital stays are presented in relation with the survival. The median survival time (35,8 months; CI 95%: [31.7-39.1]) since the first metastasis does not differ significantly according to the hospital. Ninety-three different chemotherapy protocols are observed combining from one to five molecules. Thirty-two different molecules are identified. In first line treatment, there is a significant difference in the use of the new molecules according to hospital (Chi(2) test; P cost of a chemotherapy treatment is 3,919 euro (+/- 8,069 euro), the higher cost is observed for trastuzumab (23,443 euro). The average time period before the beginning of a new chemotherapy line is 212 days (+/- 237 days) and the mean cost of hospital stay during this period is 3,903 euro (+/- 4,097 euro). If no impact of the chemotherapy treatment strategy is observed on the survival time of the patient, it is the opposite for the hospital treatment cost. These results are asking for a better control system of the authorization procedure of new molecules marketing and the harmonization of the practices.

  5. British Gas: remuneration. There may be trouble ahead

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    When the Chairman and Chief Executive of British Gas was awarded a huge salary increase recently, a major revolt occurred amongst 4,000 of British Gas's small shareholders. The increase was awarded despite the intense opposition because the pension funds voted with the Board. A critique is offered of the occasion, and a comparison with the rather fairer rise requested by Ofgas's Director General, the gas company regulator, who had been paid as a 3 day a week contract, but had been working six days a week. With deregulation of the gas supply market, British Gas has been under governmental pressure to publish its prices, and has been undercut by competitors. The newly developed contractural relationships in the United Kingdom gas market are very complex and, for the first time subject to legal enforcement. (UK)

  6. Looking for trouble? Diagnostics expanding disease and producing patients.

    Science.gov (United States)

    Hofmann, Bjørn

    2018-05-23

    Novel tests give great opportunities for earlier and more precise diagnostics. At the same time, new tests expand disease, produce patients, and cause unnecessary harm in overdiagnosis and overtreatment. How can we evaluate diagnostics to obtain the benefits and avoid harm? One way is to pay close attention to the diagnostic process and its core concepts. Doing so reveals 3 errors that expand disease and increase overdiagnosis. The first error is to decouple diagnostics from harm, eg, by diagnosing insignificant conditions. The second error is to bypass proper validation of the relationship between test indicator and disease, eg, by introducing biomarkers for Alzheimer's disease before the tests are properly validated. The third error is to couple the name of disease to insignificant or indecisive indicators, eg, by lending the cancer name to preconditions, such as ductal carcinoma in situ. We need to avoid these errors to promote beneficial testing, bar harmful diagnostics, and evade unwarranted expansion of disease. Accordingly, we must stop identifying and testing for conditions that are only remotely associated with harm. We need more stringent verification of tests, and we must avoid naming indicators and indicative conditions after diseases. If not, we will end like ancient tragic heroes, succumbing because of our very best abilities. © 2018 John Wiley & Sons, Ltd.

  7. Physics is in trouble, the string theory has failed

    International Nuclear Information System (INIS)

    Smolin, L.

    2007-01-01

    The popularity of the string theory is based on its claim to explain both the very big and the very small: gravity and elementary particles. The string theory assumes that the real world contains dimensions that have not yet been observed and that any elementary particle is a vibration of a unique entity called string that obeys simple and elegant laws. Most theoretical physicists and mathematicians have focused their attention on this theory for the last 25 years and the diagnosis is clear: string theory fails to cope with the standard model and to explain the existence of dark matter or the mass of neutrinos. The string theory is hailed for its beauty or elegancy but this theory has never been backed by experimental data. While science has made significant progress in numerous domains, particle physics seems to have reached a dead-end. It is high time we officially questioned the string theory and opened the gate for alternative theories. (A.C.)

  8. Trouble at teens' fingertips: Youth sexting and the law.

    Science.gov (United States)

    Holoyda, Brian; Landess, Jacqueline; Sorrentino, Renee; Friedman, Susan Hatters

    2018-03-01

    The last decade has seen a rapid increase in the use of smartphones among young children and adolescents. One consequence of this phenomenon is sexting. Although researchers of sexting have yet to arrive at a single, cohesive definition for the behavior, it generally involves the transmission of text, pictures, or videos containing sexual material. Different definitions of the behavior have led to widely varying estimates of its prevalence, although some studies have documented relatively high rates of sexting among teenagers. As adolescence is the time period in people's lives where the psychological tasks of identity consolidation and the development of intimate relationships become primary, it is not surprising that many teens utilize sexting as one way of practicing skills associated with successful completion of these tasks. The criminal prosecution of sexting cases, then, raises many legal and ethical questions. Offenders may be prosecuted under state or federal child pornography laws or state-specific sexting laws. Sexting laws, particularly in instances of consensual sext exchange, call into question who they are meant to protect and from what. In this article we review the research on teen sexting, its prevalence, and its association with mental health problems; summarize legal responses to the behavior in the United States; and identify considerations for prosecutors and legal decision-makers facing sexting cases. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Asthma and overweight/obese: double trouble for urban children.

    Science.gov (United States)

    Wiesenthal, Elise N; Fagnano, Maria; Cook, Stephen; Halterman, Jill S

    2016-06-01

    To evaluate the effects of overweight/obese versus normal weight on symptoms, activity limitation and health care utilization among a group of urban children with persistent asthma. Data were obtained from the School Based Asthma Therapy trial. We enrolled 530 children ages 3-10 with persistent asthma from 2006 to 2009 (response rate: 74%). We conducted in-home interviews to assess symptoms and health care utilization. We measured height and weight in school nurse offices to determine BMI percentile, and compared normal weight children to overweight/obese (BMI >85th percentile) children. Bivariate and multivariate analyses were used. We collected BMI data from 472 children (89%); 49% were overweight/obese. When controlling for child race, child ethnicity, intervention group, caregiver age and screen time, overweight/obese children had more days with asthma symptoms (4.25 versus 3.42/2 weeks, p = 0.035) and more activity limitation (3.43 versus 2.55/2 weeks, p = 0.013) compared to normal weight children. Overweight/obese children were more likely to have had an ED visit or hospitalization for any reason (47% versus 36%, OR 1.5, 95% CI 1.01, 2.19), and there was a trend for overweight/obese children to have more acute asthma visits in the past year (1.68 versus 1.31, p = 0.090). Overweight/obese children were not more likely to be taking a daily preventive inhaled corticosteroid (OR 1.0, 95% CI 0.68, 1.56). Overweight/obese children with persistent asthma experience more asthma symptoms, activity limitation and health care utilization compared to normal weight children, with no increased use of inhaled corticosteroids. Further efforts are needed to improve the health of these children.

  10. Two-Sample Statistics for Testing the Equality of Survival Functions Against Improper Semi-parametric Accelerated Failure Time Alternatives: An Application to the Analysis of a Breast Cancer Clinical Trial

    Science.gov (United States)

    BROËT, PHILIPPE; TSODIKOV, ALEXANDER; DE RYCKE, YANN; MOREAU, THIERRY

    2010-01-01

    This paper presents two-sample statistics suited for testing equality of survival functions against improper semi-parametric accelerated failure time alternatives. These tests are designed for comparing either the short- or the long-term effect of a prognostic factor, or both. These statistics are obtained as partial likelihood score statistics from a time-dependent Cox model. As a consequence, the proposed tests can be very easily implemented using widely available software. A breast cancer clinical trial is presented as an example to demonstrate the utility of the proposed tests. PMID:15293627

  11. Two-sample statistics for testing the equality of survival functions against improper semi-parametric accelerated failure time alternatives: an application to the analysis of a breast cancer clinical trial.

