WorldWideScience

Sample records for total numeric risk

  1. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  2. Global Drought Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Drought Total Economic Loss Risk Deciles is a 2.5 minute grid of global drought total economic loss risks. A process of spatially allocating Gross Domestic...

  3. Global Landslide Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Landslide Total Economic Loss Risk Deciles is a 2.5 minute grid of global landslide total economic loss risks. A process of spatially allocating Gross...

  4. A numerical 4D Collision Risk Model

    Science.gov (United States)

    Schmitt, Pal; Culloch, Ross; Lieber, Lilian; Kregting, Louise

    2017-04-01

    With the growing number of marine renewable energy (MRE) devices being installed across the world, some concern has been raised about the possibility of harming mobile, marine fauna by collision. Although physical contact between a MRE device and an organism has not been reported to date, these novel sub-sea structures pose a challenge for accurately estimating collision risks as part of environmental impact assessments. Even if the animal motion is simplified to linear translation, ignoring likely evasive behaviour, the mathematical problem of establishing an impact probability is not trivial. We present a numerical algorithm to obtain such probability distributions using transient, four-dimensional simulations of a novel marine renewable device concept, Deep Green, Minesto's power plant and hereafter referred to as the 'kite' that flies in a figure-of-eight configuration. Simulations were carried out altering several configurations including kite depth, kite speed and kite trajectory while keeping the speed of the moving object constant. Since the kite assembly is defined as two parts in the model, a tether (attached to the seabed) and the kite, collision risk of each part is reported independently. By comparing the number of collisions with the number of collision-free simulations, a probability of impact for each simulated position in the cross- section of the area is considered. Results suggest that close to the bottom, where the tether amplitude is small, the path is always blocked and the impact probability is 100% as expected. However, higher up in the water column, the collision probability is twice as high in the mid line, where the tether passes twice per period than at the extremes of its trajectory. The collision probability distribution is much more complex in the upper end of the water column, where the kite and tether can simultaneously collide with the object. Results demonstrate the viability of such models, which can also incorporate empirical

  5. The total theory about risk management

    International Nuclear Information System (INIS)

    Furuya, Shunsuke

    2003-01-01

    A general working procedure of risk management, some example of other countries, topics and problems in the future are described. A definition of risk, risk assessment, risk management process, setting of aim and definite policy are explained. As a fundamental way of thinking, risk is controlled by ALARP (As Low As Reasonably Practicable). The upper and lower limit of risk level is called as Quantitative Safety Goal and Target Level of Safety, respectively. These limits in the atomic power and airplane are decided. Evaluation of risk, countermeasure and practice are explained. For example, a permissible range of risk and practical use in England, U.S.A, Holland and Japan are stated. Recently, accountability risk, missing demand risk and control risk are important. (S.Y.)

  6. Total Risk Management for Low Dose Radiation Exposures

    International Nuclear Information System (INIS)

    Simic, Z.; Mikulicic, V.; Sterc, D.

    2012-01-01

    health. This view is supported with numerous evidences, and explained with beneficial effects from the increased activity of immune system activated with small radiation exposures. Finally, theory in between is that small doses are less than linearly proportionally harmful and that they are presenting a much smaller risks than according to the LNT. This view is derived from the use of different evidences. Difficulties to find one single theory about effects of small radiation doses are related to existence of huge variability and uncertainty in the evidence data. This is very hard experimental and theoretical problem. It will require lots of additional research to reduce these uncertainties and find final theory. This might be too late for the number of people affected in different ways with current single most conservative LNT approach. The problem with the conservative LNT regulatory approach is resulting in enormous additional costs of nuclear energy and medical applications. Which is reasonable and acceptable during the regular operation when source is high and concentrated. But, this becomes unreasonable huge economic burden after accidents and for cleanups with nuclear facilities. Similar problem arises with restriction of medical examinations and treatments based on over conservative risk estimate. Special circumstances are with evacuated people from contaminated areas where they are on the one side saved from small radiation exposures, and on the other side exposed to years of life away from their home and with numerous direct and indirect additional risks (i.e., stress, social problems, etc.). It seems reasonable that some alternative (total) risk management approach might be much more suitable for this situation. Evacuation of people from contaminated area with small doses sources should not be done when that induces larger risks from even what is expected from radiation based on LNT. Similar total risk management could be also applied for with medical

  7. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    Soerensen, B.

    1982-01-01

    The paper discusses a methodology for total impact assessment of energy systems, ideally evaluating all the impacts that a given energy system has on the society in which it is imbedded or into which its introduction is being considered. Impacts from the entire energy conversion chain ('fuel cycle' if the system is fuel-based), including energy storage, transport and transmission, as well as the institutions formed in order to manage the system, should be compared on the basis of the energy service provided. A number of impacts are considered, broadly classified as impacts on satisfaction of biological needs, on health, on environment, on social relations and on the structure of society. Further considerations include impacts related to cost and resilience, and, last but not least, impacts on global relations. The paper discusses a number of published energy studies in the light of the comparative impact assessment methodology outlined above. (author)

  8. Managing total corporate electricity/energy market risks

    International Nuclear Information System (INIS)

    Henney, A.; Keers, G.

    1998-01-01

    The banking industry has developed a tool kit of very useful value at risk techniques for hedging risk, but these techniques must be adapted to the special complexities of the electricity market. This paper starts with a short history of the use of value-at-risk (VAR) techniques in banking risk management and then examines the specific and, in many instances, complex risk management challenges faced by electric companies from the behavior of prices in electricity markets and from the character of generation and electric retailing risks. The third section describes the main methods for making VAR calculations along with an analysis of their suitability for analyzing the risks of electricity portfolios and the case for using profit at risk and downside risk as measures of risk. The final section draws the threads together and explains how to look at managing total corporate electricity market risk, which is a big step toward managing total corporate energy market risk

  9. 'Awareness and attitudes towards total cardiovascular disease risk ...

    African Journals Online (AJOL)

    Microsoft account

    Corresponding author: Dr S Ofori, Department of Internal Medicine, ... regarding total CVD risk assessment in clinical practice among physicians in Port ..... cardiovascular risk for prevention and control of cardiovascular disease in low and.

  10. Uncertainties and demonstration of compliance with numerical risk standards

    International Nuclear Information System (INIS)

    Preyssl, C.; Cullingford, M.C.

    1987-01-01

    When dealing with numerical results of a probabilistic risk analysis performed for a complex system, such as a nuclear power plant, one major objective may be to deal with the problem of compliance or non-compliance with a prefixed risk standard. The uncertainties in the risk results associated with the consequences and their probabilities of occurrence may be considered by representing the risk as a risk band. Studying the area and distance between the upper and lower bound of the risk band provides consistent information on the uncertainties in terms of risk, not by means of scalars only but also by real functions. Criteria can be defined for determining compliance with a numerical risk standard, and the 'weighting functional' method, representing a possible tool for testing compliance of risk results, is introduced. By shifting the upper confidence bound due to redefinition, part of the risk band may exceed the standard without changing the underlying results. Using the concept described it is possible to determine the amount of risk, i.e. uncertainty, exceeding the standard. The mathematical treatment of uncertainties therefore allows probabilistic risk assessment results to be compared. A realistic example illustrates the method. (author)

  11. Risk management in radiotherapy: analysis for total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Banguero, Y., E-mail: ybanguero@cin.edu.uy [Universidad de la República, Montevideo (Uruguay); Píriz, G.; Guerrero, L.; Cardozo, L.; Quarneti, A. [Centro Hospital Pereira Rossell, Montevideo (Uruguay); Nader, A. [Autoridad Reguladora Nacional de Radioprotección, Montevideo (Uruguay)

    2017-07-01

    Introduction: Management of risk in any technique that is using radiation energy is very important to prevent incidents and accidents. Pretending evaluate the risk in the all process of Total Body Irradiation (TBI), this work present a risk matrix with different possible events than could occur. Methods: SEVRRA-R platform that run in windows is using to build a risk matrix separating the process of TBI in commissioning, prescription, planning and delivering dose. Any stage has a procedure with different errors associated. We build a matrix using all this information to evaluate the kind of risk we have in the technique. Results: It was obtained a template that describes in general the process of TBI with principles events, barriers and consequences. Conclusion: Analyzing the risk in any stage of the process in Total Body irradiation is a useful tool to understand the key points to work in safety for this technique. (author)

  12. The Impact of Total Risk Management on Company's Performance

    OpenAIRE

    Mohammed, Hamdu Kedir; Knapkova, Adriana

    2016-01-01

    Traditionally risk management used to be considered as a means to alleviate perhaps eliminate negative outcomes of exposures. However, the result of this and other empirical studies shows the ability of risk management to go beyond this and respond to market factors which are out of management control in order to control volatilities in earning which ultimately improve corporate performance. The empirical study investigates the relationship between total risk management and company's performa...

  13. Functional-analytic and numerical issues in splitting methods for total variation-based image reconstruction

    International Nuclear Information System (INIS)

    Hintermüller, Michael; Rautenberg, Carlos N; Hahn, Jooyoung

    2014-01-01

    Variable splitting schemes for the function space version of the image reconstruction problem with total variation regularization (TV-problem) in its primal and pre-dual formulations are considered. For the primal splitting formulation, while existence of a solution cannot be guaranteed, it is shown that quasi-minimizers of the penalized problem are asymptotically related to the solution of the original TV-problem. On the other hand, for the pre-dual formulation, a family of parametrized problems is introduced and a parameter dependent contraction of an associated fixed point iteration is established. Moreover, the theory is validated by numerical tests. Additionally, the augmented Lagrangian approach is studied, details on an implementation on a staggered grid are provided and numerical tests are shown. (paper)

  14. The Total Risk Analysis of Large Dams under Flood Hazards

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2018-02-01

    Full Text Available Dams and reservoirs are useful systems in water conservancy projects; however, they also pose a high-risk potential for large downstream areas. Flood, as the driving force of dam overtopping, is the main cause of dam failure. Dam floods and their risks are of interest to researchers and managers. In hydraulic engineering, there is a growing tendency to evaluate dam flood risk based on statistical and probabilistic methods that are unsuitable for the situations with rare historical data or low flood probability, so a more reasonable dam flood risk analysis method with fewer application restrictions is needed. Therefore, different from previous studies, this study develops a flood risk analysis method for large dams based on the concept of total risk factor (TRF used initially in dam seismic risk analysis. The proposed method is not affected by the adequacy of historical data or the low probability of flood and is capable of analyzing the dam structure influence, the flood vulnerability of the dam site, and downstream risk as well as estimating the TRF of each dam and assigning corresponding risk classes to each dam. Application to large dams in the Dadu River Basin, Southwestern China, demonstrates that the proposed method provides quick risk estimation and comparison, which can help local management officials perform more detailed dam safety evaluations for useful risk management information.

  15. Risk factors for total hip arthroplasty aseptic revision.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

    2014-07-01

    The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    OpenAIRE

    De Chiara, Benedetta; Sedda, Valentina; Parolini, Marina; Campolo, Jonica; De Maria, Renata; Caruso, Raffaele; Pizzi, Gianluigi; Disoteo, Olga; Dellanoce, Cinzia; Corno, Anna Rosa; Cighetti, Giuliana; Parodi, Oberdan

    2012-01-01

    We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs), independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination). Oxidative stress was evaluated by measuring plasma total and reduced h...

  17. Risk approximation in decision making: approximative numeric abilities predict advantageous decisions under objective risk.

    Science.gov (United States)

    Mueller, Silke M; Schiebener, Johannes; Delazer, Margarete; Brand, Matthias

    2018-01-22

    Many decision situations in everyday life involve mathematical considerations. In decisions under objective risk, i.e., when explicit numeric information is available, executive functions and abilities to handle exact numbers and ratios are predictors of objectively advantageous choices. Although still debated, exact numeric abilities, e.g., normative calculation skills, are assumed to be related to approximate number processing skills. The current study investigates the effects of approximative numeric abilities on decision making under objective risk. Participants (N = 153) performed a paradigm measuring number-comparison, quantity-estimation, risk-estimation, and decision-making skills on the basis of rapid dot comparisons. Additionally, a risky decision-making task with exact numeric information was administered, as well as tasks measuring executive functions and exact numeric abilities, e.g., mental calculation and ratio processing skills, were conducted. Approximative numeric abilities significantly predicted advantageous decision making, even beyond the effects of executive functions and exact numeric skills. Especially being able to make accurate risk estimations seemed to contribute to superior choices. We recommend approximation skills and approximate number processing to be subject of future investigations on decision making under risk.

  18. A total risk assessment methodology for security assessment

    International Nuclear Information System (INIS)

    Auilar, Richard; Pless, Daniel J.; Kaplan, Paul Garry; Silva, Consuelo Juanita; Rhea, Ronald Edward; Wyss, Gregory Dane; Conrad, Stephen Hamilton

    2009-01-01

    Sandia National Laboratories performed a two-year Laboratory Directed Research and Development project to develop a new collaborative risk assessment method to enable decision makers to fully consider the interrelationships between threat, vulnerability, and consequence. A five-step Total Risk Assessment Methodology was developed to enable interdisciplinary collaborative risk assessment by experts from these disciplines. The objective of this process is promote effective risk management by enabling analysts to identify scenarios that are simultaneously achievable by an adversary, desirable to the adversary, and of concern to the system owner or to society. The basic steps are risk identification, collaborative scenario refinement and evaluation, scenario cohort identification and risk ranking, threat chain mitigation analysis, and residual risk assessment. The method is highly iterative, especially with regard to scenario refinement and evaluation. The Total Risk Assessment Methodology includes objective consideration of relative attack likelihood instead of subjective expert judgment. The 'probability of attack' is not computed, but the relative likelihood for each scenario is assessed through identifying and analyzing scenario cohort groups, which are groups of scenarios with comparable qualities to the scenario being analyzed at both this and other targets. Scenarios for the target under consideration and other targets are placed into cohort groups under an established ranking process that reflects the following three factors: known targeting, achievable consequences, and the resources required for an adversary to have a high likelihood of success. The development of these target cohort groups implements, mathematically, the idea that adversaries are actively choosing among possible attack scenarios and avoiding scenarios that would be significantly suboptimal to their objectives. An adversary who can choose among only a few comparable targets and scenarios (a

  19. Risk factors for renal dysfunction after total hip joint replacement

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Sahlström, Arne; Dessau, Ram Benny Christian

    2015-01-01

    BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surger...... creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors........ METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test......, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum...

  20. Total cholesterol and the risk of Parkinson disease.

    Science.gov (United States)

    Hu, G; Antikainen, R; Jousilahti, P; Kivipelto, M; Tuomilehto, J

    2008-05-20

    To examine the association between serum total cholesterol at baseline and the risk of Parkinson disease (PD). Study cohorts included 24,773 Finnish men and 26,153 women aged 25 to 74 years without a history of PD and stroke at baseline. Hazard ratios (HRs) of incident PD were estimated for different levels of total cholesterol. During a mean follow-up period of 18.1 years, 321 men and 304 women developed incident PD. After adjustment for confounding factors (age, study years, body mass index, systolic blood pressure, education, leisure-time physical activity, smoking, alcohol consumption, coffee and tea consumption, and history of diabetes), the HRs of PD at different levels of total cholesterol (or=7 mmol/L) were 1.00, 1.33, 1.53, and 1.84 (p for trend = 0.035) in men; 1.00, 1.55, 1.57, and 1.86 (p for trend = 0.113) in women; and 1.00, 1.42, 1.56, and 1.86 (p for trend = 0.002) in men and women combined (adjusted also for sex). In both sexes combined, the increased risk of PD associated with increasing levels of serum total cholesterol was present both in subjects aged 25-44 years and in subjects aged 45-54 years at baseline, and in never smokers and smokers; however, no association was found among subjects aged 55 years or older at baseline. This large prospective study suggests that high total cholesterol at baseline is associated with an increased risk of Parkinson disease.

  1. Preoperative Optimization of Total Joint Arthroplasty Surgical Risk: Obesity.

    Science.gov (United States)

    Fournier, Matthew N; Hallock, Justin; Mihalko, William M

    2016-08-01

    Obesity is a problem that is increasing in prevalence in the United States and in other countries, and it is a common comorbidity in patients seeking total joint arthroplasty for degenerative musculoskeletal diseases. Obesity, as well as commonly associated comorbidities such as diabetes mellitus, cardiovascular disease, and those contributing to the diagnosis of metabolic syndrome, have been shown to have detrimental effects on total joint arthroplasty outcomes. Although there are effective surgical and nonsurgical interventions which can result in weight loss in these patients, concomitant benefit on arthroplasty outcomes is not clear. Preoperative optimization of surgical risk in obese total joint arthroplasty patients is an important point of intervention to improve arthroplasty outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Individualized Risk Model for Venous Thromboembolism After Total Joint Arthroplasty.

    Science.gov (United States)

    Parvizi, Javad; Huang, Ronald; Rezapoor, Maryam; Bagheri, Behrad; Maltenfort, Mitchell G

    2016-09-01

    Venous thromboembolism (VTE) after total joint arthroplasty (TJA) is a potentially fatal complication. Currently, a standard protocol for postoperative VTE prophylaxis is used that makes little distinction between patients at varying risks of VTE. We sought to develop a simple scoring system identifying patients at higher risk for VTE in whom more potent anticoagulation may need to be administered. Utilizing the National Inpatient Sample data, 1,721,806 patients undergoing TJA were identified, among whom 15,775 (0.9%) developed VTE after index arthroplasty. Among the cohort, all known potential risk factors for VTE were assessed. An initial logistic regression model using potential predictors for VTE was performed. Predictors with little contribution or poor predictive power were pruned from the data, and the model was refit. After pruning of variables that had little to no contribution to VTE risk, using the logistic regression, all independent predictors of VTE after TJA were identified in the data. Relative weights for each factor were determined. Hypercoagulability, metastatic cancer, stroke, sepsis, and chronic obstructive pulmonary disease had some of the highest points. Patients with any of these conditions had risk for postoperative VTE that exceeded the 3% rate. Based on the model, an iOS (iPhone operating system) application was developed (VTEstimator) that could be used to assign patients into low or high risk for VTE after TJA. We believe individualization of VTE prophylaxis after TJA can improve the efficacy of preventing VTE while minimizing untoward risks associated with the administration of anticoagulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    Directory of Open Access Journals (Sweden)

    Benedetta De Chiara

    2012-01-01

    Full Text Available We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs, independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination. Oxidative stress was evaluated by measuring plasma total and reduced homocysteine, cysteine (Cys, glutathione, cysteinylglycine, blood reduced glutathione, and malondialdehyde. Twenty-seven percent of subjects were in group 0 RF, 26% in 1 RF, 31% in 2 RF, and 16% in ≥3 RF. By multivariable ordinal regression analysis, plasma total Cys was associated to a higher number of RF (OR = 1.068; 95% CI = 1.027–1.110, =0.002. Total RF burden is associated with increased total Cys levels. These findings support a prooxidant effect of Cys in conjunction with RF burden, and shed light on the pathophysiologic role of redox state unbalance in preclinical atherosclerosis.

  4. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Manatakis

    2016-01-01

    Full Text Available Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia, pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy, and biochemical (serum calcium and phosphate levels factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003. Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49. Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  5. Managing the total cost of risk exposures through risk mapping techniques

    International Nuclear Information System (INIS)

    Unione, A.J.; Rode, D.M.

    1998-01-01

    In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

  6. Numerical model of total artificial heart hemodynamics and the effect of its size on stress accumulation.

    Science.gov (United States)

    Marom, Gil; Chiu, Wei-Che; Slepian, Marvin J; Bluestein, Danny

    2014-01-01

    The total artificial heart (TAH) is a bi-ventricular mechanical circulatory support device that replaces the heart in patients with end-stage congestive heart failure. The device acts as blood pump via pneumatic activation of diaphragms altering the volume of the ventricular chambers. Flow in and out of the ventricles is controlled by mechanical heart valves. The aim of this study is to evaluate the flow regime in the TAH and to estimate the thrombogenic potential during systole. Toward that goal, three numerical models of TAHs of differing sizes, that include the deforming diaphragm and the blood flow from the left chamber to the aorta, are introduced. A multiphase model with injection of platelet particles is employed to calculate their trajectories. The shear stress accumulation in the three models are calculated along the platelets trajectories and their probability density functions, which represent the `thrombogenic footprint' of the device are compared. The calculated flow regime successfully captures the mitral regurgitation and the flows that open and close the aortic valve during systole. Physiological velocity magnitudes are found in all three models, with higher velocities and increased stress accumulation predicted for smaller devices.

  7. Risk factors for acute nerve injury after total knee arthroplasty.

    Science.gov (United States)

    Shetty, Teena; Nguyen, Joseph T; Sasaki, Mayu; Wu, Anita; Bogner, Eric; Burge, Alissa; Cogsil, Taylor; Dalal, Aashka; Halvorsen, Kristin; Cummings, Kelianne; Su, Edwin P; Lyman, Stephen

    2018-06-01

    In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-1.3%. Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (ORs). Sixty-five nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, P = 0.003) and patients with history of lumbar pathology (OR 6.12, P = 0.026) were associated with increased risk of nerve injury. Tourniquet pressure nerve injury was unexpected and requires further investigation. Muscle Nerve 57: 946-950, 2018. © 2017 Wiley Periodicals, Inc.

  8. Increasing risk of prosthetic joint infection after total hip arthroplasty

    DEFF Research Database (Denmark)

    Dale, Håvard; Fenstad, Anne M; Hallan, Geir

    2012-01-01

    Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA.......Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods...... The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection...

  9. Preoperative risk factors in total thyroidectomy of substernal goiter

    Directory of Open Access Journals (Sweden)

    Bove A

    2016-11-01

    Full Text Available Aldo Bove, Raffaella Maria Di Renzo, Gauro D’Urbano, Manuela Bellobono, Vincenzo D’ Addetta, Alfonso Lapergola, Giuseppe Bongarzoni Department of Medicine, Dentistry and Biotechnology, University “G. d’Annunzio” Chieti-Pescara, Chieti Scalo, Italy Abstract: The definition of substernal goiter (SG is based on variable criteria leading to a considerable variation in the reported incidence (from 0.2% to 45%. The peri- and postoperative complications are higher in total thyroidectomy (TT for SG than that for cervical goiter. The aim of this study was to evaluate the preoperative risk factors associated with postoperative complications. From 2002 to 2014, 142 (8.5%; 98 women and 44 men of the 1690 patients who underwent TT had a SG. We retrospectively evaluated the following parameters: sex, age, histology, pre- and retrovascular position, recurrence, and extension beyond the carina. These parameters were then related to the postoperative complications: seroma/hematoma, transient and permanent hypocalcemia, transient and permanent laryngeal nerve palsy, and the length of surgery. The results were further compared with a control group of 120 patients operated on in the same period with TT for cervical goiter. All but two procedures were terminated via cervicotomy, where partial sternotomies were required. No perioperative mortality was observed. Results of the statistical analysis (Student’s t-test and Fisher’s exact test indicated an association between recurrence and extension beyond the carina with all postoperative complications. The group that underwent TT of SG showed a statistically significant higher risk for transient hypocalcemia (relative risk =1.767 with 95% confidence interval: 1.131–2.7605, P=0.0124, and need to treat =7.1 and a trend toward significance for transient recurrent laryngeal nerve palsy (relative risk =6.7806 with 95% confidence interval: 0.8577–53.2898, P=0.0696, and need to treat =20.8 compared to the

  10. Measurement of total risk of spontaneous abortion: the virtue of conditional risk estimation

    DEFF Research Database (Denmark)

    Modvig, J; Schmidt, L; Damsgaard, M T

    1990-01-01

    The concepts, methods, and problems of measuring spontaneous abortion risk are reviewed. The problems touched on include the process of pregnancy verification, the changes in risk by gestational age and maternal age, and the presence of induced abortions. Methods used in studies of spontaneous...... abortion risk include biochemical assays as well as life table technique, although the latter appears in two different forms. The consequences of using either of these are discussed. It is concluded that no study design so far is appropriate for measuring the total risk of spontaneous abortion from early...... conception to the end of the 27th week. It is proposed that pregnancy may be considered to consist of two or three specific periods and that different study designs should concentrate on measuring the conditional risk within each period. A careful estimate using this principle leads to an estimate of total...

  11. Risk factors for revision of primary total hip arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Prokopetz Julian JZ

    2012-12-01

    Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

  12. A preclinical numerical assessment of a polyetheretherketone femoral component in total knee arthroplasty during gait

    NARCIS (Netherlands)

    Ruiter, L. de; Janssen, D.W.; Briscoe, A.; Verdonschot, N.J.

    2017-01-01

    BACKGROUND: Conventional total knee replacement designs show high success rates but in the long term, the stiff metal components may affect bone quality of the distal femur. In this study we introduce an all-polymer total knee replacement device containing a PEEK femoral component on an UHMWPE

  13. A preclinical numerical assessment of a polyetheretherketone femoral component in total knee arthroplasty during gait

    NARCIS (Netherlands)

    de Ruiter, Lennert; Janssen, Dennis W.; Briscoe, Adam; Verdonschot, Nico

    2017-01-01

    Background Conventional total knee replacement designs show high success rates but in the long term, the stiff metal components may affect bone quality of the distal femur. In this study we introduce an all-polymer total knee replacement device containing a PEEK femoral component on an UHMWPE tibial

  14. Estimating and localizing the algebraic and total numerical errors using flux reconstructions

    Czech Academy of Sciences Publication Activity Database

    Papež, Jan; Strakoš, Z.; Vohralík, M.

    2018-01-01

    Roč. 138, č. 3 (2018), s. 681-721 ISSN 0029-599X R&D Projects: GA ČR GA13-06684S Grant - others:GA MŠk(CZ) LL1202 Institutional support: RVO:67985807 Keywords : numerical solution of partial differential equations * finite element method * a posteriori error estimation * algebraic error * discretization error * stopping criteria * spatial distribution of the error Subject RIV: BA - General Mathematics Impact factor: 2.152, year: 2016

  15. A Numerical Study of Effects of the Manufacture Perturbations to Contacts of the Total Hip Replacement

    Czech Academy of Sciences Publication Activity Database

    Koukal, M.; Fuis, Vladimír; Florian, Z.; Janíček, P.

    2011-01-01

    Roč. 18, č. 1 (2011), s. 33-42 ISSN 1802-1484 Institutional research plan: CEZ:AV0Z20760514 Keywords : total hip replacement * FEM * roundness * contact pressure * frictional moment Subject RIV: BO - Biophysics

  16. Numerical

    Directory of Open Access Journals (Sweden)

    M. Boumaza

    2015-07-01

    Full Text Available Transient convection heat transfer is of fundamental interest in many industrial and environmental situations, as well as in electronic devices and security of energy systems. Transient fluid flow problems are among the more difficult to analyze and yet are very often encountered in modern day technology. The main objective of this research project is to carry out a theoretical and numerical analysis of transient convective heat transfer in vertical flows, when the thermal field is due to different kinds of variation, in time and space of some boundary conditions, such as wall temperature or wall heat flux. This is achieved by the development of a mathematical model and its resolution by suitable numerical methods, as well as performing various sensitivity analyses. These objectives are achieved through a theoretical investigation of the effects of wall and fluid axial conduction, physical properties and heat capacity of the pipe wall on the transient downward mixed convection in a circular duct experiencing a sudden change in the applied heat flux on the outside surface of a central zone.

  17. Numerical Modelling of the Weight-Bearing Total Knee Joint Replacement and Usage in Practice

    Czech Academy of Sciences Publication Activity Database

    Daněk, Josef; Nedoma, Jiří; Hlaváček, Ivan; Vavřík, P.; Denk, F.

    2007-01-01

    Roč. 76, č. 1-3 (2007), s. 49-56 ISSN 0378-4754 R&D Projects: GA MPO FT-TA/087 Institutional research plan: CEZ:AV0Z10300504 Keywords : total knee joint replacement * contact problem * non-overlapping domain decomposition method Subject RIV: BA - General Mathematics Impact factor: 0.738, year: 2007

  18. Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty.

    Science.gov (United States)

    van der Heide, Huub J L; van der Kraan, Peter M; Rijnberg, Willard J; Buma, Pieter; Schreurs, B Willem

    2010-12-01

    As cytokines are involved in wound healing and other inflammatory processes, it could be valuable to measure their levels at the operative site. This study was conducted to investigate whether different cytokines are measurable in drainage fluid and, when measurable, whether we can find a difference in cytokine levels between one and six hours postoperatively. Samples from the drainage system in 30 consecutive patients undergoing primary total hip replacement were collected at one and six hours after closure of the wound. Levels of several cytokines were measured in the drainage fluids. A significant elevation of almost all cytokines was observed between the sample after one hour and six hours postoperatively. We found a strong correlation between the different pro-inflammatory cytokines. The IL-6 to IL-10 ratio were also raised, showing a pro-inflammatory predominance. Levels were much higher than those previously shown in serum.

  19. The numerical solution of total variation minimization problems in image processing

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, C.R.; Oman, M.E. [Montana State Univ., Bozeman, MT (United States)

    1994-12-31

    Consider the minimization of penalized least squares functionals of the form: f(u) = 1/2 ({parallel}Au {minus} z{parallel}){sup 2} + {alpha}{integral}{sub {Omega}}{vert_bar}{del}u{vert_bar}dx. Here A is a bounded linear operator, z represents data, {parallel} {center_dot} {parallel} is a Hilbert space norm, {alpha} is a positive parameter, {integral}{sub {Omega}}{vert_bar}{del}u{vert_bar} dx represents the total variation (TV) of a function u {element_of} BV ({Omega}), the class of functions of bounded variation on a bounded region {Omega}, and {vert_bar} {center_dot} {vert_bar} denotes Euclidean norm. In image processing, u represents an image which is to be recovered from noisy data z. Certain {open_quotes}blurring processes{close_quotes} may be represented by the action of an operator A on the image u.

  20. The Program Module of Information Risk Numerical Estimation

    Directory of Open Access Journals (Sweden)

    E. S. Stepanova

    2011-03-01

    Full Text Available The algorithm of information risks analysis realized in the program module on the basis of threats matrixes and fuzzy cognitive maps describing potential threats on resources is offered in this paper.

  1. Totally "Online” High School for People at Educational Risk

    Directory of Open Access Journals (Sweden)

    Giancarlo De Agostini

    2010-02-01

    Full Text Available The Iberoamerican Virtual Foundation (http://fuvia.org is dedicated to providing e-learning solutions to universities and other institutions that may require it. It is develops a pedagogical, methodological and technological online High School model based on WEB2 tools, which could be easily replicated elsewhere, and is delivered completely through an online ICT technological GNU open source platform, implemented completely online through the “Colegio Virtual Iberoamericano” (http://cvi.edu.ec, which caters to vulnerable students at pedagogical risk who for different reasons were not able to finish their secondary education. The selected students receive scholarships, thus tuition is totally free. The Iberoamerican online High School Project started on October 2004 with UNESCO support, implementing the last six years of High School in four specialties, with student ages being between 16 and 65, located in almost 50 communities both rural and urban-marginal. We are also working in four detention centers of young law violators and with young men and women from street gangs through community centers. Thus far our strategic alliances (over 20 are with central and local governments, and national and international Foundations. In the near future we plan to: extend the online High School coverage to the rest of the Country in order to help decrease the digital divide gap and the student drop out rate from high school (nearly 80 %; replicate the experience in the rest of the region and in other countries in Africa and Asia; and develop a complete professional online digital Library service and a functional online student orientation Department.La Fondation Virtuelle Ibéro-américaine (http://fuvia.org est spécialisée dans la fourniture de solutions d’apprentissage en ligne aux universités et autres institutions. Elle développe un modèle d’enseignement secondaire en ligne à la fois pédagogique, méthodologique et technologique, et bas

  2. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

    Science.gov (United States)

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

    2011-04-01

    To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

  3. Risk factors for postoperative complications after total laryngectomy following radiotherapy or chemoradiation

    DEFF Research Database (Denmark)

    Wulff, N B; Kristensen, C.A.; Andersen, E

    2015-01-01

    OBJECTIVES: To determine the rates of and risk factors for postoperative complications following total laryngectomy in patients treated with radiotherapy or chemoradiation. DESIGN: Retrospective longitudinal study. SETTING: Tertiary medical centres. PARTICIPANTS: A total of 143 patients undergoin...

  4. Using a familiar risk comparison within a risk ladder to improve risk understanding by low numerates: a study of visual attention.

    Science.gov (United States)

    Keller, Carmen

    2011-07-01

    Previous experimental research provides evidence that a familiar risk comparison within a risk ladder is understood by low- and high-numerate individuals. It especially helps low numerates to better evaluate risk. In the present study, an eye tracker was used to capture individuals' visual attention to a familiar risk comparison, such as the risk associated with smoking. Two parameters of information processing-efficiency and level-were derived from visual attention. A random sample of participants from the general population (N= 68) interpreted a given risk level with the help of the risk ladder. Numeracy was negatively correlated with overall visual attention on the risk ladder (r(s) =-0.28, p= 0.01), indicating that the lower the numeracy, the more the time spent looking at the whole risk ladder. Numeracy was positively correlated with the efficiency of processing relevant frequency (r(s) = 0.34, p improving risk communication formats. © 2011 Society for Risk Analysis.

  5. Circulating Total Bilirubin and Risk of Incident Cardiovascular Disease in the General Population

    NARCIS (Netherlands)

    Kunutsor, Setor K.; Bakker, Stephan J. L.; Gansevoort, Ronald T.; Chowdhury, Rajiv; Dullaart, Robin P. F.

    OBJECTIVE: To assess the association of circulating total bilirubin and cardiovascular disease (CVD) risk in a new prospective study and to determine whether adding information on total bilirubin values to established cardiovascular risk factors is associated with improvement in prediction of CVD

  6. Numerical analysis of the biomechanical complications accompanying the total hip replacement with NANOS-Prosthetic: bone remodelling and prosthesis migration

    Directory of Open Access Journals (Sweden)

    Almohallami A.

    2015-09-01

    Full Text Available Aseptic loosening of the prosthesis is still a problem in artificial joint implants. The ýloosening can be caused by the resorption of the bone surrounding ýthe prosthesis according to stress shielding. A numerical model was developed and validated by means of DEXA-studies in order to ýanalyse the bone remodelling process in the periprosthetic bone. A total loss of about 3.7% of the bone density in the periprosthetic Femur with NANOS is computed. The bone remodelling calculation was validated by means of a DEXA-study with a 3-years-follow-up. The model was further developed in order to be able to calculate and consider the migration of the implants. This method was applied on the ýNANOS-implant with a computed total migration of about 0.43 mm. These calculations showed good results in comparison with a 2-year-follow-up clinical study, whereby a RSA-method was used to determine the stem migration in the bone. In order to ýstudy the mutual influence between the implant migration and the hip contact forces ý, a software is developed by our scientific group to couple a multi body simulation (MBS of human lower limps with the FEA of the periprosthetic Femur.

  7. A Numerical Study for Robust Active Portfolio Management with Worst-Case Downside Risk Measure

    Directory of Open Access Journals (Sweden)

    Aifan Ling

    2014-01-01

    Full Text Available Recently, active portfolio management problems are paid close attention by many researchers due to the explosion of fund industries. We consider a numerical study of a robust active portfolio selection model with downside risk and multiple weights constraints in this paper. We compare the numerical performance of solutions with the classical mean-variance tracking error model and the naive 1/N portfolio strategy by real market data from China market and other markets. We find from the numerical results that the tested active models are more attractive and robust than the compared models.

  8. Development and Validation of Perioperative Risk-Adjustment Models for Hip Fracture Repair, Total Hip Arthroplasty, and Total Knee Arthroplasty.

    Science.gov (United States)

    Schilling, Peter L; Bozic, Kevin J

    2016-01-06

    Comparing outcomes across providers requires risk-adjustment models that account for differences in case mix. The burden of data collection from the clinical record can make risk-adjusted outcomes difficult to measure. The purpose of this study was to develop risk-adjustment models for hip fracture repair (HFR), total hip arthroplasty (THA), and total knee arthroplasty (TKA) that weigh adequacy of risk adjustment against data-collection burden. We used data from the American College of Surgeons National Surgical Quality Improvement Program to create derivation cohorts for HFR (n = 7000), THA (n = 17,336), and TKA (n = 28,661). We developed logistic regression models for each procedure using age, sex, American Society of Anesthesiologists (ASA) physical status classification, comorbidities, laboratory values, and vital signs-based comorbidities as covariates, and validated the models with use of data from 2012. The derivation models' C-statistics for mortality were 80%, 81%, 75%, and 92% and for adverse events were 68%, 68%, 60%, and 70% for HFR, THA, TKA, and combined procedure cohorts. Age, sex, and ASA classification accounted for a large share of the explained variation in mortality (50%, 58%, 70%, and 67%) and adverse events (43%, 45%, 46%, and 68%). For THA and TKA, these three variables were nearly as predictive as models utilizing all covariates. HFR model discrimination improved with the addition of comorbidities and laboratory values; among the important covariates were functional status, low albumin, high creatinine, disseminated cancer, dyspnea, and body mass index. Model performance was similar in validation cohorts. Risk-adjustment models using data from health records demonstrated good discrimination and calibration for HFR, THA, and TKA. It is possible to provide adequate risk adjustment using only the most predictive variables commonly available within the clinical record. This finding helps to inform the trade-off between model performance and data

  9. Combining numerical simulations with time-domain random walk for pathogen risk assessment in groundwater

    Science.gov (United States)

    Cvetkovic, V.; Molin, S.

    2012-02-01

    We present a methodology that combines numerical simulations of groundwater flow and advective transport in heterogeneous porous media with analytical retention models for computing the infection risk probability from pathogens in aquifers. The methodology is based on the analytical results presented in [1,2] for utilising the colloid filtration theory in a time-domain random walk framework. It is shown that in uniform flow, the results from the numerical simulations of advection yield comparable results as the analytical TDRW model for generating advection segments. It is shown that spatial variability of the attachment rate may be significant, however, it appears to affect risk in a different manner depending on if the flow is uniform or radially converging. In spite of the fact that numerous issues remain open regarding pathogen transport in aquifers on the field scale, the methodology presented here may be useful for screening purposes, and may also serve as a basis for future studies that would include greater complexity.