    Science.gov (United States)

    Broët, Philippe; Tsodikov, Alexander; De Rycke, Yann; Moreau, Thierry

    2004-06-01

    This paper presents two-sample statistics suited for testing equality of survival functions against improper semi-parametric accelerated failure time alternatives. These tests are designed for comparing either the short- or the long-term effect of a prognostic factor, or both. These statistics are obtained as partial likelihood score statistics from a time-dependent Cox model. As a consequence, the proposed tests can be very easily implemented using widely available software. A breast cancer clinical trial is presented as an example to demonstrate the utility of the proposed tests.

  12. 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.

  13. Accidents, troubles and others in nuclear fuel facilities in fiscal year 1988

    International Nuclear Information System (INIS)

    1990-01-01

    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.)

  14. 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 ...

  15. Improvement of HAART in Brazil, 1998-2008: a nationwide assessment of survival times after AIDS diagnosis among men who have sex with men.

    Science.gov (United States)

    Malta, Monica; da Silva, Cosme M F P; Magnanini, Monica Mf; Wirtz, Andrea L; Perissé, André R S; Beyrer, Chris; Strathdee, Steffanie A; Bastos, Francisco I

    2015-03-07

    In 1996, Brazil became the first developing country to provide free, universal access to HAART, laboratory monitoring, and clinical care to any eligible patient. As of June 2014, approximately 400,000 patients were under treatment, making it the most comprehensive HIV treatment initiative implemented thus far in a middle-income country, worldwide. The Brazilian epidemic is highly concentrated among men who have sex with men (MSM). Four national information systems were combined and Cox regression was used to conduct retrospective cohort analysis of HAART availability/access on all-cause mortality among MSM diagnosed with AIDS reported to the information systems between 1998-2008, adjusting for demographic, clinical, and behavioral factors and controlling for spatially-correlated survival data by including a frailty effect. Multiple imputation by chained equations was used to handle missing data. Among 50,683 patients, 10,326 died during the 10 year of period. All-cause mortality rates declined following introduction of HAART, and were higher among non-white patients and those starting HAART with higher viral load and lower CD4 counts. In multivariable analysis adjusted for race, age at AIDS diagnosis, and baseline CD4 cell count, MSM diagnosed in latter periods had almost a 50% reduction in the risk of death, compared to those diagnosed between 1998-2001 (2002-2005 adjHR: 0.54, 95% CI:0.51-0.57; 2006-2008 adjHR: 0.51, 95% CI:0.48-0.55). After controlling for spatially correlated survival data, mortality remained higher among those diagnosed in the earliest diagnostic cohort and lower among non-white patients and those starting HAART with higher viral load and lower CD4 lymphocyte counts. Universal and free access to HAART has helped achieve impressive declines in AIDS mortality in Brazil. However, after a 10-years follow-up, differential AIDS-related mortality continue to exist. Efforts are needed to identify and eliminate these health disparities, therefore

  16. Carbonaceous Survivability on Impact

    Science.gov (United States)

    Bunch, T. E.; Becker, Luann; Morrison, David (Technical Monitor)

    1994-01-01

    In order to gain knowledge about the potential contributions of comets and cosmic dust to the origin of life on Earth, we need to explore the survivability of their potential organic compounds on impact and the formation of secondary products that may have arisen from the chaotic events sustained by the carriers as they fell to Earth. We have performed a series of hypervelocity impact experiments using carbon-bearing impactors (diamond, graphite, kerogens, PAH crystals, and Murchison and Nogoya meteorites) into Al plate targets at velocities - 6 km/s. Estimated peak shock pressures probably did not exceed 120 GPa and peak shock temperatures were probably less than 4000 K for times of nano- to microsecs. Nominal crater dia. are less than one mm. The most significant results of these experiments are the preservation of the higher mass PAHs (e. g., pyrene relative to napthalene) and the formation of additional alkylated PAHs. We have also examined the residues of polystyrene projectiles impacted by a microparticle accelerator into targets at velocities up to 15 km/s. This talk will discuss the results of these experiments and their implications with respect to the survival of carbonaceous deliverables to early Earth. The prospects of survivability of organic molecules on "intact" capture of cosmic dust in space via soft: and hard cosmic dust collectors will also be discussed.

  17. Troubling Diversity?

    DEFF Research Database (Denmark)

    Jæger, Kirsten; Jensen, Annie Aarup

    2009-01-01

    for the interpretation of results, based on governmentality studies, will be suggested. This theoretical framework allows for a more systematic consideration of the complex interplay between culturally and professionally based power relations, relevant to a wide range of intercultural encounters in institutional...

  18. Swallowing Trouble

    Science.gov (United States)

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  19. 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)

  20. 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…

  1. Swallowing Trouble

    Science.gov (United States)

    ... throat discomfort in the throat or chest (when gastro esophageal reflux is present) a sensation of a foreign body ... to the particular cause of the swallowing disorder. Gastro esophageal reflux can often be treated by changing eating and ...

  2. Study on the effect of the survival time and the T cells in the discordant heart xenotransplantation produced by intrathymic inoculation with xenogeneic antigen using the model of pig to monkey

    International Nuclear Information System (INIS)

    Qu Jichen; Jiang Gening; Ding Jiaan

    2005-01-01

    Objective: This study was designed to investigate the effect of survival time and T cells on the delayed xenograft rejection caused by intrathymic injection of xenogeneic antigen in the discordant cardiac xenotransplantation, and to investigate the possibility of inducing the tolerance for cardiac xenografts. Methods: In this experiment, pig and monkey were, respectively, selected as donor and recipient. Donor and recipient were divided randomly into four groups. In the blank group (group A) recipients didn't accept any treatments but heart xenotransplantation; In the whole body irradiation (WBI) group (group B) 3 Gy ( 60 Co) was received on d30 before transplantation. In the intrathymic injection group (group C) monkeys were pretreated by the intrathymic injection of pig spleen cells (5 x 10 7 ) on d21 before transplantation, the other treatments were the same as that in group A. In the irradiation and intrathymic injection group (group D) monkeys were pretreated by WBI and the intrathymic injection of pig spleen cells at the time just as that in group B and group C. In every group, monkeys were performed heterotopic heart xenotransplantation in abdomen in order to observe the survival time of cardiac xenografts. Results: (1) Survival time of donor heart in group D (91.1 ± 22.8 h) was significantly longer than group B(42.56 ± 1.4 h) and group A (35.6 ± 2.2 h) (P 0.05). (3) The results of MLR showed that there is significant reduction in group D than in group A and B (P + and CD8+ T cells in peripheral blood, but pretreatment with IT and WBI can induce T cells immune 4 suppression or immune tolerance, that is similar to allotransplantation in the rodent. (2) Pretreatment with IT and WBI can induce T cells immune suppression or immune tolerance. (authors)

  3. Development and external validation of nomograms to predict the risk of skeletal metastasis at the time of diagnosis and skeletal metastasis-free survival in nasopharyngeal carcinoma.

    Science.gov (United States)

    Yang, Lin; Xia, Liangping; Wang, Yan; He, Shasha; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Hong, Shaodong; Chen, Yong

    2017-09-06

    The skeletal system is the most common site of distant metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal metastasis at initial diagnosis (SMAD) and skeletal metastasis-free survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 2496 patients without skeletal metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P system (P skeletal metastasis, which may improve counseling and facilitate individualized management of patients with NPC.

  4. Aircraft Survivability: Space Survivability - Time to Get Serious, Summer 2008

    Science.gov (United States)

    2008-01-01

    Forward Team. CDR Askin put the finishing touches on a solid tour in country with the completion of a comprehensive OIC turnover folder. While serving in... Armour Strength and Reducing the IED Threat in Combat Theatres” 22–24 September 2008 Berlin, Germany http://www.vssummit.com OCT MCAA October 2008

  5. 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....

  6. Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

    Science.gov (United States)

    Tentori, Francesca; Zhang, Jinyao; Li, Yun; Karaboyas, Angelo; Kerr, Peter; Saran, Rajiv; Bommer, Juergen; Port, Friedrich; Akiba, Takashi; Pisoni, Ronald; Robinson, Bruce

    2012-11-01

    Longer dialysis session length (treatment time, TT) has been associated with better survival among hemodialysis (HD) patients. The impact of TT on clinical markers that may contribute to this survival advantage is not well known. Using data from the international Dialysis Outcomes and Practice Patterns Study, we assessed the association of TT with clinical outcomes using both standard regression analyses and instrumental variable approaches. The study included 37,414 patients on in-center HD three times per week with prescribed TT from 120 to 420 min. Facility mean TT ranged from 214 min in the USA to 256 min in Australia-New Zealand. Accounting for country effects, mortality risk was lower for patients with longer TT {hazard ratio for every 30 min: all-cause mortality: 0.94 [95% confidence interval (CI): 0.92-0.97], cardiovascular mortality: 0.95 (95% CI: 0.91-0.98) and sudden death: 0.93 (95% CI: 0.88-0.98)}. Patients with longer TT had lower pre- and post-dialysis systolic blood pressure, greater intradialytic weight loss, higher hemoglobin (for the same erythropoietin dose), serum albumin and potassium and lower serum phosphorus and white blood cell counts. Similar associations were found using the instrumental variable approach, although the positive associations of TT with weight loss and potassium were lost. Favorable levels of a variety of clinical markers may contribute to the better survival of patients receiving longer TT. These findings support longer TT prescription in the setting of in-center, three times per week HD.

  7. Asset Depletion, Chronic Financial Stress, and Mortgage Trouble Among Older Female Homeowners.

    Science.gov (United States)

    Castro Baker, Amy; West, Stacia; Wood, Anna

    2017-09-08

    The Great Recession disproportionately impacted older adults and women of color, suggesting that women may be entering retirement without adequate assets. However, the current literature lacks a detailed account of women's experiences of mortgage trouble and foreclosure, as well as a longitudinal view of how these experiences impacted their overall financial assets. Grounded in cumulative inequality theory, this mixed methods study employed a QUAL→quan approach to gather qualitative data from a sample of 21 older adult women regarding their experiences of mortgage trouble. Quantitative longitudinal data was gathered for a subsample of the Early Baby Boomer Cohort using the Health and Retirement Study. Qualitative findings indicated women approaching retirement experienced chronic underemployment, wage stagnation, and financial volatility as contributors to asset depletion and eventual mortgage default or foreclosure. Quantitative results indicated asset depletion both during and post-Recession was considerably more pronounced among older adult women of color compared to older adult White men. These findings suggest that a lifetime of financial disadvantage coupled with macroeconomic instability situates older adult women, particularly women of color, in a financially vulnerable position for retirement. The ways in which 2017 attacks on the Consumer Financial Protection Bureau, Dodd-Frank, and the Fiduciary rule carry potential to further destabilize this population are also discussed. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  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. Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program.

    Science.gov (United States)

    Hui, Siu-kuen Azor; Grandner, Michael A

    2015-10-01

    To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period. Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes. EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P work performance ratings (all P health care costs (P work attendance, work performance, and health care costs.

  10. Trouble Sleeping Associated with Lower Work Performance and Greater Healthcare Costs: Longitudinal Data from Kansas State Employee Wellness Program

    Science.gov (United States)

    Hui, Siu-kuen Azor; Grandner, Michael A.

    2015-01-01

    Objective To examine the relationships between employees’ trouble sleeping and absenteeism, work performance, and healthcare expenditures over a two year period. Methods Utilizing the Kansas State employee wellness program (EWP) dataset from 2008–2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and healthcare costs as the outcomes. Results EWP participants (N=11,698 in 2008; 5,636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all p performance ratings (all p performance, and healthcare costs. PMID:26461857

  11. Impact of diagnosis-to-treatment waiting time on survival in esophageal cancer patients – A population-based study in The Netherlands

    NARCIS (Netherlands)

    Visser, E.; van Rossum, P.S.N.; Leeftink, Anne Greetje; Siesling, Sabine; van Hillegersberg, R.; Ruurda, J.P.

    Background The aim of this study was to determine whether the waiting time from diagnosis to treatment with curative intent for esophageal cancer impacts oncologic outcomes. Patients and methods All patients treated by esophagectomy for esophageal carcinoma in 2005–2013 were identified from the

  12. 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

  13. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study.

    Science.gov (United States)

    Häggström, J; Boswood, A; O'Grady, M; Jöns, O; Smith, S; Swift, S; Borgarelli, M; Gavaghan, B; Kresken, J-G; Patteson, M; Ablad, B; Bussadori, C M; Glaus, T; Kovacević, A; Rapp, M; Santilli, R A; Tidholm, A; Eriksson, A; Belanger, M C; Deinert, M; Little, C J L; Kvart, C; French, A; Rønn-Landbo, M; Wess, G; Eggertsdottir, A V; O'Sullivan, M L; Schneider, M; Lombard, C W; Dukes-McEwan, J; Willis, R; Louvet, A; DiFruscia, R

    2008-01-01

    Myxomatous mitral valve disease (MMVD) continues to be an important cause of morbidity and mortality in geriatric dogs despite conventional therapy. Pimobendan in addition to conventional therapy will extend time to sudden cardiac death, euthanasia for cardiac reasons, or treatment failure when compared with conventional therapy plus benazepril in dogs with congestive heart failure (CHF) attributable to MMVD. Two hundred and sixty client-owned dogs in CHF caused by MMVD were recruited from 28 centers in Europe, Canada, and Australia. A prospective single-blinded study with dogs randomized to PO receive pimobendan (0.4-0.6 mg/kg/d) or benazepril hydrochloride (0.25-1.0 mg/kg/d). The primary endpoint was a composite of cardiac death, euthanized for heart failure, or treatment failure. Eight dogs were excluded from analysis. One hundred and twenty-four dogs were randomized to pimobendan and 128 to benazepril. One hundred and ninety dogs reached the primary endpoint; the median time was 188 days (267 days for pimobendan, 140 days for benazepril hazard ratio = 0.688, 95% confidence limits [CL]=0.516-0.916, P= .0099). The benefit of pimobendan persisted after adjusting for all baseline variables. A longer time to reach the endpoint was also associated with being a Cavalier King Charles Spaniel, requiring a lower furosemide dose, and having a higher creatinine concentration. Increases in several indicators of cardiac enlargement (left atrial to aortic root ratio, vertebral heart scale, and percentage increase in left ventricular internal diameter in systole) were associated with a shorter time to endpoint, as was a worse tolerance for exercise. Pimobendan plus conventional therapy prolongs time to sudden death, euthanasia for cardiac reasons, or treatment failure in dogs with CHF caused by MMVD compared with benazepril plus conventional therapy.

  14. Posttreatment prostatic-specific antigen doubling time as a surrogate endpoint for prostate cancer-specific survival: An analysis of Radiation Therapy Oncology Group Protocol 92-02

    International Nuclear Information System (INIS)

    Valicenti, Richard K.; DeSilvio, Michelle; Hanks, Gerald E.; Porter, Arthur; Brereton, Harmar; Rosenthal, Seth A.; Shipley, William U.; Sandler, Howard M.