  10. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis

    DEFF Research Database (Denmark)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik

    2016-01-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare......,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk...... of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients....

  11. Evaluation of Total Cardiovascular Risk in Patients with Hypertension and Impaired Glucose Tolerance

    Directory of Open Access Journals (Sweden)

    I.V. Cherniavska

    2016-11-01

    Full Text Available Aim. Timely reveal of the patients at high risk of cardiovascular diseases for whom earlier intervention for cardiovascular risk correction is the most effective. Materials and methods. Seventy patients aged 30–55 years old with stage 2 hypertension, impaired glucose tolerance (IGT and high cardiovascular risk were examined according to Framingham criteria. Cardiovascular risk was compared by SCORE and PROCAM results. Results. Percentage ratio of males with high cardiovascular risk was higher by 52.3 % in comparison to females by SCORE and by 2.3 % in comparison to females by PROCAM. Males did not present any significant discrepancy by evaluation of cardiovascular risk by both scores unlike females. Obtained results showed that total cardiovascular risk in females was twofold higher by PROCAM compared to SCORE scale. Conclusions. Total cardiovascular risk level in patients with stage 2 hypertension and IGT is influenced by age, systolic blood pressure level, smoking, lipid storage disease and carbohydrate metabolism disorder. When we evaluate total cardiovascular risk, we should not be limited only by determination of factors determined in SCORE. It is reasonable to evaluate risk factors by PROCAM, too, especially for females.

  12. Application of Total Quality Management (TQM Requirements in Risk Management in Construction Projects in Iraq

    Directory of Open Access Journals (Sweden)

    Entisar K. Al-Geelawee

    2016-06-01

    Full Text Available Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. The research has consist of two main parts firstly have included a review of the most important concepts of total quality management in addition to the concept of risk analysis and management in construction projects and how to apply the concept of total quality management in the risk analysis and management. Second part included the practical part of the research, which was open and closed questionnaire for experts in the construction industry to obtain required informations for the application of total quality management requirements in risk management in construction projects in Iraq. One of the main findings of the research is that top management support has a high impact on risk management in addition to continuous improvement, training and education, while the participation of all employees in the organization and constant stimulation and focusing on the customer as one of the total quality management requirements had a moderate impact on risk management.

  13. Risk management for existing energy facilities. A global approach to numerical safety goals

    International Nuclear Information System (INIS)

    Pate-Cornell, M.E.

    1993-01-01

    This paper presents a structured set of numerical safety goals for risk management of existing energy facilities. The rationale behind these safety goals is based on principles of equity and economic efficiency. Some of the issues involved when using probabilistic risk analyses results for safety decisions are discussed. A brief review of existing safety targets and open-quotes floating numbersclose quotes is presented, and a set of safety goals for industrial risk management is proposed. Relaxation of these standards for existing facilities, the relevance of the lifetime of the plant, the treatment of uncertainties, and problems of failure dependencies are discussed briefly. 17 refs., 1 fig

  14. Risk assessment of storm surge disaster based on numerical models and remote sensing

    Science.gov (United States)

    Liu, Qingrong; Ruan, Chengqing; Zhong, Shan; Li, Jian; Yin, Zhonghui; Lian, Xihu

    2018-06-01

    Storm surge is one of the most serious ocean disasters in the world. Risk assessment of storm surge disaster for coastal areas has important implications for planning economic development and reducing disaster losses. Based on risk assessment theory, this paper uses coastal hydrological observations, a numerical storm surge model and multi-source remote sensing data, proposes methods for valuing hazard and vulnerability for storm surge and builds a storm surge risk assessment model. Storm surges in different recurrence periods are simulated in numerical models and the flooding areas and depth are calculated, which are used for assessing the hazard of storm surge; remote sensing data and GIS technology are used for extraction of coastal key objects and classification of coastal land use are identified, which is used for vulnerability assessment of storm surge disaster. The storm surge risk assessment model is applied for a typical coastal city, and the result shows the reliability and validity of the risk assessment model. The building and application of storm surge risk assessment model provides some basis reference for the city development plan and strengthens disaster prevention and mitigation.

  15. The language of uncertainty in genetic risk communication: framing and verbal versus numerical information.

    Science.gov (United States)

    Welkenhuysen, M; Evers-Kiebooms, G; d'Ydewalle, G

    2001-05-01

    Within a group of 300 medical students, two characteristics of risk communication in the context of a decision regarding prenatal diagnosis for cystic fibrosis are manipulated: verbal versus numerical probabilities and the negative versus positive framing of the problem (having a child with versus without cystic fibrosis). Independently of the manipulations, most students were in favor of prenatal diagnosis. The effect of framing was only significant in the conditions with verbal information: negative framing produced a stronger choice in favor of prenatal diagnosis than positive framing. The framing effect in the verbal conditions and its absence in the numerical conditions are explained by the dominance of the problem-occurrence orientation in health matters as well as a recoding process which is more likely to occur in the numerical (the probability "1-P" switches to its counterpart "P") than in the verbal conditions. The implications for the practice of genetic counseling are discussed.

  16. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis.

    Science.gov (United States)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik; Jepsen, Peter

    2016-06-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare data to identify all Danish residents diagnosed with cirrhosis in 1994-2011, and matched them 1:5 by age and sex to non-cirrhotic reference individuals from the general population. We excluded people with a previous total hip arthroplasty, a previous hip fracture, or a previous diagnosis of avascular necrosis. We used stratified Cox regression to estimate the hazard ratio (HR) for cirrhosis patients relative to reference individuals, adjusting for potential confounders. We used the cumulative incidence function to compute 5-year risks. Results - We included 25,421 cirrhosis patients and 114,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients.

  17. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain

    DEFF Research Database (Denmark)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B

    2018-01-01

    AIMS: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. METHODS: A total of 76,438 adults answered questions regarding their total sitting time and physical...... activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment...... disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk...

  18. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013

    DEFF Research Database (Denmark)

    Ackerman, Ilana N; Bohensky, Megan A; de Steiger, Richard

    2017-01-01

    OBJECTIVE: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. METHODS: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, N....... These multi-national risk estimates can inform resource planning for OA service delivery. This article is protected by copyright. All rights reserved....

  19. Application of Total Quality Management (TQM) Requirements in Risk Management in Construction Projects in Iraq

    OpenAIRE

    Entisar K. Al-Geelawee; Anfal Nadhel Mohammed

    2016-01-01

    Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be a...

  20. Pre-Operative Patient Education is Associated With Decreased Risk of Arthrofibrosis After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Livbjerg, Anna Emilie; Frøkjær, Sara; Simonsen, Ole

    2013-01-01

    The purpose was to investigate risk factors for postoperative stiffness and long-term outcome following manipulation under anaesthesia (MUA). In one of the five Danish regions, all patients in a 4-year period who received MUA following total knee arthroplasty (N=36) were included in two case-cont...

  1. Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty

    Czech Academy of Sciences Publication Activity Database

    Gallo, J.; Havránek, Vítězslav; Zapletová, J.

    2013-01-01

    Roč. 34, č. 1 (2013), 19-26 ISSN 0341-2695 Grant - others:GA MŠk(CZ) OC 168 Program:OC Institutional research plan: CEZ:AV0Z10100522 Keywords : risk * factors * accelerated * polyethylene * wear * osteolysis * ABG * total * arthroplasty Subject RIV: FI - Traumatology, Orthopedics Impact factor: 2.019, year: 2013

  2. BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children.

    Science.gov (United States)

    Gishti, Olta; Gaillard, Romy; Durmus, Busra; Abrahamse, Marieke; van der Beek, Eline M; Hofman, Albert; Franco, Oscar H; de Jonge, Layla L; Jaddoe, Vincent W V

    2015-05-01

    More specific total body and abdominal fat mass measures might be stronger associated with cardiovascular risk factors in childhood, than BMI. We examined the independent associations of total and abdominal fat measures with cardiovascular risk factors in school age children. We performed a population-based cohort study among 6,523 children. At the age of 6 y, we measured childhood BMI, and general and abdominal fat mass, using dual-energy X-ray absorptiometry, and ultrasound and cardiovascular risk factors. Conditional on BMI, higher fat mass percentage and abdominal fat mass were associated with higher blood pressure, total- and low-density lipoprotein (LDL)-cholesterol, insulin and c-peptide levels, but with lower left ventricular mass and high-density lipoprotein (HDL)-cholesterol (P values children. Higher childhood adiposity measures were associated with increased odds of cardiovascular risk factors clustering, with the strongest effect for fat mass percentage (odds ratios: 3.01 (95% confidence interval: 2.67, 3.9). Our results suggest that general and abdominal fat measures are associated with cardiovascular risk factors in childhood, independent from BMI. These measures may provide additional information for identification of children with an adverse cardiovascular profile.

  3. Blood trihalomethane levels and the risk of total cancer mortality in US adults

    International Nuclear Information System (INIS)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Background: Although animal data have suggested the carcinogenic activity of trihalomethanes (THMs), there is inconsistent evidence supporting the link between THM exposure and cancers in humans. Objectives: We investigated the association between specific and total blood THM levels with the risk of total cancer mortality in adults. Methods: We analyzed data from the 1999–2004 Third National Health and Nutrition Examination Survey and the Linked Mortality File of the United States. A total of 933 adults (20–59 years of age) with available blood THM levels and no missing data for other variables were included. Four different THM species (chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM) and bromoform) were included, and the codes associated with cancer (malignant neoplasm) were C00 through C97, based on the underlying causes of death listed in the International Classification of Disease 10the Revision. Results: Compared with adults in the lowest DBCM, bromoform, and total brominated THM tertiles, those in the highest DBCM, bromoform, and total brominated THM tertiles exhibited adjusted hazard ratios (HR) of total cancer mortality of 4.97 (95% confidence interval (CI) = 1.59–15.50), 4.94 (95% CI = 1.56–15.61), and 3.42 (95% CI = 1.21–15.43) respectively. The risk of total cancer mortality was not associated with increases in blood chloroform and total THM levels. Conclusions: We found that the baseline blood THM species, particularly brominated THMs, were significantly associated with total cancer mortality in adults. Although this study should be confirm by other studies, our findings suggest a possible link between THM exposures and cancer. - Highlights: • Trihalomethanes (THM) are classified as either probable or possible carcinogens. • Limited evidence on the link between THM and the incidence of cancer in humans. • We investigated the association between blood THM levels and the risk of total cancer mortality. • High

  4. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk

    DEFF Research Database (Denmark)

    Sanikini, Harinakshi; Dik, Vincent K; Siersema, Peter D

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site...... and histological type in the EPIC study. Coffee and tea consumption was assessed by dietary questionnaires at baseline. Adjusted hazard ratios (HRs) were calculated using Cox regression models. During 11.6 years of follow up, 683 gastric adenocarcinoma cases were identified among 477,312 participants. We found......) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive...

  5. High dietary protein intake is associated with an increased body weight and total death risk.

    Science.gov (United States)

    Hernández-Alonso, Pablo; Salas-Salvadó, Jordi; Ruiz-Canela, Miguel; Corella, Dolores; Estruch, Ramón; Fitó, Montserrat; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Basora, Josep; Serra-Majem, Lluis; Muñoz, Miguel Ángel; Buil-Cosiales, Pilar; Saiz, Carmen; Bulló, Mònica

    2016-04-01

    High dietary protein diets are widely used to manage overweight and obesity. However, there is a lack of consensus about their long-term efficacy and safety. Therefore, the aim of this study was to assess the effect of long-term high-protein consumption on body weight changes and death outcomes in subjects at high cardiovascular risk. A secondary analysis of the PREDIMED trial was conducted. Dietary protein was assessed using a food-frequency questionnaire during the follow-up. Cox proportional hazard models were used to estimate the multivariate-adjusted hazard ratio (HR) and 95% confidence intervals (95%CI) for protein intake in relation to the risk of body weight and waist circumference changes, cardiovascular disease, cardiovascular death, cancer death and total death. Higher total protein intake, expressed as percentage of energy, was significantly associated with a greater risk of weight gain when protein replaced carbohydrates (HR: 1.90; 95%CI: 1.05, 3.46) but not when replaced fat (HR: 1.69; 95%CI: 0.94, 3.03). However, no association was found between protein intake and waist circumference. Contrary, higher total protein intake was associated with a greater risk of all-cause death in both carbohydrate and fat substitution models (HR: 1.59; 95%CI: 1.08, 2.35; and HR: 1.66; 95%CI: 1.13, 2.43, respectively). A higher consumption of animal protein was associated with an increased risk of fatal and non-fatal outcomes when protein substituted carbohydrates or fat. Higher dietary protein intake is associated with long-term increased risk of body weight gain and overall death in a Mediterranean population at high cardiovascular risk. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Lifetime total and beverage specific - alcohol intake and prostate cancer risk: a case-control study

    Directory of Open Access Journals (Sweden)

    Carruba Giuseppe

    2004-12-01

    Full Text Available Abstract Background We investigated lifetime alcohol consumption and prostate cancer risk in a case-control study conducted in Buffalo, NY (1998–2001. Methods The study included 88 men, aged 45 to 85 years with incident, histologically-confirmed prostate cancer and 272 controls. We conducted extensive in-person interviews regarding lifetime alcohol consumption and other epidemiologic data. Results Prostate cancer risk was not associated with lifetime intake of total and beverage specific ethanol. In addition we found no association with number of drinks per day (average drinks per day over the lifetime or drinks per drinking day (average drinks per day on drinking days only over the lifetime. However, we observed an inverse association with the total number of drinking years. Men in the lowest tertile of total drinking years had a two-fold prostate cancer risk than men in the highest tertile (OR 2.16, 95% CI 0.98–4.78, p for trend Conclusion Our results suggest that alcohol intake distribution across lifetime may play a more important role in prostate cancer etiology than total lifetime consumption.

  7. Osteonecrosis - A rare complication of HIV infection. Association with numerous risk factors

    International Nuclear Information System (INIS)

    Meyer, D.; Behrens, G.; Stoll, M.; Schmidt, R.E.

    2000-01-01

    Osteonecrosis is a rare complication of HIV infection. The presumptive cause of the aseptic osteonecrosis is a disturbed blood supply to the bone. Most cases of osteonecrosis are associated with numerous risk factors, such as use of steroids, alcohol abuse, coagulopathies or metabolic derangements. Since conventional X-rays appear unremarkable, early forms often go unrecognized or are diagnosed late. Methods of establishing the diagnosis are MRI and three-phase skeletal scintigraphy. The pathogenesis of osteonecrosis in HIV infection is unclear. So far, about 30 cases have been reported in the literature. We would recommend that in HIV patients with typical symptoms - in particular when classical risk factors are present - osteonecrosis be included in the differential diagnostic considerations. (orig.) [de

  8. Communicating global cardiovascular risk: are icon arrays better than numerical estimates in improving understanding, recall and perception of risk?

    Science.gov (United States)

    Ruiz, Jorge G; Andrade, Allen D; Garcia-Retamero, Rocio; Anam, Ramanakumar; Rodriguez, Remberto; Sharit, Joseph

    2013-12-01

    Experts recommend that adults have their global cardiovascular risk assessed. We investigated whether icon arrays increase understanding, recall, perception of CVR, and behavioral intent as compared with numerical information. Male outpatient veterans, at an intermediate to high cardiovascular risk participated in a randomized controlled trial of a computer tutorial presenting individualized risk. Message format was presented in 3 formats: percentages, frequencies, and frequencies with icon arrays. We assessed understanding immediately (T1) and recall at 20 min (T2) and 2 weeks (T3) after the intervention. We assessed perceptions of importance/seriousness, intent to adhere, and self-efficacy at T1. Self-reported adherence was assessed at T3. One-hundred and twenty male veterans participated. Age, education, race, health literacy and numeracy were comparable at baseline. There were no differences in understanding at T1 [p = .31] and recall at T3 [p = .10]. Accuracy was inferior with frequencies with icon arrays than percentages or frequencies at T2 [p ≤ .001]. There were no differences in perception of seriousness and importance for heart disease, behavioral intent, self-efficacy, actual adherence and satisfaction. Icon arrays may impair short-term recall of CVR. Icon arrays will not necessarily result in better understanding and recall of medical risk in all patients. Published by Elsevier Ireland Ltd.

  9. Prevalence and risk factors for postoperative delirium in total joint arthroplasty patients: A prospective study.

    Science.gov (United States)

    Chen, Wenliang; Ke, Xiurong; Wang, Xiaoqing; Sun, Xiaoliang; Wang, Juncheng; Yang, Guojing; Xia, Haijie; Zhang, Lei

    2017-05-01

    The aim of this prospective study was to investigate the incidence and clinical features of delirium after total joint arthroplasty, and to establish the potential risk factors for postoperative delirium. A total of 212 consecutive patients undergoing hip or knee arthroplasty, who met the inclusion and exclusive criteria were enrolled. The general characteristics, preoperative and postoperative hematological variables were documented respectively. According to the presence of delirium, all patients were divided into the delirium group and non-delirium group. Univariate and multivariate logistic regression were performed to identify the possible predictors for postoperative delirium. At a minimum of 6months of follow-up, 35 patients were observed with postoperative delirium at an estimated total incidence of 16.5%. The incidence of delirium was statistically higher in hip arthroplasty (22.8%) than that in knee arthroplasty (7.1%). The multivariate regression analysis identified older age (OR=1.590, P=0.023), a history of stroke (OR=190.23, P=0.036), preoperative PaO 2 (OR=1.277, P=0.018) and equivalent fentanyl dose (OR=1.010, P=0.012) as the predictive factors for postoperative delirium after total joint arthroplasty. The incidence of postoperative delirium after total joint arthroplasty is higher than expected. Based on our findings, we suggest that the surgeons should focus on those patients who have these risk factors and ensure the appropriate management to avoid postoperative delirium. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty.

    Science.gov (United States)

    Duque, Andres F; Post, Zachary D; Orozco, Fabio R; Lutz, Rex W; Ong, Alvin C

    2018-04-01

    Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. Our group developed a protocol to identify and prevent delirium in patients undergoing TJA. All patients were screened and scored in the preoperative assessment, on criteria such as age, history of forgetfulness, history of agitation or visual hallucinations, history of falls, history of postoperative confusion, and inability to perform higher brain functions. Patients were scored on performance in a simple mental examination. The patients were classified as low, medium, or high risk. Patients who were identified as high risk were enrolled in a delirium avoidance protocol that minimized narcotics and emphasized nursing involvement and fluids administration. Five of 7659 (0.065%) consecutive TJA patients from 2010 to 2015 developed delirium. A total of 422 patients were identified as high risk. All 5 patients who suffered delirium were within the high risk group. No low or medium risk patients suffered a delirium complication. Three (0.039%) patients suffered drug-induced delirium, 1 (0.013%) had delirium related to alcohol withdrawal, and 1 (0.013%) had delirium after a systemic infection. This protocol is effective in identifying patients at high delirium risk and diminishing the incidence of this complication by utilizing a simple screening tool and perioperative protocol. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Numerical analysis of variations in posterior cruciate ligament properties and balancing techniques on total knee arthroplasty loading.

    NARCIS (Netherlands)

    Zelle, J.; Heesterbeek, P.J.; De Waal Malefijt, M.; Verdonschot, Nicolaas Jacobus Joseph

    2010-01-01

    Total knee arthroplasty (TKA) is a widely used and successful orthopaedic procedure. During TKA, the posterior cruciate ligament (PCL) can either be retained or substituted by a post-cam mechanism. One of the main functions of the PCL is to facilitate femoral rollback during knee flexion. For

  12. Fibrosis-Related Biomarkers and Risk of Total and Cause-Specific Mortality

    Science.gov (United States)

    Agarwal, Isha; Glazer, Nicole L.; Barasch, Eddy; Biggs, Mary L.; Djoussé, Luc; Fitzpatrick, Annette L.; Gottdiener, John S.; Ix, Joachim H.; Kizer, Jorge R.; Rimm, Eric B.; Siscovick, David S.; Tracy, Russell P.; Zieman, Susan J.; Mukamal, Kenneth J.

    2014-01-01

    Fibrosis has been implicated in diverse diseases of the liver, kidney, lungs, and heart, but its importance as a risk factor for mortality remains unconfirmed. We determined the prospective associations of 2 complementary biomarkers of fibrosis, transforming growth factor-β (TGF-β) and procollagen type III N-terminal propeptide (PIIINP), with total and cause-specific mortality risks among community-living older adults in the Cardiovascular Health Study (1996–2010). We measured circulating TGF-β and PIIINP levels in plasma samples collected in 1996 and ascertained the number of deaths through 2010. Both TGF-β and PIIINP were associated with elevated risks of total and pulmonary mortality after adjustment for sociodemographic, clinical, and biochemical risk factors. For total mortality, the hazard ratios per doubling of TGF-β and PIIINP were 1.09 (95% confidence interval (CI): 1.01, 1.17; P = 0.02) and 1.14 (CI: 1.03, 1.27; P = 0.01), respectively. The corresponding hazard ratios for pulmonary mortality were 1.27 (CI: 1.01, 1.60; P = 0.04) for TGF-β and 1.52 (CI: 1.11, 2.10; P = 0.01) for PIIINP. Associations of TGF-β and PIIINP with total and pulmonary mortality were strongest among individuals with higher C-reactive protein concentrations (P for interaction < 0.05). Our findings provide some of the first large-scale prospective evidence that circulating biomarkers of fibrosis measured late in life are associated with death. PMID:24771724

  13. Assessment of Total Risk on Non-Target Organisms in Fungicide Application for Agricultural Sustainability

    Directory of Open Access Journals (Sweden)

    Ali Musa Bozdogan

    2014-02-01

    Full Text Available In Turkey, in 2010, the amount of pesticide (active ingredient; a.i. used in agriculture was about 23,000 metric tons, of which approximately 32% was fungicides. In 2012, 14 a.i. were used for fungus control in wheat cultivation areas in Adana province, Turkey. These a.i. were: azoxystrobin, carbendazim, difenoconazole, epoxiconazole, fluquinconazole, prochloraz, propiconazole, prothioconazole, pyraclostrobin, spiroxamine, tebuconazole, thiophanate-methyl, triadimenol, and trifloxystrobin. In this study, the potential risk of a.i. on non-target organisms in fungicide application of wheat cultivation was assessed by The Pesticide Occupational and Environmental Risk (POCER indicators. In this study, the highest human health risk was for fluquinconazole (Exceedence Factor (EF 1.798 for human health, whereas the fungicide with the highest environmental risk was propiconazole (EF 2.000 for the environment. For non-target organisms, the highest potential risk was determined for propiconazole when applied at 0.1250 kg a.i. ha-1 (EF 2.897. The lowest total risk was for azoxystrobin when applied at  0.0650 kg a.i. ha-1 (EF 0.625.

  14. Dislocation of primary total hip arthroplasty and the risk of redislocation.

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

    6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).

  15. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

    Science.gov (United States)

    Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

    2007-09-01

    We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

  16. Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

    DEFF Research Database (Denmark)

    Schrama, Johannes Cornelis; Fenstad, Anne M; Dale, Håvard

    2015-01-01

    Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

  17. Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

    Science.gov (United States)

    Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

    2017-07-01

    Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P 3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

    Science.gov (United States)

    Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

    2012-12-01

    Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  19. Total Probability of Collision as a Metric for Finite Conjunction Assessment and Collision Risk Management

    Science.gov (United States)

    Frigm, Ryan C.; Hejduk, Matthew D.; Johnson, Lauren C.; Plakalovic, Dragan

    2015-01-01

    On-orbit collision risk is becoming an increasing mission risk to all operational satellites in Earth orbit. Managing this risk can be disruptive to mission and operations, present challenges for decision-makers, and is time-consuming for all parties involved. With the planned capability improvements to detecting and tracking smaller orbital debris and capacity improvements to routinely predict on-orbit conjunctions, this mission risk will continue to grow in terms of likelihood and effort. It is very real possibility that the future space environment will not allow collision risk management and mission operations to be conducted in the same manner as it is today. This paper presents the concept of a finite conjunction assessment-one where each discrete conjunction is not treated separately but, rather, as a continuous event that must be managed concurrently. The paper also introduces the Total Probability of Collision as an analogous metric for finite conjunction assessment operations and provides several options for its usage in a Concept of Operations.

  20. Diabetes Mellitus and Hyperglycemia and the Risk of Aseptic Loosening in Total Joint Arthroplasty.

    Science.gov (United States)

    Maradit Kremers, Hilal; Schleck, Cathy D; Lewallen, Eric A; Larson, Dirk R; Van Wijnen, Andre J; Lewallen, David G

    2017-09-01

    It is unknown to what extent diabetes mellitus modifies the long-term risk of aseptic loosening in total hip arthroplasty (THA) and total knee arthroplasty (TKA). We examined the association between diabetes mellitus, perioperative hyperglycemia, and the likelihood of revisions for aseptic loosening. We studied 16,085 primary THA and TKA procedures performed at a large tertiary care hospital between 2002 and 2009. All blood glucose values around the time of surgery (within 1 week) were retrieved. Subsequent revision surgeries and the reasons for revision were ascertained through the institutional joint registry. Multivariate Cox models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for aseptic loosening associated with diabetes mellitus and hyperglycemia adjusting for age, gender, body mass index, and surgery type. A total of 2911 (18%) surgeries had a diagnosis of diabetes mellitus at the time of surgery. Glucose testing was performed at least once in 7055 (44%) procedures within ±1 week of surgery. Although diabetic patients did not experience a higher risk of revision for aseptic loosening (HR, 0.87; 95% CI, 0.55-1.38), higher preoperative glucose values on the day before surgery were significantly associated with both the overall risk of revisions (HR, 2.80; 95% CI, 1.00-7.85) and revisions for aseptic loosening (HR, 4.95; 95% CI, 1.26-19.54). High preoperative hyperglycemia is a potential risk factor for aseptic loosening in THA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Assessment of risk factors in radionuclides pollution of coastal zone and river basins by numerical modelling

    International Nuclear Information System (INIS)

    Tsitskishvili, M.; Tsitskishvili, L.; Kordzakhia, G.; Diasamidze, R.; Shaptoshvili, A.; Valiaev, A.

    2006-01-01

    Full text: All types of industrial activities require the norms of protection, assessment of corresponding risks to preserve the pollution and degradation of corresponding areas. To make available the sustainable development of the country the risk assessment of possible accidents on the big enterprises is foreseen that provides preparedness of the country and possibility of the prevention measures and mitigation of the accidents. While big anthropogenic accidents in mountainous countries - the main paths for transportation of the pollution are the rivers and sea basins. Due to overpopulation of these areas assessment of the pollution risks are very important. For this aim the special deterministic models on the basis of passive admixture's turbulence diffusion equation is used. For numerical calculations Mc Kormack's predictor-corrector two steps scheme is used. The scheme is disintegrated, second order in space and time. Such scheme is established because the turbulent velocities very differ in horizontal and vertical directions and model allows implementing singular independent steps in different directions. Grid step for the model is 26.88 km in horizontal direction and 20 m m in vertical until 200 m. Time step is equal to 4 hours and computational time period - 4 months. Number of grid points is equal to 4983 for all calculation areas. Computations are carried out separately for big rivers basins as well as for Black and Caspian Seas water areas. The model calculations are made for cases with various locations of pollutant sources including accidental throws. For different realistic scenarios are calculated the concentrations of admixtures. The directions of their propagation are also determined. The risks are calculated in comparison with the Maximum Permissible Concentrations (MPC) of the pollutants according to achieved results. That gives possibility to define the most vulnerable areas in coastal zones. Realized methodology is verified by means of various

  2. Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

    Science.gov (United States)

    Costa, Jamille Oliveira; Vásquez, Cecília M Passos; Santana, Gleiciane de Jesus; Silva, Natanael de Jesus; Braz, Juciene de Matos; Jesus, Amélia M Ribeiro de; Silva, Danielle Góes da; Cunha, Luana Celina Seraphim; Barbosa, Kiriaque Barra Ferreira

    2017-07-10

    The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum

  3. Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

    Science.gov (United States)

    Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

    2018-04-01

    As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Incidence, Risk Factors, and Clinical Implications of Pneumonia Following Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Bohl, Daniel D; Saltzman, Bryan M; Sershon, Robert A; Darrith, Brian; Okroj, Kamil T; Della Valle, Craig J

    2017-06-01

    The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia following total joint arthroplasty (TJA). The American College of Surgeons National Surgical Quality Improvement Program was used to conduct a retrospective cohort study of patients undergoing TJA. Independent risk factors for the development of pneumonia within 30 days of TJA were identified using multivariate regression. Mortality and readmission rates were compared between patients who did and did not develop pneumonia. Multivariate regression was used to adjust for all demographic, comorbidity, and procedural characteristics. In total, 171,200 patients met inclusion criteria, of whom 66,493 (38.8%) underwent THA and 104,707 (61.2%) underwent TKA. Of the 171,200 patients, 590 developed pneumonia, yielding a rate of 0.34% (95% confidence interval = 0.32%-0.37%). Independent risk factors for pneumonia were chronic obstructive pulmonary disease, diabetes mellitus, greater age (most notably ≥80 years), dyspnea on exertion, dependent functional status, lower body mass index, hypertension, current smoker status, and male sex. The subset of patients who developed pneumonia following discharge had a higher readmission rate (82.1% vs 3.4%, adjusted relative risk [RR] = 16.6, P pneumonia. Pneumonia is a serious complication following TJA that occurs in approximately 1 in 300 patients. Approximately 4 in 5 patients who develop pneumonia are subsequently readmitted, and approximately 1 in 25 die. Given the serious implications of this complication, evidence-based pneumonia prevention programs including oral hygiene with chlorhexidine, sitting upright for meals, elevation of the head of the bed to at least 30°, aggressive incentive spirometry, and early ambulation should be considered for patients at greatest risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Cancer risk estimates from radiation therapy for heterotopic ossification prophylaxis after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Mazonakis, Michalis; Berris, Theoharris; Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Lyraraki, Efrossyni [Department of Radiotherapy and Oncology, University Hospital of Iraklion, 71110 Iraklion, Crete (Greece)

    2013-10-15

    Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. This study was conducted to calculate the radiation dose to organs-at-risk and estimate the probability of cancer induction from radiotherapy for HO prophylaxis.Methods: Hip irradiation for HO with a 6 MV photon beam was simulated with the aid of a Monte Carlo model. A realistic humanoid phantom representing an average adult patient was implemented in Monte Carlo environment for dosimetric calculations. The average out-of-field radiation dose to stomach, liver, lung, prostate, bladder, thyroid, breast, uterus, and ovary was calculated. The organ-equivalent-dose to colon, that was partly included within the treatment field, was also determined. Organ dose calculations were carried out using three different field sizes. The dependence of organ doses upon the block insertion into primary beam for shielding colon and prosthesis was investigated. The lifetime attributable risk for cancer development was estimated using organ, age, and gender-specific risk coefficients.Results: For a typical target dose of 7 Gy, organ doses varied from 1.0 to 741.1 mGy by the field dimensions and organ location relative to the field edge. Blocked field irradiations resulted in a dose range of 1.4–146.3 mGy. The most probable detriment from open field treatment of male patients was colon cancer with a high risk of 564.3 × 10{sup −5} to 837.4 × 10{sup −5} depending upon the organ dose magnitude and the patient's age. The corresponding colon cancer risk for female patients was (372.2–541.0) × 10{sup −5}. The probability of bladder cancer development was more than 113.7 × 10{sup −5} and 110.3 × 10{sup −5} for males and females, respectively. The cancer risk range to other individual organs was reduced to (0.003–68.5) × 10{sup −5}.Conclusions: The risk for cancer induction from radiation therapy for HO prophylaxis after total hip arthroplasty varies considerably by

  6. Cancer risk estimates from radiation therapy for heterotopic ossification prophylaxis after total hip arthroplasty

    International Nuclear Information System (INIS)

    Mazonakis, Michalis; Berris, Theoharris; Damilakis, John; Lyraraki, Efrossyni

    2013-01-01

    Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. This study was conducted to calculate the radiation dose to organs-at-risk and estimate the probability of cancer induction from radiotherapy for HO prophylaxis.Methods: Hip irradiation for HO with a 6 MV photon beam was simulated with the aid of a Monte Carlo model. A realistic humanoid phantom representing an average adult patient was implemented in Monte Carlo environment for dosimetric calculations. The average out-of-field radiation dose to stomach, liver, lung, prostate, bladder, thyroid, breast, uterus, and ovary was calculated. The organ-equivalent-dose to colon, that was partly included within the treatment field, was also determined. Organ dose calculations were carried out using three different field sizes. The dependence of organ doses upon the block insertion into primary beam for shielding colon and prosthesis was investigated. The lifetime attributable risk for cancer development was estimated using organ, age, and gender-specific risk coefficients.Results: For a typical target dose of 7 Gy, organ doses varied from 1.0 to 741.1 mGy by the field dimensions and organ location relative to the field edge. Blocked field irradiations resulted in a dose range of 1.4–146.3 mGy. The most probable detriment from open field treatment of male patients was colon cancer with a high risk of 564.3 × 10 −5 to 837.4 × 10 −5 depending upon the organ dose magnitude and the patient's age. The corresponding colon cancer risk for female patients was (372.2–541.0) × 10 −5 . The probability of bladder cancer development was more than 113.7 × 10 −5 and 110.3 × 10 −5 for males and females, respectively. The cancer risk range to other individual organs was reduced to (0.003–68.5) × 10 −5 .Conclusions: The risk for cancer induction from radiation therapy for HO prophylaxis after total hip arthroplasty varies considerably by the treatment parameters, organ

  7. Risk and Cost of 90-Day Complications in Morbidly and Superobese Patients After Total Knee Arthroplasty.

    Science.gov (United States)

    Meller, Menachem M; Toossi, Nader; Johanson, Norman A; Gonzalez, Mark H; Son, Min-Sun; Lau, Edmund C

    2016-10-01

    This study investigated the risk and cost of postoperative complications associated with morbid and super obesity after total knee arthroplasty (TKA). A retrospective cohort study was conducted of patients who underwent TKA using Medicare hospital claims data. The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code V85.4x was used to identify morbidly obese patients (body mass index [BMI] ≥40 kg/m(2)) and superobese patients (BMI ≥50 kg/m(2)) in 2011-2013. Patients without any BMI-related diagnosis codes were used as controls. Twelve complications occurred in the 90-day period after TKA were analyzed using multivariate Cox models, adjusting for patient demographic, morbidity, and institutional factors. In addition, hospital charges and payments were compared from primary surgery through subsequent 90 days. Morbidly obese patients showed a significantly elevated risk in most complications examined, with a 2-fold or higher risk in dislocation and wound dehiscence. In addition, death, periprosthetic joint infection, acute renal failure, and knee revision had significant hazard ratios between 1.5 and 2.0. However, risk of deep vein thrombosis and acute myocardial infarction did not increase for the morbidly obese patients. Superobese patients had significant increase in risk of infection, wound dehiscence, acute renal failures, revisions, death, and readmission compared with patients with BMI 40-49 kg/m(2). Significant dose-response trend was found between the level of BMI and risk for death, dislocation, implant failure, infection, readmission, revision, wound dehiscence, and acute renal failure. Controlling for patient and institutional factors, each TKA had an average total hospital charges of $75,884 among superobese patients, compared to $65,118 for the control group, a difference of $10,767. Medicare payment for the superobese patients was also higher, but only by $2703. Morbidly obese patients pose a significantly

  8. Progressive risk assessment of polychlorinated biphenyls through a Total Diet Study in the Korean population

    International Nuclear Information System (INIS)

    Shin, Eun-su; Nguyen, Khanh-Hoang; Kim, Jongchul; Kim, Cho-il; Chang, Yoon-Seok

    2015-01-01

    Human exposure to polychlorinated biphenyls (PCBs) from foods was investigated through a Total Diet Study (TDS) for the first time in Korea. A representative food list was developed from food intake data. Non-selected foods were also included in the TDS through the mapping process to anticipate practical risk assessment. For better representativeness, data (2008–2011) from the Korea National Health and Nutrition Examination Survey (KNHANES) were combined with the TDS data set. And also, we estimated the dietary exposure to PCBs from various food items using a ‘best-fit’ mapping process and assessed the differences in PCB exposures by sex and age. In this study, we examined total PCBs (62 congeners) including dioxin-like PCBs (DL-PCBs) and indicator PCBs, which are congeners that are mainly detected in various environmental matrices. The average dietary exposure (3.94 ng/kg body weight/day) that was estimated through food intake was 19.7% of the World Health Organization (WHO) recommendation. - Highlights: • A total of 282 samples, composed of the most consumed foodstuffs in Korea, were analysed and shown in detail. • The contamination status of total PCBs in food was assessed, through their various condition on cooking methods. • The dietary intakes of PCBs in various food groups were estimated in different region, gender and age groups. • The improved and systematic food selection process was applied such as ‘mapping process’. - This study is to ensure food safety through total analysis of PCBs with the improved risk assessment method.

  9. Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy.

    Science.gov (United States)

    Hata, Tatsuo; Ishida, Masaharu; Motoi, Fuyuhiko; Sakata, Naoaki; Yoshimatsu, Gumpei; Naitoh, Takeshi; Katayose, Yu; Egawa, Shinichi; Unno, Michiaki

    2016-03-01

    The occurrence of hepatic steatosis after pancreatectomy is known to be associated with the remnant pancreatic function. However, other risk factors for hepatic steatosis after pancreatectomy remain unknown. The aims of this study were to identify other risk factors in addition to the remnant pancreatic function and elucidate the relationship between postoperative hepatic steatosis and pancreatic exocrine insufficiency in totally pancreatomized patients. Forty-three patients who underwent total pancreatectomy were analyzed. Hepatic steatosis was defined as the attenuation of unenhanced computed tomography values. Clinical findings and laboratory data were compared between patients with and without hepatic steatosis. Sixteen (37.2%) patients developed hepatic steatosis after total pancreatectomy, with marked declines in the Controlling Nutritional Status score and body mass index. Multiple linear regression analysis revealed that the attenuation of computed tomography values was correlated with female sex (P = 0.002), early postoperative serum albumin levels (P = 0.003), and pancreatic enzyme replacement therapy with high-dose pancrelipase (P = 0.032). Postoperative hepatic steatosis after pancreatectomy is associated with sex, malnutrition, and pancreatic exocrine insufficiency. High-dose pancreatic enzyme replacement therapy may have preventive effects on hepatic steatosis occurring after pancreatectomy.

  10. A probabilistic approach for debris impact risk with numerical simulations of debris behaviors

    International Nuclear Information System (INIS)

    Kihara, Naoto; Matsuyama, Masafumi; Fujii, Naoki

    2013-01-01

    We propose a probabilistic approach for evaluating the impact risk of tsunami debris through Monte Carlo simulations with a combined system comprising a depth-averaged two-dimensional shallow water model and a discrete element model customized to simulate the motions of floating objects such as vessels. In the proposed method, first, probabilistic tsunami hazard analysis is carried out, and the exceedance probability of tsunami height and numerous tsunami time series for various hazard levels on the offshore side of a target site are estimated. Second, a characteristic tsunami time series for each hazard level is created by cluster analysis. Third, using the Monte Carlo simulation model the debris impact probability with the buildings of interest and the exceedance probability of debris impact speed are evaluated. (author)

  11. Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement.

    Science.gov (United States)

    Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W

    2017-10-01

    Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.

  12. SYNERGISTIC EFFECTS OF TOTAL QUALITY MANAGEMENT AND OPERATIONAL RISK MANAGEMENT IN CENTRAL BANKS

    Directory of Open Access Journals (Sweden)

    Radoica Luburić

    2012-12-01

    Full Text Available This paper focuses on two very important and current approaches to management: Total Quality Management (TQM and Operational Risk Management (ORM. As a paradigm of business success, TQM provides the key assumptions for survival, development and success of an organisation, regardless of any limitations whatsoever. ORM, on the other hand, is predetermined to be an irreplaceable managerial tool that enables organisations to survive in any environment. In times of accelerated political, economic and technological changes, frequent natural disasters, acts of terrorism and other external events, a successful risk management has been gaining importance and becomes one of the key competitive advantages of an organisation. The ultimate objective is to make TQM and ORM, as two rather compatible and complementary approaches to risk management, harmonized, efficient and functional in order to get their synergistic effects in an organisation in full swing and practice. Various organisations, and thus central banks as conservative institutions, have an innovative opportunity to timely minimize their operational risk through preventive, comprehensive and synergistic operation of TQM and ORM and thus significantly contribute to improving their business performance.

  13. Less Than Total Excision of Infected Prosthetic PTFE Graft Does Not Increase the Risk of Reinfection.

    Science.gov (United States)

    Sgroi, Michael D; Kirkpatrick, Vincent E; Resnick, Karen A; Williams, Russell A; Wilson, Samuel E; Gordon, Ian L

    2015-01-01

    Traditional treatment of infected polytetrafluoroethylene (PTFE) grafts consist of removal of the entire prosthesis. Closure of the native vessels may compromise vascular patency. We examined the outcomes for patients in whom a PTFE remnant of an infected graft was retained on the vessel. We reviewed the operating room log from 2000 to 2011 and identified all patients who had partial removal of an infected PTFE graft used for hemodialysis or peripheral bypass. These patients were examined for subsequent complications. Twenty-seven patients underwent 30 partial graft excisions with mean follow-up of 27 months. A total of 17% (5 of 30) of the partial graft resection procedures resulted in complications. Of 48 total remnants left behind at the arterial or venous anastomoses, reinfection occurred in 15%. Leaving a well-incorporated small 1-to 5-mm PTFE remnant at the arterial or venous anastomoses can be performed safely with a low risk of complications. © The Author(s) 2015.

  14. Genetic Schizophrenia Risk Variants Jointly Modulate Total Brain and White Matter Volume

    DEFF Research Database (Denmark)

    Terwisscha van Scheltinga, Afke F; Bakker, Steven C; van Haren, Neeltje E M

    2013-01-01

    with total brain volume (R(2)=.048, p=1.6×10(-4)) and white matter volume (R(2)=.051, p=8.6×10(-5)) equally in patients and control subjects. The number of (independent) SNPs that substantially influenced both disease risk and white matter (n=2020) was much smaller than the entire set of SNPs that modulated...... modulating schizophrenia and brain volume. METHODS: Odds ratios for genome-wide SNP data were calculated in the sample collected by the Psychiatric Genome-wide Association Study Consortium (8690 schizophrenia patients and 11,831 control subjects, excluding subjects from the present study). These were used...

  15. Levels of plasma selenium and urinary total arsenic interact to affect the risk for prostate cancer.

    Science.gov (United States)

    Hsueh, Yu-Mei; Su, Chien-Tien; Shiue, Horng-Sheng; Chen, Wei-Jen; Pu, Yeong-Shiau; Lin, Ying-Chin; Tsai, Cheng-Shiuan; Huang, Chao-Yuan

    2017-09-01

    This study investigated whether plasma selenium levels modified the risk for prostate cancer (PC) related to arsenic exposure. We conducted a case-control study that included 318 PC patients and 318 age-matched, healthy control subjects. Urinary arsenic profiles were examined using HPLC-HG-AAS and plasma selenium levels were measured by ICP-MS. We found that plasma selenium levels displayed a significant dose-dependent inverse association with PC. The odds ratio (OR) and 95% confidence interval (CI) for PC was 0.07 (0.04-0.13) among participants with a plasma selenium level >28.06 μg/dL vs. ≤19.13 μg/dL. A multivariate analysis showed that participants with a urinary total arsenic concentration >29.28 μg/L had a significantly higher OR (1.75, 1.06-2.89) for PC than participants with ≤29.89 μg/L. The combined presence of a low plasma selenium level and a high urinary total arsenic concentration exponentially increased the OR for PC, and additively interacted with PSA at levels ≥20 ng/mL. This is the first epidemiological study to examine the combined effects of plasma selenium and urinary total arsenic levels on the OR for PC. Our data suggest a low plasma selenium level coupled with a high urinary total arsenic concentration creates a significant risk for aggressive PC. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

    International Nuclear Information System (INIS)

    Kelsey, Chris R.; Horwitz, Mitchell E.; Chino, Junzo P.; Craciunescu, Oana; Steffey, Beverly; Folz, Rodney J.; Chao, Nelson J.; Rizzieri, David A.; Marks, Lawrence B.

    2011-01-01

    Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

  17. Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Burns LC

    2015-01-01

    Full Text Available Lindsay C Burns,1–3 Sarah E Ritvo,1 Meaghan K Ferguson,1 Hance Clarke,3–5 Ze’ev Seltzer,3,5 Joel Katz1,3–5 1Department of Psychology, York University, Toronto, ON, Canada; 2Arthritis Research Centre of Canada, Vancouver, BC, Canada; 3Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 4Department of Anesthesia, University of Toronto, Toronto, ON, Canada; 5Centre for the Study of Pain, Faculties of Dentistry and Medicine, University of Toronto, Toronto, ON, Canada Background: Total knee arthroplasty (TKA is a common and costly surgical procedure. Despite high success rates, many TKA patients develop chronic pain in the months and years following surgery, constituting a public health burden. Pain catastrophizing is a construct that reflects anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain vis-à-vis health implications, and a sense of helplessness regarding pain. Recent research suggests that it may be an important risk factor for untoward TKA outcomes. To clarify this impact, we systematically reviewed the literature to date on pain catastrophizing as a prospective predictor of chronic pain following TKA. Methods: We searched MEDLINE, EMBASE, and PsycINFO databases to identify articles related to pain catastrophizing, TKA, risk models, and chronic pain. We reviewed titles and abstracts to identify original research articles that met our specified inclusion criteria. Included articles were then rated for methodological quality. including methodological quality. Due to heterogeneity in follow-up, analyses, and outcomes reported across studies, a quantitative meta-analysis could not be performed. Results: We identified six prospective longitudinal studies with small-to-mid-sized samples that met the inclusion criteria. Despite considerable variability in reported pain outcomes, pain catastrophizing was identified as a significant

  18. The role of risk-based prioritization in total quality management

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.T.

    1994-10-01

    The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approach - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.

  19. Can an arthroplasty risk score predict bundled care events after total joint arthroplasty?

    Directory of Open Access Journals (Sweden)

    Blair S. Ashley, MD

    2018-03-01

    Full Text Available Background: The validated Arthroplasty Risk Score (ARS predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS, discharge disposition, and episode-of-care cost (EOCC. Methods: We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patient characteristics, 90-day EOCC, LOS, and readmission rates were compared before and after ARS implementation. Results: ARS implementation was associated with fewer patients going to a skilled nursing or rehabilitation facility after discharge (63% vs 74%, P = .002. There was no difference in LOS, EOCC, readmission rates, or complications. While the adoption of the ARS did not change the mean EOCC, ARS >3 was predictive of high EOCC outlier (odds ratio 2.65, 95% confidence interval 1.40-5.01, P = .003. Increased ARS correlated with increased EOCC (P = .003. Conclusions: Implementation of the ARS was associated with increased disposition to home. It was predictive of high EOCC and should be considered in risk adjustment variables in alternative payment models. Keywords: Bundled payments, Risk stratification, Arthroplasty

  20. Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones.

    Science.gov (United States)

    Ferraro, Pietro Manuel; Curhan, Gary C; Gambaro, Giovanni; Taylor, Eric N

    2016-03-01

    Previous studies of vitamin C and kidney stones were conducted mostly in men and either reported disparate results for supplemental and dietary vitamin C or did not examine dietary vitamin C. Prospective cohort analysis. 156,735 women in the Nurses' Health Study (NHS) I and II and 40,536 men in the Health Professionals Follow-up Study (HPFS). Total, dietary, and supplemental vitamin C intake, adjusted for age, body mass index, thiazide use, and dietary factors. Incident kidney stones. During a median follow-up of 11.3 to 11.7 years, 6,245 incident kidney stones were identified. After multivariable adjustment, total vitamin C intake (vitamin C intake for the 500- to 999-mg/d category was ∼700mg/d. Supplemental vitamin C intake (no use [reference], vitamin C intake was not associated with stones among men or women, although few participants had dietary intakes > 700mg/d. Nutrient intakes derived from food-frequency questionnaires, lack of data on stone composition for all cases. Total and supplemental vitamin C intake was significantly associated with higher risk for incident kidney stones in men, but not in women. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  1. Incidence and Risk Factors for Blood Transfusion in Total Joint Arthroplasty: Analysis of a Statewide Database.

    Science.gov (United States)

    Slover, James; Lavery, Jessica A; Schwarzkopf, Ran; Iorio, Richard; Bosco, Joseph; Gold, Heather T

    2017-09-01

    Significant attempts have been made to adopt practices to minimize blood transfusion after total joint arthroplasty (TJA) because of transfusion cost and potential negative clinical consequences including allergic reactions, transfusion-related lung injuries, and immunomodulatory effects. We aimed to evaluate risk factors for blood transfusion in a large cohort of TJA patients. We used the all-payer California Healthcare Cost and Utilization Project data from 2006 to 2011 to examine the trends in utilization of blood transfusion among arthroplasty patients (n = 320,746). We performed descriptive analyses and multivariate logistic regression clustered by hospital, controlling for Deyo-Charlson comorbidity index, age, insurance type (Medicaid vs others), gender, procedure year, and race/ethnicity. Eighteen percent (n = 59,038) of TJA patients underwent blood transfusion during their surgery, from 15% with single knee to 45% for bilateral hip arthroplasty. Multivariate analysis indicated that compared with the referent category of single knee arthroplasty, single hip had a significantly higher odds of blood transfusion (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.68-1.83), as did bilateral knee (OR, 3.57; 95% CI, 3.20-3.98) and bilateral hip arthroplasty (OR, 6.17; 95% CI, 4.85-7.85). Increasing age (eg, age ≥80 years; OR, 2.99; 95% CI, 2.82-3.17), Medicaid insurance (OR, 1.36; 95% CI, 1.27-1.45), higher comorbidity index (eg, score of ≥3; OR, 2.33; 95% CI, 2.22-2.45), and females (OR, 1.75; 95% CI, 1.70-1.80) all had significantly higher odds of blood transfusion after TJA. Primary hip arthroplasties have significantly greater risk of transfusion than knee arthroplasties, and bilateral procedures have even greater risk, especially for hips. These factors should be considered when evaluating the risk for blood transfusions. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The carcinogenic risk of high dose total body irradiation in non-human primates

    International Nuclear Information System (INIS)

    Broerse, J.J.; Bartstra, R.W.; Bekkum, D.W. van; Hage, M.H. van der; Zurcher, C.; Zwieten, M.J. van; Hollander, C.F.

    2000-01-01

    High dose total body irradiation (TBI) in combination with chemotherapy, followed by rescue with bone marrow transplantation (BMT), is increasingly used for the treatment of haematological malignancies. With the increasing success of this treatment and its current introduction for treating refractory autoimmune diseases the risk of radiation carcinogenesis is of growing concern. Studies on turnout induction in non-human primates are of relevance in this context since the response of this species to radiation does not differ much from that in man. Since the early sixties, studies have been performed on acute effects in Rhesus monkeys and the protective action of bone marrow transplantation after irradiation with X-rays (average total body dose 6.8 Gy) and fission neutrons (average dose 3.4 Gy). Of those monkeys, which were irradiated and reconstituted with autologous bone marrow, 20 animals in the X-irradiated group and nine animals in the neutron group survived more than 3 years. A group of 21 non-irradiated Rhesus monkeys of a comparable age distribution served as controls. All animals were regularly screened for the occurrence of neoplasms. Complete necropsies were performed after natural death or euthanasia. At post-irradiation intervals of 4-21 years an appreciable number of tumours was observed. In the neutron irradiated group eight out of nine animals died with one or more malignant tumours. In the X-irradiated group this fraction was 10 out of 20. The tumours in the control group, in seven out of the 21 animals, appeared at much older a-e compared with those in the irradiated cohorts. The histogenesis of the tumours was diverse with a preponderance of renal carcinoma, sarcomas among which osteosarcormas, and malignant glomus tumours in the irradiated groups. When corrected for competing risks, the carcinogenic risk of TBI in the Rhesus monkeys is similar to that derived from the studies of the Japanese atomic bomb survivors. The increase of the risk by a

  3. Daily total physical activity level and total cancer risk in men and women: results from a large-scale population-based cohort study in Japan.

    Science.gov (United States)

    Inoue, Manami; Yamamoto, Seiichiro; Kurahashi, Norie; Iwasaki, Motoki; Sasazuki, Shizuka; Tsugane, Shoichiro

    2008-08-15

    The impact of total physical activity level on cancer risk has not been fully clarified, particularly in non-Western, relatively lean populations. The authors prospectively examined the association between daily total physical activity (using a metabolic equivalents/day score) and subsequent cancer risk in the Japan Public Health Center-based Prospective Study. A total of 79,771 general-population Japanese men and women aged 45-74 years who responded to a questionnaire in 1995-1999 were followed for total cancer incidence (4,334 cases) through 2004. Compared with subjects in the lowest quartile, increased daily physical activity was associated with a significantly decreased risk of cancer in both sexes. In men, hazard ratios for the second, third, and highest quartiles were 1.00 (95% confidence interval (CI): 0.90, 1.11), 0.96 (95% CI: 0.86, 1.07), and 0.87 (95% CI: 0.78, 0.96), respectively (p for trend = 0.005); in women, hazard ratios were 0.93 (95% CI: 0.82, 1.05), 0.84 (95% CI: 0.73, 0.96), and 0.84 (95% CI: 0.73, 0.97), respectively (p for trend = 0.007). The decreased risk was more clearly observed in women than in men, especially among the elderly and those who regularly engaged in leisure-time sports or physical exercise. By site, decreased risks were observed for cancers of the colon, liver, and pancreas in men and for cancer of the stomach in women. Increased daily physical activity may be beneficial in preventing cancer in a relatively lean population.

  4. Acetabular cup position and risk of dislocation in primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik

    2017-01-01

    Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We performed...... a systematic review to describe the different methods for measuring cup placement, target zones for cup positioning, and the association between cup positioning and dislocation following primary THA. Methods - A systematic search of literature in the PubMed database was performed (January and February 2016......) to identify articles that compared acetabular cup positioning and the risk of dislocation. Surgical approach and methods for measurement of cup angles were also considered. Results - 28 articles were determined to be relevant to our research question. Some articles demonstrated that cup positioning influenced...

  5. [Risk factors for elevated serum total bile acid in preterm infants].

    Science.gov (United States)

    Song, Yan-Ting; Wang, Yong-Qin; Zhao, Yue-Hua; Zhu, Hai-Ling; Liu, Qian; Zhang, Xiao; Gao, Yi-Wen; Zhang, Wei-Ye; Sang, Yu-Tong

    2018-03-01

    To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (PTBA in preterm infants. Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.

  6. Oil characterisation: assessment of composition, risks, degradation and remediation potential of total petroleum hydrocarbons in soil

    International Nuclear Information System (INIS)

    Lookman, R.; Vanermen, G.; Van De Weghe, H.; Gemoets, J.; Van der Sterren, G.; Alphenaar, A.

    2005-01-01

    Several methods are available for the characterization of petroleum hydrocarbons. The TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based on a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). This method was mainly developed for assessing human risks of oil compounds. Within NOBIS (Dutch Research program Biological In-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes that are relevant for assessing the remediation potential of the specific oil pollution. In this paper we present results of a research project in which we developed a new method, the 'OK-method' that combines these two procedures and allows a complete characterisation of the oil in terms of composition, (human) risks, volatility, solubility, plume behaviour (migration velocities of the soluble components) and aerobic degradation potential. (authors)

  7. Oil characterisation: assessment of composition, risks, degradation and remediation potential of total petroleum hydrocarbons in soil

    Energy Technology Data Exchange (ETDEWEB)

    Lookman, R.; Vanermen, G.; Van De Weghe, H.; Gemoets, J. [Vito, Mol (Belgium); Van der Sterren, G.; Alphenaar, A. [TTE, Deventer (Netherlands)

    2005-07-01

    Several methods are available for the characterization of petroleum hydrocarbons. The TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based on a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). This method was mainly developed for assessing human risks of oil compounds. Within NOBIS (Dutch Research program Biological In-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes that are relevant for assessing the remediation potential of the specific oil pollution. In this paper we present results of a research project in which we developed a new method, the 'OK-method' that combines these two procedures and allows a complete characterisation of the oil in terms of composition, (human) risks, volatility, solubility, plume behaviour (migration velocities of the soluble components) and aerobic degradation potential. (authors)

  8. Risk of contralateral avascular necrosis (AVN) after total hip arthroplasty (THA) for non-traumatic AVN.

    Science.gov (United States)

    Goker, Berna; Block, Joel A

    2006-01-01

    The risk of developing bilateral disease progressing to total hip arthroplasty (THA) among patients who undergo unilateral THA for non-traumatic avascular necrosis (AVN) remains poorly understood. An analysis of the time-course to contralateral THA, as well as the effects of underlying AVN risk factors, is presented. Forty-seven consecutive patients who underwent THA for AVN were evaluated. Peri-operative and annual post-operative antero-posterior pelvis radiographs were examined for evidence of contralateral involvement. Patient age, weight, height, underlying AVN risk factor(s), date of onset of contralateral hip pain if occurred, and date of contralateral THA if performed, were recorded. Bone scan, computerized tomography and magnetic resonance imaging data were utilized when available. Twenty-one patients (46.6%) underwent contralateral THA for AVN within a median of 9 months after the initial THA (range 0-93, interquartile range 28.5 months). The median follow-up for patients without contralateral THA was 75 months (range 3-109, interquartile range 69 months). Thirty-four patients had radiographic findings of contralateral AVN at study entry; 25 were symptomatic bilaterally at entry and 7 developed contralateral symptoms within a mean time of 12 months (median 10 months, interquartile range 12 months). None of the 13 patients who were free of radiographic evidence of contralateral AVN at study entry developed evidence of AVN during the follow-up. AVN associated with glucocorticoid use was more likely to manifest as bilateral disease than either idiopathic AVN or ethanol-associated AVN (P=0.02 and P=0.03 respectively). Radiographically-evident AVN in the contralateral hip at THA is unlikely to remain asymptomatic for a prolonged period of time. Conversely, asymptomatic contralateral hips without radiographic evidence of AVN are unlikely to develop clinically significant AVN.

  9. Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

    Science.gov (United States)

    Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

    2017-06-01

    Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Liye Liu

    2016-01-01

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

  11. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    International Nuclear Information System (INIS)

    Li, Richard; Polishchuk, Alexei; DuBois, Steven; Hawkins, Randall; Lee, Stephanie W.; Bagatell, Rochelle; Shusterman, Suzanne; Hill-Kayser, Christine; Al-Sayegh, Hasan; Diller, Lisa; Haas-Kogan, Daphne A.; Matthay, Katherine K.; London, Wendy B.

    2017-01-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  12. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Richard [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Polishchuk, Alexei [School of Medicine, University of California San Francisco, San Francisco, California (United States); DuBois, Steven [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hawkins, Randall [School of Medicine, University of California San Francisco, San Francisco, California (United States); Lee, Stephanie W. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bagatell, Rochelle [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Shusterman, Suzanne [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hill-Kayser, Christine [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Al-Sayegh, Hasan [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Diller, Lisa [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Haas-Kogan, Daphne A. [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Matthay, Katherine K. [School of Medicine, University of California San Francisco, San Francisco, California (United States); London, Wendy B. [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); and others

    2017-02-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  13. Low-dose total skin electron beam therapy for cutaneous lymphoma : Minimal risk of acute toxicities.

    Science.gov (United States)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor

    2017-12-01

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T‑cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses.

  14. Psychological factors as risk factors for poor hip function after total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Benditz A

    2017-02-01

    Full Text Available Achim Benditz,1 Petra Jansen,2 Jan Schaible,1 Christina Roll,1 Joachim Grifka,1 Jürgen Götz1 1Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, 2Department of Sport Science, University of Regensburg, Regensburg, Germany Abstract: Recovery after total hip arthroplasty (THA is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure. Additional objectives were perioperative changes in the psychological status and their influence on perioperative outcome. This observational study analyzed depression, anxiety, resilience, and personality traits in 50 patients after primary unilateral THA. Hip functionality was measured by means of the Harris Hip Score. Depression, state anxiety, and resilience were evaluated preoperatively as well as 1 and 5 weeks postoperatively. Trait anxiety and personality traits were measured once preoperatively. Patients with low depression and anxiety levels had significantly better outcomes with respect to early hip functionality. Resilience and personality traits did not relate to hip functionality. Depression and state anxiety levels significantly decreased within the 5-week stay in the acute and rehabilitation clinic, whereas resilience remained at the same level. Our study suggests that low depression and anxiety levels are positively related to early functionality after THA. Therefore, perioperative measurements of these factors seem to be useful to provide the best support for patients with risk factors. Keywords: total hip arthroplasty, psychological factors, depression, state anxiety, trait anxiety, resilience, personality traits

  15. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk : Results from the EPIC cohort study

    NARCIS (Netherlands)

    Sanikini, Harinakshi; Dik, Vincent K.; Siersema, Peter D.; Bhoo-Pathy, Nirmala; Uiterwaal, Cuno S. P. M.; Peeters, Petra H. M.; Alez, Carlos A. Gonz; Zamora-Ros, Raul; Overvad, Kim; Nneland, Anne Tj; Roswall, Nina; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Kuehn, Tilman; Katzke, Verena; Boeing, Heiner; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Tumino, Rosario; Panico, Salvatore; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Huerta, Jose Maria; Sanchez-Cantalejo, Emilio; Barricarte, Aurelio; Sonestedt, Emily; Wallstrom, Peter; Nilsson, Lena Maria; Johansson, Ingegerd; Bradbury, Kathryn E.; Khaw, Kay-Tee; Wareham, Nick; Huybrechts, Inge; Freisling, Heinz; Cross, Amanda J.; Riboli, Elio; Bueno-de-Mesquita, H. B(as)

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and

  16. Total petroleum hydrocarbons: Characterization of physico-chemical behaviour and risks

    Energy Technology Data Exchange (ETDEWEB)

    Gemoets, J.; Lookman, R.; Vanermen, G.; Houtven, D. van; Bertels, D.; Weltens, R.; Cornelis, C. [VITO, Mol (Belgium); Vries, P. de; Sterren, G. van der; Alphenaar, A. [TTE, Deventer (Netherlands)

    2003-07-01

    Several methods are available for the characterization of petroleum hydrocarbons. Recently, the TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based upon a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). Within NOBIS (Dutch Research program Biological I-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes. The present study aims at a verification (reproducibility; accuracy) and optimization of both methods and a critical review on the relevance of the proposed fractions for the prediction of human health risks. Two 'umpire' methods were selected for reference: GS-MS in full scan mode and liquid state NMR. (orig.)

  17. Fractionated total lymphoid irradiation as preparative immunosuppression in high risk renal transplantation

    International Nuclear Information System (INIS)

    Najarian, J.S.; Ferguson, R.M.; Sutherland, D.E.; Slavin, S.; Kim, T.; Kersey, J.; Simmons, R.L.

    1982-01-01

    Twenty-two patients at high risk to reject renal allografts have been treated with fractionated total lymphoid irradiation (FTLI) prior to transplantation of primary (2), secondary (16) or tertiary (4) renal allografts. All patients undergoing retransplantation had rapidly rejected previous grafts. At 24 months following transplantation, 72% of grafts were functioning in the TLI group compared with a 38% graft function in an historical control group of recipients receiving secondary or tertiary grafts and treated with conventional immunosuppression. Important variables in determining success of transplantation following fractionated TLI include the dose of TLI, the interval from radiation to transplantation, and maintenance post-transplant immunosuppressive therapy. Optimal results were achieved with 2500 rads delivered in 100 rad fractions followed by transplantation within two weeks, and a tapering prednisone schedule and maintenance azathioprine post-transplantation. Seventeen patients had significant complications of the radiation treatment and there was one death, prior to transplantation, associated with pneumonitis. In vitro assessment of immune function demonstrated marked peripheral T cell depletion and loss of in vitro responsiveness to mitogen and allogeneic stimulation following FTLI. The administration of donor bone marrow at the time of transplantation did not produce chimerism. The results suggest that when properly utilized FTLI can produce effective adjunctive immunosuppression for clinical transplantation

  18. Total flying hours and risk of high systolic blood pressure in the civilian pilot in Indonesia

    Directory of Open Access Journals (Sweden)

    Ferdi Afian

    2016-07-01

    medical examinations in the Civil Aviation Medical Center  on 18 to 29 May 2015. Several data among other, others, were on demographic and job characteristics, clinical, exercise habits, eating habits, and history of the disease. High systolic blood pressure defined as systolic blood pressure  140 mmHg or more. Results: Of the 690 pilots who conduct periodic health examinations, 428 male pilots willing to participate this study. Age and history of hypertension is the dominant risk factor associated with high systolic blood pressure. When compared with the pilot age 19-39 years, 40-65 years old had 15.1-fold greater risk of high systolic blood pressure [odds ratio (adjusted ORa= 15.12; p= 0.001]. Pilot with a history of hypertension compared to those without a history of having high systolic blood pressure risk 93.2 times larger (ORa= 93.21; p= 0.001. Conclusion: Age of 40-65 years and had history of hypertension increased the riskj of systolic blood pressure among civilian pilot in Indonesia. Key words: systolic blood pressure, total flight hours, civilian pilot, Indonesia

  19. Analytical and numerical study of the salinity intrusion in the Sebou river estuary (Morocco) - effect of the "Super Blood Moon" (total lunar eclipse) of 2015

    Science.gov (United States)

    Haddout, Soufiane; Igouzal, Mohammed; Maslouhi, Abdellatif

    2016-09-01

    The longitudinal variation of salinity and the maximum salinity intrusion length in an alluvial estuary are important environmental concerns for policy makers and managers since they influence water quality, water utilization and agricultural development in estuarine environments and the potential use of water resources in general. The supermoon total lunar eclipse is a rare event. According to NASA, they have only occurred 5 times in the 1900s - in 1910, 1928, 1946, 1964 and 1982. After the 28 September 2015 total lunar eclipse, a Super Blood Moon eclipse will not recur before 8 October 2033. In this paper, for the first time, the impact of the combination of a supermoon and a total lunar eclipse on the salinity intrusion along an estuary is studied. The 28 September 2015 supermoon total lunar eclipse is the focus of this study and the Sebou river estuary (Morocco) is used as an application area. The Sebou estuary is an area with high agricultural potential, is becoming one of the most important industrial zones in Morocco and it is experiencing a salt intrusion problem. Hydrodynamic equations for tidal wave propagation coupled with the Savenije theory and a numerical salinity transport model (HEC-RAS software "Hydrologic Engineering Center River Analysis System") are applied to study the impact of the supermoon total lunar eclipse on the salinity intrusion. Intensive salinity measurements during this extreme event were recorded along the Sebou estuary. Measurements showed a modification of the shape of axial salinity profiles and a notable water elevation rise, compared with normal situations. The two optimization parameters (Van der Burgh's and dispersion coefficients) of the analytical model are estimated based on the Levenberg-Marquardt's algorithm (i.e., solving nonlinear least-squares problems). The salinity transport model was calibrated and validated using field data. The results show that the two models described very well the salt intrusion during the

  20. Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income.

    Science.gov (United States)

    Bennett, Kevin J; Dismuke, Clara E

    2010-05-01

    High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden. The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics. Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios. Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

  1. Assessment of risk factors in pollution of coastal zone and river basins by numerical modelling

    International Nuclear Information System (INIS)

    Tsitskishvili, M.; Kordzakhia, G.; Shaptoshvili, A.; Tsitskishvili, L.; Diasamidze, R.; Soloduchin, V.

    2005-01-01

    pollution. For this aim the special deterministic models on the basis of passive admixture's turbulence diffusion equation is used. For numerical calculations Mc Kormack's predictor-corrector two steps scheme is used. The scheme is disintegrated, second order in space and time. Such scheme is established because the turbulent velocities very differ in horizontal and vertical directions and model allows implementing singular independent steps in different directions. Grid step for the model is 26.88 km in horizontal direction and 20 m m in vertical until 200 m. Time step is equal to 4 hours and computational time period - 4 months. Number of grid points is equal to 4983 for all calculation areas. Computations are carried out separately for big rivers basins as well as for Black and Caspian Seas water areas. The model calculations are made for cases with various locations of pollutant sources including accidental throws. For different realistic scenarios are calculated the concentrations of admixtures. The directions of their propagation are also determined. The risks are calculated in comparison with the Maximum Permissible Concentrations (MPC) of the pollutants according to achieved results. That gives possibility to define the most vulnerable areas in coastal zones. Realized methodology is verified by means of various scenarios for mentioned rivers and sea basins. The maps with indication of risk zones in river basins as well as of Black and Caspian Seas water areas are created

  2. Risk factors for deep infection after total knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Chen, Jie; Cui, Yunying; Li, Xin; Miao, Xiangwan; Wen, Zhanpeng; Xue, Yan; Tian, Jing

    2013-05-01

    Estimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence. The meta-analysis collected twelve cohorts or case-control studies which included 548 infected persons in 57,223 general cases. Review Manager 5.0 was operated to assess the heterogeneity and to give an overall estimate of the association of factors with postoperative infection after TKA. The main factors distinctly associated with infection after TKA were BMI (BMI >30: OR = 2.53, 95 % CI 1.25, 5.13; BMI >40: OR = 4.00, 95 % CI 1.23, 12.98), diabetes mellitus (OR = 3.72, 95 % CI 2.30, 6.01), hypertension (OR = 2.53, 95 % CI 1.07, 5.99), steroid therapy (OR = 2.04, 95 % CI 1.11, 3.74), and rheumatoid arthritis (OR = 1.83; 95 % CI 1.42, 2.36). It had no sufficient evidences to reveal that gender could lead to infection after TKA. Osteoarthritis appeared to have a moderately protective effect. Statistical analysis revealed no correlation between urinary tract infection, fixation method, ASA, bilateral operation, age, transfusion, antibiotics, bone graft, and infection. There were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.

  3. Risk Assessment of Total Coliform in X WTP’s Water Production Using Failure Mode And Effect Analysis Method

    Directory of Open Access Journals (Sweden)

    Bella Apriliani Amanda

    2017-07-01

    Full Text Available The greatest risk of drinking water supply is a failure to provide safe drinking water for communities. Based on IPA Kedunguling testing report on March 2016 noted that sample exceeding the quality standart of Peraturan Menteri Kesehatan RI No 492/2010 for the total coliform quality standart. The presence of total coliforms indicating water contamination by pathogen means the water is not safe to consume. The disinfection process has an importance rule in pathogen inactivation. Disinfectant performance is influenced by temperature, pH, turbidity, and the presence of organic materials. One way to control the quality of water produced by using a risk management approach Failure Modes and Effect Analysis (FMEA methods. The potential risks should be measured to determine causes of the problems and find the appropriate risk reduction. The risk assessment is using Risk Priority Number (RPN scale as a basis prioritization of remedial action on issues. Based on identification and risk analysis using FMEA known that the greatest risk of failure is the stipulation of chlorine dose and organic substances (category of high risk level; residual chlorine (category of moderate risk level; turbidity and pH (very low risk level category. Improvement proposal that can be done to reduce total coliforms presence in IPA Kedunguling is by increasing residual chlorine to 0.6 mg/l, set a daily chlorine level, controlling DBPs forming by lowering the concentration of organic precursor using granular activated carbon (GAC or aeration, by lowering the dose of disinfectant, set aside DBPs after the compound is formed using granular activated carbon (GAC, turbidity and pH monitoring, and regularly washing the filters

  4. Industry-specific risk models for numerical scoring of hazards and prioritization of safety measures

    International Nuclear Information System (INIS)

    Khali, Y.F.; Johnson, K.

    2004-01-01

    Risk analysis consists of five cornerstones that have to be viewed in an holistic manner by risk practitioners of any organization regardless of the industry type or nature of its critical infrastructures. The cornerstones are hazard identification, risk assessment and consequence analysis, determination of risk management actions required to reduce risks to acceptable levels, communication of risk insights among the stake-holders, and continuous monitoring and verification to ensure sustained attainment of tolerable risk levels. Our primary objectives in this research are two fold: first, we compare and contrast a wide spectrum of current industry-specific and application-dependent semi-quantitative risk models. Secondly, based on the insights to be gained from the first task, we propose a framework for a robust risk-based approach for conducting security vulnerability assessment (SVA). Risk practitioners of critical infrastructures, such as commercial nuclear power plants, water utilities, chemical plants, transmission and distribution substations... etc., could readily use this proposed approach to classify, evaluate, and prioritize risks to support allocation of resources required to ensure protection of public health and safety. (author)

  5. A numerical investigation into the influence of the properties of cobalt chrome cellular structures on the load transfer to the periprosthetic femur following total hip arthroplasty.

    Science.gov (United States)

    Hazlehurst, Kevin Brian; Wang, Chang Jiang; Stanford, Mark

    2014-04-01

    Stress shielding of the periprosthetic femur following total hip arthroplasty is a problem that can promote the premature loosening of femoral stems. In order to reduce the need for revision surgery it is thought that more flexible implant designs need to be considered. In this work, the mechanical properties of laser melted square pore cobalt chrome molybdenum cellular structures have been incorporated into the design of a traditional monoblock femoral stem. The influence of incorporating the properties of cellular structures on the load transfer to the periprosthetic femur was investigated using a three dimensional finite element model. Eleven different stiffness configurations were investigated by using fully porous and functionally graded approaches. This investigation confirms that the periprosthetic stress values depend on the stiffness configuration of the stem. The numerical results showed that stress shielding is reduced in the periprosthetic Gruen zones when the mechanical properties of cobalt chrome molybdenum cellular structures are used. This work identifies that monoblock femoral stems manufactured using a laser melting process, which are designed for reduced stiffness, have the potential to contribute towards reducing stress shielding. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Low-dose total skin electron beam therapy for cutaneous lymphoma. Minimal risk of acute toxicities

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany)

    2017-12-15

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T-cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P < 0.001). A lower grade 3 AE rate was also observed in patients who had received the low-dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses. (orig.) [German] Eine niedrigdosierte Ganzhautelektronenbestrahlung (TSEBT) wird vermehrt zur effektiven palliativen Behandlung von Patienten mit primaer kutanen T-Zell-Lymphomen (pCTCL) eingesetzt. In dieser Studie vergleichen wir die Toxizitaetsprofile verschiedener Dosiskonzepte. Untersucht wurden 60 zwischen 2000 und 2016 am Universitaetsklinikum Muenster mittels TSEBT

  7. Real-world effectiveness of valsartan on hypertension and total cardiovascular risk: review and implications of a translational research program

    Science.gov (United States)

    Abraham, Ivo; MacDonald, Karen; Hermans, Christine; Aerts, Ann; Lee, Christopher; Brié, Heidi; Vancayzeele, Stefaan

    2011-01-01

    The pharmacological efficacy of various monotherapy, single pill, and combination therapies of the angiotensin II receptor blocker valsartan have been established, mainly through randomized controlled trials that used similar methodological and statistical platforms and thus enabled synthesis of evidence. The real world effectiveness of valsartan has been studied extensively, but the relative lack of scientific and technical congruence of these studies render synthesis virtually impossible. To date, all have focused on blood pressure outcomes, despite evidence-based calls to grade antihypertensive treatment to patients’ total cardiovascular risk. We review a T3 translational research program of seven studies involving valsartan monotherapy as well as single and separate pill combinations, and the determinants and effect on blood pressure and total cardiovascular risk outcomes. All seven studies examined not only the impact of valsartan-based regimens on blood pressure values and control, but also, within a statistical hierarchical approach, the physician- and patient-related determinants of these blood pressure outcomes. Two studies also investigated the determinants and outcomes of valsartan-based treatment on total cardiovascular risk – among the first studies to use this risk coefficient as an outcome rather than only a determinant. These seven studies included a total of 19,533 patients, contributed by 3434 physician-investigators in Belgium – a country particularly well-suited for observational effectiveness studies because of demographics and epidemiology. Each study used the same methodological and statistical platform. We summarize the impact of various valsartan regimens on such outcomes as blood pressure values and control, change in total cardiovascular risk, and reduction in risk by at least one category. We also review the results of statistical multilevel and logistic modeling of physician- and patient-related determinants on these outcomes

  8. Numerical tool for tsunami risk assessment in the southern coast of Dominican Republic

    Science.gov (United States)

    Macias Sanchez, J.; Llorente Isidro, M.; Ortega, S.; Gonzalez Vida, J. M., Sr.; Castro, M. J.