    2006-01-01

    Purpose: We evaluated whether posttreatment prostatic-specific antigen doubling time (PSADT) was predictive of prostate cancer mortality by testing the Prentice requirements for a surrogate endpoint. Methods and Materials: We analyzed posttreatment PSA measurements in a cohort of 1,514 men with localized prostate cancer (T2c-4 and PSA level Cox = 0.002), PSADT Cox Cox Cox Cox = 0.4). The significant posttreatment PSADTs were also significant predictors of CSS (p Cox < 0.001). After adjusting for T stage, Gleason score and PSA, all of Prentice's requirements were not met, indicating that the effect of PSADT on CSS was not independent of the randomized treatment. Conclusions: Prostatic specific antigen doubling time is significantly associated with CSS, but did not meet all of Prentice's requirements for a surrogate endpoint of CSS. Thus, the risk of dying of prostate cancer is not fully explained by PSADT

  15. Investigation of survival time and disability characteristics in 5 subjects with bilateral thalamus infarction near median line%双侧中线旁丘脑梗死5例致残特点及生存期调查

    Institute of Scientific and Technical Information of China (English)

    翟明; 刘江; 钟静玫; 林岚

    2002-01-01

    @@ Background:Bilateral thalamus infarction near median line is uncommon in clinic.Reports concerned with this conditions were more less.It is characterized by conscious disorder and Korsakoff syndrome.The main caused may be the injury of intralaminar nuclei,dorsomedial nuclei,and injury of cortical matter,mammalillary bodies,fasciculus thalamicus around cerebral chamer III.Comprehensing the disability characteristics in pateints with bilateral thalamus infarction near median line is important for direction of rehabilitation.While study of survival time will improve evaluation of prognosis. Design:Patients recruited from June 1997~ October 2000 were analyzed. Unit:Intraneural Department of First People's Hospital of Yunnan Province. Subjects:55 subjects with MRI proved bilateral thalamus infarction near median line entered study.These patients included 3 women,2 men(age ranging from 50 to 77 years old,mean age:68.6 years).The period from onset to admission ranged from 5 hours to 2 days.All subejcts experienced acute bilateral thalamus infarction near median line.All had hypertension previously,1 had diabetes,2 had auricular fibrillation. Intervention:All patients received management which was conducted according to protocol for treatment of ischemic cerebrovascular diseases. Patients clinical characteristics were summari-zed and analyzed.Follow up was conducted to determine the survival period. Main evaluation indexes:Survival time and conscious disorder were evaluated. Result:All patients showed different level of conscious disorder.3 cases developed thalamic dementia,2 developed vision numb,In 1 case,condition progressively deteriorated manifesting as moderate coma progressed to deep coma,and bilateral mydriasis.Finally,this patients died of central respiratory and circulatory failure after 8 days.4 cases with favorable prognosis discharged,3 out of them died within 1 year after discharge.Survival subject suffered from reduced memory was followed up till now

  16. Survival pathways under stress

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Survival pathways under stress. Bacteria survive by changing gene expression. pattern. Three important pathways will be discussed: Stringent response. Quorum sensing. Proteins performing function to control oxidative damage.

  17. 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…

  18. SANTÉ PUBLIQUE Les troubles de santé font fi des frontières – les ...

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

    SANTÉ PUBLIQUE Les troubles de santé font fi des frontières – les connaissances et les solutions devraient elles ... Dangers du tabac et des narguilés pour la santé ... ÉTUDE DE CAS : Nouvelles armes dans la guerre contre le paludisme.

  19. 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.

  20. Modest associations between self-reported physical workload and neck trouble

    DEFF Research Database (Denmark)

    Holm, Jonas Winkel; Hartvigsen, Jan; Lings, Svend

    2013-01-01

    -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......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...... and walking," "light physical," and "heavy physical" work). Paired analyses including conditional logistic regression were made for all participants and for each sex, and MZ and DZ pairs separately. RESULTS: No marked associations between physical workload and NT were seen. A moderate risk elevation in "heavy...

  1. Foundations of Torey Hayden’s Relationship-Driven Classroom Practice with Troubled Children

    Directory of Open Access Journals (Sweden)

    Mike Marlowe

    2012-06-01

    Full Text Available This paper discusses the relationship-driven classroom practice of Torey Hayden, a teacher of children with emotional and behavioral difficulties, and author of eight books chronicling her day-to-day work in special education and child psychology. Seven philosophical principles which underpin and inform all action taken in her relationship-driven classroom model are delineated: 1 relationships are a process, not a goal; 2 there is a difference between a person and the person’s actions; 3 no one chooses to be unhappy; 4 misbehavior is a teaching opportunity; 5 everyone can change; 6 personal change is very difficult; and 7 the world is complex. A consilience of evidence supporting the use of a relationship-driven methodology with troubled children is presented. Final thoughts on Hayden’s relationship-driven classroom are offered.

  2. 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...... of incentives. We apply two alternative multivariate structural default risk models: the classical Gaussian Merton model and a model based on Normal Inverse Gaussian processes. Using a data set on annual farm level data from 1996 to 2009, we use the Danish agricultural sector as a case study and price an APS...... on an agricultural loan portfolio. We compute the economic capital for this loan portfolio with and without an APS. Moreover, we illustrate how model risk in the form of parameter uncertainty is reduced when an APS is attached to the loan portfolio....

  3. Accidents and troubles in nuclear fuel facilities in fiscal year 1987

    International Nuclear Information System (INIS)

    1988-01-01

    The number of the accidents and troubles reported in fiscal year 1987 in relation to nuclear fuel facilities based on the stipulation of the law on the regulation of nuclear raw materials, nuclear fuel materials and nuclear reactors was two. In Tokai Works, Power Reactor and Nuclear Fuel Development Corp., on September 17, 1987, the conveyor for transporting spent fuel in the separation and refining shop of the reprocessing plant broke down, consequently, the operation of the reprocessing plant was stopped for about five months. In Tokai Testing Works, Mitsubishi Heavy Industries Ltd., on February 7, 1988, a worker who was putting up posters in the control area of the uranium experiment facilities fell from a stepladder, and required treatment by entering a hospital for about one month, suffering bone fracture. (K.I.)

  4. Achieving world's highest level of nuclear safety learning from overseas nuclear trouble events

    International Nuclear Information System (INIS)

    Okumoto, Masaru

    2014-01-01

    Nuclear Information Research Project of Institute of Nuclear Safety System, Incorporated (INSS) had acquired trouble information of nuclear power plants (NPPs) up to annual several thousand events issued by overseas regulatory agencies for more than 20 years since INSS established and analyzed it in details respectively after the screening. Lessons extracted from the analysis were offered as suggestions to electric utilities having PWRs in Japan. Such activities would surely contribute to maintain and improve nuclear safety with no objection. However, they could not prevent the occurrence of accident of Fukushima Daiichi NPPs. Thus the project had reviewed usefulness of past activities and how improved could be by listening sincerely to outside opinions. This report introduced outlines of recent activities. Competent suggestions to electric utilities might be made with improved reflection of lessons to needed rules, deepened information sharing within the project and raised awareness of the problem. (T. Tanaka)

  5. Logistics of national radioimmunoassay services and radioimmunoassay trouble shooting in developing countries

    International Nuclear Information System (INIS)

    Hazra, D.K.; Shukla, A.K.; Arvind, B.; Khandelwal, S.; Singh, R.; Lahiri, V.L.