    2016-12-01

    The southern coast of Dominican Republic is a very populated region, with several important cities including Santo Domingo, its capital. Important activities are rooted in the southern coast including tourism, industry, commercial ports, and, energy facilities, among others. According to historical reports, it has been impacted by big earthquakes accompanied by tsunamis as in Azua in 1751 and recently Pedernales in 2010, but their sources are not clearly identified. The aim of the present work is to develop a numerical tool to simulate the impact in the southern coast of the Dominican Republic of tsunamis generated in the Caribbean Sea. This tool, based on the Tsunami-HySEA model from EDANYA group (University of Malaga, Spain), could be used in the framework of a Tsunami Early Warning Systems due the very short computing times when only propagation is computed or it could be used to assess inundation impact, computing inundation with a initial 5 meter resolution. Numerical results corresponding to three theoretical sources are used to test the numerical tool.

  9. Transferrin saturation ratio and risk of total and cardiovascular mortality in the general population.

    LENUS (Irish Health Repository)

    Stack, A G

    2014-08-01

    The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear.

  10. Fatores de Risco para Infecção Pós-histerectomia Total Abdominal Risk Factors for Infection after Total Abdominal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2000-08-01

    with the occurrence of surgical site infection in patients submitted to total abdominal hysterectomy at the Instituto Materno ¾ Infantil de Pernambuco (iMIP. Methods: a cross-sectional study was conducted, enrolling patients submitted to total abdominal hysterectomy at IMIP who returned to postsurgical consultation for infection control, between January, 1995 and December, 1998 (n = 414. The frequency of surgical site infection (defined according to the CDC criteria, 1998 was 10% (42 cases. Prevalence risk (PR of infection (dependent variable and its 95% confidence interval (CI were calculated for independent variables: age, obesity, hypertension, diabetes, malignant pathology, type of incision, duration of surgery and antibiotic prophylaxis. Multiple logistic regression analysis was used to determine adjusted risk of infection. Results: a significantly increased risk of infection was found for the following variables: age >60 years (PR = 2.39, 95% CI = 1.15-4.94, obesity (PR = 3.2, 95% CI = 1.83-5.59, duration of surgery >2 hours (PR = 2.35, 95% CI = 1.32-4.21 and diabetes (PR = 6.0, 95% CI = 3.41-10.57. On the other hand, risk of infection was significantly reduced when antibiotic prophylaxis was administered (PR = 0.38, 95% CI = 0.21-0.68. Type of incision, malignant disease and hypertension were not associated with infection. Conclusions: the factors associated with increased risk of surgical site infection after total abdominal hysterectomy at IMIP were: age >60 years, obesity, diabetes and surgical duration >2 hours. Antibiotic prophylaxis showed a protective effect with reduction of risk of infection.

  11. Numerical analysis on hydrogen stratification and post-inerting of hydrogen risk

    International Nuclear Information System (INIS)

    Peng, Cheng; Tong, Lili; Cao, Xuewu

    2016-01-01

    Highlights: • A three-dimensional computational model was built and the applicability was discussed. • The formation of helium stratification was further studied. • Three influencing factors on the post-inerting of hydrogen risk were analyzed. - Abstract: In the case of severe accidents, the risk of hydrogen explosion threatens the integrity of the nuclear reactor containment. According to nuclear regulations, hydrogen control is required to ensure the safe operation of the nuclear reactor. In this study, the method of Computational Fluid Dynamics (CFD) has been applied to analyze process of hydrogen stratification and the post-inerting of hydrogen risk in the Large-Scale Gas Mixing Facility. A three-dimensional computational model was built and the applicability of different turbulence models was discussed. The result shows that the helium concentration calculated by the standard k–ε turbulence model is closest to the experiment data. Through analyzing the formation of helium stratification at different injection velocities, it is found that when the injection mass flow is constant and the injection velocity of helium increases, the mixture of helium and air is enhanced while there is rarely influence on the formation of helium stratification. In addition, the influences of mass flow rate, injection location and direction and inert gas on the post-inerting of hydrogen risk have been analyzed and the results are as follows: with the increasing of mass flow rate, the mitigation effect of nitrogen on hydrogen risk will be further improved; there is an obvious local difference between the mitigation effects of nitrogen on hydrogen risk in different injection directions and locations; when the inert gas is injected at the same mass flow rate, the mitigation effect of steam on hydrogen risk is better than that of nitrogen. This study can provide technical support for the mitigation of hydrogen risk in the small LWR containment.

  12. Total and HDL cholesterol and risk of stroke. EUROSTROKE: a collaborative study among research centres in Europe

    NARCIS (Netherlands)

    M.L. Bots (Michiel); D.E. Grobbee (Diederick); P.C. Elwood; Y. Nikitin; J.T. Salonen; A. Freire de Concalves; D. Inzitari; J. Sivenius; V. Benetou (Vassiliki); J. Tuomilehto; P.J. Koudstaal (Peter Jan)

    2002-01-01

    textabstractBACKGROUND: Controversy remains on the relation between serum lipids levels and stroke risk. This paper investigated the association of total and HDL cholesterol level to fatal and non-fatal, and haemorrhagic and ischaemic stroke in four European cohorts participating

  13. Evaluation of total effort and risk of membraneless tubular fuel cell concept

    Energy Technology Data Exchange (ETDEWEB)

    Bambace, Luis Antonio Waack [Instituto Nacional de Pesquisas Espaciais - INPE, Sao Jose dos Campos, SP (Brazil)], e-mail: bambace@dem.inpe.br

    2010-07-01

    Traditionally people estimate project risks and duration by comparing predicted actions with similar ones. This methodology is rather difficult to apply in very innovative projects, as several of their Work Breakdown Structure (WBS) actions are quite new to a particular developer, even if this action is a standard procedure in another field or company. This paper proposes the use of an alternative methodology with fuel cell design example, which is inspired in Suh third axiom, Jelinsky-Moranda Model of software reliability (JMSRM). This model considers human error with JMRSR, relates the number of trials with entropy and search residual risk, feasibility with model uncertainty and acceptable and target risks, and the matching of search field and real solution field with statistical tools. (author)

  14. Risk assessment of welders` exposure to total fume in an automobile industry

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Full Text Available Introduction: Risk assessment of Toxic or hazardous chemicals enables the Industrial Hygienists to make the appropriate decision in providing healthy work place. This project was conducted in an assembling plant,(4workshop of an Automobile Industry in IRAN with 2 types of welding operations, including GMAW (CO2 welding and Spot resistance welding operations. . Method and Materials: Welders` exposures were assessed via collecting 143 breathing zone air samples based on NIOSH 0500 method. Risk assessment was carried out using Singapore recommended method. .Results: Finding showed that the mean of welders exposure in GMAW and Spot resistance welding operations 5.61 ± 5.78and 2.38± 2.15 mg/m3, respectively(p<0.05. The results showed that in GMAW welders had the highe exposure in comparison with Spot resistance welders (p<0.05. The findings also demonstrated that the risk rate of GMAW welders were high, while this rate for Spot resistance was low. .Conclusion: more hygienic attention is needed for GTAW welders. Control approaches are required including effective engineering control, conduct air monitoring, biological monitoring training, adopt respiratory protection program, develop and implement safe and correct work procedures and finally reassess the risk after all the controls have been done.

  15. Risk of Myocardial Infarction Attributable to Elevated Levels of Total Cholesterol Among Hypertensives

    NARCIS (Netherlands)

    Glazer, Nicole L.; Smith, Nicholas L.; Heckbert, Susan R.; Doggen, Catharina Jacoba Maria; Lemaitre, Rozenn N.; Psaty, Bruce M.

    2005-01-01

    Background Although cholesterol is an important risk factor for coronary heart disease (CHD) among hypertensives, the burden of CHD among hypertensives that may be due to elevated cholesterol has not been well documented. This study aimed to estimate the proportion of incident myocardial infarction

  16. Social network diversity and risks of ischemic heart disease and total mortality

    DEFF Research Database (Denmark)

    Barefoot, John C; Grønbaek, Morten; Jensen, Gorm

    2005-01-01

    Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991-1994, and pa......Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991...

  17. Numerical modelling for quantitative environmental risk assessment for the disposal of drill cuttings and mud

    Science.gov (United States)

    Wahab, Mohd Amirul Faiz Abdul; Shaufi Sokiman, Mohamad; Parsberg Jakobsen, Kim

    2017-10-01

    To investigate the fate of drilling waste and their impacts towards surrounding environment, numerical models were generated using an environmental software; MIKE by DHI. These numerical models were used to study the transportation of suspended drill waste plumes in the water column and its deposition on seabed in South China Sea (SCS). A random disposal site with the model area of 50 km × 25 km was selected near the Madalene Shoal in SCS and the ambient currents as well as other meteorological conditions were simulated in details at the proposed location. This paper was focusing on sensitivity study of different drill waste particle characteristics on impacts towards marine receiving environment. The drilling scenarios were obtained and adapted from the oil producer well at offshore Sabah (Case 1) and data from actual exploration drilling case at Pumbaa location (PL 469) in the Norwegian Sea (Case 2). The two cases were compared to study the effect of different drilling particle characteristics and their behavior in marine receiving environment after discharged. Using the Hydrodynamic and Sediment Transport models simulated in MIKE by DHI, the variation of currents and the behavior of the drilling waste particles can be analyzed and evaluated in terms of multiple degree zones of impacts.

  18. [Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

    Science.gov (United States)

    Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

    2014-01-01

    To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

  19. Real-world effectiveness of valsartan on hypertension and total cardiovascular risk: review and implications of a translational research program

    Directory of Open Access Journals (Sweden)

    Abraham I

    2011-03-01

    Full Text Available Ivo Abraham1,2, Karen MacDonald2, Christine Hermans3, Ann Aerts3, Christopher Lee2,4, Heidi Brié3, Stefaan Vancayzeele31Center for Health Outcomes and Pharmacoeconomic Research, and Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA; 2Matrix45, Earlysville, VA, USA; 3Novartis Pharma, Vilvoorde, Belgium; 4School of Nursing, Oregon Health and Science University, Portland, OR, USAAbstract: The pharmacological efficacy of various monotherapy, single pill, and combination therapies of the angiotensin II receptor blocker valsartan have been established, mainly through randomized controlled trials that used similar methodological and statistical platforms and thus enabled synthesis of evidence. The real world effectiveness of valsartan has been studied extensively, but the relative lack of scientific and technical congruence of these studies render synthesis virtually impossible. To date, all have focused on blood pressure outcomes, despite evidence-based calls to grade antihypertensive treatment to patients' total cardiovascular risk. We review a T3 translational research program of seven studies involving valsartan monotherapy as well as single and separate pill combinations, and the determinants and effect on blood pressure and total cardiovascular risk outcomes. All seven studies examined not only the impact of valsartan-based regimens on blood pressure values and control, but also, within a statistical hierarchical approach, the physician- and patient-related determinants of these blood pressure outcomes. Two studies also investigated the determinants and outcomes of valsartan-based treatment on total cardiovascular risk – among the first studies to use this risk coefficient as an outcome rather than only a determinant. These seven studies included a total of 19,533 patients, contributed by 3434 physician-investigators in Belgium – a country particularly well-suited for observational

  20. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  1. Selecting a Risk-Based SQC Procedure for a HbA1c Total QC Plan.

    Science.gov (United States)

    Westgard, Sten A; Bayat, Hassan; Westgard, James O

    2017-09-01

    Recent US practice guidelines and laboratory regulations for quality control (QC) emphasize the development of QC plans and the application of risk management principles. The US Clinical Laboratory Improvement Amendments (CLIA) now includes an option to comply with QC regulations by developing an individualized QC plan (IQCP) based on a risk assessment of the total testing process. The Clinical and Laboratory Standards Institute (CLSI) has provided new practice guidelines for application of risk management to QC plans and statistical QC (SQC). We describe an alternative approach for developing a total QC plan (TQCP) that includes a risk-based SQC procedure. CLIA compliance is maintained by analyzing at least 2 levels of controls per day. A Sigma-Metric SQC Run Size nomogram provides a graphical tool to simplify the selection of risk-based SQC procedures. Current HbA1c method performance, as demonstrated by published method validation studies, is estimated to be 4-Sigma quality at best. Optimal SQC strategies require more QC than the CLIA minimum requirement of 2 levels per day. More complex control algorithms, more control measurements, and a bracketed mode of operation are needed to assure the intended quality of results. A total QC plan with a risk-based SQC procedure provides a simpler alternative to an individualized QC plan. A Sigma-Metric SQC Run Size nomogram provides a practical tool for selecting appropriate control rules, numbers of control measurements, and run size (or frequency of SQC). Applications demonstrate the need for continued improvement of analytical performance of HbA1c laboratory methods.

  2. An ignored risk factor in toxicology: The total imprecision of exposure assessment

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Budtz-Jørgensen, Esben

    2010-01-01

    twice as much for maternal hair. The total imprecision of these biomarkers much exceeded the normal laboratory variability of less than 5%. Such imprecision can cause underestimation of dose-related toxicity, and data analysis should therefore include sensitivity analyses that take this factor...... were determined in cord blood, cord tissue, and maternal hair. We determined their mutual correlations and their associations with the child's neurobehavioral effect variables at age 7 years. The exposure biomarkers correlated well with one another, but the cord blood mercury concentration showed......Quality assurance of exposure biomarkers usually focuses on laboratory performance only. Using data from a prospective birth cohort study in the Faroe Islands, we have assessed the total imprecision of exposure biomarkers. As biomarkers of prenatal methylmercury exposure, mercury concentrations...

  3. The preparation of landslide map by Landslide Numerical Risk Factor (LNRF model and Geographic Information System (GIS

    Directory of Open Access Journals (Sweden)

    Ali Mohammadi Torkashvand

    2014-12-01

    Full Text Available One of the risks to threaten mountainous areas is that hillslope instability caused damage to lands. One of the most dangerous instabilities is mass movement and much movement occurs due to slip. The aim of this study is zonation of landslide hazards in a basin of the Ardebil province, the eastern slopes of Sabalan, Iran. Geological and geomorphologic conditions, climate and type of land use have caused susceptibility of this watershed to landslides. Firstly, maps of the main factors affecting landslide occurrence including slope, distance from faults, lithology, elevation and precipitation were prepared and digitized. Then, by using interpretation of aerial photos and satellite images and field views, the ground truth map of landslides was prepared. Each basic layer (factor and landslide map were integrated to compute the numeric value of each factor with the help of a Landslide Numerical Risk Factor (LNRF model and landslide occurrence percent obtained in different units from each of the maps. Finally, with overlapping different data layers, a landslide hazard zonation map was prepared. Results showed that 67.85% of the basin has high instability, 7.76% moderate instability and 24.39% low instability.

  4. Total mercury in muscles and liver of Mugil spp. from three coastal lagoons of NW Mexico: concentrations and risk assessment.

    Science.gov (United States)

    Delgado-Alvarez, C G; Frías-Espericueta, M G; Ruelas-Inzunza, J; Becerra-Álvarez, M J; Osuna-Martínez, C C; Aguilar-Juárez, M; Osuna-López, J I; Escobar-Sánchez, O; Voltolina, D

    2017-07-01

    Total mercury (Hg) concentrations were determined by atomic absorption spectrophotometry in muscles and liver of composite samples of Mugil cephalus and M. curema collected during November 2013 and in January, April, and July 2014 from the coastal lagoons Altata-Ensenada del Pabellón (AEP), Ceuta (CEU), and Teacapán-Agua Brava (TAG) of Sinaloa State. The mean Hg contents and information on local consumption were used to assess the possible risk caused by fish ingestion. Mean total mercury levels in the muscles ranged from 0.11 to 0.39 μg/g, while the range for liver was 0.12-3.91 μg/g. The mean Hg content of the liver was significantly (p mercury calculated for the younger age classes of one fishing community were >1, indicating a possible risk for some fishing communities of the Mexican Pacific coast.

  5. For which option is credit risk more representative on China banks' total factor productivity Efficiency change or technological progress?

    Institute of Scientific and Technical Information of China (English)

    Fadzlan Sufian

    2012-01-01

    Purpose-The purpose of this paper is to provide new empirical evidence on the impact of credit risk on China banks' total factor productivity.Design/methodology/approach-The paper employs the Malmquist Productivity Index (MP1) which allows for the examination of five different indices:total factor productivity change (TFPCH);technological change (TECHCH);efficiency change (EFFCH);pure technical efficiency change (PEFFCH);and scale efficiency change (SECH) indices.Findings-The empirical findings indicate that the State Owned Commercial Banks (SOCB),Joint Stock Commercial Banks (JSCB),and City Commercial Banks (CCB) have exhibited lower TFPCH levels with the inclusion of risk factor.It was found that the JSCB and CCB have exhibited lower TFPCH due to TECHCH,while the SOCB have exhibited lower TFPCH due to EFFCH.The empirical findings suggest that the inclusion of credit risk factor has resulted in a higher JSCB EFFCH levels.On the other hand,the SOCB and CCB have exhibited a lower EFFCH levels due to SECH and PEFFCH,respectively.Research limitations/implications-The results clearly highlight the importance of credit risk and lending quality in determining the total factor productivity change of banks operating in the China banking sector.The author demonstrates that the inclusion of credit risk factor has resulted in a lower TFPCH level of all banks operating in the China banking sector.Thus,excluding the credit risk factor from the analysis on the China banking sector may potentially bias the result upwards.Practical impIications-In an environment of heavy government influence over the lending process,a large proportion of loans extended by Chinese banks over the years have gone bad.Policymakers should prevent the flow of new non-performing loans by separating bad clients from banks that are being restructured and recapitalized in the reform of the banking sector.Originality/value-By employing the Malmquist Productivity Index (MPI),the present paper contributes to

  6. Risk factors and clinical course of hungry bone syndrome after total parathyroidectomy in dialysis patients with secondary hyperparathyroidism.

    Science.gov (United States)

    Ho, Lo-Yi; Wong, Ping-Nam; Sin, Ho-Kwan; Wong, Yuk-Yi; Lo, Kwok-Chi; Chan, Shuk-Fan; Lo, Man-Wai; Lo, Kin-Yee; Mak, Siu-Ka; Wong, Andrew Kui-Man

    2017-01-10

    Hungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial. We did a single-center retrospective study on 62 consecutive dialysis patients who underwent total parathyroidectomy for SHPT to examine the risk factors, clinical course and outcome. Data on demographic characteristics, perioperative laboratory parameters including serum calcium, phosphate, alkaline phosphatase (ALP) and parathyroid hormone (PTH), drug treatment for SHPT and operative details of parathyroidectomy were collected. Seventeen (27.4%) patients developed severe postoperative hypocalcemia with HBS. The serum calcium dropped progressively while serum ALP rose after operation until 2 weeks later when serum calcium reached the trough and serum ALP peaked. Serum phosphate also fell but stabilized between 4 and 14 days. The total postoperative calcium and vitamin D supplementation was significantly larger, and hospital stay was significantly longer in the group with HBS as compared with those without HBS. Young age, high body weight, high preoperative ALP level, and low preoperative calcium level independently predicted the development of HBS while preoperative PTH and use of cinacalcet or paricalcitol did not. HBS was common after total parathyroidectomy in patients with SHPT, and it is important to closely monitor the postoperative serum calcium, phosphate and ALP levels in the following 2 weeks, especially for those at risk. The implications of our findings on perioperative management are discussed.

  7. Total management of chronic obstructive pulmonary disease (COPD) as an independent risk factor for cardiovascular disease.

    Science.gov (United States)

    Onishi, Katsuya

    2017-08-01

    Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress. Overall, patients with COPD have a 2-3-fold increased risk of CVD as compared to age-matched controls when adjusted for tobacco smoking. Chronic heart failure (HF) is a frequent and important comorbidity which has a significant impact on prognosis in COPD, and vice versa. HF overlaps in symptoms and signs and has a common comorbidity with COPD, so that diagnosis of COPD is difficult in patients with HF. The combination of HF and COPD presents many therapeutic challenges including beta-blockers (BBs) and beta-agonists. Inhaled long-acting bronchodilators including beta2-agonists and anticholinergics for COPD would not worsen HF. Diuretics are relatively safe, and angiotensin-converting enzyme inhibitors are preferred to treat HF accompanied with COPD. BBs are only relatively contraindicated in asthma, but not in COPD. Low doses of cardioselective BBs should be aggressively initiated in clinically stable patients with HF accompanied with COPD combined with close monitoring for signs of airway obstruction and gradually up-titrated to the maximum tolerated dose. Encouraging appropriate and aggressive treatment for both HF and COPD should be recommended to improve quality of life and mortality in HF patients with COPD. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  8. Risk of pneumonia and urinary tract infection within the first week after total hip arthroplasty and the impact on survival

    Directory of Open Access Journals (Sweden)

    Glassou EN

    2017-01-01

    Full Text Available Eva N Glassou,1,2 Torben B Hansen,1,3 Alma B Pedersen2 1University Clinic of Hand, Hip and Knee Surgery, Department of Orthopedic Surgery, Regional Hospital West Jutland, Aarhus University, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3The Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement, Aarhus University, Aarhus, Denmark Background: Pneumonia and urinary tract infections (UTIs increase morbidity and mortality. There is little epidemiological evidence from large population-based studies on risk factors for these infections and subsequent mortality in total hip arthroplasty (THA patients.Aim: To examine the risk factors of postoperative pneumonia and UTI after THA and their impact on survival.Patients and methods: We used the Danish Hip Arthroplasty Register to identify THAs due to osteoarthritis registered from 2000 to 2013. We collected data about comorbidities, mortality and infections in relation to primary hospitalization and potential predictive variables from administrative databases. Regression models were used to estimate associations between potential risk factors and infection, and subsequently, between infection and mortality.Results: In total 84,812 THAs were included. The cumulative incidence of pneumonia and UTI within 7 days of the primary procedure were 0.21 (95% confidence interval [CI]: 0.18–0.25 and 0.29 (95% CI: 0.26–0.33, respectively. Patient-related risk factors for infection were being 80 years or older, gender and a comorbidity burden at time of surgery. The hazard ratio (HR of dying within 90 days of the primary THA was 10.67 (95% CI: 5.79–19.57 compared to patients without pneumonia. For patients with UTIs, the HR was 1.64 (95% CI: 0.41–6.59 compared to those without a UTI.Conclusion: Pneumonia was associated with an increased short-term risk of dying, despite adjustment for coexisting comorbidity and other potential confounders. Age, gender and comorbidity were the most

  9. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  10. Total Mercury in Squalid Callista Megapitaria squalida from the SW Gulf of California, Mexico: Tissue Distribution and Human Health Risk.

    Science.gov (United States)

    Romo-Piñera, Abril K; Escobar-Sánchez, Ofelia; Ruelas-Inzunza, Jorge; Frías-Espericueta, Martín G

    2018-03-01

    We evaluated the total Hg concentration in different tissues of squalid callista Megapitaria squalida in order to measure Hg distribution in tissue and to estimate human health risk. Samples were obtained by free diving in the SW Gulf of California, Mexico. Concentrations are given on a wet weight basis. A total of 89 squalid callista specimens were obtained, presenting an average Hg concentration of 0.07 ± 0.04 µg g -1 . There were no significant differences (p > 0.05) in Hg concentration between tissues (visceral mass = 0.09 ± 0.08 µg g -1 ; mantle = 0.06 ± 0.07 µg g -1 ; muscle = 0.06 ± 0.04 µg g -1 ). The low Hg values found in squalid callista and its low risk quotient (HQ = 0.03) suggest that the consumption of squalid callista does not represent a human health risk. However, HQ calculated using MeHg was > 1, it which could indicate a potential risk related to consumption of clams.

  11. An In Silico Approach for Evaluating a Fraction-Based, Risk Assessment Method for Total Petroleum Hydrocarbon Mixtures

    Directory of Open Access Journals (Sweden)

    Nina Ching Y. Wang

    2012-01-01

    Full Text Available Both the Massachusetts Department of Environmental Protection (MADEP and the Total Petroleum Hydrocarbon Criteria Working Group (TPHCWG developed fraction-based approaches for assessing human health risks posed by total petroleum hydrocarbon (TPH mixtures in the environment. Both organizations defined TPH fractions based on their expected environmental fate and by analytical chemical methods. They derived toxicity values for selected compounds within each fraction and used these as surrogates to assess hazard or risk of exposure to the whole fractions. Membership in a TPH fraction is generally defined by the number of carbon atoms in a compound and by a compound's equivalent carbon (EC number index, which can predict its environmental fate. Here, we systematically and objectively re-evaluate the assignment of TPH to specific fractions using comparative molecular field analysis and hierarchical clustering. The approach is transparent and reproducible, reducing inherent reliance on judgment when toxicity information is limited. Our evaluation of membership in these fractions is highly consistent (̃80% on average across various fractions with the empirical approach of MADEP and TPHCWG. Furthermore, the results support the general methodology of mixture risk assessment to assess both cancer and noncancer risk values after the application of fractionation.

  12. Tourniquets do not increase the total blood loss or re-amputation risk in transtibial amputations

    DEFF Research Database (Denmark)

    Wied, Christian; Tengberg, Peter T; Holm, Gitte

    2017-01-01

    AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January...... 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed...... portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS: Seventy-four out of 86 consecutive patients who underwent TTA within...

  13. Ileus following total hip or knee arthroplasty is associated with increased risk of deep venous thrombosis and pulmonary embolism.

    Science.gov (United States)

    Berend, Keith R; Lombardi, Adolph V; Mallory, Thomas H; Dodds, Kathleen L; Adams, Joanne B

    2004-10-01

    Venous thromboembolic disease (VTD), deep venous thrombosis and pulmonary embolism, causes morbidity and mortality following total hip and total knee arthroplasties, while ileus complicates up to 4.0%. The clinical courses of 2,949 patients undergoing 3,364 consecutive primary and revision total hip and total knee arthroplasties, radical debridements, and reimplantations at one institution over a 2-year period were reviewed to examine the relationship between ileus and VTD. VTD prophylaxis consisted of aspirin and intermittent plantar pulse boots for all patients except those at high risk, who received parenteral chemical prophylaxis and boots. Ileus occurred in 62 patients (2.1%) and symptomatic DVT in 51 (1.7%). With ileus, the incidence of DVT was 8.1%: odds ratio 5.5 (P =.0036). Symptomatic pulmonary embolism occurred in 7 patients (0.24%); with ileus the incidence was 3.2%: odds ratio 19.6 (P =.0082). A significant increase was observed in rates of VTD with ileus. We recommend using parenteral chemical and mechanical prophylaxis in patients with ileus following total hip and total knee arthroplasties.

  14. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk

    DEFF Research Database (Denmark)

    Abuyaman, Omar; Torring, Niels; Obeid, Rima

    2016-01-01

    transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN...... preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS: First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases...... and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\\L for sCD320, 20-140 (70) pmol...

  15. Using Numerical Models in the Development of Software Tools for Risk Management of Accidents with Oil and Inert Spills

    Science.gov (United States)

    Fernandes, R.; Leitão, P. C.; Braunschweig, F.; Lourenço, F.; Galvão, P.; Neves, R.

    2012-04-01

    The increasing ship traffic and maritime transport of dangerous substances make it more difficult to significantly reduce the environmental, economic and social risks posed by potential spills, although the security rules are becoming more restrictive (ships with double hull, etc.) and the surveillance systems are becoming more developed (VTS, AIS). In fact, the problematic associated to spills is and will always be a main topic: spill events are continuously happening, most of them unknown for the general public because of their small scale impact, but with some of them (in a much smaller number) becoming authentic media phenomena in this information era, due to their large dimensions and environmental and social-economic impacts on ecosystems and local communities, and also due to some spectacular or shocking pictures generated. Hence, the adverse consequences posed by these type of accidents, increase the preoccupation of avoiding them in the future, or minimize their impacts, using not only surveillance and monitoring tools, but also increasing the capacity to predict the fate and behaviour of bodies, objects, or substances in the following hours after the accident - numerical models can have now a leading role in operational oceanography applied to safety and pollution response in the ocean because of their predictive potential. Search and rescue operation, oil, inert (ship debris, or floating containers), and HNS (hazardous and noxious substances) spills risk analysis are the main areas where models can be used. Model applications have been widely used in emergency or planning issues associated to pollution risks, and contingency and mitigation measures. Before a spill, in the planning stage, modelling simulations are used in environmental impact studies, or risk maps, using historical data, reference situations, and typical scenarios. After a spill, the use of fast and simple modelling applications allow to understand the fate and behaviour of the spilt

  16. The Ohio River Valley CO2 Storage Project AEP Mountaineer Plant, West Virginia Numerical Simulation and Risk Assessment Report

    Energy Technology Data Exchange (ETDEWEB)

    Neeraj Gupta

    2008-03-31

    A series of numerical simulations of carbon dioxide (CO{sub 2}) injection were conducted as part of a program to assess the potential for geologic sequestration in deep geologic reservoirs (the Rose Run and Copper Ridge formations), at the American Electric Power (AEP) Mountaineer Power Plant outside of New Haven, West Virginia. The simulations were executed using the H{sub 2}O-CO{sub 2}-NaCl operational mode of the Subsurface Transport Over Multiple Phases (STOMP) simulator (White and Oostrom, 2006). The objective of the Rose Run formation modeling was to predict CO{sub 2} injection rates using data from the core analysis conducted on the samples. A systematic screening procedure was applied to the Ohio River Valley CO{sub 2} storage site utilizing the Features, Elements, and Processes (FEP) database for geological storage of CO{sub 2} (Savage et al., 2004). The objective of the screening was to identify potential risk categories for the long-term geological storage of CO{sub 2} at the Mountaineer Power Plant in New Haven, West Virginia. Over 130 FEPs in seven main classes were assessed for the project based on site characterization information gathered in a geological background study, testing in a deep well drilled on the site, and general site conditions. In evaluating the database, it was apparent that many of the items were not applicable to the Mountaineer site based its geologic framework and environmental setting. Nine FEPs were identified for further consideration for the site. These FEPs generally fell into categories related to variations in subsurface geology, well completion materials, and the behavior of CO{sub 2} in the subsurface. Results from the screening were used to provide guidance on injection system design, developing a monitoring program, performing reservoir simulations, and other risk assessment efforts. Initial work indicates that the significant FEPs may be accounted for by focusing the storage program on these potential issues. The

  17. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    International Nuclear Information System (INIS)

    Cheng, Zhang; Li, Han-Han; Wang, Hong-sheng; Zhu, Xue-Mei; Sthiannopkao, Suthipong; Kim, Kyoung-Woong; Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham; Wong, Ming-Hung

    2016-01-01

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g −1 , 0.19–1.65 (median 0.86) μg g −1 and 0.24–3.05 (median 0.59) μg g −1 wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg −1 bw d −1 , respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  18. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Zhang; Li, Han-Han [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Wang, Hong-sheng [Department of Microbial and Biochemical Pharmacy, School of Pharmaceutical Sciences, Sun Yat-sen University, No.132 Waihuandong Road, University Town, Guangzhou 510006 (China); Zhu, Xue-Mei [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Sthiannopkao, Suthipong [Department of Environmental and Occupational Health, National Cheng Kung University, Tainan City, Taiwan (China); Kim, Kyoung-Woong [School of Environmental Science and Engineering, Gwangju Institute of Science and Technology, Gwangju (Korea, Republic of); Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham [United Nations University-International Institute for Global Health, Kuala Lumpur (Malaysia); Wong, Ming-Hung, E-mail: minghwong@ied.edu.hk [Consortium on Health, Environment, Education and Research (CHEER), and Department of Science and Environmental Studies, Hong Kong Institute of Education, Tai Po, Hong Kong (China); School of Environment, Jinan University, Guangzhou (China)

    2016-10-15

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g{sup −1}, 0.19–1.65 (median 0.86) μg g{sup −1} and 0.24–3.05 (median 0.59) μg g{sup −1} wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg{sup −1} bw d{sup −1}, respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  19. Total flight hours, irritated and burning eye and risk of mild myopia in civilian pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Pritha Maya Savitri

    2016-07-01

      in civilian aviator and other populatian. This study aims to identify risk factors that affect the incidence of mild myopia in  civilian pilot in Indonesia. Methods: This study using cross-sectional method with purposive sampling. Subjects answered the questionaire.  Subject of this study are 21-45 years old male civilian aviators which performs scheduled medical check up at Civil Aviatian Medical Centre at May 5 – 21, 2014. The researcher using the medical record to get data about visual acuity. Cox regression analyses using Stata 9. Mild myopia in this study is defect distant visual acuity with corrected lens power -0.25 s/d -0.30. Results: The percentage of mild myopia in this study was 36%. Subjects with a total of 1000 hours of flying hours or more had a 28% higher risk of experiencing mild myopia [relative risk (RRa = 1.28; 95% confidence interval (CI = 1.00 to 1.64; P = 0.047]. A history of parental myopia will increase the risk of mild myopia 5 times (RRa = 5.32, P = 0.000. Subjects with symptoms of difficulty focus has 48% higher risk of experiencing mild myopia (RRa = 1.48, 95% CI = 1.19 to 1.85, P = 0.001. Subjects with symptoms such as eye irritation, gritty, burning has a 54% lower risk of experiencing mild myopia (RRa = 0.46, 95% CI = 0.26-0.83, P = 0.009. Conclusions: Total flight time, parental myopia, visual fatigue; difficulty in focusing and foggy letters are influenced risk factors for mild myopia in civilian aviator in Indonesia. Key words: mild myopia, civilian aviator, total flight time, Indonesia.

  20. Total Dietary Fiber, and Selected Vegetable, Fruit, Legume and Cereal Fiber Intake and Risk of Heart Attack in Periodontitis Subjects

    Directory of Open Access Journals (Sweden)

    Nelson Wood

    2011-10-01

    Full Text Available Background: Epidemiological studies have found an association between periodontal disease and coronary artery disease(Arbes, Slade et al. 1999; Beck, Elter et al. 2001; Genco, Offenbacher et al. 2002, and have even implicated periodontal disease as a risk factor(Arbes, Slade et al. 1999; Beck, Elter et al. 2001, however have not proven causality(Hujoel, Drangholt et al. 2000. Although dietary amounts, sources, and types (soluble versus insoluble of fiber have been shown to reduce the risk of heart attack (Liu, Buring et al. 2002; Negri, Vecchia et al. 2003, this author is unaware of studies that have examined the association between food sources of dietary fiber and heart attack risk in subjects with periodontitis.This study was designed to determine whether total dietary fiber and fiber from different plant sources (vegetables, fruits, legumes, or cereals modified self-reported HA risk, as well as acute-phase inflammatory responses in subjects with periodontitis using NHANES III data.Objectives: The objective of this study was to investigate the association between total dietary fiber intake levels, and selected vegetables, fruits, legumes, and cereal fiber intake and the risk of self-reported history of heart attack (HA in periodontitis subjects using data available in the Third National Health and Nutrition Examination Survey (NHANES III.Materials and Methods: Adult participants in NHANES III were used in this study. Zero to thirty three (0-33 percent of sites with periodontal attachment loss > 3 mm was considered a healthy periodontium, while greater than thirty three percent (>33 of sites with periodontal attachment loss of > 3 mm as periodontitis. The outcome variable was the self-reported history of HA. Total dietary fiber, and monthly selected vegetable, fruit, legume and cereal consumption were divided into low and adequate levels. Data was analyzed by Kruskal-Wallis, ANOVA and multivariate analyses using SPSS ®. P<0.05 was used to

  1. Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

    2017-12-06

    For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Total flight hours, irritated and burning eye and risk of mild myopia in civilian pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Pritha Maya Savitri

    2016-07-01

    Full Text Available Latar belakang: Miopia merupakan kelainan refraksi yang sering terjadi di antara penerbang. Penelitianini bertujuan mengidentifikasi beberapa faktor risiko dominan terhadap miopia ringan pada penerbang sipildi Indonesia.Metode: Subyek adalah penerbang sipil pria berusia 21-45 tahun yang dipilih secara purposif di antara yangsedang melaksanakan pemeriksaan kesehatan berkala di Balai Kesehatan Penerbangan Jakarta. Data tajampenglihatan dan gula darah didapatkan dari rekam medik. Miopia ringan adalah subyek dengan penurunantajam penglihatan dengan koreksi lensa -0,25 sampai dengan -0,30. Analisis data dengan regresi Coxmenggunakan Stata 10.Hasil: Persentase miopia ringan dalam penelitian ini sebesar 36%. Faktor risiko dominan terhadap myopiaringan adalah jam terbang total, riwayat orang tua myopia, dan gejala iritasi dan gatal mata. Subyekdengan dibandingkan dengan yang kurang dari 1000 jam terbang 28% lebih tinggi berisiko myopia ringan[risiko relatif suaian (RRa = 1,28; 95% interval kepercayaan (CI =1,00-1,64; P = 0,047]. Subyek dengandibandingkan ttanpa riwayat orang tua myopia 32% lebih tinggi berisiko myopia ringan (RRa = 5,32; 95%CI = 3,75-7,55; P = 0,000. Sedangkan subyek dengan dibandingkan tanpa gejala iritasi mata 48% lebihbesar berisiko miopia ringan RRa = 1,48; 95% CI = 1,19-1,85; P = 0,001. Subyek dengan dibandingkantanpa gejala iritasi mata 46% lebih berisiko miopia ringan (RRa = 0,46; 95% CI = 0,26-0,83; P = 0,009.Kesimpulan: Jam terbang total lebih dari 1000 jam, riwayat orang tua miopia, iritasi mata merupakanfaktor risiko dominan terhadap miopia ringan pada penerbang sipil di Indonesia. (Health Science Journalof Indonesia 2016;7:49-53Kata kunci: miopia ringan, penerbang sipil, jam terbang, Indonesia Background: Spatial orientation is the main problem to pilots that determined by visual, vestibuler andpropioseptif. This study aims to identify several dominant risk factors related to mild myopia in civilianpilots in Indonesia

  3. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  4. Acyl/free carnitine ratio is a risk factor for hepatic steatosis after pancreatoduodenectomy and total pancreatectomy.

    Science.gov (United States)

    Nakamura, Masafumi; Nakata, Kohei; Matsumoto, Hideo; Ohtsuka, Takao; Yoshida, Koji; Tokunaga, Shoji; Hino, Keisuke

    Hepatic steatosis, one of the most frequent long-term complications of pancreatectomy, influences not only hepatic function but also survival rate. However, its risk factors and pathogenesis have not been established. The purpose of this study was to clarify the risk factors for hepatic steatosis after pancreatectomy. In this retrospective study of 21 patients who had undergone pancreatectomy (19 cases of pancreatoduodenectomy and 2 cases of total pancreatectomy), serum carnitine concentrations, fractions of carnitine, and hepatic attenuation on computed tomography images were analyzed with the aim of identifying risk factors for hepatic steatosis. Thirteen (61.9%) of the 21 patients were diagnosed as having hypocarnitinemia after pancreatectomy. Average hepatic attenuation was as low as 42.2HU (±21.3 SD). A high ratio of acyl/free carnitine was associated with less pronounced hepatic attenuation according to both univariate (P pancreatectomy in some patients. The statistical analyses suggest that a high ratio of acyl/free carnitine is an independent risk factor for hepatic steatosis after pancreatectomy. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  5. Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Kong, Lingde; Cao, Junming; Zhang, Yingze; Ding, Wenyuan; Shen, Yong

    2017-06-01

    To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  6. Stratifying risk in chronic kidney disease: an observational study of UK guidelines for measuring total proteinuria and albuminuria.

    Science.gov (United States)

    Methven, S; Traynor, J P; Hair, M D; St J O'Reilly, D; Deighan, C J; MacGregor, M S

    2011-08-01

    Proteinuria predicts poor renal and cardiovascular outcomes. Some guidelines recommend measuring proteinuria using albumin:creatinine ratio (ACR), while others recommend total protein:creatinine ratio (TPCR). To compare renal outcomes and mortality in the populations identified by these different recommendations. Retrospective longitudinal cohort study. Baseline ACR and TPCR measurements were obtained from 5586 patients with chronic kidney disease (CKD) attending a Scottish hospital nephrology clinic. The cohort was divided into three groups with concordant results by ACR and TPCR (no proteinuria; low proteinuria; significant proteinuria) and one group with discordant results (significant proteinuria with TPCR, but not ACR). Outcomes were assessed using Kaplan-Meier plots and Cox proportional hazards models. Median follow-up was 3.5 years [interquartile range (IQR) 2.1-6.0]; 844 (15%) died at 3.0 years (IQR 1.8-4.7) and 468 (8%) started renal replacement therapy (RRT) at 1.7 years (IQR 0.6-3.4). Proteinuria was associated with a substantially increased risk of RRT and death. Patients with significant proteinuria by TPCR, but not ACR (n = 231) had high renal risk, and the highest all-cause mortality (log-rank P < 0.001). With multivariate analysis the risk fell below those with significant proteinuria with concordant results by ACR and TPCR but remained considerably higher than those without significant proteinuria. Proteinuria screening with TPCR identifies an additional 16% of patients with significant proteinuria, not identified using ACR. This subgroup has high renal risk, and high risk of all-cause mortality and therefore warrant identification. Guideline recommendations on proteinuria screening in CKD should be reconsidered.

  7. Does IQ predict total and cardiovascular disease mortality as strongly as other risk factors? Comparison of effect estimates using the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G D; Shipley, M J; Gale, C R

    2008-01-01

    To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality.......To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality....

  8. Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.

    Science.gov (United States)

    Ryan, Devon J; Yoshihara, Hiroyuki; Yoneoka, Daisuke; Zuckerman, Joseph D

    2015-05-01

    Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. This study used national hospital discharge data from the National Inpatient Sample between 2000 and 2009. The data were used to generate the overall blood transfusion rate, and linear regression was used to assess trends in transfusion patterns over time. Logistic regression analysis was performed to analyze which patient and hospital characteristics independently influence the likelihood that a given patient undergoes ALBT. The overall blood transfusion rate (ie, the proportion of patients who received at least 1 transfusion of any kind) was 6.7%. This rate increased over time, from 4.9% in 2000 to 7.1% in 2009 (P blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.

    Science.gov (United States)

    Börekçi, A; Gür, M; Şeker, T; Baykan, A O; Özaltun, B; Karakoyun, S; Karakurt, A; Türkoğlu, C; Makça, I; Çaylı, M

    2015-09-01

    Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality. The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers. We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients. The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (prisk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion. © The Author(s) 2014.

  10. Benefit–risk assessment of rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total hip or knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Levitan B

    2014-03-01

    Full Text Available Bennett Levitan,1 Zhong Yuan,1 Alexander GG Turpie,2 Richard J Friedman,3 Martin Homering,4 Jesse A Berlin,1 Scott D Berkowitz,5 Rachel B Weinstein,1 Peter M DiBattiste61Janssen Research & Development, LLC, Titusville, NJ, USA; 2Hamilton Health Sciences McMaster Clinic, McMaster University, Hamilton, ON, Canada; 3Charleston Orthopaedic Associates, Charleston, SC, USA; 4Bayer HealthCare, Berlin, Germany; 5Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA; 6Janssen Research & Development, Raritan, NJ, USAPurpose: Venous thromboembolism is a common complication after major orthopedic surgery. When prescribing anticoagulant prophylaxis, clinicians weigh the benefits of thromboprophylaxis against bleeding risk and other adverse events. Previous benefit–risk analyses of the REgulation of Coagulation in ORthopaedic surgery to prevent Deep vein thrombosis and pulmonary embolism (RECORD randomized clinical studies of rivaroxaban versus enoxaparin after total hip (THA or knee (TKA arthroplasty generally used pooled THA and TKA results, counted fatal bleeding as both an efficacy and a safety event, and included the active and placebo-controlled portions of RECORD2, which might confound benefit–risk assessments. We conducted a post hoc analysis without these constraints to assess benefit–risk for rivaroxaban versus enoxaparin in the RECORD studies.Patients and methods: Data from the safety population of the two THA and two TKA studies were pooled separately. The primary analysis compared the temporal course of event rates and rate differences between rivaroxaban and enoxaparin prophylaxis for symptomatic venous thromboembolism plus all-cause mortality (efficacy events versus nonfatal major bleeding (safety events. Additionally, these rates were used to derive measures of net clinical benefit, number needed to treat (NNT, and number needed to harm (NNH for these two end points.Results: After THA or TKA, and compared with enoxaparin, rivaroxaban

  11. Effect of human movement on airborne disease transmission in an airplane cabin: study using numerical modeling and quantitative risk analysis.

    Science.gov (United States)

    Han, Zhuyang; To, Gin Nam Sze; Fu, Sau Chung; Chao, Christopher Yu-Hang; Weng, Wenguo; Huang, Quanyi

    2014-08-06

    Airborne transmission of respiratory infectious disease in indoor environment (e.g. airplane cabin, conference room, hospital, isolated room and inpatient ward) may cause outbreaks of infectious diseases, which may lead to many infection cases and significantly influences on the public health. This issue has received more and more attentions from academics. This work investigates the influence of human movement on the airborne transmission of respiratory infectious diseases in an airplane cabin by using an accurate human model in numerical simulation and comparing the influences of different human movement behaviors on disease transmission. The Eulerian-Lagrangian approach is adopted to simulate the dispersion and deposition of the expiratory aerosols. The dose-response model is used to assess the infection risks of the occupants. The likelihood analysis is performed as a hypothesis test on the input parameters and different human movement pattern assumptions. An in-flight SARS outbreak case is used for investigation. A moving person with different moving speeds is simulated to represent the movement behaviors. A digital human model was used to represent the detailed profile of the occupants, which was obtained by scanning a real thermal manikin using the 3D laser scanning system. The analysis results indicate that human movement can strengthen the downward transport of the aerosols, significantly reduce the overall deposition and removal rate of the suspended aerosols and increase the average infection risk in the cabin. The likelihood estimation result shows that the risk assessment results better fit the outcome of the outbreak case when the movements of the seated passengers are considered. The intake fraction of the moving person is significantly higher than most of the seated passengers. The infection risk distribution in the airplane cabin highly depends on the movement behaviors of the passengers and the index patient. The walking activities of the crew

  12. Industrial water resources management based on violation risk analysis of the total allowable target on wastewater discharge.

    Science.gov (United States)

    Yue, Wencong; Cai, Yanpeng; Xu, Linyu; Yang, Zhifeng; Yin, Xin'An; Su, Meirong

    2017-07-11

    To improve the capabilities of conventional methodologies in facilitating industrial water allocation under uncertain conditions, an integrated approach was developed through the combination of operational research, uncertainty analysis, and violation risk analysis methods. The developed approach can (a) address complexities of industrial water resources management (IWRM) systems, (b) facilitate reflections of multiple uncertainties and risks of the system and incorporate them into a general optimization framework, and (c) manage robust actions for industrial productions in consideration of water supply capacity and wastewater discharging control. The developed method was then demonstrated in a water-stressed city (i.e., the City of Dalian), northeastern China. Three scenarios were proposed according to the city's industrial plans. The results indicated that in the planning year of 2020 (a) the production of civilian-used steel ships and machine-made paper & paperboard would reduce significantly, (b) violation risk of chemical oxygen demand (COD) discharge under scenario 1 would be the most prominent, compared with those under scenarios 2 and 3, (c) the maximal total economic benefit under scenario 2 would be higher than the benefit under scenario 3, and (d) the production of rolling contact bearing, rail vehicles, and commercial vehicles would be promoted.

  13. Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme

    NARCIS (Netherlands)

    Nevens, Daan; Deschuymer, Sarah; Langendijk, Johannes A.; Daisne, Jean -Francois; Duprez, Frederic; De Neve, Wilfried; Nuyts, Sandra

    Background and purpose: A risk model, the total dysphagia risk score (TDRS), was developed to predict which patients are most at risk to develop grade >= 2 dysphagia at 6 months following radiotherapy (RT) for head and neck cancer. The purpose of this study was to validate this model at 6 months and

  14. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study.

    Directory of Open Access Journals (Sweden)

    Shona J Livingstone

    previously reported in other developed countries, CVD and mortality rates may not be generalizable to other countries. Limitations included lack of information on the specific insulin therapy used.Although the relative risks for CVD and total mortality associated with T1DM in this population have declined relative to earlier studies, T1DM continues to be associated with higher CVD and death rates than the non-diabetic population. Risk factor management should be improved to further reduce risk but better treatment approaches for achieving good glycaemic control are badly needed. Please see later in the article for the Editors' Summary.

  15. Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort.

    Science.gov (United States)

    Shadyab, A H; Terkeltaub, R; Kooperberg, C; Reiner, A; Eaton, C B; Jackson, R D; Krok-Schoen, J L; Salem, R M; LaCroix, A Z

    2018-05-22

    To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  16. Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

    Science.gov (United States)

    Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

    2016-01-01

    Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

  17. Incidence of and risk factors for postoperative urinary retention in fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars; Bogø, Stina; Raaschou, Sofie

    2015-01-01

    BACKGROUND AND PURPOSE: Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). PATIENTS AND METHODS......, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. RESULTS: The incidence of POUR was 40% (range between departments: 30-55%). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk...... was 40%, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future....

  18. SU-F-T-248: FMEA Risk Analysis Implementation (AAPM TG-100) in Total Skin Electron Irradiation Technique

    Energy Technology Data Exchange (ETDEWEB)

    Ibanez-Rosello, B; Bautista-Ballesteros, J; Bonaque, J [Hospital La Fe, Valencia, Valencia (Spain); Perez-Calatayud, J [Hospital La Fe, Valencia, Valencia (Spain); Clinica Benidorm, Benidorm, Alicante (Spain); Gonzalez-Sanchis, A; Lopez-Torrecilla, J; Brualla-Gonzalez, L; Garcia-Hernandez, T; Vicedo-Gonzalez, A; Granero, D; Serrano, A; Borderia, B; Solera, C [Hospital General ERESA, Valencia, Valencia (Spain); Rosello, J [Hospital General ERESA, Valencia, Valencia (Spain); Universidad de Valencia, Valencia, Valencia (Spain)

    2016-06-15

    Purpose: Total Skin Electron Irradiation (TSEI) is a radiotherapy treatment which involves irradiating the entire body surface as homogeneously as possible. It is composed of an extensive multi-step technique in which quality management requires high consumption of resources and a fluid communication between the involved staff, necessary to improve the safety of treatment. The TG-100 proposes a new perspective of quality management in radiotherapy, presenting a systematic method of risk analysis throughout the global flow of the stages through the patient. The purpose of this work has been to apply TG-100 approach to the TSEI procedure in our institution. Methods: A multidisciplinary team specifically targeting TSEI procedure was formed, that met regularly and jointly developed the process map (PM), following TG-100 guidelines of the AAPM. This PM is a visual representation of the temporal flow of steps through the patient since start until the end of his stay in the radiotherapy service. Results: This is the first stage of the full risk analysis, which is being carried out in the center. The PM provides an overview of the process and facilitates the understanding of the team members who will participate in the subsequent analysis. Currently, the team is implementing the analysis of failure modes and effects (FMEA). The failure modes of each of the steps have been identified and assessors are assigning a value of severity (S), frequency of occurrence (O) and lack of detection (D) individually. To our knowledge, this is the first PM made for the TSEI. The developed PM can be useful for those centers that intend to implement the TSEI technique. Conclusion: The PM of TSEI technique has been established, as the first stage of full risk analysis, performed in a reference center in this treatment.

  19. Total joint replacement: A multiple risk factor analysis of physical activity level 1-2 years postoperatively.

    Science.gov (United States)

    Paxton, Elizabeth W; Torres, Andy; Love, Rebecca M; Barber, Thomas C; Sheth, Dhiren S; Inacio, Maria C S

    2016-07-01

    Background and purpose - The effect of total joint arthroplasty (TJA) on physical activity is not fully understood. We investigated the change in physical activity after TJA and patient factors associated with change. Patients and methods - Using a total joint replacement registry, primary total hip arthroplasty (THA) patients (n = 5,678) and knee arthroplasty (TKA) patients (n = 11,084) between January 1, 2010 and December 31, 2012 were identified. Median age at THA was 68 and median age at TKA was 67. Change in self-reported physical activity (minutes per week) from before TJA (within 1 year of surgery) to after TJA (1-2 years) was the outcome of interest. Patient demographics and comorbidities were evaluated as risk factors. Multiple linear regression was used. Results - Median physical activity before surgery was 50 min/week (IQR: 0-140) for THA patients and 58 (IQR: 3-143) for TKA patients. Median physical activity after surgery was 150 min/week (IQR: 60-280) for both THA patients and TKA patients. Following TJA, 50% of patients met CDC/WHO physical activity guideline criteria. Higher body mass index was associated with lower change in physical activity (THA: -7.1 min/week; TKA: -5.9 min/week). Females had lower change than males (THA: -11 min/week; TKA: -9.1 min/week). In TKA patients, renal failure was associated with lower change (-17 min/week), as were neurological disorders (-30 min/week). Interpretation - Self-reported minutes of physical activity increased from before to after TJA, but 50% of TJA patients did not meet recommended physical activity guideline criteria. Higher body mass index, female sex, and specific comorbidities were found to be associated with low change in physical activity. Patient education on the benefits of physical activity should concentrate on these subgroups of patients.

  20. Using ambient vibration measurements for risk assessment at an urban scale: from numerical proof of concept to Beirut case study (Lebanon)

    Science.gov (United States)

    Salameh, Christelle; Bard, Pierre-Yves; Guillier, Bertrand; Harb, Jacques; Cornou, Cécile; Gérard, Jocelyne; Almakari, Michelle

    2017-04-01

    Post-seismic investigations repeatedly indicate that structures having frequencies close to foundation soil frequencies exhibit significantly heavier damages (Caracas 1967; Mexico 1985; Pujili, Ecuador 1996; L'Aquila 2009). However, observations of modal frequencies of soils and buildings in a region or within a current seismic risk analysis are not fully considered together, even when past earthquakes have demonstrated that coinciding soil and building frequencies leads to greater damage. The present paper thus focuses on a comprehensive numerical analysis to investigate the effect of coincidence between site and building frequencies. A total of 887 realistic soil profiles are coupled with a set of 141 single-degree-of-freedom elastoplastic oscillators, and their combined (nonlinear) response is computed for both linear and nonlinear soil behaviors, for a large number (60) of synthetic input signals with various PGA levels and frequency contents. The associated damage is quantified on the basis of the maximum displacement as compared to both yield and ultimate post-elastic displacements, according to the RISK-UE project recommendations (Lagomarsino and Giovinazzi in Bull Earthq Eng 4(4):415-443, 2006), and compared with the damage obtained in the case of a similar building located on rock. The correlation between this soil/rock damage increment and a number of simplified mechanical and loading parameters is then analyzed using a neural network approach. The results emphasize the key role played by the building/soil frequency ratio even when both soil and building behave nonlinearly; other important parameters are the PGA level, the soil/rock velocity contrast and the building ductility. A numerical investigation based on simulation of ambient noise for the whole set of 887 profiles also indicates that the amplitude of H/ V ratio may be considered as a satisfactory proxy for site amplification when applied to measurements at urban scale. A very easy implementation

  1. Lung cancer risk assessment due to traffic-generated particles exposure in urban street canyons: A numerical modelling approach.

    Science.gov (United States)

    Scungio, M; Stabile, L; Rizza, V; Pacitto, A; Russi, A; Buonanno, G

    2018-08-01

    Combustion-generated nanoparticles are responsible for negative health effects due to their ability to penetrate in the lungs, carrying toxic compounds with them. In urban areas, the coexistence of nanoparticle sources and particular street-building configurations can lead to very high particle exposure levels. In the present paper, an innovative approach for the evaluation of lung cancer incidence in street canyon due to exposure to traffic-generated particles was proposed. To this end, the literature-available values of particulate matter, PAHs and heavy metals emitted from different kind of vehicles were used to calculate the Excess Lifetime Cancer Risk (ELCR) at the tailpipe. The estimated ELCR was then used as input data in a numerical CFD (Computational Fluid Dynamics) model that solves the mass, momentum, turbulence and species transport equations, in order to evaluate the cancer risk in every point of interest inside the street canyon. Thus, the influence of wind speed and street canyon geometry (H/W, height of building, H and width of the street, W) on the ELCR at street level was evaluated by means of a CFD simulation. It was found that the ELCR calculated on the leeward and windward sides of the street canyon at a breathable height of 1.5 m, for people exposed 15 min per day for 20 years, is equal to 1.5 × 10 -5 and 4.8 × 10 -6 , respectively, for wind speed of 1 m/s and H/W equal to 1. The ELCR at street level results higher on the leeward side for aspect ratios equal to 1 and 3, while for aspect ratio equal to 2 it is higher on the windward side. In addition, the simulations showed that with the increasing of wind speed the ELCR becomes lower everywhere in the street canyon, due to the increased in dispersion. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Simulating infectious disease risk based on climatic drivers: from numerical weather prediction to long term climate change scenario

    Science.gov (United States)

    Caminade, C.; Ndione, J. A.; Diallo, M.; MacLeod, D.; Faye, O.; Ba, Y.; Dia, I.; Medlock, J. M.; Leach, S.; McIntyre, K. M.; Baylis, M.; Morse, A. P.

    2012-04-01

    Climate variability is an important component in determining the incidence of a number of diseases with significant health and socioeconomic impacts. In particular, vector born diseases are the most likely to be affected by climate; directly via the development rates and survival of both the pathogen and the vector, and indirectly through changes in the surrounding environmental conditions. Disease risk models of various complexities using different streams of climate forecasts as inputs have been developed within the QWeCI EU and ENHanCE ERA-NET project frameworks. This work will present two application examples, one for Africa and one for Europe. First, we focus on Rift Valley fever over sub-Saharan Africa, a zoonosis that affects domestic animals and humans by causing an acute fever. We show that the Rift Valley fever outbreak that occurred in late 2010 in the northern Sahelian region of Mauritania might have been anticipated ten days in advance using the GFS numerical weather prediction system. Then, an ensemble of regional climate projections is employed to model the climatic suitability of the Asian tiger mosquito for the future over Europe. The Asian tiger mosquito is an invasive species originally from Asia which is able to transmit West Nile and Chikungunya Fever among others. This species has spread worldwide during the last decades, mainly through the shipments of goods from Asia. Different disease models are employed and inter-compared to achieve such a task. Results show that the climatic conditions over southern England, central Western Europe and the Balkans might become more suitable for the mosquito (including the proviso that the mosquito has already been introduced) to establish itself in the future.

  3. Total working period and other risk factors related to eating protein foods habits among civil pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Indah Imelda Hutabarat

    2017-07-01

    pilots in Indonesia. Methods: A cross-sectional study using secondary data from the survey of eating, drinking and physical exercise habits among civilian pilots in Indonesia 2016. Data collected were demographic characteristics, physical exercise habits, smoking habits, knowledge, body mass index and flight characteristics. Cox regression analysis was used to analyze the dominant factors associated with protein eating habits. Results: Among 528 pilots aged 19-64 years, 194 (36.74% pilots had excessive protein eating habits . Long working period and body mass index were the dominant risk factors associated with protein eating habit in pilots. Compared to pilots with 1-9 years working period, pilots with 10-40 years working period had 35% lower risk of excessive protein eating habits (RRA = 0.65; 95% CI 0:49 - 0.87. Compared to pilots with normal body mass index, overweight pilots had 34% lower risk of excessive protein eating habits (RRA = 0.66; 95% CI 0:47 - 0.93. Conclusion: Long working period and overweight were protective factors from the risk of excessive protein eating habits Keywords: protein eating habits, total working periode, body mass index, civilian pilots Indonesia

  4. Cross-sectional associations of total sitting and leisure screen time with cardiometabolic risk in adults. Results from the HUNT Study, Norway

    NARCIS (Netherlands)

    Chau, J.Y.; Grunseit, A.; Midthjell, K.; Holmen, J.; Holmen, T.L.; Bauman, A.E.; van der Ploeg, H.P.

    2014-01-01

    Objectives: To examine associations of total sitting time, TV-viewing and leisure-time computer use with cardiometabolic risk biomarkers in adults. Design: Population based cross-sectional study. Methods: Waist circumference, BMI, total cholesterol, HDL cholesterol, blood pressure, non-fasting

  5. Patient risk taking and spending habits correlate with willingness to pay for novel total joint arthroplasty implants

    Directory of Open Access Journals (Sweden)

    Ran Schwarzkopf, MD, MSc

    2015-03-01

    Full Text Available In this study, we compare patients' risk-taking and spending behaviors to their willingness to pay (WTP for novel implants in a joint arthroplasty. 210 patients were surveyed regarding risk-taking and spending behavior, and WTP for novel implants with either increased-longevity, increased-longevity with higher risk of complications, or decreased risk of complications compared to a standard implant. Patients with increased recreational risk-taking behavior were more WTP for increased-longevity. Patients who “rarely“ take health-risks were more WTP for decreased risk of complications. Patients with higher combined risk scores were more WTP for all novel implants. Patients who paid more than $50,000 for their current car were more WTP for decreased complications. This study shows that patients' risk taking and spending behavior influences their WTP for novel implants.

  6. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  7. Influence of risk factors on stomal recurrence after total laryngectomy for laryngeal carcinomas: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhi-Yi Wang

    2017-01-01

    Conclusions: In this study, we proved that subglottic location, advanced tumor stage, especially T4 stage, and preoperative tracheostomy were risk factors for SRAL for larynx cancer. However, many other potential risk factors, such as surgical margins, could not be determined for inadequate records. Hence, more prospective trials should be designed to determine the risk factors for SRAL for larynx cancer.

  8. Use of Hip Arthroscopy and Risk of Conversion to Total Hip Arthroplasty: A Population-Based Analysis.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; McCormick, Frank; Lyman, Stephen; Mayman, David

    2016-04-01

    To use population-level data to (1) evaluate the conversion rate of total hip arthroplasty (THA) within 2 years of hip arthroscopy and (2) assess the influence of age, arthritis, and obesity on the rate of conversion to THA. We used the State Ambulatory Surgery Databases and State Inpatient Databases for California and Florida from 2005 through 2012, which contain 100% of patient visits. Hip arthroscopy patients were tracked for subsequent primary THA within 2 years. Out-of-state patients and patients with less than 2 years follow-up were excluded. Multivariate analysis identified risks for subsequent hip arthroplasty after arthroscopy. We identified 7,351 patients who underwent hip arthroscopy with 2 years follow-up. The mean age was 43.9 ± 13.7 years, and 58.8% were female patients. Overall, 11.7% of patients underwent THA conversion within 2 years. The conversion rate was lowest in patients aged younger than 40 years (3.0%) and highest in the 60- to 69-year-old group (35.0%) (P arthroscopy. Patients treated at high-volume hip arthroscopy centers had a lower THA conversion rate than those treated at low-volume centers (15.1% v 9.7%, P arthroscopy is performed in patients of various ages, including middle-aged and elderly patients. Older patients have a higher rate of conversion to THA, as do patients with osteoarthritis or obesity. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. Preoperative preparation of high-risk, specifically hyperimmunized canine renal allograft recipients with total-lymphoid irradiation and cyclosporine

    International Nuclear Information System (INIS)

    Rapaport, F.T.; Meek, A.G.; Arnold, A.N.; Miura, S.; Hayashi, R.; Strober, S.

    1987-01-01

    Hyperimmunized subjects are a particularly high-risk and rapidly growing group in the patient population awaiting renal transplantation. In a search for methods designed to ameliorate the prognosis in such cases, dogs of defined DLA genotype were sensitized with DLA incompatible skin allografts and injections of buffy coat. Each recipient was challenged with a renal allograft bearing the same DLA incompatibilities. Five dogs received kidney transplants, without any other treatment, and rejected their transplants at 2.5, 4, 5, 6, and 6.5 days, respectively. Another four dogs were given a 9-11-week course (1760 +/- 35 cGy) of total-lymphoid irradiation (TLI), followed by rabbit antithymocyte globulin (ATG); these animals rejected their renal allografts at 7, 8, 14, and 17 days, respectively. Five other dogs were treated with TLI and received cyclosporine (CsA) and methylprednisolone (MPd) daily until graft rejection. Their renal allografts survived for 7.5, 8.5, 20, 62, and 227 days, respectively. Renal allografts placed in normal recipients under the same conditions of donor-recipient DLA incompatibility had a mean survival time of 12.4 days (range: 10-18 days). At the time of transplantation, the specific anti-DLA antibody titers in the recipients were 81 to 243 in the untreated dogs; 27 to 81 in the TLI-ATG-treated group, and 3 to 243 in the TLI-CsA/MPd-treated group. The titers fell within 24-48 hr after renal transplantation, to 3 to 81 in the untreated sensitized dogs; they were 3 to 9 in the TLI-ATG-treated group, and were 9 to 243 in the TLI-CsA/MPd treated group. The cytotoxic antibody titers reached postoperative peaks of 6500 to 200,000 in the untreated dogs; 729 to 6500 in the TLI-ATG-treated dogs, and 243 to 6500 in the TLI-CsA/MPd-treated recipients

  10. Dietary total flavonoids intake and risk of mortality from all causes and cardiovascular disease in the general population: A systematic review and meta-analysis of cohort studies.

    Science.gov (United States)

    Liu, Xue-Ming; Liu, Yu-Jian; Huang, Yao; Yu, Hong-Jie; Yuan, Shuai; Tang, Bo-Wen; Wang, Pei-Gang; He, Qi-Qiang

    2017-06-01

    Epidemiologic studies assessing the association between dietary total flavonoids intake and the risk of mortality from cardiovascular disease (CVD) and all causes have yielded inconsistent results. Therefore, we conducted a dose-response meta-analysis to investigate this association. We searched PubMed and Embase databases from January 1966 through May 2016 and examined the references of retrieved articles to identify relevant prospective cohort studies. The random-effect model was used to calculate the summary risk estimates and dose-response analysis was performed. Ten studies were included in the present meta-analysis. The relative risk (RR) of all-cause mortality for the highest versus lowest category of total flavonoids intake was 0.82 (95% confidence interval (CI): 0.72-0.92). Dose-response analysis showed that those consuming 200 mg/day of total flavonoids had the lowest risk of all-cause mortality. Furthermore, a marginally significant association was found between dietary total flavonoids consumption and risk of death from CVD (summary RR: 0.85; 95% CI: 0.70-1.03; P = 0.099) and coronary heart diseases (summary RR: 0.74; 95% CI: 0.54-1.02; P = 0.069), respectively. The meta-analysis provides strong evidence for the recommendation of consuming flavonoids-rich food to reduce risks of mortality from all causes as part of a healthy diet among general adults. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Effect of Antihypertensive Therapy on SCORE-Estimated Total Cardiovascular Risk: Results from an Open-Label, Multinational Investigation—The POWER Survey

    Directory of Open Access Journals (Sweden)

    Guy De Backer

    2013-01-01

    Full Text Available Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. The Physicians' Observational Work on patient Education according to their vascular Risk (POWER survey was an open-label investigation of eprosartan-based therapy (EBT for control of high blood pressure in primary care centers in 16 countries. A prespecified element of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the Systematic Coronary Risk Evaluation (SCORE model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718 patients in 15 countries (6504 men and from 9577 patients at 6 months. During EBT mean (±SD systolic/diastolic blood pressures declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4 mmHg. This was accompanied by a 38% reduction in mean SCORE-estimated CVD risk and an improvement in SCORE risk classification of one category or more in 3506 patients (36.6%. Conclusion. Experience in POWER affirms that (a effective pharmacological control of blood pressure is feasible in the primary care setting and is accompanied by a reduction in total CVD risk and (b the SCORE instrument is effective in this setting for the monitoring of total CVD risk.

  12. Effect of Antihypertensive Therapy on SCORE-Estimated Total Cardiovascular Risk: Results from an Open-Label, Multinational Investigation—The POWER Survey

    Science.gov (United States)

    De Backer, Guy; Petrella, Robert J.; Goudev, Assen R.; Radaideh, Ghazi Ahmad; Rynkiewicz, Andrzej; Pathak, Atul

    2013-01-01

    Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. The Physicians' Observational Work on patient Education according to their vascular Risk (POWER) survey was an open-label investigation of eprosartan-based therapy (EBT) for control of high blood pressure in primary care centers in 16 countries. A prespecified element of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the Systematic Coronary Risk Evaluation (SCORE) model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718 patients in 15 countries (6504 men) and from 9577 patients at 6 months. During EBT mean (±SD) systolic/diastolic blood pressures declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4 mmHg. This was accompanied by a 38% reduction in mean SCORE-estimated CVD risk and an improvement in SCORE risk classification of one category or more in 3506 patients (36.6%). Conclusion. Experience in POWER affirms that (a) effective pharmacological control of blood pressure is feasible in the primary care setting and is accompanied by a reduction in total CVD risk and (b) the SCORE instrument is effective in this setting for the monitoring of total CVD risk. PMID:23997946

  13. Assessment on the pedestrian risk during floods based on numerical simulation - A case study in Jinan City

    Science.gov (United States)

    Cheng, T.; Xu, Z.; Hong, S.

    2017-12-01

    Flood disasters frequently attack the urban area in Jinan City during past years, and the city is faced with severe road flooding which greatly threaten pedestrians' safety. Therefore, it is of great significance to investigate the pedestrian risk during floods under specific topographic condition. In this study, a model coupled hydrological and hydrodynamic processes is developed in the study area to simulate the flood routing process on the road for the "7.18" rainstorm and validated with post-disaster damage survey information. The risk of pedestrian is estimated with a flood risk assessment model. The result shows that the coupled model performs well in the rainstorm flood process. On the basis of the simulation result, the areas with extreme risk, medium risk, and mild risk are identified, respectively. Regions with high risk are generally located near the mountain front area with steep slopes. This study will provide scientific support for the flood control and disaster reduction in Jinan City.

  14. Use of multi-objective air pollution monitoring sites and online air pollution monitoring system for total health risk assessment in Hyderabad, India.

    Science.gov (United States)

    Anjaneyulu, Y; Jayakumar, I; Hima Bindu, V; Sagareswar, G; Mukunda Rao, P V; Rambabu, N; Ramani, K V

    2005-08-01

    A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.). On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad "it has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PM". These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000-15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS) environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real-time monitoring system was designed using advanced

  15. Use of Multi-Objective Air Pollution Monitoring Sites and Online Air Pollution Monitoring System for Total Health Risk Assessment in Hyderabad, India

    Directory of Open Access Journals (Sweden)

    K. V. Ramani

    2005-08-01

    Full Text Available A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.. On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad “it has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PM”. These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000–15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real

  16. Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Gromov, Kirill; Greene, Meridith E; Huddleston, James I

    2016-01-01

    BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

  17. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  18. Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up

    DEFF Research Database (Denmark)

    Langsted, A; Freiberg, J J; Tybjaerg-Hansen, A

    2011-01-01

    Abstract. Langsted A, Freiberg JJ, Tybjaerg-Hansen A, Schnohr P, Jensen GB, Nordestgaard BG (Herlev Hospital, Herlev; University of Copenhagen; Bispebjerg Hospital; and Rigshospitalet, Copenhagen Ø, Denmark) Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction...... and total mortality: the Copenhagen City Heart Study with 31 years of follow-up. J Intern Med 2010; doi: 10.1111/j.1365-2796.2010.02333.x. Objectives. We compared the ability of very high levels of nonfasting cholesterol and triglycerides to predict risk of myocardial infarction and total mortality. Design...

  19. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007-2008.

    Science.gov (United States)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B; Aadahl, Mette; Meyrowitsch, Dan W; Tolstrup, Janne S

    2018-02-01

    This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.

  20. Combined effect of blood pressure and total cholesterol levels on long-term risks of subtypes of cardiovascular death: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan.

    Science.gov (United States)

    Satoh, Michihiro; Ohkubo, Takayoshi; Asayama, Kei; Murakami, Yoshitaka; Sakurai, Masaru; Nakagawa, Hideaki; Iso, Hiroyasu; Okayama, Akira; Miura, Katsuyuki; Imai, Yutaka; Ueshima, Hirotsugu; Okamura, Tomonori

    2015-03-01

    No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP ×4 total cholesterol categories, the group with systolic BP ≥160 mm Hg with total cholesterol ≥5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; Pdeath, and total cholesterol was inversely associated with intraparenchymal hemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population. © 2015 American Heart Association, Inc.

  1. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  2. Numerical relativity

    International Nuclear Information System (INIS)

    Piran, T.

    1982-01-01

    There are many recent developments in numerical relativity, but there remain important unsolved theoretical and practical problems. The author reviews existing numerical approaches to solution of the exact Einstein equations. A framework for classification and comparison of different numerical schemes is presented. Recent numerical codes are compared using this framework. The discussion focuses on new developments and on currently open questions, excluding a review of numerical techniques. (Auth.)

  3. Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component

    DEFF Research Database (Denmark)

    Gromov, K; Bersang, A; Nielsen, C S

    2017-01-01

    ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture. RESULTS: The mean follow-up was 713 days (1 to 2058). A total of 48......AIMS: The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana...... periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near...

  4. Changes in lifestyle, biological risk factors and total homocysteine in relation to MTHFR C677T genotype: a 5-year follow-up study

    DEFF Research Database (Denmark)

    Husemoen, L L N; Linneberg, A; Fenger, M

    2009-01-01

    to increased tHcy in cross-sectional studies. In addition, the methylenetetrahydrofolate reductase (MTHFR) C677T gene variant is an important determinant of elevated tHcy. The main objective of the study was to examine the effect of changes in biological risk factors and lifestyle on tHcy in relation to MTHFR......, physical activity, smoking status, coffee, tea, total alcohol or wine consumption. An inverse relationship was observed between changes in tHcy and changes in the intake of beer in TT individuals but not in CC/CT individuals (P (interaction)=0.01). In addition, changes in tHcy were positively associated......BACKGROUND/OBJECTIVES: Total homocysteine (tHcy) has been associated with increased risk of several diseases in the general population. It is not clear whether these associations are causal. A less healthy lifestyle as well as a less favorable biological risk factor profile have been related...