    1986-01-01

    The logistics of national radioimmunoassay services are analysed in regard to: applications of immunoassays in developing countries; provision of matched reagents; collection, storage and transport of patient samples, particularly from rural areas; development of robust new immunoassay systems, especially those using non-isotopic labels; quality control; and interrelation with international agencies and commercial suppliers. The effect of using different methods and temperatures of sample storage on representative glycoprotein, steroid, thyroid and communicable disease analytes is examined. The need for stratification of assay services (district, state and national/regional levels) for various tests is discussed in relation to their clinical urgency. A trouble shooting guide suited to developing countries has been written. Starting from various symptoms of assay failure, it describes the differential diagnosis of likely causes, lists appropriate tests to confirm the diagnosis and finally suggests remedial action to prevent future similar mishaps or to salvage the assay. (author)

  6. Design Concept of Human Interface System for Risk Monitoring for Proactive Trouble Prevention

    DEFF Research Database (Denmark)

    Hidekazu, Yoshikawa; Ming, Yang; Zhijian, Zhang

    2011-01-01

    interface systems to support the collaboration work between workers at local workplace and the main control room. In this paper, the general issues are reviewed on how to configure the whole human interface system for helping proactive trouble prevention and risk evaluation on the basis of the presented......) with the risk monitor to watch Defense-in Depth plant safety functions. The proposed concept is applied for a liquid metal fast reactor Monju and necessary R&D subjects are reviewed to realize human interface system for the maintenance work in Monju plant. Because of using high temperature liquid sodium...... as reactor coolant in Monju plant, the maintenance for Monju should utilize more automated equipments of remote control and robotics than that of light water reactor. It is necessary to design optimum task allocation between human and automated machine as the requisites for good communication design of human...

  7. The influence of scenario-based training and real-time audiovisual feedback on out-of-hospital cardiopulmonary resuscitation quality and survival from out-of-hospital cardiac arrest.

    Science.gov (United States)

    Bobrow, Bentley J; Vadeboncoeur, Tyler F; Stolz, Uwe; Silver, Annemarie E; Tobin, John M; Crawford, Scott A; Mason, Terence K; Schirmer, Jerome; Smith, Gary A; Spaite, Daniel W

    2013-07-01

    We assess whether an initiative to optimize out-of-hospital provider cardiopulmonary resuscitation (CPR) quality is associated with improved CPR quality and increased survival from out-of-hospital cardiac arrest. This was a before-after study of consecutive adult out-of-hospital cardiac arrest. Data were obtained from out-of-hospital forms and defibrillators. Phase 1 included 18 months with real-time audiovisual feedback disabled (October 2008 to March 2010). Phase 2 included 16 months (May 2010 to September 2011) after scenario-based training of 373 professional rescuers and real-time audiovisual feedback enabled. The effect of interventions on survival to hospital discharge was assessed with multivariable logistic regression. Multiple imputation of missing data was used to analyze the effect of interventions on CPR quality. Analysis included 484 out-of-hospital cardiac arrest patients (phase 1 232; phase 2 252). Median age was 68 years (interquartile range 56-79); 66.5% were men. CPR quality measures improved significantly from phase 1 to phase 2: Mean chest compression rate decreased from 128 to 106 chest compressions per minute (difference -23 chest compressions; 95% confidence interval [CI] -26 to -19 chest compressions); mean chest compression depth increased from 1.78 to 2.15 inches (difference 0.38 inches; 95% CI 0.28 to 0.47 inches); median chest compression fraction increased from 66.2% to 83.7% (difference 17.6%; 95% CI 15.0% to 20.1%); median preshock pause decreased from 26.9 to 15.5 seconds (difference -11.4 seconds; 95% CI -15.7 to -7.2 seconds), and mean ventilation rate decreased from 11.7 to 9.5/minute (difference -2.2/minute; 95% CI -3.9 to -0.5/minute). All-rhythms survival increased from phase 1 to phase 2 (20/231, 8.7% versus 35/252, 13.9%; difference 5.2%; 95% CI -0.4% to 10.8%), with an adjusted odds ratio of 2.72 (95% CI 1.15 to 6.41), controlling for initial rhythm, witnessed arrest, age, minimally interrupted cardiac resuscitation

  8. 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

  9. 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.

  10. Network survivability performance

    Science.gov (United States)

    1993-11-01

    This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

  11. Survivability Assessment: Modeling A Recovery Process

    OpenAIRE

    Paputungan, Irving Vitra; Abdullah, Azween

    2009-01-01

    Survivability is the ability of a system to continue operating, in a timely manner, in the presence ofattacks, failures, or accidents. Recovery in survivability is a process of a system to heal or recover from damageas early as possible to fulfill its mission as condition permit. In this paper, we show a preliminary recoverymodel to enhance the system survivability. The model focuses on how we preserve the system and resumes itscritical service under attacks as soon as possible.Keywords: surv...

  12. 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...

  13. 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....... Surprisingly, existing methods only deal with special cases. In this paper, we clarify different kinds of left-truncation and suggest estimators for semiparametric survival models under specific truncation schemes. The large-sample properties of the estimators are established. Small-sample properties...

  14. 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: global design

  15. 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

  16. Foreign Ownership and Long-term Survival

    DEFF Research Database (Denmark)

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    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...

  17. 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.

  18. Understanding survival analysis: Kaplan-Meier estimate.

    Science.gov (United States)

    Goel, Manish Kumar; Khanna, Pardeep; Kishore, Jugal

    2010-10-01

    Kaplan-Meier estimate is one of the best options to be used to measure the fraction of subjects living for a certain amount of time after treatment. In clinical trials or community trials, the effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of time. The time starting from a defined point to the occurrence of a given event, for example death is called as survival time and the analysis of group data as survival analysis. This can be affected by subjects under study that are uncooperative and refused to be remained in the study or when some of the subjects may not experience the event or death before the end of the study, although they would have experienced or died if observation continued, or we lose touch with them midway in the study. We label these situations as censored observations. The Kaplan-Meier estimate is the simplest way of computing the survival over time in spite of all these difficulties associated with subjects or situations. The survival curve can be created assuming various situations. It involves computing of probabilities of occurrence of event at a certain point of time and multiplying these successive probabilities by any earlier computed probabilities to get the final estimate. This can be calculated for two groups of subjects and also their statistical difference in the survivals. This can be used in Ayurveda research when they are comparing two drugs and looking for survival of subjects.

  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. 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.

  1. ASURV: Astronomical SURVival Statistics

    Science.gov (United States)

    Feigelson, E. D.; Nelson, P. I.; Isobe, T.; LaValley, M.

    2014-06-01

    ASURV (Astronomical SURVival Statistics) provides astronomy survival analysis for right- and left-censored data including the maximum-likelihood Kaplan-Meier estimator and several univariate two-sample tests, bivariate correlation measures, and linear regressions. ASURV is written in FORTRAN 77, and is stand-alone and does not call any specialized libraries.

  2. Pharma TARP: A Troubled Asset Relief Program for Novel, Abandoned Projects in the Pharmaceutical Industry

    Directory of Open Access Journals (Sweden)

    Tamas Bartfai

    2011-01-01

    Full Text Available Within days of each other, Pfizer, Merck, and GlaxoSmithKline announced that they will focus on a few therapeutic areas only and abandon others entirely. Pfizer alone will close well over a hundred drug development projects that have reached two-thirds of the way to launch. The programs are deemed to be too risky and not lucrative enough for Big Pharma in the current climate. Society has a real need for the drugs that are no longer going to be developed for, among others, drug-resistant epilepsy, neuropathic and cancer pain, type-2 diabetes, obesity, and schizophrenia. The authors propose a radical response by the U.S. government and the National Institutes of Health to rescue these abandoned projects, and to continue selected programs for drug approval by the U.S. Food and Drug Administration and the European Medicines Agency. The investment required is small compared to the Troubled Asset Relief Program bank bail out, but the return on investment in financial terms and in satisfying societal needs makes this proposal attractive.

  3. 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.

  4. 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.