  5. Ten-Year Trends and Independent Risk Factors for Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital.

    Science.gov (United States)

    Varacallo, Matthew A; Herzog, Leah; Toossi, Nader; Johanson, Norman A

    2017-06-01

    Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013. In total, 1165 primary total hip (511) and knee (654) arthroplasty procedures were identified, and the 30-day and 90-day unplanned readmission rates were 4.6% and 7.3%, respectively. A multivariate regression model controlled for a variety of potential clinical and surgical confounders. Increasing body mass index levels, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each independently correlated with risk of both 30-day and 90-day unplanned readmission to our institution. Additionally, use of general anesthesia during the procedure independently correlated with risk of readmission at 30 days only, while congestive heart failure independently correlated with risk of 90-day unplanned readmission. Readmissions related directly to the surgical site accounted for 47% of the cases, and collectively totaled more than any single medical or clinical complication leading to unplanned readmission within the 90-day period. Increasing body mass index values, general anesthesia, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each were independent risk factors for early unplanned readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Risk of colorectal cancer in relation to frequency and total amount of red meat consumption. Systematic review and meta-analysis.

    Science.gov (United States)

    Smolińska, Katarzyna; Paluszkiewicz, Piotr

    2010-08-30

    The colon and rectum are common sites of food-related cancer in developed countries. Recent studies strongly suggest that red meat intake is associated with colon cancer, whereas for rectal cancer such an association still needs to be proved. The aim of the study was to assess the role of total amount and frequency of red meat intake in colorectal carcinogenesis based on published data using meta-analysis methods. The literature published until 2009 was selected from: MEDLINE, PubMed, Scopus, Embase, CancerLit, Google Scholar and Cochrane Library databases. The used search terms were: colorectal cancer, colon cancer, rectal cancer, meat intake, red meat intake, red meat consumption, meat consumption, colorectal cancer risk, colon cancer risk, rectal cancer risk and lifestyle. Articles investigating red meat intake of more often than once a day or 50 g per day were reviewed and selected for further analysis. Twenty-two studies fulfilled the established criteria. A meta-analysis confirmed the carcinogenic effect of the consumption of over 50 g of red meat per day for the colon (relative risk 1.21, 1.07-1.37) but not for the rectum (relative risk 1.30, 0.90-1.89). Red meat intake more frequently than once a day can induce both colonic (relative risk 1.37, 1.09-1.71) and rectal cancer (relative risk 1.43, 1.24-1.64). Red meat intake is associated with elevated risk of developing colorectal cancer. The frequency of red meat consumption rather than total amount of consumed meat is associated with a higher risk of colorectal carcinogenesis.

  7. Mutation in APOA1 predicts increased risk of ischaemic heart disease and total mortality without low HDL cholesterol levels

    DEFF Research Database (Denmark)

    Haase, C L; Frikke-Schmidt, R; Nordestgaard, B G

    2011-01-01

    levels. Mutations in apolipoprotein (apo) A-I, the major protein constituent of HDL, might be associated with low HDL cholesterol and predispose to IHD and early death. DESIGN: We resequenced APOA1 in 190 individuals and examined the effect of mutations on HDL cholesterol, risk of IHD, myocardial...

  8. The association between nut consumption and the risk of total and ischemic stroke in a German cohort study.

    Science.gov (United States)

    di Giuseppe, R; Fjeld, M K; Dierkes, J; Theoflylaktopoulou, D; Arregui, M; Boeing, H; Weikert, C

    2015-04-01

    Nuts have beneficial effects on coronary heart disease and many cardiovascular risk factors. However, their effect on stroke is less established, and no studies on the topic are available in Northern and Central European populations. Therefore, we aimed at investigating the association between nut consumption and the risk of stroke in a German population. We used data from a prospective cohort of 26,285 participants of the European Prospective Investigation into the Cancer and Nutrition Potsdam Study. During a median follow-up time of 8.3 years (interquartile range: 7.5-9.2), 288 incident cases of stroke occurred. Nut consumption (standard portion size of 50 g) was assessed at baseline with a semiquantitative food-frequency questionnaire. The median nut intake was 0.82 g per day, interquartile range: 0.41-4.11. In the multivariable model, an increased risk of stroke was observed among participants who never consumed nuts (hazard ratio (HR): 1.56, 95% confidence interval: 1.17-2.08), compared with those consuming 1 portion/week. Similar nonsignificant associations were observed in stratified analysis for gender, or for fatal and nonfatal stroke. We could not observe an association between nut consumption and the risk of developing stroke (fatal/nonfatal) in a population with low habitual nut consumption.

  9. Can Surgeons Reduce the Risk for Dislocation After Primary Total Hip Arthroplasty Performed Using the Posterolateral Approach?

    DEFF Research Database (Denmark)

    Seagrave, Kurt G; Troelsen, Anders; Madsen, Bjørn G

    2017-01-01

    was used to identify risk factors for dislocation. Follow-up was coordinated by the Danish National Patient Registry. RESULTS: Age and American Society of Anesthesiologists scores were higher in dislocating THA compared with those in the nondislocating THA. Cup anteversion was less in dislocating THA...

  10. Effect of Risk Acceptance for Bundled Care Payments on Clinical Outcomes in a High-Volume Total Joint Arthroplasty Practice After Implementation of a Standardized Clinical Pathway.

    Science.gov (United States)

    Kee, James R; Edwards, Paul K; Barnes, Charles L

    2017-08-01

    The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes. We retrospectively reviewed all primary total joint arthroplasty patients during the initial 2-year "at risk" period for both BPCI and API and determined discharge disposition, LOS, and readmission rate. During the "at risk" period, the average LOS decreased in our total joint arthroplasty patients and our patients discharged home >94%. Patients within the BPCI group had a decreased discharge to home and decreased readmission rates after total hip arthroplasty, but also tended to be older than both API and nonbundled payment patients. While participating in the BPCI and API, continued use of a standardized CP in a high-performing, high-volume total joint practice resulted in maintenance of a low-average LOS. In addition, BPCI patients had similar outcomes after total knee arthroplasty, but had decreased rates of discharge to home and readmission after total hip arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Psychiatric Disorders and Psychopharmacologic Treatment as Risk Factors in Elective Fast-track Total Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer C; Knop, Joachim; Nordentoft, Merete

    2015-01-01

    BACKGROUND: Psychiatric disorder (PsD) is rarely considered when evaluating perioperative risk factors. Studies on PsD are often limited by use of administrative coding, incomplete follow-up, and lack of preoperative data on psychopharmacological treatment. METHODS: A multicenter study with prosp......BACKGROUND: Psychiatric disorder (PsD) is rarely considered when evaluating perioperative risk factors. Studies on PsD are often limited by use of administrative coding, incomplete follow-up, and lack of preoperative data on psychopharmacological treatment. METHODS: A multicenter study...... inhibitors (SSRIs), 31.6% used other antidepressants, 8.5% used a combination, and 16.5% used antipsychotics. PsD was associated with increased risk of LOS more than 4 days (16.5 vs. 7.3%; odds ratio, 1.90; 95% CI, 1.52 to 2.37), regardless of treatment with SSRIs (2.19; 1.62 to 2.97), other antidepressants...... (2.24; 1.51 to 3.32 and 1.82; 1.27 to 2.61), and antipsychotics (1.85; 1.03 to 3.31, 30 days only). In PsD patients, pain (1.4%), postoperative anemia (1.1%), and pulmonary complications (1.1%) were the most frequent causes of LOS more than 4 days. Hip displacements (2.8%) and falls (1.9%) were...

  12. Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population-based cohort of men.

    Science.gov (United States)

    Mnatzaganian, George; Ryan, Philip; Norman, Paul E; Davidson, David C; Hiller, Janet E

    2011-08-01

    To assess the associations of smoking, body weight, and physical activity with risk of undergoing total joint replacement (TJR) in a population-based cohort of men. A cohort study of 11,388 men that integrated clinical data with hospital morbidity data and mortality records was undertaken. The risk of undergoing TJR was modeled on baseline weight, height, comorbidity, socioeconomic status, years of smoking, and exercise in 3 separate age groups, using Cox proportional hazards regressions and competing risk regressions (CRRs). Dose-response relationships between weight and risk of TJR and between smoking and risk of TJR were observed. Being overweight independently increased the risk of TJR, while smoking lowered the risk. The decreased risk among smokers was demonstrated in both Cox and CRR models and became apparent after 23 years of exposure. Men who were in the highest quartile (≥48 years of smoking) were 42-51% less likely to undergo TJR than men who had never smoked. Tests for trend in the log hazard ratios (HRs) across both smoking and weight quantiles yielded significant P values. Vigorous exercise increased the hazard of TJR; however, the association reached statistical significance only in the 70-74-year-old age group (adjusted HR 1.64 [95% confidence interval 1.19-2.24]). Adjusting for Deyo-Charlson Index or Elixhauser's comorbidity measures did not eliminate these associations. Our findings indicate that being overweight and reporting vigorous physical activity increase the risk of TJR. This study is the first to demonstrate a strong inverse dose-response relationship between duration of smoking and risk of TJR. More research is needed to better understand the role of smoking in the pathogenesis of osteoarthritis. Copyright © 2011 by the American College of Rheumatology.

  13. Cross-sectional associations of total sitting and leisure screen time with cardiometabolic risk in adults. Results from the HUNT Study, Norway.

    Science.gov (United States)

    Chau, Josephine Y; Grunseit, Anne; Midthjell, Kristian; Holmen, Jostein; Holmen, Turid L; Bauman, Adrian E; van der Ploeg, Hidde P

    2014-01-01

    To examine associations of total sitting time, TV-viewing and leisure-time computer use with cardiometabolic risk biomarkers in adults. Population based cross-sectional study. Waist circumference, BMI, total cholesterol, HDL cholesterol, blood pressure, non-fasting glucose, gamma glutamyltransferase (GGT) and triglycerides were measured in 48,882 adults aged 20 years or older from the Nord-Trøndelag Health Study 2006-2008 (HUNT3). Adjusted multiple regression models were used to test for associations between these biomarkers and self-reported total sitting time, TV-viewing and leisure-time computer use in the whole sample and by cardiometabolic disease status sub-groups. In the whole sample, reporting total sitting time ≥10 h/day was associated with poorer BMI, waist circumference, total cholesterol, HDL cholesterol, diastolic blood pressure, systolic blood pressure, non-fasting glucose, GGT and triglyceride levels compared to those reporting total sitting time Leisure-time computer use ≥1 h/day was associated with poorer BMI, total cholesterol, diastolic blood pressure, GGT and triglycerides compared with those reporting no leisure-time computing. Sub-group analyses by cardiometabolic disease status showed similar patterns in participants free of cardiometabolic disease, while similar albeit non-significant patterns were observed in those with cardiometabolic disease. Total sitting time, TV-viewing and leisure-time computer use are associated with poorer cardiometabolic risk profiles in adults. Reducing sedentary behaviour throughout the day and limiting TV-viewing and leisure-time computer use may have health benefits. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

    DEFF Research Database (Denmark)

    Pedersen, A. B.; Mehnert, F.; Havelin, L. I.

    2014-01-01

    Objectives: To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design: 29,558 primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were...... identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results: In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision...

  15. Socioeconomic and hygienic aspects of nutrition correction and water supply in order to improve total resistance and reduce the risk of radiation carcinogenesis

    International Nuclear Information System (INIS)

    Knizhnikov, V.A.; Shandala, N.K.; Komleva, V.A.; Tutel'yan, V.A.

    1995-01-01

    The authors have experimentally demonstrated that selenium deficit in the dies of the population the Russian Federation increases the risk of cancer similarly as total irradiation dose equal to 200 sZv, that is, much more than the doses of irradiation of the population after the Chernobyl power plant accident. Artificial enrichment of diets for selenium helps reduce the risk of death from leukemia and cancer by 5 up to times. Combinations of trace elements and vitamins may bring about a still better effect. The authors discuss nutrition correction and its economic and social validity. 6 refs.; 3 tabs

  16. Numerical analysis

    CERN Document Server

    Khabaza, I M

    1960-01-01

    Numerical Analysis is an elementary introduction to numerical analysis, its applications, limitations, and pitfalls. Methods suitable for digital computers are emphasized, but some desk computations are also described. Topics covered range from the use of digital computers in numerical work to errors in computations using desk machines, finite difference methods, and numerical solution of ordinary differential equations. This book is comprised of eight chapters and begins with an overview of the importance of digital computers in numerical analysis, followed by a discussion on errors in comput

  17. Numerical relativity

    CERN Document Server

    Shibata, Masaru

    2016-01-01

    This book is composed of two parts: First part describes basics in numerical relativity, that is, the formulations and methods for a solution of Einstein's equation and general relativistic matter field equations. This part will be helpful for beginners of numerical relativity who would like to understand the content of numerical relativity and its background. The second part focuses on the application of numerical relativity. A wide variety of scientific numerical results are introduced focusing in particular on the merger of binary neutron stars and black holes.

  18. Relationships of different types of event to cardiovascular death in trials of antihypertensive treatment: an aid to definition of total cardiovascular disease risk in hypertension.

    Science.gov (United States)

    Zambon, Antonella; Arfè, Andrea; Corrao, Giovanni; Zanchetti, Alberto

    2014-03-01

    Guidelines for management of cardiovascular diseases stratify absolute cardiovascular risk into categories with a high-risk threshold defined at a 20% cardiovascular events risk in 10 years, but it is unclear whether only major events or the Framingham-extended definition should be considered. The 2013 ESH-ESC hypertension guidelines, instead, define cardiovascular risk as a risk of cardiovascular death in 10 years, as in the SCORE model, setting the threshold for high risk at the 5% level. It would be therefore convenient to know the quantitative relationship between the risks of the different outcomes adopted by the different guidelines, especially because some outcome definitions include serious nonfatal cardiovascular events relevant in cardiovascular prevention. We have therefore analysed these relationships in trials of antihypertensive therapy as an aid to defining total cardiovascular risk in hypertensive patients. Sixty-one trials were identified, and 51 retained for analysis of the relationship of cardiovascular death to the incidence of all-cause death, major cardiovascular events and inclusive (Framingham) cardiovascular events. The relationship between cardiovascular death rates and each type of event rates was explored by fitting flexible regression models. The included trials provided 15164 cardiovascular deaths and 1674427 patient-years. The relation of each event rate to cardiovascular death rate was best explained by a model considering the logarithm of each event rate as a dependent variable and the logarithm of cardiovascular death rate as a predictor. Mean patients' age and treatment were also predictors, but to a minor extent. The increase of the incidence rates of all types of events was less steep the higher the CV death rate: the rate ratios of all-cause death to cardiovascular death were 2.2, 1.9 and 1.8 at low-moderate (cardiovascular death hypertensive patients whose cardiovascular death risk is calculated by the SCORE model.

  19. Effects of total vitamin A, vitamin C, and fruit intake on risk for metabolic syndrome in Korean women and men.

    Science.gov (United States)

    Park, Sunmin; Ham, Jung-O; Lee, Byung-Kook

    2015-01-01

    The question of whether the consumption of antioxidants prevents and alleviates metabolic syndrome (MetS) by reducing insulin resistance remains controversial. The aim of this study was to assess whether the intake of vitamin A (including β-carotene), vitamin C, fruits, or vegetables was negatively associated with MetS in Korean adults aged ≥ 20 y. We conducted a cross-sectional study of 27,656 adults ≥ 20 y of age who participated in the 2007-2012 Korean National Health and Nutrition Examination Survey. Daily intake of vitamin A and vitamin C was assessed by 24-h recall, and the consumption of fruits and vegetables was determined using a food frequency questionnaire. Odds ratios (ORs) for MetS were calculated for log2-transformed vitamin A and C intake values and for the interaction of sex with vitamin A and C intake, after covariate adjustment. Interactions were seen between total vitamin A and C intake and sex for MetS. With a twofold increase in total vitamin A and C intake in women, the ORs (95% confidence intervals) for metabolic syndrome were 0.942 (0.901-0.985) and 0.933 (0.883-0.987), indicating decreases of 5.8% and 6.7% in MetS, respectively. There were no equivalent decreases in men. Women in the second and highest tertiles of fruit intake exhibited 17.5% and 21.8% lower incidences of MetS, respectively, compared with women in the lowest tertile. The intake of total vitamin A and C, as well as moderate and high fruit intake, may have alleviated MetS in women, but not in men, in a representative sample of the general South Korean population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Red meat and poultry intakes and risk of total and cause-specific mortality: results from cohort studies of Chinese adults in Shanghai.

    Directory of Open Access Journals (Sweden)

    Yumie Takata

    Full Text Available Most previous studies of meat intake and total or cause-specific mortality were conducted in North America, whereas studies in other areas have been limited and reported inconsistent results. This study investigated the association of red meat or poultry intake with risk of total and cause-specific mortality, including cancer and cardiovascular disease (CVD, in two large population-based prospective cohort studies of 134,290 Chinese adult women and men in Shanghai. Meat intakes were assessed through validated food frequency questionnaires administered in person at baseline. Vital status and dates and causes of deaths were ascertained through annual linkage to the Shanghai Vital Statistics Registry and Shanghai Cancer Registry databases and home visits every 2-3 years. Cox regression was used to calculate hazard ratios (HRs and 95% confidence intervals (CIs for the risk of death associated with quintiles of meat intake. During 803,265 person-years of follow up for women and 334,281 person-years of follow up for men, a total of 4,210 deaths in women and 2,733 deaths in men accrued. The median intakes of red meat were 43 g/day among women and 54 g/day among men, and pork constituted at least 95% of total meat intake for both women and men. Red meat intake was associated with increased total mortality among men, but not among women; the HR (95% CI comparing the highest with the lowest quintiles were 1.18 (1.02-1.35 and 0.92 (0.82-1.03, respectively. This sex difference was statistically significant (P = 0.01. Red meat intake was associated with increased risk of ischemic heart disease mortality (HR = 1.41, 95% CI = 1.05-1.89 and with decreased risk of hemorrhagic stroke mortality (HR = 0.62, 95% CI = 0.45-0.87. There were suggestive inverse associations of poultry intake with risk of total and all-CVD mortality among men, but not among women. Further investigations are needed to elucidate the sex-specific associations between red

  1. Social network diversity and risks of ischemic heart disease and total mortality: findings from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Barefoot, JC; Grønbæk, M; Jensen, Gorm Boje

    2005-01-01

    Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991-1994, and pa......Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991......-1994, and participants were followed until the end of 1997. Contacts with parents, children, family members, and friends were associated with better health. The presence of a spouse or partner was protective for men. Contacts with neighbors showed a trend toward a reversed pattern, and the effects of contacts with work...... colleagues and children differed by gender. Most types of contacts that occurred at least monthly were just as protective as those occurring more frequently. An index of intimate social contact diversity with family and friends had graded relations with both outcomes. Comparisons of persons reporting three...

  2. Relationship of bifenthrin sediment concentrations to grain size and total organic carbon in California waterbodies: implications for ecological risk.

    Science.gov (United States)

    Hall, Lenwood W; Anderson, Ronald D

    2014-12-01

    A summary analysis of data sets from six California waterbodies was conducted to determine the relationship of bifenthrin sediment concentrations to: % sand/gravel; % silt; % clay; % silt/clay and % total organic carbon (TOC). The relationship of TOC to % sand/gravel, % silt, % clay, and % silt/clay was also analyzed. Statistically significant and meaningful direct relationships were reported between bifenthrin and % TOC, % silt, % clay and % silt/clay while a significant and meaningful inverse relationship was reported between bifenthrin and % sand/gravel. A significant and meaningful inverse relationship was reported between % TOC and % sand/gravel, while a significant and meaningful direct relationship was reported between % TOC and % silt, % clay and % silt/clay. Significant bifenthrin sediment concentrations would not be expected in non-depositional (sand/gravel) areas which have been reported to be dominant in various streams in California's Central Valley and are also the preferred habitat for many benthic macroinvertebrate taxa.

  3. Total Androgen Blockade Versus a Luteinizing Hormone-Releasing Hormone Agonist Alone in Men With High-Risk Prostate Cancer Treated With Radiotherapy

    International Nuclear Information System (INIS)

    Nanda, Akash; Chen, M.-H.; Moran, Brian J.; Braccioforte, Michelle H.; Dosoretz, Daniel; Salenius, Sharon; Katin, Michael; Ross, Rudi; D'Amico, Anthony V.

    2010-01-01

    Purpose: To assess whether short-course total androgen blockade vs. a luteinizing hormone-releasing hormone (LHRH) agonist alone affects the risk of prostate cancer-specific mortality (PCSM) in men with localized but high-risk disease treated with radiotherapy. Methods and Materials: The study cohort comprised 628 men with T1-T4, N0, M0 prostate cancer with high-risk disease (prostate-specific antigen level >20 ng/mL, Gleason score ≥8, or clinical category ≥T3) treated with 45 Gy of external beam radiotherapy followed by a brachytherapy boost in addition to receiving a median of 4.3 (interquartile range [IQR], 3.6-6.4) months of hormonal blockade with an LHRH agonist plus an antiandrogen or monotherapy with an LHRH agonist. Fine and Gray's multivariable regression analysis was used to determine whether combination androgen suppression therapy (AST) vs. monotherapy affected the risk of PCSM, adjusting for treatment year, duration of AST, age, and known prognostic factors. Results: After a median follow-up of 4.9 (IQR, 3.5-6.5) years, men receiving combination AST had a lower risk of PCSM than those treated with monotherapy (adjusted hazard ratio [AHR], 0.18; 95% confidence interval [CI], 0.04-0.90; p = 0.04). An increasing prostate-specific antigen level (AHR, 2.70; 95% CI, 1.64-4.45; p < 0.001) and clinical category T3/4 disease (AHR, 29.6; 95% CI, 2.88-303.5; p = 0.004) were also associated with an increased risk of PCSM. Conclusions: In men with localized but high-risk prostate cancer treated with external beam radiotherapy and brachytherapy, short-course AST with an LHRH agonist plus an antiandrogen is associated with a decreased risk of PCSM when compared with monotherapy with an LHRH agonist.

  4. Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen.

    Science.gov (United States)

    Wu, T; Trevisan, M; Genco, R J; Falkner, K L; Dorn, J P; Sempos, C T

    2000-02-01

    Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the relation between periodontal health and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. A total of 10,146 participants were included in the analyses of cholesterol and C-reactive protein and 4,461 in the analyses of fibrinogen. Periodontal health indicators included the gingival bleeding index, calculus index, and periodontal disease status (defined by pocket depth and attachment loss). While cholesterol and fibrinogen were analyzed as continuous variables, C-reactive protein was dichotomized into two levels. The results show a significant relation between indicators of poor periodontal status and increased C-reactive protein and fibrinogen. The association between periodontal status and total cholesterol level is much weaker. No consistent association between periodontal status and high density lipoprotein cholesterol was detectable. Similar patterns of association were observed for participants aged 17-54 years and those 55 years and older. In conclusion, this study suggests that total cholesterol, C-reactive protein, and fibrinogen are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

  5. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies

    International Nuclear Information System (INIS)

    Zhang, Chi; Qin, Ying-Yi; Wei, Xin; Yu, Fei-Fei; Zhou, Yu-Hao; He, Jia

    2015-01-01

    Studies that investigated the association between tea consumption and the risk of major cardiovascular events have reported inconsistent results. We conducted a meta-analysis of prospective observational studies in order to summarize the evidence regarding the association between tea consumption and major cardiovascular outcomes or total mortality. In July 2014, we performed electronic searches in PubMed, EmBase, and the Cochrane Library, followed by manual searches of reference lists from the resulting articles to identify other relevant studies. Prospective observational studies that reported effect estimates, with 95 % confidence intervals (CIs), for coronary heart disease (CHD), stroke, cardiac death, stroke death, or total mortality for more than two dosages of tea consumption were included. A random-effects meta-analysis was performed to determine the risk of major cardiovascular outcomes associated with an increase in tea consumption by 3 cups per day. Of the 736 citations identified from database searches, we included 22 prospective studies from 24 articles reporting data on 856,206 individuals, and including 8,459 cases of CHD, 10,572 of stroke, 5,798 cardiac deaths, 2,350 stroke deaths, and 13,722 total deaths. Overall, an increase in tea consumption by 3 cups per day was associated with a reduced risk of CHD (relative risk [RR], 0.73; 95 % CI: 0.53–0.99; P = 0.045), cardiac death (RR, 0.74; 95 % CI: 0.63–0.86; P < 0.001), stroke (RR, 0.82; 95 % CI: 0.73–0.92; P = 0.001), total mortality (RR, 0.76; 95 % CI: 0.63–0.91; P = 0.003), cerebral infarction (RR, 0.84; 95 % CI: 0.72–0.98; P = 0.023), and intracerebral hemorrhage (RR, 0.79; 95 % CI: 0.72–0.87; P < 0.001), but had little or no effect on stroke mortality (RR, 0.93; 95 % CI: 0.83–1.05; P = 0.260). The findings from this meta-analysis indicate that increased tea consumption is associated with a reduced risk of CHD, cardiac death, stroke, cerebral infarction, and

  6. Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase–Control Study in Spain

    Science.gov (United States)

    Pastor-Barriuso, Roberto; Fernández, Mariana F.; Castaño-Vinyals, Gemma; Whelan, Denis; Pérez-Gómez, Beatriz; Llorca, Javier; Villanueva, Cristina M.; Guevara, Marcela; Molina-Molina, José-Manuel; Artacho-Cordón, Francisco; Barriuso-Lapresa, Laura; Tusquets, Ignasi; Dierssen-Sotos, Trinidad; Aragonés, Nuria; Olea, Nicolás; Kogevinas, Manolis; Pollán, Marina

    2016-01-01

    Background: Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings. Objectives: We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk. Methods: A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase–control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models. Results: Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk. Conclusions: This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers. Citation: Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM

  7. Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

    Science.gov (United States)

    Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

    2015-01-13

    An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a

  8. Use of vitamin supplements and risk of total cancer and cardiovascular disease among the Japanese general population: A population-based survey

    Directory of Open Access Journals (Sweden)

    Ishihara Junko

    2011-07-01

    Full Text Available Abstract Background Despite the popular use of vitamin supplements and several prospective cohort studies investigating their effect on cancer incidence and cardiovascular disease (CVD, scientific data supporting their benefits remain controversial. Inconsistent results may be partly explained by the fact that use of supplements is an inconsistent behavior in individuals. We examined whether vitamin supplement use patterns affect cancer and CVD risk in a population-based cohort study in Japan. Methods A total of 28,903 men and 33,726 women in the Japan Public Health Center-based Prospective Study cohort, who answered questions about vitamin supplement use in the first survey from 1990-1994 and the second survey from 1995-1998, were categorized into four groups (never use, past use, recent use, and consistent use and followed to the end of 2006 for cancer and 2005 for CVD. Sex-specific hazard ratios (HRs and 95% confidence intervals (95% CIs were used to describe the relative risks of cancer and CVD associated with vitamin supplement use. Results During follow-up, 4501 cancer and 1858 CVD cases were identified. Multivariate adjusted analysis revealed no association of any pattern of vitamin supplement use with the risk of cancer and CVD in men. In women, consistent use was associated with lower risk of CVD (HR 0.60, 95% CI 0.41-0.89, whereas past (HR 1.17, 95% CI 1.02-1.33 and recent use (HR 1.24, 95% CI 1.01-1.52 were associated with higher risk of cancer. Conclusions To our knowledge, this is the first prospective cohort study to examine simultaneously the associations between vitamin supplement use patterns and risk of cancer and CVD. This prospective cohort study demonstrated that vitamin supplement use has little effect on the risk of cancer or CVD in men. In women, however, consistent vitamin supplement use might reduce the risk of CVD. Elevated risk of cancer associated with past and recent use of vitamin supplements in women may be partly

  9. Assessing bottled water nitrate concentrations to evaluate total drinking water nitrate exposure and risk of birth defects.

    Science.gov (United States)

    Weyer, Peter J; Brender, Jean D; Romitti, Paul A; Kantamneni, Jiji R; Crawford, David; Sharkey, Joseph R; Shinde, Mayura; Horel, Scott A; Vuong, Ann M; Langlois, Peter H

    2014-12-01

    Previous epidemiologic studies of maternal exposure to drinking water nitrate did not account for bottled water consumption. The objective of this National Birth Defects Prevention Study (NBDPS) (USA) analysis was to assess the impact of bottled water use on the relation between maternal exposure to drinking water nitrate and selected birth defects in infants born during 1997-2005. Prenatal residences of 1,410 mothers reporting exclusive bottled water use were geocoded and mapped; 326 bottled water samples were collected and analyzed using Environmental Protection Agency Method 300.0. Median bottled water nitrate concentrations were assigned by community; mothers' overall intake of nitrate in mg/day from drinking water was calculated. Odds ratios for neural tube defects, limb deficiencies, oral cleft defects, and heart defects were estimated using mixed-effects models for logistic regression. Odds ratios (95% CIs) for the highest exposure group in offspring of mothers reporting exclusive use of bottled water were: neural tube defects [1.42 (0.51, 3.99)], limb deficiencies [1.86 (0.51, 6.80)], oral clefts [1.43 (0.61, 3.31)], and heart defects [2.13, (0.87, 5.17)]. Bottled water nitrate had no appreciable impact on risk for birth defects in the NBDPS.

  10. Does tranexamic acid increase the risk of thromboembolism after bilateral simultaneous total knee arthroplasties in Asian Population?

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Seo, Dong-Hyuk

    2018-01-01

    To ascertain whether tranexamic acid reduces the blood loss and transfusion rate and volumes; increase the prevalence of deep vein thrombosis (DVT); and investigate factors associated with DVT in patients undergoing primary bilateral total knee arthroplasties (TKAs) without use of chemical thromboprophylaxis. There were 874 patients (1748 knees) in the control group who did not receive tranexamic acid and 871 patients (1742 knees) in the study group who received tranexamic acid. Mechanical compression device was applied without any chemical thromboprophylaxis. Transfusion rates and volumes were recorded. DVT was diagnosed using both sonogram and venogram at 7 or 8 day post-operatively. Intra- and post-operative blood loss and transfusion volumes were significantly lower in the tranexamic acid group. The prevalence of DVT was 14% (245 of 1748 knees) in the control group and 18% (314 of 1742 knees) in the tranexamic acid group. Pre- and post-operative perfusion lung scans revealed no evidence of PE in any patients in either group. Coagulation or thrombophilic data or molecular genetic testing was not significantly different between the two groups. The use of tranexamic acid reduces the volume of blood transfusion and does not increase the prevalence of DVT or PE in the patients who did not receive routine chemical thromboprophylaxis after primary bilateral simultaneous sequential TKAs in Asian patients.

  11. Paraphyseal changes on bone-age studies predict risk of delayed radiation-associated skeletal complications following total body irradiation

    International Nuclear Information System (INIS)

    Kitazono Hammell, Mary T.; Edgar, J.C.; Jaramillo, Diego; Bunin, Nancy

    2013-01-01

    Children undergoing total body irradiation (TBI) often develop delayed skeletal complications. Bone-age studies in these children often reveal subtle paraphyseal changes including physeal widening, metaphyseal irregularity and paraphyseal exostoses. To investigate whether paraphyseal changes on a bone-age study following TBI indicate a predisposition toward developing other radiation-associated skeletal complications. We retrospectively reviewed medical records and bone-age studies of 77 children receiving TBI at our institution between 1995 and 2008 who had at least 2 years of clinical follow-up and one bone-age study after TBI. We graded bone-age studies according to the severity of paraphyseal changes. All documented skeletal complications following TBI were tabulated. Kendall's tau-b was used to examine associations between degree of paraphyseal change and development of a skeletal complication. Kendall's tau analyses showed that physeal widening and metaphyseal irregularity/sclerosis (tau = 0.87, P < 0.001) and paraphyseal exostoses (tau = 0.68, P < 0.001) seen on bone-age studies were significantly positively associated with the development of delayed skeletal complications following TBI. Thirty percent of children with no or mild paraphyseal changes developed a delayed skeletal complication, compared with 58% of children with moderate paraphyseal changes and 90% of children with severe paraphyseal changes. Paraphyseal changes identified on a bone-age study correlate positively with the development of delayed skeletal complications elsewhere in the skeleton following TBI. (orig.)

  12. Risk factors for central line-associated bloodstream infection in pediatric oncology patients with a totally implantable venous access port: A cohort study.

    Science.gov (United States)

    Viana Taveira, Michelle Ribeiro; Lima, Luciana Santana; de Araújo, Cláudia Corrêa; de Mello, Maria Júlia Gonçalves

    2017-02-01

    Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients. Sociodemographic, clinical, and TIVAP insertion-related variables were evaluated, with the endpoint being the first CLABSI. A Kaplan-Meier analysis was performed to determine CLABSI-free catheter survival. Overall, 188 children were evaluated over 77,541 catheter days, with 94 being diagnosed with CLABSI (50%). Although coagulase-negative staphylococci were the pathogens most commonly isolated, Gram-negative microorganisms (46.8%) were also prevalent. In the multivariate analysis, factors that increased the risk for CLABSI were TIVAP insertion prior to chemotherapy (risk ratio [RR] = 1.56; P Risk factors for CLABSI in pediatric cancer patients with a TIVAP may be related to the severity of the child's condition at catheter insertion. Insertion of the catheter before chemotherapy and unfavorable conditions such as malnutrition and bone marrow aplasia can increase the risk of CLABSI. Protocols must be revised and surveillance increased over the first 10 weeks of treatment. © 2016 Wiley Periodicals, Inc.

  13. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  14. Combined effects of DNA methyltransferase 1 and 3A polymorphisms and urinary total arsenic levels on the risk for clear cell renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shu-Mei [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Huang, Chao-Yuan [Department of Urology, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan (China); Shiue, Horng-Sheng [Department of Chinese Medicine, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan (China); Pu, Yeong-Shiau [Department of Urology, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan (China); Hsieh, Yi-Hsun; Chen, Wei-Jen [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Lin, Ying-Chin [Department of Family Medicine, Shung Ho Hospital, Taipei Medical University, Taipei, Taiwan (China); Department of Health Examination, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (China); Division of Family Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan (China); Hsueh, Yu-Mei, E-mail: ymhsueh@tmu.edu.tw [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China)

    2016-08-15

    Our previous study showed that high urinary total arsenic levels were associated with higher odds ratio (OR) for renal cell carcinoma (RCC). Single nucleotide polymorphisms (SNPs) of DNA methyltransferases (DNMTs) might influence DNMT enzyme activity associated with tumorigenesis. In this study, we investigated the association of five SNPs from DNMT1 (rs8101626 and rs2228611), DNMT3A (rs34048824 and rs1550117), and DNMT3B (rs1569686) with the risk of clear cell renal cell carcinoma (ccRCC). We also examined the combined effects of DNMT genotypes and urinary arsenic levels on ccRCC risk. We conducted a hospital-based case-control study, which included 293 subjects with ccRCC and 293 age- and gender-matched controls. The urinary arsenic species were determined by a high performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. Genotypes were investigated using polymerase chain reaction and restriction fragment length polymorphism analyses. We observed that the DNMT1 rs8101626 G/G genotype was significantly associated with reduced odds ratio (OR) of ccRCC [OR = 0.38, 95% confidence interval (CI) 0.14–0.99]. Subjects with concurrent DNMT1 rs8101626 A/A + A/G and DNMT3A rs34048824 T/T + T/C genotypes had significantly higher OR for ccRCC [OR = 2.88, 95% CI 1.44–5.77]. Participants with the high-risk genotype of DNMT1 rs8101626 and DNMT3A rs34048824 with concurrently high urinary total arsenic levels had even higher OR of ccRCC in a dose-response manner. This is the first study to evaluate variant DNMT1 rs8101626 and DNMT3A rs34048824 genotypes that modify the arsenic-related ccRCC risk in a geographic area without significant arsenic exposure in Taiwan. - Highlights: • High urinary total arsenic level or polymorphism of DNMT1 increased the OR of ccRCC. • High risk genotypes of combination of DNMT1 and DNMT3A increased the OR of ccRCC. • A joint effect of urinary total arsenic level and DNMTs genotypes may affect ccRCC.

  15. Intake of total omega-3 fatty acids, eicosapentaenoic acid and docosahexaenoic acid and risk of coronary heart disease in the Spanish EPIC cohort study.

    Science.gov (United States)

    Amiano, P; Machón, M; Dorronsoro, M; Chirlaque, M Dolores; Barricarte, A; Sánchez, M-J; Navarro, C; Huerta, J M; Molina-Montes, E; Sánchez-Cantalejo, E; Urtizberea, M; Arriola, L; Larrañaga, N; Ardanaz, E; Quirós, J R; Moreno-Iribas, C; González, C A

    2014-03-01

    The evidence about the benefits of omega-3 fatty acid intake on coronary heart disease (CHD) is not consistent. We thus aimed to assess the relation between dietary intake of total omega-3 fatty acids (from plant and marine foods) and marine polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on the risk of CHD in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 41,091 men and women aged 20-69 years, recruited from 1992 to 1996 and followed-up until December 2004. Omega-3 fatty acid intake was estimated from a validated dietary questionnaire. Only participants with definite incident CHD event were considered as cases. Cox regression models were used to assess the association between the intake of total omega-3 fatty acids, EPA or DHA and CHD. A total of 609 participants (79% men) had a definite CHD event. Mean intakes of total omega-3 fatty acids, EPA and DHA were very similar in the cases and in the cohort, both in men and women. In the multivariate adjusted model, omega-3 fatty acids, EPA and DHA were not related to incident CHD in either men or women. The hazard ratios (HR) for omega-3 were 1.23 in men (95% CI 0.94-15.9, p = 0.20); and 0.77 in women (95% CI 0.46-1.30, p = 0.76). In the Spanish EPIC cohort, with a relatively high intake of fish, no association was found between EPA, DHA and total omega-3 fatty acid intake and risk of CHD. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Numerical Development

    Science.gov (United States)

    Siegler, Robert S.; Braithwaite, David W.