  5. MMPI profiles of troubled employees in relation to nuclear power plant personnel norms

    International Nuclear Information System (INIS)

    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

  6. Design Concept of Human Interface System for Risk Monitoring for Proactive Trouble Prevention

    Energy Technology Data Exchange (ETDEWEB)

    Yoshikawa, Hidekazu; Yang, Ming; Zhang, Zhijian; Hashim, Muhammad [Harbin Engineering University, Harbin (China); Lind, Morten [Technical University of Denmark, Kongens Lyngby (Djibouti); Tamayama, Kiyoshi; Okusa, Kyoichi [Japan Atomic Energy Agency, Tsuruga (Japan)

    2011-08-15

    A new concept is first proposed of distributed human interface system to integrate both operation and maintenance of nuclear power plant. Then, a method of constructing human interface system is introduced by integrating the plant knowledge database system based on Multilevel Flow Model (MFM) with the risk monitor to watch Defense-in Depth plant safety functions. The proposed concept is applied for a liquid metal fast reactor Monju and necessary R and D subjects are reviewed to realize human interface system for the maintenance work in Monju plant. Because of using high temperature liquid sodium as reactor coolant in Monju plant, the maintenance for Monju should utilize more automated equipment of remote control and robotics than that of light water reactor. It is necessary to design optimum task allocation between human and automated machine as the requisites for good communication design of human interface systems to support the collaboration work between workers at local workplace and the main control room. In this paper, the general issues are reviewed on how to configure the whole human interface system for helping proactive trouble prevention and risk evaluation on the basis of the presented target plant model before the concrete proposition of the hardware and software systems development to be used by both the staffs of operation and maintenance of NPP.

  7. Design Concept of Human Interface System for Risk Monitoring for Proactive Trouble Prevention

    International Nuclear Information System (INIS)

    Yoshikawa, Hidekazu; Yang, Ming; Zhang, Zhijian; Hashim, Muhammad; Lind, Morten; Tamayama, Kiyoshi; Okusa, Kyoichi

    2011-01-01

    A new concept is first proposed of distributed human interface system to integrate both operation and maintenance of nuclear power plant. Then, a method of constructing human interface system is introduced by integrating the plant knowledge database system based on Multilevel Flow Model (MFM) with the risk monitor to watch Defense-in Depth plant safety functions. The proposed concept is applied for a liquid metal fast reactor Monju and necessary R and D subjects are reviewed to realize human interface system for the maintenance work in Monju plant. Because of using high temperature liquid sodium as reactor coolant in Monju plant, the maintenance for Monju should utilize more automated equipment of remote control and robotics than that of light water reactor. It is necessary to design optimum task allocation between human and automated machine as the requisites for good communication design of human interface systems to support the collaboration work between workers at local workplace and the main control room. In this paper, the general issues are reviewed on how to configure the whole human interface system for helping proactive trouble prevention and risk evaluation on the basis of the presented target plant model before the concrete proposition of the hardware and software systems development to be used by both the staffs of operation and maintenance of NPP

  8. Unsettling care: Troubling transnational itineraries of care in feminist health practices.

    Science.gov (United States)

    Murphy, Michelle

    2015-10-01

    Responding to the call by Maria Puig de la Bellacasa for Science and Technology Studies to take up 'matters of care', this article cautions against equating care with positive feelings and, in contrast, argues for the importance of grappling with the non-innocent histories in which the politics of care already circulates, particularly in transnational couplings of feminism and health. The article highlights these histories by tracing multiple versions of the politics of care in a select set of feminist engagements with the pap smear and cervical cancer. Drawing on postcolonial and indigenous feminist commitments, as well as amplifying Donna Haraway's call to 'stay with the trouble', the article seeks to disturb hegemonic histories and arrangements of race, colonialism, and political economy, while simultaneously valuing divergent multi-local itineraries as relevant to technoscientific matters of care. This call for a politics of 'unsettling' care strives to stir up and put into motion what is sedimented, while embracing the generativity of discomfort, critique, and non-innocence.

  9. 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.

  10. Survival Processing Enhances Visual Search Efficiency.

    Science.gov (United States)

    Cho, Kit W

    2018-05-01

    Words rated for their survival relevance are remembered better than when rated using other well-known memory mnemonics. This finding, which is known as the survival advantage effect and has been replicated in many studies, suggests that our memory systems are molded by natural selection pressures. In two experiments, the present study used a visual search task to examine whether there is likewise a survival advantage for our visual systems. Participants rated words for their survival relevance or for their pleasantness before locating that object's picture in a search array with 8 or 16 objects. Although there was no difference in search times among the two rating scenarios when set size was 8, survival processing reduced visual search times when set size was 16. These findings reflect a search efficiency effect and suggest that similar to our memory systems, our visual systems are also tuned toward self-preservation.

  11. Evaluation of the activities of the commission on minor’s affairs and protection of their rights dealing with troubled teenagers (based on materials of Nizhnekamsk municipal district)

    OpenAIRE

    Tuhvatullina, Marina

    2013-01-01

    Evaluation of the activities of the commission on minor’s affairs and protection of their rights dealing with troubled teenagers is very important problem is very relevant in connection with the increase of teenage crime. In article present the evaluation of the activities of the commission on minor’s affairs and protection of their rights dealing with troubled teenagers. A particular example of the conducted qualitative and quantitative analysis of activities and on this basis to identify pr...

  12. Survival after stereotactic biopsy of malignant gliomas

    International Nuclear Information System (INIS)

    Coffey, R.J.; Lunsford, L.D.; Taylor, F.H.

    1988-01-01

    For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was less than or equal to 11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time

  13. Male microchimerism and survival among women

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Hjalgrim, Henrik; Andersen, Anne-Marie Nybo

    2014-01-01

    During pregnancy, woman and fetus exchange small quantities of cells, and their persistence at later times is termed microchimerism. Microchimerism is known to substantially impact on women's later health. This study examined the survival of women according to male microchimerism status.......During pregnancy, woman and fetus exchange small quantities of cells, and their persistence at later times is termed microchimerism. Microchimerism is known to substantially impact on women's later health. This study examined the survival of women according to male microchimerism status....

  14. Improved survival for women with stage I breast cancer in south-east Sweden: A comparison between two time periods before and after increased use of adjuvant systemic therapy

    International Nuclear Information System (INIS)

    Johansson, Patrik; Fohlin, Helena; Arnesson, Lars-Gunnar

    2009-01-01

    Purpose. Continuous minor steps of improvement in the management of breast cancer have resulted in decreased mortality rates during the last decades. The aim of this study was to compare the clinical outcome of patients with stage I breast cancer diagnosed during two time periods that differed with respect to adjuvant systemic therapy. Material and methods. The studied population consisted of all women < 60 years of age, who were diagnosed breast cancer stage I between 1986 and 1999 in south-east Sweden, a total of 1 407 cases. The cohort was divided into two groups based on the management programmes of 1986 and 1992, hereafter referred to as Period 1 and Period 2. Before 1992 the only adjuvant systemic therapy recommended was tamoxifen for hormone receptor positive patients aged 50 years or older. During Period 2 the use of adjuvant treatment was extended to younger patients at high risk, identified by a high tumour S-phase fraction, with either hormonal or cytotoxic treatment. Results. The estimated distant recurrence-free survival rate was significantly higher during Period 2 than during Period 1 (p = 0.008). Subgroup analysis showed that the most evident reduction of distant recurrence risk was among hormone receptor-negative patients (HR = 0.58, 95% CI 0.31-1.09, p = 0.09) and among patients with a high tumour S-phase fraction (HR = 0.53, 0.30-0.93, p = 0.028). The risk reduction between the periods was still statistically significant in multivariate analysis when adjusting for different tumour characteristics and treatment modalities, indicating an influence of other factors not controlled for. One such factor may be the duration of tamoxifen treatment, which likely was more frequently five years during Period 2 than during Period 1. Conclusions. We conclude that the causes of the increase in distant recurrence free survival for women with breast cancer stage I are complex. The results support though that high-risk subgroups of stage I breast cancer patients

  15. 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....

  16. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  17. Survivability and Hope

    Science.gov (United States)

    ... Current Issue Past Issues Special Section Survivability and Hope Past Issues / Spring 2007 Table of Contents For ... cure or long-term survivorship." This message of hope is a hallmark of the latest advances in ...

  18. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  19. Troubles for the sustainability of the quality assurance in the laboratories of radiological control in Peru

    International Nuclear Information System (INIS)

    Gonzales, Susana; Lopez, Edith

    2008-01-01

    Full text: The Nuclear Energy Peruvian Institute (IPEN) has laboratories which offer services of radiological control. Radiometric analysis in raw and processed foodstuff is requested by several enterprises of both public and private sectors which uses the results for trading purposes like exportation, importation and licitations. The service of assays and calibration with reliable results has become a need due to the external audits performed by accredited laboratories to fulfil the requirements of the Peruvian standard organism. With the support of the International Atomic Energy Agency (IAEA), the IPEN laboratory of radiometric analysis implemented its quality system in 2001 under the ISO IEC 17025 Standard 'General Requirements for the Competence of the Calibration and Testing Laboratories' with the purpose to organize the activities and offer an enhanced service to the clients. The implementation of the quality system has allowed giving a better service with enhanced efficiency to the clients, assuring the reliability of the final output, the analytical results. It had been possible since the laboratories have participated in worldwide proficiency tests sponsored by the IAEA and currently work with reference material. The quality system allows identifying potential faults in any stage of the process in order to prevent any problem in the final output, assuring the appropriate quality of the issued analytical results and to take the necessary corrective actions to avoid those events to happen again. This study has identified and assessed several difficulties and troubles which prevent to fulfil the requirements of the Quality Standard and as a consequence, disable the sustainability of the quality systems and prevent the accreditation. Several proposals and solution alternatives which involve the Executive Staff and the proactive participation of the personnel are presented. (author)

  20. Trouble with diffusion: Reassessing hillslope erosion laws with a particle-based model

    Science.gov (United States)

    Tucker, Gregory E.; Bradley, D. Nathan

    2010-03-01

    Many geomorphic systems involve a broad distribution of grain motion length scales, ranging from a few particle diameters to the length of an entire hillslope or stream. Studies of analogous physical systems have revealed that such broad motion distributions can have a significant impact on macroscale dynamics and can violate the assumptions behind standard, local gradient flux laws. Here, a simple particle-based model of sediment transport on a hillslope is used to study the relationship between grain motion statistics and macroscopic landform evolution. Surface grains are dislodged by random disturbance events with probabilities and distances that depend on local microtopography. Despite its simplicity, the particle model reproduces a surprisingly broad range of slope forms, including asymmetric degrading scarps and cinder cone profiles. At low slope angles the dynamics are diffusion like, with a short-range, thin-tailed hop length distribution, a parabolic, convex upward equilibrium slope form, and a linear relationship between transport rate and gradient. As slope angle steepens, the characteristic grain motion length scale begins to approach the length of the slope, leading to planar equilibrium forms that show a strongly nonlinear correlation between transport rate and gradient. These high-probability, long-distance motions violate the locality assumption embedded in many common gradient-based geomorphic transport laws. The example of a degrading scarp illustrates the potential for grain motion dynamics to vary in space and time as topography evolves. This characteristic renders models based on independent, stationary statistics inapplicable. An accompanying analytical framework based on treating grain motion as a survival process is briefly outlined.

  1. Cancer survival among Alaska Native people.

    Science.gov (United States)

    Nash, Sarah H; Meisner, Angela L W; Zimpelman, Garrett L; Barry, Marc; Wiggins, Charles L

    2018-03-26

    Recent cancer survival trends among American Indian and Alaska Native (AN) people are not well understood; survival has not been reported among AN people since 2001. This study examined cause-specific survival among AN cancer patients for lung, colorectal, female breast, prostate, and kidney cancers. It evaluated whether survival differed between cancers diagnosed in 1992-2002 (the earlier period) and cancers diagnosed in 2003-2013 (the later period) and by the age at diagnosis (<65 vs ≥65 years), stage at diagnosis (local or regional/distant/unknown), and sex. Kaplan-Meier and Cox proportional hazards models were used to estimate univariate and multivariate-adjusted cause-specific survival for each cancer. An improvement was observed in 5-year survival over time from lung cancer (hazard ratio [HR] for the later period vs the earlier period, 0.83; 95% confidence interval [CI], 0.72-0.97), and a marginally nonsignificant improvement was observed for colorectal cancer (HR, 0.81; 95% CI, 0.66-1.01). Site-specific differences in survival were observed by age and stage at diagnosis. This study presents the first data on cancer survival among AN people in almost 2 decades. During this time, AN people have experienced improvements in survival from lung and colorectal cancers. The reasons for these improvements may include increased access to care (including screening) as well as improvements in treatment. Improving cancer survival should be a priority for reducing the burden of cancer among AN people and eliminating cancer disparities. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  2. 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.

  3. Prospective study of serial 18F-FDG PET and 18F-fluoride (18F-NaF) PET to predict time to skeletal related events, time-to-progression, and survival in patients with bone-dominant metastatic breast cancer.

    Science.gov (United States)

    Peterson, Lanell M; O'Sullivan, Janet; Wu, Qian Vicky; Novakova-Jiresova, Alena; Jenkins, Isaac; Lee, Jean H; Shields, Andrew; Montgomery, Susan; Linden, Hannah M; Gralow, Julie R; Gadi, Vijayakrishna K; Muzi, Mark; Kinahan, Paul E; Mankoff, David A; Specht, Jennifer M

    2018-05-10

    Assessing therapy response of breast cancer bone metastases is challenging. In retrospective studies, serial 18 F-FDG PET was predictive of time to skeletal related events (tSRE) and time-to-progression (TTP). 18 F-NaF PET improves bone metastasis detection compared to bone scans. We prospectively tested 18 F-FDG PET and 18 F-NaF PET to predict tSRE, TTP, and overall survival (OS) in patients with bone-dominant metastatic breast cancer (BD MBC). Methods: Patients with BD MBC were imaged with 18 F-FDG PET and 18 F-NaF PET prior to starting new therapy (scan1) and again at a range of times centered around approximately 4 months later (scan2). SUV max and SULpeak were recorded for a single index lesion and up to 5 most dominant lesions for each scan. tSRE, TTP, and OS were assessed exclusive of the PET images. Univariate Cox regression was performed to test the association between clinical endpoints and 18 F-FDG PET and 18 F-NaF PET measures. mPERCIST (Modified PET Response Criteria in Solid Tumors) criteria were also applied. Survival curves for mPERCIST compared response categories of Complete Response+Partial Response+Stable Disease versus Progressive Disease (CR+PR+SD vs PD) for tSRE, TTP, and OS. Results: Twenty-eight patients were evaluated. Higher FDG SULpeak at scan2 predicted shorter time to tSRE ( P = PET mPERCIST, tSRE and TTP were longer in responders (CR, PR, or stable) compared to non-responders (PD) ( P = 0.007, 0.028 respectively), with a trend toward improved survival ( P = 0.1). An increase in the uptake between scans of up to 5 lesions by 18 F-NaF PET was associated with longer OS ( P = 0.027). Conclusion: Changes in 18 F-FDG PET parameters during therapy are predictive of tSRE and TTP, but not OS. mPERCIST evaluation in bone lesions may be useful in assessing response to therapy and is worthy of evaluation in multicenter, prospective trials. Serial 18 F-NaF PET was associated with OS, but was not useful for predicting TTP or tSRE in BD MBC

  4. Timing of blood transfusion and not ABO blood type is associated with survival in patients treated with radical cystectomy for nonmetastatic bladder cancer: Results from a single high-volume institution.