    2016-01-01

    In this review, we attempt to integrate two crucial aspects of numerical development: learning the magnitudes of individual numbers and learning arithmetic. Numerical magnitude development involves gaining increasingly precise knowledge of increasing ranges and types of numbers: from non-symbolic to small symbolic numbers, from smaller to larger…

  17. Hindi Numerals.

    Science.gov (United States)

    Bright, William

    In most languages encountered by linguists, the numerals, considered as a paradigmatic set, constitute a morpho-syntactic problem of only moderate complexity. The Indo-Aryan language family of North India, however, presents a curious contrast. The relatively regular numeral system of Sanskrit, as it has developed historically into the modern…

  18. Numerical analysis

    CERN Document Server

    Rao, G Shanker

    2006-01-01

    About the Book: This book provides an introduction to Numerical Analysis for the students of Mathematics and Engineering. The book is designed in accordance with the common core syllabus of Numerical Analysis of Universities of Andhra Pradesh and also the syllabus prescribed in most of the Indian Universities. Salient features: Approximate and Numerical Solutions of Algebraic and Transcendental Equation Interpolation of Functions Numerical Differentiation and Integration and Numerical Solution of Ordinary Differential Equations The last three chapters deal with Curve Fitting, Eigen Values and Eigen Vectors of a Matrix and Regression Analysis. Each chapter is supplemented with a number of worked-out examples as well as number of problems to be solved by the students. This would help in the better understanding of the subject. Contents: Errors Solution of Algebraic and Transcendental Equations Finite Differences Interpolation with Equal Intervals Interpolation with Unequal Int...

  19. Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register).

    Science.gov (United States)

    Hellevik, Alf Inge; Johnsen, Marianne Bakke; Langhammer, Arnulf; Baste, Valborg; Furnes, Ove; Storheim, Kjersti; Zwart, John Anker; Flugsrud, Gunnar Birkeland; Nordsletten, Lars

    2018-01-01

    Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50-69.9 and ≥70 years) and adjusted for gender, body mass index, smoking, physical activity and education. Of the 62,661 participants, 12,593 (20.1%) were identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and 1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40-0.83). However, when including only participants whose exposure status did not change during follow-up, this protective association was no longer significant. Increased waist circumference was associated with increased risk of TKR in participants <50 years (HR 1.62, 95% CI 1.10-2.39) and 50-69.9 years (HR 1.43, 95% CI 1.14-1.80). Hypertension significantly increased the risk of TKR in participants <50 years (HR 1.38, 95% CI 1.05-1.81), and this risk was greater for men. This study found an increased risk of TKR in men <50 years with hypertension and persons <70 years with increased waist circumference. Apart from this, neither metabolic syndrome nor its components were associated with increased risk of THR or TKR due to primary osteoarthritis.

  20. Total petroleum hydrocarbons and heavy metals in the surface sediments of Bohai Bay, China: long-term variations in pollution status and adverse biological risk.

    Science.gov (United States)

    Zhou, Ran; Qin, Xuebo; Peng, Shitao; Deng, Shihuai

    2014-06-15

    Surface sediments collected from 2001 to 2011 were analyzed for total petroleum hydrocarbons (TPH) and five heavy metals. The sediment concentration ranges of TPH, Zn, Cu, Pb, Cd and Hg were 6.3-535 μg/g, 58-332 μg/g, 7.2-63 μg/g, 4.3-138 μg/g, 0-0.98μg/g, and 0.10-0.68 μg/g, respectively. These results met the highest marine sediment quality standards in China, indicating that the sediment was fairly clean. However, based on the effects range-median (ERM) quotient method, the calculated values for all of the sampling sites were higher than 0.10, suggesting that there was a potential adverse biological risk in Bohai Bay. According to the calculated results, the biological risk decreased from 2001 to 2007 and increased afterwards. High-risk sites were mainly distributed along the coast. This study suggests that anthropogenic influences might be responsible for the potential risk of adverse biological effects from TPH and heavy metals in Bohai Bay. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Evaluation the total exposure of soil sample in Adaya site and the obtain risk assessments for the worker by Res Rad code program

    International Nuclear Information System (INIS)

    Mahadi, A. M.; Khadim, A. A. N.; Ibrahim, Z. H.; Ali, S. A.

    2012-12-01

    The present study aims to evaluation the total exposure to the worker in Adaya site risk assessment by using Res Rad code program. The study including 5 areas soil sample calculate in the site and analysis it by High Pure Germaniums (Hg) system made (CANBERRA) company. The soil sample simulation by (Res Rad) code program by inter the radioactive isotope concentration and the specification of the contamination zone area, depth and the cover depth of it. The total exposure of same sample was about 9 mSv/year and the (Heast 2001 Morbidity, FGR13 Morbidity) about 2.045 state every 100 worker in the year. There are simple different between Heast 2001 Morbidity and FGR13 Morbidity according to the Dose Conversion Factor (DCF) use it. The (FGR13 Morbidity) about 2.041 state every 100 worker in the year. (Author)

  2. Use of BEIR V and UNSCEAR 1988 in radiation risk assessment: Lifetime total cancer mortality risk estimates at low doses and low dose rates for low-LET radiation

    International Nuclear Information System (INIS)

    1992-12-01

    In November 1986, the Department of Defense (DoD) asked the Committee on Interagency Radiation Research and Policy Coordination (CIRRPC) to develop a coordinated Federal position on risk assessment for low levels of ionizing radiation. Since Federal risk assessment activities are based primarily on the scientific data and analyses in authoritative review documents prepared by groups like the National Academy of Sciences' Committee on the Biological Effects of Ionizing Radiation (BEIR), the National Council on Radiation Protection and Measurements (NCRP) and the United Nations' Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), DoD proposed that the CIRRPC Science Panel undertake the task of providing coordinated interagency positions on the use of information in the reports of such groups. The practice has been for individual Federal agencies to interpret and decide independently how to use the information provided in such reports. As a result of its deliberations, the Subpanel recommends two nominal risk estimates for lifetime total cancer mortality following whole-body exposure to low levels of low-LET ionizing radiation, one for the general population and one for the working-age population (see Section II). The recommended risk estimates reflect the general agreement of information in BEIR V and UNSCEAR 1988 for total cancer mortality. The Subpanel's risk estimates and associated statements are intended to meet the needs of the Federal agencies for: (a) values that are current; (b) values that are relevant to the low-dose and low dose-rate ionizing radiation exposures principally encountered in carrying out Federal responsibilities; (c) a statement of the change in the estimates of lifetime total cancer mortality relative to estimates in previous authoritative review documents; and (d) a practical statement on the scientific uncertainty associated with applying the lifetime total cancer mortality values at very low doses

  3. Osteonecrosis - A rare complication of HIV infection. Association with numerous risk factors; Osteonekrose: eine seltene Komplikation der HIV-Infektion. Assoziation mit bestimmten Risikofaktoren

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, D.; Behrens, G.; Stoll, M.; Schmidt, R.E. [Medizinische Hochschule Hannover (Germany). Abt. Klinische Immunologie

    2000-03-13

    Osteonecrosis is a rare complication of HIV infection. The presumptive cause of the aseptic osteonecrosis is a distrubed blood supply to the bone. Most cases of osteonecrosis are associated with numerous risk factors, such as use of steroids, alcohol abuse, coagulopathies or metabolic derangements. Since conventional X-rays appear unremarkable, early forms often go unrecognized or are diagnosed late. Methods of establishing the diagnosis are MRI and three-phase skeletal scintigraphy. The pathogenesis of osteonecrosis in HIV infection is unclear. So far, about 30 cases have been reported in the literature. We would recommend that in HIV patients with typical symptoms - in particular when classical risk factors are present - osteonecrosis be included in the differential diagnostic considerations. (orig.) [German] Die Osteonekrose ist eine seltene Komplikation der HIV-Infektion. Als Ursache werden Stoerungen in der Gefaessversorgung des Knochengewebes angenommen. Aufgrund unauffaelliger Befunde im konventionellen Roentgen werden Fruehformen haeufig verkannt oder erst verspaetet diagnostiziert. Methoden zur Diagnosesicherung sind die Kernspintomographie oder die 3-Phasen-Knochenszintigraphie. Die Pathogenese der Osteonekrose bei der HIV-Infektion ist unklar. Bisher sind in der Literatur etwa 30 Kasuistiken beschrieben. Wir empfehlen, bei Vorliegen einer typischen Symptomatik bei HIV-Patienten - insbesondere wenn typische Risikofaktoren vorliegen - die Osteonekrose in die differenzialdiagnostischen Ueberlegungen mit einzubeziehen. (orig.)

  4. Probabilistic-numerical assessment of pyroclastic current hazard at Campi Flegrei and Naples city: Multi-VEI scenarios as a tool for "full-scale" risk management.

    Science.gov (United States)

    Mastrolorenzo, Giuseppe; Palladino, Danilo M; Pappalardo, Lucia; Rossano, Sergio

    2017-01-01

    The Campi Flegrei volcanic field (Italy) poses very high risk to the highly urbanized Neapolitan area. Eruptive history was dominated by explosive activity producing pyroclastic currents (hereon PCs; acronym for Pyroclastic Currents) ranging in scale from localized base surges to regional flows. Here we apply probabilistic numerical simulation approaches to produce PC hazard maps, based on a comprehensive spectrum of flow properties and vent locations. These maps are incorporated in a Geographic Information System (GIS) and provide all probable Volcanic Explosivity Index (VEI) scenarios from different source vents in the caldera, relevant for risk management planning. For each VEI scenario, we report the conditional probability for PCs (i.e., the probability for a given area to be affected by the passage of PCs in case of a PC-forming explosive event) and related dynamic pressure. Model results indicate that PCs from VEIextreme event) would affect a large part of the Campanian Plain to the north and the city of Naples to the east. Thus, in case of renewal of eruptive activity at Campi Flegrei, up to 3 million people will be potentially exposed to volcanic hazard, pointing out the urgency of an emergency plan. Considering the present level of uncertainty in forecasting the future eruption type, size and location (essentially based on statistical analysis of previous activity), we suggest that appropriate planning measures should face at least the VEI 5 reference scenario (at least 2 occurrences documented in the last 10 ka).

  5. Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register

    Directory of Open Access Journals (Sweden)

    Hellevik AI

    2018-01-01

    Full Text Available Alf Inge Hellevik,1,2 Marianne Bakke Johnsen,3,4 Arnulf Langhammer,1 Valborg Baste,5 Ove Furnes,6,7 Kjersti Storheim,3,4 John Anker Zwart,3,4 Gunnar Birkeland Flugsrud,2 Lars Nordsletten2,4 1The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger, 2Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, 3Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, 4Faculty of Medicine, University of Oslo, Oslo, 5Uni Research Health, Bergen, 6The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, 7Department of Clinical Medicine, Institute of Medicine and Dentistry, University of Bergen, Bergen, Norway Objective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance were risk factors for subsequent total hip replacement (THR or total knee replacement (TKR due to primary osteoarthritis.Design: In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2 were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50–69.9 and ≥70 years and adjusted for gender, body mass index, smoking, physical activity and education.Results: Of the 62,661 participants, 12,593 (20.1% were identified as having metabolic syndrome, and we recorded 1,840 (2.9% THRs and 1,111 (1.8% TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk

  6. Numerical analysis

    CERN Document Server

    Scott, L Ridgway

    2011-01-01

    Computational science is fundamentally changing how technological questions are addressed. The design of aircraft, automobiles, and even racing sailboats is now done by computational simulation. The mathematical foundation of this new approach is numerical analysis, which studies algorithms for computing expressions defined with real numbers. Emphasizing the theory behind the computation, this book provides a rigorous and self-contained introduction to numerical analysis and presents the advanced mathematics that underpin industrial software, including complete details that are missing from most textbooks. Using an inquiry-based learning approach, Numerical Analysis is written in a narrative style, provides historical background, and includes many of the proofs and technical details in exercises. Students will be able to go beyond an elementary understanding of numerical simulation and develop deep insights into the foundations of the subject. They will no longer have to accept the mathematical gaps that ex...

  7. Lack of Association Between the Use of Nerve Blockade and the Risk of Postoperative Chronic Opioid Use Among Patients Undergoing Total Knee Arthroplasty: Evidence From the Marketscan Database.

    Science.gov (United States)

    Sun, Eric C; Bateman, Brian T; Memtsoudis, Stavros G; Neuman, Mark D; Mariano, Edward R; Baker, Laurence C

    2017-09-01

    Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade. We then used a multivariable logistic regression to estimate the association between nerve blockade and the risk of chronic opioid use, defined as having filled ≥10 prescriptions or ≥120 days' supply for an opioid in the first postsurgical year. Our analyses were adjusted for an extensive set of potential confounding variables, including medical comorbidities, previous opioid use, and previous use of other medications. We did not find an association between nerve blockade and the risk of postsurgical chronic opioid use across any of these 3 groups: adjusted relative risk (ARR) 0.984 for patients opioid-naïve in the year before surgery (98.3% confidence interval [CI], 0.870-1.12, P = .794), ARR 1.02 for intermittent opioid users (98.3% CI, 0.948-1.09, P = .617), and ARR 0.986 (98.3% CI, 0.963-1.01, P = .257) for chronic opioid users. Similar results held for alternative measures of postsurgical opioid use. Although the use of perioperative nerve blockade for TKA may improve short-term outcomes, the analyzed types of blocks do not appear to decrease the risk of persistent opioid use in the longer term.

  8. Clinicopathological Risk Factors and Biochemical Predictors of Safe Discharge after Total Thyroidectomy and Central Compartment Node Dissection for Thyroid Cancer: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Yu-mi Lee

    2015-01-01

    Full Text Available To determine the clinicopathological risk factors and reliable biochemical predictors of the development of hypocalcemic symptoms after total thyroidectomy on the basis of serum calcium and intact parathyroid hormone (PTH levels measured 1 hour after surgery, a prospective study was performed on 817 patients who underwent a total thyroidectomy with central compartment node dissection (CCND due to well-differentiated thyroid cancer. We evaluated the correlations between hypocalcemic symptom development and clinicopathological factors. And the predictability for hypocalcemic symptom development of intact PTH cut-offs (<10 pg/mL and <20 pg/mL, resp. according to serum calcium level subgroup was analyzed. Female gender (P<0.001 was the only independent risk factor for hypocalcemic symptom development in multivariate regression analysis. The negative predictive value (NPV of intact PTH, signifying nondevelopment of hypocalcemic symptoms, was higher than the positive predictive value (PPV which signified development of hypocalcemic symptoms. In addition, when we applied the different adoption of the intact PTH cut-off according to serum calcium level, we could obtain more increased NPVs. A female gender and the application of more specific cut-offs for intact PTH according to the serum calcium levels measured 1 hour after surgery may help the patients to be more safely discharged.

  9. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  10. Identification of Genetic Loci Jointly Influencing Schizophrenia Risk and the Cognitive Traits of Verbal-Numerical Reasoning, Reaction Time, and General Cognitive Function.

    Science.gov (United States)

    Smeland, Olav B; Frei, Oleksandr; Kauppi, Karolina; Hill, W David; Li, Wen; Wang, Yunpeng; Krull, Florian; Bettella, Francesco; Eriksen, Jon A; Witoelar, Aree; Davies, Gail; Fan, Chun C; Thompson, Wesley K; Lam, Max; Lencz, Todd; Chen, Chi-Hua; Ueland, Torill; Jönsson, Erik G; Djurovic, Srdjan; Deary, Ian J; Dale, Anders M; Andreassen, Ole A

    2017-10-01

    Schizophrenia is associated with widespread cognitive impairments. Although cognitive deficits are one of the factors most strongly associated with functional outcome in schizophrenia, current treatment strategies largely fail to ameliorate these impairments. To develop more efficient treatment strategies in patients with schizophrenia, a better understanding of the pathogenesis of these cognitive deficits is needed. Accumulating evidence indicates that genetic risk of schizophrenia may contribute to cognitive dysfunction. To identify genomic regions jointly influencing schizophrenia and the cognitive domains of reaction time and verbal-numerical reasoning, as well as general cognitive function, a phenotype that captures the shared variation in performance across cognitive domains. Combining data from genome-wide association studies from multiple phenotypes using conditional false discovery rate analysis provides increased power to discover genetic variants and could elucidate shared molecular genetic mechanisms. Data from the following genome-wide association studies, published from July 24, 2014, to January 17, 2017, were combined: schizophrenia in the Psychiatric Genomics Consortium cohort (n = 79 757 [cases, 34 486; controls, 45 271]); verbal-numerical reasoning (n = 36 035) and reaction time (n = 111 483) in the UK Biobank cohort; and general cognitive function in CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) (n = 53 949) and COGENT (Cognitive Genomics Consortium) (n = 27 888). Genetic loci identified by conditional false discovery rate analysis. Brain messenger RNA expression and brain expression quantitative trait locus functionality were determined. Among the participants in the genome-wide association studies, 21 loci jointly influencing schizophrenia and cognitive traits were identified: 2 loci shared between schizophrenia and verbal-numerical reasoning, 6 loci shared between schizophrenia and

  11. A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score.

    Science.gov (United States)

    Namazi, Mohammad Hasan; Serati, Ali Reza; Vakili, Hosein; Safi, Morteza; Parsa, Saeed Ali Pour; Saadat, Habibollah; Taherkhani, Maryam; Emami, Sepideh; Pedari, Shamseddin; Vatanparast, Masoomeh; Movahed, Mohammad Reza

    2017-06-01

    Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach. A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97-23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95-17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46-7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28-6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08-6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03-6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate. Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

  12. Simvastatin mitigates increases in risk factors for and the occurrence of cardiac disease following 10 Gy total body irradiation.

    Science.gov (United States)

    Lenarczyk, Marek; Su, Jidong; Haworth, Steven T; Komorowski, Richard; Fish, Brian L; Migrino, Raymond Q; Harmann, Leanne; Hopewell, John W; Kronenberg, Amy; Patel, Shailendra; Moulder, John E; Baker, John E

    2015-06-01

    The ability of simvastatin to mitigate the increases in risk factors for and the occurrence of cardiac disease after 10 Gy total body irradiation (TBI) was determined. This radiation dose is relevant to conditioning for stem cell transplantation and threats from radiological terrorism. Male rats received single dose TBI of 10 Gy. Age-matched, sham-irradiated rats served as controls. Lipid profile, heart and liver morphology and cardiac mechanical function were determined for up to 120 days after irradiation. TBI resulted in a sustained increase in total- and LDL-cholesterol (low-density lipoprotein-cholesterol), and triglycerides. Simvastatin (10 mg/kg body weight/day) administered continuously from 9 days after irradiation mitigated TBI-induced increases in total- and LDL-cholesterol and triglycerides, as well as liver injury. TBI resulted in cellular peri-arterial fibrosis, whereas control hearts had less collagen and fibrosis. Simvastatin mitigated these morphological injuries. TBI resulted in cardiac mechanical dysfunction. Simvastatin mitigated cardiac mechanical dysfunction 20-120 days following TBI. To determine whether simvastatin affects the ability of the heart to withstand stress after TBI, injury from myocardial ischemia/reperfusion was determined in vitro. TBI increased the severity of an induced myocardial infarction at 20 and 80 days after irradiation. Simvastatin mitigated the severity of this myocardial infarction at 20 and 80 days following TBI. It is concluded simvastatin mitigated the increases in risk factors for cardiac disease and the extent of cardiac disease following TBI. This statin may be developed as a medical countermeasure for the mitigation of radiation-induced cardiac disease.

  13. Suggested cut-off values for vitamin D as a risk marker for total and cardiac death in patients with suspected acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Patrycja Anna Naesgaard

    2016-02-01

    Full Text Available Background: Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut off levels are still under debate. Objectives: To assess two cut-off levels, 40 nmol/L and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D [25(OHD] in chest pain patients with suspected acute coronary syndrome.Methods: We investigated 1853 patients from coastal-Norway and inland Northern-Argentina. A similar database was used for pooling of data. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death in the total patient population were analyzed, applying univariate and multivariable analysis. Results: 255 patients with known vitamin D concentrations died. In the multivariable analysis, there was a decrease in total mortality above a cut-off level of 40 nmol/L and a decrease in cardiac death above a cut-off level of 70 nmol/L, [HRs of 0.66 (95% CI, 0.50 – 0.88, p = 0.004 and 0.46 (95% CI, 0.22 – 0.94, p = 0.034, respectively].Conclusion: Vitamin D cut-off levels of 40 nmol/L and 70 nmol/L, were related to total mortality and cardiac death, respectively.

  14. Numerical analysis

    CERN Document Server

    Brezinski, C

    2012-01-01

    Numerical analysis has witnessed many significant developments in the 20th century. This book brings together 16 papers dealing with historical developments, survey papers and papers on recent trends in selected areas of numerical analysis, such as: approximation and interpolation, solution of linear systems and eigenvalue problems, iterative methods, quadrature rules, solution of ordinary-, partial- and integral equations. The papers are reprinted from the 7-volume project of the Journal of Computational and Applied Mathematics on '/homepage/sac/cam/na2000/index.html<

  15. The effect of bearing surface on risk of periprosthetic joint infection in total hip arthroplasty: a systematic review and meta-analysis.

    Science.gov (United States)

    Hexter, A T; Hislop, S M; Blunn, G W; Liddle, A D

    2018-02-01

    Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Different bearing surface materials have different surface properties and it has been suggested that the choice of bearing surface may influence the risk of PJI after THA. The objective of this meta-analysis was to compare the rate of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and ceramic-on-ceramic (CoC) bearings. Electronic databases (Medline, Embase, Cochrane library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature) were searched for comparative randomized and observational studies that reported the incidence of PJI for different bearing surfaces. Two investigators independently reviewed studies for eligibility, evaluated risk of bias, and performed data extraction. Meta-analysis was performed using the Mantel-Haenzel method and random-effects model in accordance with methods of the Cochrane group. Our search strategy revealed 2272 studies, of which 17 met the inclusion criteria and were analyzed. These comprised 11 randomized controlled trials and six observational studies. The overall quality of included studies was high but the observational studies were at high risk of bias due to inadequate adjustment for confounding factors. The overall cumulative incidence of PJI across all studies was 0.78% (1514/193 378). For each bearing combination, the overall incidence was as follows: MoP 0.85% (1353/158 430); CoP 0.38% (67/17 489); and CoC 0.53% (94/17 459). The meta-analysis showed no significant difference between the three bearing combinations in terms of risk of PJI. On the basis of the clinical studies available, there is no evidence that bearing choice influences the risk of PJI. Future research, including basic science studies and large, adequately controlled registry studies, may be helpful in determining whether implant materials play a role in determining the risk of PJI following arthroplasty

  16. Numerical Relativity

    Science.gov (United States)

    Baker, John G.

    2009-01-01

    Recent advances in numerical relativity have fueled an explosion of progress in understanding the predictions of Einstein's theory of gravity, General Relativity, for the strong field dynamics, the gravitational radiation wave forms, and consequently the state of the remnant produced from the merger of compact binary objects. I will review recent results from the field, focusing on mergers of two black holes.

  17. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  18. Increased risk for diabetes development in subjects with large variation in total cholesterol levels in 2,827,950 Koreans: A nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Eun-Jung Rhee

    Full Text Available Recent studies suggest a role for hyperlipidemia in the development of diabetes. The aim of this study is to analyze the relationship between variations of total cholesterol (TC levels and the risk for type 2 diabetes development from a Korean nationwide population-based database.We examined the General Health Check-up sub-dataset of the Korean National Health Insurance Service (NHIS of 2,827,950 participants who had at least three health check-ups between 2002 and 2007, and were not reported to have diabetes during that time. The variations of TC levels between the examinations were calculated as follows: [Formula: see text]. The examinees were divided into 10 groups according to TC variation, and the hazard ratio for diabetes development from 2007 to 2013, were analyzed.During the follow-up period, 3.4% of the participants had developed diabetes. The hazard ratio (HR for diabetes development relative to the overall risk in the whole study population started to be higher than 1.0 from eighth decile of TC variation. The highest decile group showed an increased HR for diabetes development after adjustment for confounding variables (1.139; 95% confidence interval 1.116~1.163. These results were similar regardless of the use of anti-hyperlipidemic medication and baseline TC levels.The participants with a large variation in TC levels showed an increased risk for diabetes development, independent of the use of anti-hyperlipidemic medications. These results suggest a relationship between fluctuations in lipid levels and the development of type 2 diabetes.

  19. Heavy metal pollution in vegetables grown in the vicinity of a multi-metal mining area in Gejiu, China: total concentrations, speciation analysis, and health risk.

    Science.gov (United States)

    Li, Yanyan; Wang, Hongbin; Wang, Haijuan; Yin, Fei; Yang, Xiaoyan; Hu, Yongjun

    2014-11-01

    A field survey was conducted to investigate the present situation and health risk of arsenic (As), lead (Pb), cadmium (Cd), copper (Cu), and zinc (Zn) in soils and vegetables in a multi-metal mining area, Gejiu, China. Furthermore, three vegetables (water spinach, potato, and summer squash) containing high metal concentrations were selected to further analyze metal speciation. The results showed that the average concentrations of five metals in soil exceeded the limiting values, and their bioavailable concentrations were significantly positively correlated to the total ones. Heavy metals in the edible parts of vegetables also exceeded the corresponding standards. The leaves of pakchoi, peppermint, and coriander had a strong metal-accumulative ability and they were not suitable for planting. Except the residue forms, the main forms of metals in the edible parts of three selected vegetables were ethanol-, NaCl-, and HAc-extractable fractions for As, Pb, and Cd, respectively; however, Cu was mainly presented as NaCl-extractable and Zn as HAc-extractable fractions. A high proportion of ethanol-extractable As showed that As bioactivity and toxic effects were the highest. Although the total and bioavailable Cd were high in soil, its speciation in vegetables was mainly presented as HAc-extractable fraction, which has a relatively low bioactivity. Lead and arsenic were imposing a serious threat on the local residents via vegetable consumption.

  20. Malnutrition Increases With Obesity and Is a Stronger Independent Risk Factor for Postoperative Complications: A Propensity-Adjusted Analysis of Total Hip Arthroplasty Patients.

    Science.gov (United States)

    Fu, Michael C; D'Ambrosia, Christopher; McLawhorn, Alexander S; Schairer, William W; Padgett, Douglas E; Cross, Michael B

    2016-11-01

    Obesity is frequently associated with complications after total hip arthroplasty (THA) and is often concomitant with malnutrition. The purpose of this study was to investigate the independent morbidity risk of malnutrition relative to obesity. The National Surgical Quality Improvement Program from 2005 to 2013 was queried for elective primary THA cases. Malnutrition was defined as albumin malnutrition with 30-day outcomes. A total of 40,653 THA cases were identified, of which 20,210 (49.7%) had preoperative albumin measurements. Propensity score adjustment successfully reduced potential selection bias, with P > .05 for differences between those with and without albumin data. Malnutrition incidence increased from 2.8% in obese I to 5.7% in obese III patients. With multivariable propensity-adjusted logistic regression, malnutrition was a more robust predictor than any obesity class for any postoperative complication(s) (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.25-2.08), major complications (OR 1.63, 95% CI 1.21-2.19), respiratory complications (OR 2.35, 95% CI 1.27-4.37), blood transfusions (OR 1.71, 95% CI 1.44-2.03), and extended length of stay (OR 1.35, 95% CI 1.14-1.59). Malnutrition incidence increased significantly from obese I to obese III patients and was a stronger and more consistent predictor than obesity of complications after THA. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Informed consent: do information pamphlets improve post-operative risk-recall in patients undergoing total thyroidectomy: prospective randomized control study.

    Science.gov (United States)

    Alsaffar, Hussain; Wilson, Lindsay; Kamdar, Dev P; Sultanov, Faizullo; Enepekides, Danny; Higgins, Kevin M

    2016-02-13

    Informed consent consists of basic five elements: voluntarism, capacity, disclosure, understanding, and ultimate decision-making. Physician disclosure, patient understanding, and information retention are all essential in the doctor-patient relationship. This is inclusive of helping patients make and manage their decisions and expectations better and also to deal with any consequences and/or complications that arise. This study investigates whether giving patients procedure-specific handouts pre-operatively as part of the established informed consent process significantly improves overall risk-recall following surgery. These handouts outline the anticipated peri-operative risks and complications associated with total thyroidectomy, as well as the corrective measures to address complications. In addition, the influence of potential confounders affecting risk-recall, such as anxiety and pre-existing memory disturbance, are also examined. Consecutive adult (≥18 years old) patients undergoing total thyroidectomy at a single academic tertiary care referral centre are included. Participants are randomly assigned into either the experimental group (with pamphlets) or the control group by a computerized randomization system (Clinstat). All participants filled out a Hospital Anxiety and Depression Scale (HADS) and they are tested by the physician for short-term memory loss using the Memory Impairment Screen (MIS) exam. All patients are evaluated at one week post-operatively. The written recall questionnaire test is also administered during this clinical encounter. Forty-nine patients are included--25 of them receive verbal consent only, while another 24 patients received both verbal consent and patient education information pamphlets. The overall average of correct answers for each group was 83% and 80% in the control and intervention groups, respectively, with no statistically significant differences. There are also no statistically significant differences between the

  2. Numerical relativity

    CERN Document Server

    Nakamura, T

    1993-01-01

    In GR13 we heard many reports on recent. progress as well as future plans of detection of gravitational waves. According to these reports (see the report of the workshop on the detection of gravitational waves by Paik in this volume), it is highly probable that the sensitivity of detectors such as laser interferometers and ultra low temperature resonant bars will reach the level of h ~ 10—21 by 1998. in this level we may expect the detection of the gravitational waves from astrophysical sources such as coalescing binary neutron stars once a year or so. Therefore the progress in numerical relativity is urgently required to predict the wave pattern and amplitude of the gravitational waves from realistic astrophysical sources. The time left for numerical relativists is only six years or so although there are so many difficulties in principle as well as in practice.

  3. Riesgo familiar total en familias con escolares según rendimiento académico Risco familiar total em famílias com escolares conforme aproveitamento acadêmico Total family risk in families with schoolchildren according to academic performance

    Directory of Open Access Journals (Sweden)

    CAROLINA LUCERO ENRÍQUEZ GUERRERO

    comparativo transversal com um componente analítico e abordagem quantitativa; a amostra foi de 186 famílias, durante abril -julho de 2007. Os resultados apresentam predomínio de famílias nucleares em ambos os grupos (65%, relação inversa entre o risco familiar total avaliado pelo instrumento RFT 7-70 e o aproveitamento acadêmico do escolar da família, isto é, que as famílias que registraram alto risco (9% e meio (31% em maior proporção são famílias de escolares com baixo aproveitamento acadêmico, comparado com o predomínio de risco familiar baixo (78% nas famílias de crianças de alto aproveitamento. Aplicou-se a t de student para diferença de médias e verificou-se uma associação (P = 0,02 entre o risco familiar total alto e o baixo aproveitamento acadêmico do escolar. Em conclusão, estes resultados sugerem principalmente que é preciso priorizar os fatores de risco que determinam maior risco familiar em famílias com escolares de aproveitamento acadêmico alto e cuidar a saúde integral com uma abordagem familiar e intersectorial, além de participar ativamente nas comunidades, continuar pesquisando sobre as possíveis associações entre a saúde individual, práticas de saúde, educação, ambiente socioeconômico e psicoafetivo da família, e o sucesso educativo de escolares em famílias com idade escolar.This article presents the results of a study whose objective was to establish the family risk differences among two groups of families: one with schoolchildren that show high academic performance and children that show low academic performance in an educational center in Bogotá. Methodology: cross-sectional comparative study with and analytic component and a quantitative approach; the sample was 186 families during the period April-July 2007. The results show a predominance of nuclear families in both groups (65%, reverse relation between the family risk evaluated by the RFT 7-70 instrument and the academic performance of the family´s schoolchild

  4. Riesgo familiar total en familias con escolares según rendimiento académico Total family risk in families with schoolchildren according to academic performance Risco familiar total em famílias com escolares conforme aproveitamento acadêmico

    Directory of Open Access Journals (Sweden)

    CATAÑO ORDÓÑEZ NHORA

    2009-12-01

    Full Text Available Este artículo presenta los resultados del estudio cuyo objetivo fue establecer las diferencias en el riesgo familiar entre dos grupos de familias: con niños escolares de alto rendimiento y niños de bajo rendimiento académico en un centro educativo distrital de Bogotá. Metodología: estudio descriptivo comparativo transversal con un componente analítico y abordaje cuantitativo; la muestra fue de 186 familias, durante abril a julio de 2007. Los resultados muestran predominio de familias nucleares en ambos grupos (65%, relación inversa entre el riesgo familiar total evaluado por el instrumento RFT 7-70 y el rendimiento académico del escolar de la familia, es decir que las familias que registraron riesgo alto (9% y medio (31% en mayor proporción son familias con escolares de bajo rendimiento académico, frente al predominio del riesgo familiar bajo (78% en las familias con niños de alto rendimiento. Se aplicó t de student para diferencia de medias y se encontró asociación (P = 0,02 entre el riesgo familiar total alto y el bajo rendimiento académico del escolar. En conclusión, estos resultados sugieren principalmente que se deben priorizar los factores de riesgo que determinan mayor riesgo familiar en familias con escolares de bajo rendimiento académico y dar atención de salud integral con enfoque familiar e intersectorial, y participación activa de la comunidad. Continuar investigando en posibles asociaciones entre salud individual, prácticas de salud, educación, ambiente socioeconómico y psicoafectivo de la familia y el logro educativo de escolares en familias con niños en edad escolar.This article presents the results of a study whose objective was to establish the family risk differences among two groups of families: one with schoolchildren that show high academic performance and children that show low academic performance in an educational center in Bogotá. Methodology: cross-sectional comparative study with and

  5. Probabilistic-numerical assessment of pyroclastic current hazard at Campi Flegrei and Naples city: Multi-VEI scenarios as a tool for "full-scale" risk management.

    Directory of Open Access Journals (Sweden)

    Giuseppe Mastrolorenzo

    Full Text Available The Campi Flegrei volcanic field (Italy poses very high risk to the highly urbanized Neapolitan area. Eruptive history was dominated by explosive activity producing pyroclastic currents (hereon PCs; acronym for Pyroclastic Currents ranging in scale from localized base surges to regional flows. Here we apply probabilistic numerical simulation approaches to produce PC hazard maps, based on a comprehensive spectrum of flow properties and vent locations. These maps are incorporated in a Geographic Information System (GIS and provide all probable Volcanic Explosivity Index (VEI scenarios from different source vents in the caldera, relevant for risk management planning. For each VEI scenario, we report the conditional probability for PCs (i.e., the probability for a given area to be affected by the passage of PCs in case of a PC-forming explosive event and related dynamic pressure. Model results indicate that PCs from VEI<4 events would be confined within the Campi Flegrei caldera, PC propagation being impeded by the northern and eastern caldera walls. Conversely, PCs from VEI 4-5 events could invade a wide area beyond the northern caldera rim, as well as part of the Naples metropolitan area to the east. A major controlling factor of PC dispersal is represented by the location of the vent area. PCs from the potentially largest eruption scenarios (analogous to the ~15 ka, VEI 6 Neapolitan Yellow Tuff or even the ~39 ka, VEI 7 Campanian Ignimbrite extreme event would affect a large part of the Campanian Plain to the north and the city of Naples to the east. Thus, in case of renewal of eruptive activity at Campi Flegrei, up to 3 million people will be potentially exposed to volcanic hazard, pointing out the urgency of an emergency plan. Considering the present level of uncertainty in forecasting the future eruption type, size and location (essentially based on statistical analysis of previous activity, we suggest that appropriate planning measures should

  6. Risk of venous thromboembolism after total hip and knee replacement in older adults with comorbidity and co-occurring comorbidities in the Nationwide Inpatient Sample (2003-2006

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2010-09-01

    Full Text Available Abstract Background Venous thromboembolism is a common, fatal, and costly injury which complicates major surgery in older adults. The American College of Chest Physicians recommends high potency prophylaxis regimens for individuals undergoing total hip or knee replacement (THR or TKR, but surgeons are reluctant to prescribe them due to fear of excess bleeding. Identifying a high risk cohort such as older adults with comorbidities and co-occurring comorbidities who might benefit most from high potency prophylaxis would improve how we currently perform preoperative assessment. Methods Using the Nationwide Inpatient Sample, we identified older adults who underwent THR or TKR in the U.S. between 2003 and 2006. Our outcome was VTE, including any pulmonary embolus or deep venous thrombosis. We performed multivariate logistic regression analyses to assess the effects of comorbidities on VTE occurrence. Comorbidities under consideration included coronary artery disease, congestive heart failure (CHF, chronic obstructive pulmonary disease (COPD, diabetes, and cerebrovascular disease. We also examined the impact of co-occurring comorbidities on VTE rates. Results CHF increased odds of VTE in both the THR cohort (OR = 3.08 95% CI 2.05-4.65 and TKR cohort (OR = 2.47 95% CI 1.95-3.14. COPD led to a 50% increase in odds in the TKR cohort (OR = 1.49 95% CI 1.31-1.70. The data did not support synergistic effect of co-occurring comorbidities with respect to VTE occurrence. Conclusions Older adults with CHF undergoing THR or TKR and with COPD undergoing TKR are at increased risk of VTE. If confirmed in other datasets, these older adults may benefit from higher potency prophylaxis.

  7. Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with severe mental illness: a total population study of Sweden.