    Science.gov (United States)

    Moschini, Marco; Bianchi, Marco; Rossi, Martina Sofia; Dell׳Oglio, Paolo; Gandaglia, Giorgio; Fossati, Nicola; Mattei, Agostino; Damiano, Rocco; Shariat, Shahrokh F; Salonia, Andrea; Montorsi, Francesco; Briganti, Alberto; Colombo, Renzo; Gallina, Andrea

    2016-06-01

    Perioperative transfusions have been recently associated to poor outcomes as an indirect consequence of immune-hematological changes related to transfusion itself and blood type. We tested the role of blood transfusion on cancer-specific mortality (CSM) and overall mortality (OM), considering the effect of ABO system, Rh factor, and timing of transfusions. The study focused on 728 patients with bladder cancer treated with radical cystectomy at a single tertiary care referral center between January 1995 and August 2013 with complete ABO blood type information. Kaplan-Meier analysis was used to assess the effect of transfusions, stratified according to ABO type and Rh factor, on CSM and OM. The same endpoints were tested in Cox regression models, after adjusting for all available confounders. A total of 341 (46.8%), 277 (38.0%), 83 (11.4%), and 27 (3.7%) patients had blood type O, A, B and AB, respectively. Overall, 630 (86.5%) and 98 (13.5%) patients were Rh-and Rh+, respectively. At a median follow-up time of 65 months, 225 (30.9%) and 282 (38.7%) patients recorded CSM and OM, respectively. At univariable analyses, ABO blood type and Rh status were not associated to either CSM or OM (all P>0.2). Similar results were observed when ABO blood type and Rh factor were tested in multivariable models (all P>0.3). Conversely, Charlson score, preoperative hemoglobin, number of nodes removed, pathological T stage, and number of positive nodes were associated to both CSM and OM (all Pblood units in the postoperative period (P>0.05) was associated with an increase of CSM and OM. Although ABO type or Rh factor or both were associated with several adverse outcomes in many cancers, we were not able to confirm this association in bladder cancer. Based on our results, the effect of transfusion on survival is independent by ABO type but is associated to the timing of blood supply administration. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Troubling Times-The GFC and its Implications for Regional Performance. Part One: The United States And Europe

    OpenAIRE

    Robert J. Stimson

    2012-01-01

    The Global Financial Crisis (GFC) was a profound exogenous shock which has had profound impacts the performance of national economies and the regions within them. The differential outcomes are vast. In many parts of the world there is evidence of what is being referred to as the ‘two-speed’ economy - or even a ‘multi-speed’ - economy. This has implications for regional economic development theory in which, over the last two to three decades, there has been an increasing emphasis on endogenous...

  6. Demonstrating the Value of Gerontology in Troubled Times: Taking the Future Self Exercise from the Classroom to the Community

    Science.gov (United States)

    Masters, Julie L.; Holley, Lyn M.

    2011-01-01

    Gerontologists at state-funded universities are being challenged to demonstrate the value of their programs amid looming budget cuts. This article, third in a series reporting research and development of the Future Self exercise, suggests that the latest iteration of the exercise is an effective way to demonstrate the value of a gerontology…

  7. 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

  8. Biostatistics series module 9: Survival analysis

    Directory of Open Access Journals (Sweden)

    Avijit Hazra

    2017-01-01

    Full Text Available Survival analysis is concerned with “time to event“ data. Conventionally, it dealt with cancer death as the event in question, but it can handle any event occurring over a time frame, and this need not be always adverse in nature. When the outcome of a study is the time to an event, it is often not possible to wait until the event in question has happened to all the subjects, for example, until all are dead. In addition, subjects may leave the study prematurely. Such situations lead to what is called censored observations as complete information is not available for these subjects. The data set is thus an assemblage of times to the event in question and times after which no more information on the individual is available. Survival analysis methods are the only techniques capable of handling censored observations without treating them as missing data. They also make no assumption regarding normal distribution of time to event data. Descriptive methods for exploring survival times in a sample include life table and Kaplan–Meier techniques as well as various kinds of distribution fitting as advanced modeling techniques. The Kaplan–Meier cumulative survival probability over time plot has become the signature plot for biomedical survival analysis. Several techniques are available for comparing the survival experience in two or more groups – the log-rank test is popularly used. This test can also be used to produce an odds ratio as an estimate of risk of the event in the test group; this is called hazard ratio (HR. Limitations of the traditional log-rank test have led to various modifications and enhancements. Finally, survival analysis offers different regression models for estimating the impact of multiple predictors on survival. Cox's proportional hazard model is the most general of the regression methods that allows the hazard function to be modeled on a set of explanatory variables without making restrictive assumptions concerning the

  9. Conditional survival is greater than overall survival at diagnosis in patients with osteosarcoma and Ewing's sarcoma.

    Science.gov (United States)

    Miller, Benjamin J; Lynch, Charles F; Buckwalter, Joseph A

    2013-11-01

    Conditional survival is a measure of the risk of mortality given that a patient has survived a defined period of time. These estimates are clinically helpful, but have not been reported previously for osteosarcoma or Ewing's sarcoma. We determined the conditional survival of patients with osteosarcoma and Ewing's sarcoma given survival of 1 or more years. We used the Surveillance, Epidemiology, and End Results (SEER) Program database to investigate cases of osteosarcoma and Ewing's sarcoma in patients younger than 40 years from 1973 to 2009. The SEER Program is managed by the National Cancer Institute and provides survival data gathered from population-based cancer registries. We used an actuarial life table analysis to determine any cancer cause-specific 5-year survival estimates conditional on 1 to 5 years of survival after diagnosis. We performed a similar analysis to determine 20-year survival from the time of diagnosis. The estimated 5-year survival improved each year after diagnosis. For local/regional osteosarcoma, the 5-year survival improved from 74.8% at baseline to 91.4% at 5 years-meaning that if a patient with localized osteosarcoma lives for 5 years, the chance of living for another 5 years is 91.4%. Similarly, the 5-year survivals for local/regional Ewing's sarcoma improved from 72.9% at baseline to 92.5% at 5 years, for metastatic osteosarcoma 35.5% at baseline to 85.4% at 5 years, and for metastatic Ewing's sarcoma 31.7% at baseline to 83.6% at 5 years. The likelihood of 20-year cause-specific survival from the time of diagnosis in osteosarcoma and Ewing's sarcoma was almost 90% or greater after 10 years of survival, suggesting that while most patients will remain disease-free indefinitely, some experience cancer-related complications years after presumed eradication. The 5-year survival estimates of osteosarcoma and Ewing's sarcoma improve with each additional year of patient survival. Knowledge of a changing risk profile is useful in counseling

  10. 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

  11. 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.

  12. Surviving After Suicide

    Science.gov (United States)

    ... fewer tools for communicating their feelings. Surviving After Suicide Fact Sheet 3 Children are especially vulnerable to feelings of guilt and ... to take care of them. Secrecy about the suicide in the hopes of protecting children may cause further complications. Explain the situation and ...

  13. 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.

  14. Education for Survival.

    Science.gov (United States)

    Allen, James E., Jr.

    In this address, James E. Allen, Jr., Assistant Secretary for Education and U.S. Commissioner of Education, discusses the relationship of education to the problem of ecological destruction. He states that the solutions to the problems of air, water, and soil pollution may be found in redirected education. This "education for survival" can serve to…

  15. 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....

  16. 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-prote