    Science.gov (United States)

    Bauer-Staeb, Clarissa; Jörgensen, Lena; Lewis, Glyn; Dalman, Christina; Osborn, David P J; Hayes, Joseph F

    2017-09-01

    Severe mental illness is associated with increased morbidity and mortality. The elevated risk of blood-borne viruses (BBVs) in people with severe mental illness is of concern, but the full extent of this problem is unclear. We aimed to determine the prevalence of and risk factors for BBVs in people with severe mental illness. In this nationwide, population-based, cross-sectional study, we estimated the point prevalence of HIV, hepatitis B (HBV), and hepatitis C (HCV) in people with severe mental illness, including the total adult (≥18 years) Swedish population. We defined severe mental illness as a clinical diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or other psychotic illness according to the Swedish version of the International Statistical Classification of Diseases version 8, 9, or 10. We used multivariable logistic regression to determine the odds of BBVs in individuals with severe mental illness, relative to the general population, and to identify independent risk factors (age, sex, immigration status, socioeconomic status, education, and substance misuse) for BBV infection. We also did a sensitivity analysis excluding BBV diagnoses made before the introduction of the Register for Infection Disease Control (1997). Of 6 815 931 adults in Sweden, 97 797 (1·43%) individuals had a diagnosis of severe mental illness. Prevalence of BBVs was elevated in people with severe mental illness, of which 230 (0·24%) had HIV, 518 (0·53%) had HBV, and 4476 (4·58%) had HCV. After accounting for sociodemographic characteristics, the odds of HIV were 2·57 (95% CI 2·25-2·94, pmental illness than in the general population, whereas the odds of HBV were 2·29 (2·09-2·51, pmental illness and identify interventions preventing infection. Targeting of comorbid substance misuse would have particular effect on reduction of BBV prevalence in this population. Medical Research Council and Swedish Research Council. Copyright © 2017 The Author

  8. Allogeneic bone marrow transplantation with conditioning regimen to total body irradiation + thiotepa + melphalan for 35 patients with high-risk leukemia

    International Nuclear Information System (INIS)

    Yumura-Yagi, Keiko; Inoue, Masami; Okamura, Takayuki

    1997-01-01

    Thirty-five children with high-risk leukemia received an allogeneic bone marrow transplantation (BMT) following a pre-conditioning regimen consisting of total body irradiation, thiotepa and melphalan. Twenty-one patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 acute undifferentiated leukemia, 2 acute mixed lineage leukemia, 2 myelodysplastic syndrome and 2 juvenile chronic myeloid leukemia. Sixteen patients received BMT while in complete remission (CR), but 19 were not in CR. Eighteen patients received transplants from HLA-matched related donors, 15 from unrelated donors and 2 from HLA-mismatched related donors. Cyclosporin±methotrexate was used for graft-versus-host disease (GVHD) prophylaxis in the BMTs from related donors and tacrolimus±prednisolone in the BMTs from unrelated donors. Transplant-related death occurred in 12 patients; 5 acute GVHD, 4 infections (3 fungal infections, 1 Cytomegalovirus pneumonia), 1 intracranial haemorrhage and 2 chronic GVHD. Relapses were observed in 6 patients (69, 168, 175, 222, 275 and 609 days post BMT). Event-free survival rate at 2 years is 38.1% in CR patients and 36.9% in nonCR patients. (author)

  9. Quality of life as an outcome variable and a risk factor for total mortality and cardiovascular disease: a study of men born in 1913.

    Science.gov (United States)

    Tibblin, G; Svärdsudd, K; Welin, L; Erikson, H; Larsson, B

    1993-06-01

    To construct a simple assessment of the quality of life that can be used to evaluate medical treatment in light of the need to conserve resources and limit costs. The Göteborg Quality of Life Assessment was constructed in 1973 from the responses of men who were 50 years old at the time of the initial survey (1963) and were re-evaluated 10 years later. The assessment covers 15 factors in the World Health Organization definition of health or well-being, and includes a symptom questionnaire of 30 items relating to the most common elements of physical, mental and social well-being. The assessment was validated by determining the variation in these three principle components of well-being as a function of age. The use of this assessment as an outcome variable for subjects with cardiovascular disease indicated significantly lower quality of life scores, especially with regard to the general well-being, fitness and energy of subjects with hypertension and congestive heart failure compared to subjects without these diseases. When the assessment was evaluated as a risk factor for cardiovascular disease and mortality, the results of univariate analysis showed that health, fitness and appetite were significantly correlated with total mortality, while multivariate analysis indicated that only health was a significant factor.

  10. Numerical analysis

    CERN Document Server

    Jacques, Ian

    1987-01-01

    This book is primarily intended for undergraduates in mathematics, the physical sciences and engineering. It introduces students to most of the techniques forming the core component of courses in numerical analysis. The text is divided into eight chapters which are largely self-contained. However, with a subject as intricately woven as mathematics, there is inevitably some interdependence between them. The level of difficulty varies and, although emphasis is firmly placed on the methods themselves rather than their analysis, we have not hesitated to include theoretical material when we consider it to be sufficiently interesting. However, it should be possible to omit those parts that do seem daunting while still being able to follow the worked examples and to tackle the exercises accompanying each section. Familiarity with the basic results of analysis and linear algebra is assumed since these are normally taught in first courses on mathematical methods. For reference purposes a list of theorems used in the t...

  11. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

    Science.gov (United States)

    Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

    2017-09-01

    Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with

  12. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  13. Risk factors for radiation pneumonitis after stereotactic radiation therapy for lung tumours: clinical usefulness of the planning target volume to total lung volume ratio.

    Science.gov (United States)

    Ueyama, Tomoko; Arimura, Takeshi; Takumi, Koji; Nakamura, Fumihiko; Higashi, Ryutaro; Ito, Soichiro; Fukukura, Yoshihiko; Umanodan, Tomokazu; Nakajo, Masanori; Koriyama, Chihaya; Yoshiura, Takashi

    2018-06-01

    To identify risk factors for symptomatic radiation pneumonitis (RP) after stereotactic radiation therapy (SRT) for lung tumours. We retrospectively evaluated 68 lung tumours in 63 patients treated with SRT between 2011 and 2015. RP was graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.0. SRT was delivered at 7.0-12.0 Gy per each fraction, once daily, to a total of 48-64 Gy (median, 50 Gy). Univariate analysis was performed to assess patient- and treatment-related factors, including age, sex, smoking index (SI), pulmonary function, tumour location, serum Krebs von den Lungen-6 value (KL-6), dose-volume metrics (V5, V10, V20, V30, V40 and VS5), homogeneity index of the planning target volume (PTV), PTV dose, mean lung dose (MLD), contralateral MLD and V2, PTV volume, lung volume and the PTV/lung volume ratio (PTV/Lung). Performance of PTV/Lung in predicting symptomatic RP was also analysed using receiver operating characteristic (ROC) analysis. The median follow-up period was 21 months. 10 of 63 patients (15.9%) developed symptomatic RP after SRT. On univariate analysis, V10, V20, PTV volume and PTV/Lung were significantly associated with occurrence of RP  ≥Grade 2. ROC curves indicated that symptomatic RP could be predicted using PTV/Lung [area under curve (AUC): 0.88, confidence interval (CI: 0.78-0.95), cut-off value: 1.09, sensitivity: 90.0% and specificity: 72.4%]. PTV/Lung is a good predictor of symptomatic RP after SRT. Advances in knowledge: The cases with high PTV/Lung should be carefully monitored with caution for the occurrence of RP after SRT.

  14. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihara, Takao; Fujii, Noriko [Matsushita Memorial Hospital, Moriguchi, Osaka (Japan); Naya, Mayumi [and others

    1999-02-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m{sup 2} x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin`s lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  15. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    International Nuclear Information System (INIS)

    Yoshihara, Takao; Fujii, Noriko; Naya, Mayumi

    1999-01-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m 2 x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin's lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  16. Short-term hypertension management in community is associated with long-term risk of stroke and total death in China: A community controlled trial.

    Science.gov (United States)

    Wang, Zengwu; Hao, Guang; Wang, Xin; Wang, Wen; Chen, Weiwei; Zhu, Manlu

    2016-11-01

    It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke OBJECTIVES:: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. Community controlled trail. Six community health centers (4 active, 2 control) in China, patients with hypertension. Patients were treated with normally therapy method. Patients were treated oriented by the Guideline for hypertension management. Two centers (Hebei and Zhejiang) from the Hypertension Control in Community (HCC) Project, which was conducted from 2005 to 2008, were randomly selected for this study. Four thousand hypertensive patients from these centers, who were under management for one year in the baseline, were followed up in 2013. The electronic health record system (2005-2008) was used to identify 2000 hypertensive patients, who were not included in HCC but lived in comparable community health center in the same province, as the control group. All baseline and follow-up data were collected using standardized questionnaires for stroke outcomes. Stroke. Of the 6000 participants, 3787 (63.1%) were eligible for analysis. At the time of follow-up, the average BP was kept in the lower level than that in baseline, and the control rate was 59.3%. After propensity-score matching, 110 strokes (2.0% vs 4.6%) and 141 deaths (1.4% vs 3.8%) were noted in the matched intervention and control groups (1078 pairs), respectively. Patients in the intervention group were less likely to experience a stroke or die than those in the control group (hazard ratio [HR] = 0.40, 95% confidence interval [CI]: 0.26-0.62, P stroke in hypertensive patients.

  17. Risk factors for fear of falling in elderly patients with severe knee osteoarthritis before and one year after total knee arthroplasty.

    Science.gov (United States)

    Tsonga, Theano; Michalopoulou, Maria; Kapetanakis, Stylianos; Giovannopoulou, Eirini; Malliou, Paraskevi; Godolias, George; Soucacos, Panagiotis

    2016-12-01

    To evaluate the regression of fear of falling (FOF) and identify its risk factors in patients with severe knee osteoarthritis before and one year after total knee arthroplasty (TKA). 11 men and 57 women with a mean age of 73 years and a mean body mass index of 30.36 kg/m2 who had severe (grade 3 or 4) knee osteoarthritis and knee pain of ≥1 year were included. Two weeks before and one year after TKA, patients were asked about their FOF status and falls history. Patients were asked to complete the Physical Activity Scale for the Elderly, Short Form 36 (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires. Clinical performance was assessed using the Berg Balance Scale and Timed Up and Go (TUG) test. Of the 68 patients, 56 (82.4%) had FOF preoperatively and 30 (44.1%) had FOF one year after TKA (p<0.001). The strongest predictors for FOF preoperatively were fallers (odds ratio [OR]=9.83, p=0.028), mental component summary (MCS) score of SF-36 (OR=0.88, p=0.024), and TUG (OR=3.4, p=0.013). The strongest predictors for FOF one year postoperatively were fallers (OR=16.51, p=0.041), patients with ≥2 chronic diseases (OR=17.33, p=0.011), physical function score of WOMAC (OR=1.015, p=0.005), and MCS score of SF-36 (OR=0.86, p=0.015). TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.

  18. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  19. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  20. Prediction by numerical modeling of the risk zone along a riverside exposed to a dam failure; Prevision par modelisation numerique de la zone de risque bordant un troncon de riviere subissant une rupture de barrage

    Energy Technology Data Exchange (ETDEWEB)

    Mahdi, T.F.

    2004-07-01

    The risk zone associated with the surge wave following dam failure is defined in this study using a newly developed methodology that incorporates the conventionally used maximum water levels, the sediment movement in the river bed and the possibility of bank failure. Although the risk zone is typically defined as the inundated area, extensive lateral erosion that causes landslides could also accompany the inundation. This study demonstrates that the stability of the riverbank (in terms of geotechnical considerations) can influence the delineation of the risk area. The combined disciplines of geotechnics and hydraulics can be used to follow the evolution of the riverbed and riverbanks during a flood event. This study also presents a structured methodology for the St. Venant shallow water wave equations which were used to determine the area likely to be flooded without taking into account sediment transport. It also discusses aspects of the sediment transport theory. Fluvial erosion and lateral bank failure are the basic physical processes responsible for bank retreat. The minimum energy dissipation rate theory is applied for fluvial erosion, while Bishop's modified method is used to analyze slope stability when evaluating lateral bank failures. A numerical modeling of flows over movable beds is presented along with a review of some of the available numerical models. A diagnostic phase that provides information needed to qualify the extent of the damage after a flood is also presented. Some of the numerical models to evaluate risk area were validated on a portion of the HaHa River which was affected in the 1996 Saguenay flood. The new methodology, applied to the Outaouais River at Notre Dame du Nord in Quebec, produces a risk area much greater than that obtained when only the inundated area is considered.

  1. Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G David; Shipley, Martin J; Dundas, Ruth

    2009-01-01

    The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance in this ......The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance...

  2. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register.

    Science.gov (United States)

    Julin, Jaakko; Jämsen, Esa; Puolakka, Timo; Konttinen, Yrjö T; Moilanen, Teemu

    2010-08-01

    Total knee replacements (TKRs) are being increasingly performed in patients aged age of the patient and prosthesis survival following primary TKR using nationwide data collected from the Finnish Arthroplasty Register. From Jan 1, 1997 through Dec 31, 2003, 32,019 TKRs for primary or secondary osteoarthritis were reported to the Finnish Arthroplasty Register. The TKRs were followed until the end of 2004. During the follow-up, 909 TKRs were revised, 205 (23%) due to infection and 704 for other reasons. Crude overall implant survival improved with increasing age between the ages of 40 and 80. The 5-year survival rates were 92% and 95% in patients aged 65 years of age (p age groups 65 years remained after adjustment for these factors (p age impairs the prognosis of TKR and is associated with increased revision rates for non-infectious reasons. Diagnosis, sex, type of TKR, use of patellar component, and fixation method partly explain the differences, but the effects of physical activity, patient demands, and obesity on implant survival in younger patients warrant further research.

  3. Is the Total Concentration of a Heavy Metal in Soil a Suitable Tool for Assessing the Environmental Risk? Considering the Case of Copper

    Science.gov (United States)

    Fernández-Calviño, David; Pérez-Rodríguez, Paula; Nóvoa-Muñoz, Juan Carlos; Estévez, Manuel Arias

    2017-01-01

    National legislation concerning soil pollution by heavy metals in different countries is mostly based on the total heavy metal concentration levels allowed in different soils. As soil pollution is an issue of worldwide concern, here we develop a laboratory exercise for students in which they must check the suitability of a total metal…

  4. Estimating Total Program Cost of a Long-Term, High-Technology, High-Risk Project with Task Durations and Costs That May Increase Over Time

    National Research Council Canada - National Science Library

    Brown, Gerald G; Grose, Roger T; Koyak, Robert A

    2006-01-01

    .... Each task suffers some risk of delay and changed cost. Ignoring budget constraints, we use Monte Carlo simulation of the duration of each task in the project to infer the probability distribution of the project completion time...

  5. Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

    DEFF Research Database (Denmark)

    Zamora-Ros, Raul; Cayssials, Valerie; Jenab, Mazda

    2018-01-01

    Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and ...

  6. Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada.

    Science.gov (United States)

    Sun, Zhuoyu; Liu, Lin; Wang, Peizhong Peter; Roebothan, Barbara; Zhao, Jin; Dicks, Elizabeth; Cotterchio, Michelle; Buehler, Sharon; Campbell, Peter T; McLaughlin, John R; Parfrey, Patrick S

    2012-03-26

    Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC) risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL) and Ontario (ON), Canada. Incident colorectal cancer cases (n = 1760) were identified from population-based cancer registries in the provinces of ON (1997-2000) and NL (1999-2003). Controls (n = 2481) were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ), personal history questionnaire (PHQ), and food frequency questionnaire (FFQ) were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p-trend = 0.02, 5th versus 1st quintile), whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p-trend = 0.06, 5th versus 1st quintile), carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p-trend = 0.05, 5th versus 1st quintile) and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p-trend = 0.04, 5th versus 1st quintile). Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

  7. Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Sun Zhuoyu

    2012-03-01

    Full Text Available Abstract Background Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL and Ontario (ON, Canada. Methods Incident colorectal cancer cases (n = 1760 were identified from population-based cancer registries in the provinces of ON (1997-2000 and NL (1999-2003. Controls (n = 2481 were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ, personal history questionnaire (PHQ, and food frequency questionnaire (FFQ were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Results Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p-trend = 0.02, 5th versus 1st quintile, whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p-trend = 0.06, 5th versus 1st quintile, carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p-trend = 0.05, 5th versus 1st quintile and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p-trend = 0.04, 5th versus 1st quintile. Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. Conclusion This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

  8. Development of risk assessment methodology of decay heat removal function against external hazards for sodium-cooled fast reactors. (3) Numerical simulations of forest fire spread and smoke transport as an external hazard assessment methodology development

    International Nuclear Information System (INIS)

    Okano, Yasushi; Yamano, Hidemasa

    2015-01-01

    As a part of a development of the risk assessment methodologies against external hazards, a new methodology to assess forest fire hazards is being developed. Frequency and consequence of the forest fire are analyzed to obtain the hazard intensity curve and then Level 1 probabilistic safety assessment is performed to obtain the conditional core damage probability due to the challenges by the forest fire. 'Heat', 'flame', 'smoke' and 'flying object' are the challenges to a nuclear power plant. For a sodium-cooled fast reactor, a decay heat removal under accident conditions is operated with an ultimate heat sink of air, then, the challenge by 'smoke' will potentially be on the air filter of the system. In this paper, numerical simulations of forest fire propagation and smoke transport were performed with sensibility studies to weather conditions, and the effect by the smoke on the air filter was quantitatively evaluated. Forest fire propagation simulations were performed using FARSITE code. A temporal increase of a forest fire spread area and a position of the frontal fireline are obtained by the simulation, and 'reaction intensity' and 'frontal fireline intensity' as the indexes of 'heat' are obtained as well. The boundary of the fire spread area is shaped like an ellipse on the terrain, and the boundary length is increased with time and fire spread. The sensibility analyses on weather conditions of wind, temperature, and humidity were performed, and it was summarized that 'forest fire spread rate' and 'frontal fireline intensity' depend much on wind speed and humidity. Smoke transport simulations were performed by ALOFT-FT code where three-dimensional spatial distribution of smoke density, especially of particle matters of PM2.5 and PM10, are evaluated. The snapshot outputs, namely 'reaction intensity' and 'position of frontal fireline', from the sensibility studies of the FARSITE were directly utilized as the input data for ALOFT-FT, whereas it is assumed that the

  9. Risk assessment of occupational exposure to benzene using numerical simulation in a complex geometry of a reforming unit of petroleum refinery.

    Science.gov (United States)

    Bayatian, Majid; Ashrafi, Khosro; Azari, Mansour Rezazadeh; Jafari, Mohammad Javad; Mehrabi, Yadollah

    2018-04-01

    There has been an increasing concern about the continuous and the sudden release of volatile organic pollutants from petroleum refineries and occupational and environmental exposures. Benzene is one of the most prevalent volatile compounds, and it has been addressed by many authors for its potential toxicity in occupational and environmental settings. Due to the complexities of sampling and analysis of benzene in routine and accidental situations, a reliable estimation of the benzene concentration in the outdoor setting of refinery using a computational fluid dynamics (CFD) could be instrumental for risk assessment of occupational exposure. In the present work, a computational fluid dynamic model was applied for exposure risk assessment with consideration of benzene being released continuously from a reforming unit of a refinery. For simulation of benzene dispersion, GAMBIT, FLUENT, and CFD post software are used as preprocessing, processing, and post-processing, respectively. Computational fluid dynamic validation was carried out by comparing the computed data with the experimental measurements. Eventually, chronic daily intake and lifetime cancer risk for routine operations through the two seasons of a year are estimated through the simulation model. Root mean square errors are 0.19 and 0.17 for wind speed and concentration, respectively. Lifetime risk assessments of workers are 0.4-3.8 and 0.0096-0.25 per 1000 workers in stable and unstable atmospheric conditions, respectively. Exposure risk is unacceptable for the head of shift work, chief engineer, and general workers in 141 days (38.77%) in a year. The results of this study show that computational fluid dynamics is a useful tool for modeling of benzene exposure in a complex geometry and can be used to estimate lifetime risks of occupation groups in a refinery setting.

  10. Thirty-day Postoperative Complications following Primary Total Knee Arthroplasty: A Retrospective Study of Incidence and Risk Factors at a Single Center in China

    Directory of Open Access Journals (Sweden)

    Bin Feng

    2017-01-01

    Conclusions: This study highlighted complications with cardiac and respiratory origins as the most common complications within 30 postoperative days following primary TKA. The BMI of ≥30.0 kg/m2 and age ≥80 years were significant risk factors for 30-day postoperative complications.

  11. Risk factors for adverse outcome in patients with rectal cancer treated with an abdominoperineal resection in the total mesorectal excision trial

    NARCIS (Netherlands)

    den Dulk, Marcel; Marijnen, Corrie A. M.; Putter, Hein; Rutten, Harm J. T.; Beets, Geerard L.; Wiggers, Theo; Nagtegaal, Iris D.; van de Velde, Cornelis J. H.

    Objective: This study was performed to identify tumor- and patient-related risk factors for distal rectal cancer in patients treated with an abdominoperineal resection (APR) associated with positive circumferential resection margin (CRM), local recurrence (LR), and overall survival (OS). Background:

  12. Changes in BMI before and during economic development and subsequent risk of cardiovascular disease and total mortality: a 35-year follow-up study in China.

    Science.gov (United States)

    He, Yao; Lam, Tai Hing; Jiang, Bin; Li, Lan Sun; Sun, Dong Ling; Wu, Lei; Liu, Miao; Yang, Shan Shan; Wang, Yi Yan; Tobias, Deirdre K; Sun, Qi; Hu, Frank B

    2014-09-01

    It is unclear whether changes in BMI during rapid economic development influence subsequent mortality. We analyzed whether BMI in 1976 and 1994 and changes in BMI during 1976-1994 predict cardiovascular disease (CVD) and all-cause mortality in a 35-year follow-up cohort of 1,696 Chinese (1,124 men and 572 women, aged 35-65 years) in Xi'an, China. Participants were categorized as underweight (economic development was associated with elevated risks of all-cause and CVD mortality. Higher BMI measured before economic development was associated with lower mortality risk, whereas BMI measured afterward was associated with increased mortality. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  13. Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?

    Science.gov (United States)

    Parvizi, Javad; Barnes, Sue; Shohat, Noam; Edmiston, Charles E

    2017-11-01

    In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI. In 2017, virtually all surgical disciplines are engaged in the implantation of selective biomedical devices, and these implants have been documented to be at high risk for intraoperative contamination. Approximately 1.2 million arthroplasties are performed annually in the United States, and that number is expected to increase to 3.8 million by the year 2030. The incidence of periprosthetic joint infection is perceived to be low (<2.5%); however, the personal and fiscal morbidity is significant. Although the pharmaceutic and computer industries enforce stringent air quality standards on their manufacturing processes, there is currently no U.S. standard for acceptable air quality within the OR environment. This review documents the contribution of air contamination to the etiology of periprosthetic joint infection, and evidence for selective innovative strategies to reduce the risk of intraoperative microbial aerosols. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Acute effect of weight loss on levels of total bilirubin in obese, cardiovascular high-risk patients: an analysis from the lead-in period of the Sibutramine Cardiovascular Outcome trial

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Weeke, Peter; Fosbøl, Emil Loldrup

    2009-01-01

    Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine and life......Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine...... and lifestyle change on levels of total bilirubin in an overweight or obese, cardiovascular high-risk population. Data from the first 4 weeks of the lead-in period of the Sibutramine Cardiovascular Outcome study were analyzed. A total of 10 198 patients provided body weight measurements before and after 4 weeks...... of sibutramine treatment (10 mg daily), of whom 1059 (10.4%) gained weight, 1467 (13.7%) lost greater than 0% to 1%, 2492 (23.2%) lost greater than 1% to 2%, 2280 (21.2%) lost greater than 2% to 3%, 1498 (13.9%) lost greater than 3% to 4%, and 1402 (13.1%) lost greater than 4% of their initial weight...

  15. Characterization of the total family risk among families with functional elder adults, in the area of "Patio Bonito", in Bogotá, 2005 Caracterización del riesgo familiar total en las familias con adultos mayores funcionales, sector de Patio Bonito, Bogotá, 20051

    Directory of Open Access Journals (Sweden)

    VELÁSQUEZ VELÁSQUEZ CAROL IVONNE

    2007-12-01

    Full Text Available This article is generated based on the results of a master's degree research that unveiled the characteristics of the total family risk among families with functional elder adults who are beneficiaries of the Care Program for the wellbeing of the elderly who are poor, of the Local Health Center, the "Centro Operativo Local de Kennedy", i.e. residents in the area of "Patio Bonito". Data was obtained using the RFT 7-70 instrument, designed by Dr. Pilar Amaya. The research showed in general terms the characteristics of family structures and the tabulation of total family risks having as high some 34,7%, as medium some 34,7% among the group of families; also it enable one to identify the sub categories and risk factor that are most frequent in such family systems, which may be useful as a tool when planning and carrying out health programs for families according to risk.Este artículo presenta parte de los resultados del proyecto de investigación Caracterización de familias beneficiarias del programa Atención para el bienestar del adulto mayor en situación de pobreza del Centro Operativo Local de Kennedy, financiado por la División de Investigación Bogotá, en el cual se describen las características y el riesgo familiar total de 72 familias con adultos mayores funcionales, mediante el uso del instrumento RFT 7-70, elaborado por Pilar Amaya. La investigación muestra las características de la estructura familiar, la calificación similar del riesgo familiar total alto y medio (34.7% y las subcategorías más frecuentes en dichas familias, resultados que pueden ser útiles en el momento de planear y desarrollar programas de salud familiar con enfoque de riesgo.

  16. Caracterización del riesgo familiar total en las familias con adultos mayores funcionales, sector de Patio Bonito, Bogotá, 2005 Characterization of the total family risk among families with functional elder adults, in the area of "Patio Bonito", in Bogotá, 2005

    Directory of Open Access Journals (Sweden)

    CAROL IVONNE VELÁSQUEZ VELÁSQUEZ

    2007-12-01

    Full Text Available Este artículo presenta parte de los resultados del proyecto de investigación Caracterización de familias beneficiarias del programa Atención para el bienestar del adulto mayor en situación de pobreza del Centro Operativo Local de Kennedy, financiado por la División de Investigación Bogotá, en el cual se describen las características y el riesgo familiar total de 72 familias con adultos mayores funcionales, mediante el uso del instrumento RFT 7-70, elaborado por Pilar Amaya. La investigación muestra las características de la estructura familiar, la calificación similar del riesgo familiar total alto y medio (34.7% y las subcategorías más frecuentes en dichas familias, resultados que pueden ser útiles en el momento de planear y desarrollar programas de salud familiar con enfoque de riesgoThis article is generated based on the results of a master's degree research that unveiled the characteristics of the total family risk among families with functional elder adults who are beneficiaries of the Care Program for the wellbeing of the elderly who are poor, of the Local Health Center, the "Centro Operativo Local de Kennedy", i.e. residents in the area of "Patio Bonito". Data was obtained using the RFT 7-70 instrument, designed by Dr. Pilar Amaya. The research showed in general terms the characteristics of family structures and the tabulation of total family risks having as high some 34,7%, as medium some 34,7% among the group of families; also it enable one to identify the sub categories and risk factor that are most frequent in such family systems, which may be useful as a tool when planning and carrying out health programs for families according to risk

  17. Risk of colorectal cancer in relation to frequency and total amount of red meat consumption. Systematic review and meta-analysis

    OpenAIRE

    Smolińska, Katarzyna; Paluszkiewicz, Piotr

    2010-01-01

    Introduction The colon and rectum are common sites of food-related cancer in developed countries. Recent studies strongly suggest that red meat intake is associated with colon cancer, whereas for rectal cancer such an association still needs to be proved. The aim of the study was to assess the role of total amount and frequency of red meat intake in colorectal carcinogenesis based on published data using meta-analysis methods. Material and methods The literature published until 2009 was selec...

  18. Effect of Atorvastatin on Serum Levels of Total Cholesterol and High-Sensitivity C-reactive Protein in High-Risk Patients with Atrial Fibrillation in Asia.

    Science.gov (United States)

    Shi, Ming Yu; Xue, Feng Hua; Teng, Shi Chao; Jiang, Li; Zhu, Jing; Yin, Feng; Gu, Hong Yue

    2015-08-01

    The aim of this meta-analysis was to investigate the effects of atorvastatin on serum levels of high-sensitivity C-reactive protein (hs-CRP) and total cholesterol in atrial fibrillation (AF) patients in Asia. By searching English and Chinese language-based electronic databases (ie, PubMed, EBSCO, Ovid, SpringerLink, Wiley, Web of Science, Wanfang database, China National Knowledge Infrastructure, and VIP database), we identified 13 studies relevant to our topic of interest. Data were collected from the 13 studies and analyzed with Comprehensive Meta-Analysis software (version 2.0, Biostat Inc., Englewood, New Jersey). Initially, our database searches retrieved 356 studies (45 in English, 311 in Chinese). Thirteen studies were selected for the meta-analysis following stringent criteria. The data included 1239 patients with AF, of whom 634 were treated with atorvastatin and included in the treatment group, and 605 patients were treated with conventional treatment and included in the control group. The results of our meta-analysis suggested that the serum levels of hs-CRP (mg/L) and total cholesterol (mmol/L) in the treatment group were significantly lower than those of the control group (hs-CRP: standardized mean difference = 0.962; 95% CI, 0.629-1.295, P < 0.001; total cholesterol: standardized mean difference = 1.400; 95% CI, 0.653-2.146, P < 0.001). The findings of this study suggest that atorvastatin may be very effective in decreasing serum levels of hs-CRP and total cholesterol to prevent cardiovascular events. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  19. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  20. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  1. Comparison of Serum Concentrations of Total Cholesterol and Total ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is one of the most dangerous tropical diseases that complicates HIV infection in Nigeria to date. Over two million Nigerians are known to be infected with TB and many more are at risk of the infection. Serum concentrations of total cholesterol and total lipid of 117 female TB patients attending chest clinic at ...

  2. Human health risk assessment of lead from mining activities at semi-arid locations in the context of total lead exposure.

    Science.gov (United States)

    Zheng, Jiajia; Huynh, Trang; Gasparon, Massimo; Ng, Jack; Noller, Barry

    2013-12-01

    Lead from historical mining and mineral processing activities may pose potential human health risks if materials with high concentrations of bioavailable lead minerals are released to the environment. Since the Joint Expert Committee on Food Additives of Food and Agriculture Organization/World Health Organization withdrew the Provisional Tolerable Weekly Intake of lead in 2011, an alternative method was required for lead exposure assessment. This study evaluated the potential lead hazard to young children (0-7 years) from a historical mining location at a semi-arid area using the U.S. EPA Integrated Exposure Uptake Biokinetic (IEUBK) Model, with selected site-specific input data. This study assessed lead exposure via the inhalation pathway for children living in a location affected by lead mining activities and with specific reference to semi-arid conditions and made comparison with the ingestion pathway by using the physiologically based extraction test for gastro-intestinal simulation. Sensitivity analysis for major IEUBK input parameters was conducted. Three groups of input parameters were classified according to the results of predicted blood concentrations. The modelled lead absorption attributed to the inhalation route was lower than 2 % (mean ± SE, 0.9 % ± 0.1 %) of all lead intake routes and was demonstrated as a less significant exposure pathway to children's blood, compared with ingestion. Whilst dermal exposure was negligible, diet and ingestion of soil and dust were the dominant parameters in terms of children's blood lead prediction. The exposure assessment identified the changing role of dietary intake when house lead loadings varied. Recommendations were also made to conduct comprehensive site-specific human health risk assessment in future studies of lead exposure under a semi-arid climate.

  3. Spatial and temporal analysis of the risks posed by total petroleum hydrocarbon and trace element contaminants in coastal waters of Kuwait.

    Science.gov (United States)

    Nicolaus, E E M; Wright, S R; Barry, J; Bolam, T P C; Ghareeb, K; Ghaloom, M; Al-Kanderi, N; Harley, B F M; Le Quesne, W J F; Devlin, M J; Lyons, B P

    2017-07-15

    Nine trace elements including As, Cd, Cu, Fe, Hg, Ni, Pb, V and Zn, and total petroleum hydrocarbons were analysed from water samples collected from 23 stations since 1984 from Kuwaiti coastal waters. Here it was investigated whether concentrations of these determinants are at levels above Kuwaiti and internationally established assessment criteria (AC). The results indicate that Cu and Cd had the most Kuwaiti AC breaches over time. Comparing the data of the last sampled year to the least stringent international AC, then Cu and Cd showed breaches at all stations. The trends for trace metals are significantly downwards, especially for Cd and Hg. No determinant measured showed a significant upward trend, indicating that water pollution for these contaminants is not a worsening situation. However, further sampling should be carried out to confirm these findings, especially at shoreline locations, where routine monitoring ceased in 2011 to investigate any recent changes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity.

    Science.gov (United States)

    Kerr, Katelyn; Romaniuk, Madeline; McLeay, Sarah; Khoo, Andrew; Dent, Michael T; Boshen, Mark

    2018-06-01

    Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social

  5. Using drug sales data to evaluate the epidemiology of cardiometabolic risk factors and their inequality: an ecological study on atorvastatin and total cholesterol in Iran.

    Science.gov (United States)

    Ahmadvand, Alireza; Farzadfar, Farshad; Jamshidi, Hamid Reza; Mohammadi, Naser; Holakouie-Naieni, Kourosh

    2015-01-01

    Statins have been effective medications in lowering serum total cholesterol (TC) concentrations across populations over time. The aim of this study was to estimate national and provincial trends in atorvastatin sales in Iran, to systematically quantify its relationship with socioeconomic indicators, and changes in TC level. In this retrospective ecological study, conducted in Iran, we examined trends in atorvastatin sales, the wealth index (WI) as a validly-available socio-economic indicator, and TC level between 2004 and 2011. The main outcome variable was mean atorvastatin sold in defined daily dose per 100,000 people per day (DPD). We analyzed the relationship between WI and DPD and between DPD and mean TC across time and space. At national level, both mean WI and mean DPD showed increasing trend over time, while we observed decreasing trend for TC. Mean WI and DPD in 2011 was nearly 5 and 50 time that of their respective figures in 2004, while the mean TC decreased for nearly 10%. Increases in both WI and DPD had happened in every province, but with different patterns. The maximum and minimum changes in DPD versus WI were seen in Gilan and North Khorasan respectively. A striking increase occurred in the sales for atorvastatin in Iran from 2004-2012 in most provinces examined. The wealthier a province became, the more sales were seen for atorvastatin. TC optimistically decreased from 2005 to 2011 and its decrease was positively correlated with increasing sales for atorvastatin.

  6. Numerical Optimization in Microfluidics

    DEFF Research Database (Denmark)

    Jensen, Kristian Ejlebjærg

    2017-01-01

    Numerical modelling can illuminate the working mechanism and limitations of microfluidic devices. Such insights are useful in their own right, but one can take advantage of numerical modelling in a systematic way using numerical optimization. In this chapter we will discuss when and how numerical...... optimization is best used....

  7. Methods of numerical relativity

    International Nuclear Information System (INIS)

    Piran, T.

    1983-01-01

    Numerical Relativity is an alternative to analytical methods for obtaining solutions for Einstein equations. Numerical methods are particularly useful for studying generation of gravitational radiation by potential strong sources. The author reviews the analytical background, the numerical analysis aspects and techniques and some of the difficulties involved in numerical relativity. (Auth.)

  8. The evaluation of total mercury and arsenic in skin bleaching creams commonly used in Trinidad and Tobago and their potential risk to the people of the Caribbean

    Directory of Open Access Journals (Sweden)

    Terry Mohammed

    2017-10-01

    Full Text Available Background. Skin lightening is very popular among women and some men of the Caribbean, and its popularity appears to be growing. The lightening of skin colour is done to produce a lighter complexion which is believed to increase attractiveness, social standing and improves one’s potential of being successful. Design and Methods. Fifteen (15 common skin lightening creams found in pharmacies and cosmetic retailers throughout Trinidad and Tobago were evaluated for Mercury by Cold Vapor Atomic Absorption Spectrophotometry (CVAAS and Arsenic by Hydride Generation Atomic Absorption Spectrophotometry (HGAAS. The results obtained were compared to global standards and previous research. Results. Fourteen (14 of the fifteen samples analysed contained Mercury in the range of 0.473 μg/g to 0.766 μg/g. One sample had a Mercury content of 14,507.74±490.75 μg/g which was over 14,000 times higher than the USFDA limit for mercury in cosmetics of 1 μg/g. All samples contained Arsenic in the range 1.016 μg/g to 6.612 μg/g, which exceeds the EU limit for cosmetics of 0 μg/g. Conclusions. All the samples analysed contained significant amounts of Mercury and Arsenic and none of them can be considered safe for prolonged human use. The samples that contained Mercury levels which were lower than the USFDA limit contained Arsenic levels which exceeded the EU standard of 0 μg/g in cosmetics. The popularity of these skin lightening creams in the Caribbean region places the population at elevated risk of chronic Mercury and Arsenic poisoning and possibly acute Mercury Poisoning.

  9. The evaluation of total mercury and arsenic in skin bleaching creams commonly used in Trinidad and Tobago and their potential risk to the people of the Caribbean.

    Science.gov (United States)

    Mohammed, Terry; Mohammed, Elisabeth; Bascombe, Shermel

    2017-12-13

    Background. Skin lightening is very popular among women and some men of the Caribbean, and its popularity appears to be growing. The lightening of skin colour is done to produce a lighter complexion which is believed to increase attractiveness, social standing and improves one's potential of being successful. Design and Methods. Fifteen (15) common skin lightening creams found in pharmacies and cosmetic retailers throughout Trinidad and Tobago were evaluated for Mercury by Cold Vapor Atomic Absorption Spectrophotometry (CVAAS) and Arsenic by Hydride Generation Atomic Absorption Spectrophotometry (HGAAS). The results obtained were compared to global standards and previous research. Results. Fourteen (14) of the fifteen samples analysed contained Mercury in the range of 0.473 μg/g to 0.766 μg/g. One sample had a Mercury content of 14,507.74±490.75 μg/g which was over 14,000 times higher than the USFDA limit for mercury in cosmetics of 1 μg/g. All samples contained Arsenic in the range 1.016 μg/g to 6.612 μg/g, which exceeds the EU limit for cosmetics of 0 μg/g. Conclusions. All the samples analysed contained significant amounts of Mercury and Arsenic and none of them can be considered safe for prolonged human use. The samples that contained Mercury levels which were lower than the USFDA limit contained Arsenic levels which exceeded the EU standard of 0 μg/g in cosmetics. The popularity of these skin lightening creams in the Caribbean region places the population at elevated risk of chronic Mercury and Arsenic poisoning and possibly acute Mercury Poisoning.

  10. The Evaluation of a Risk Degree for the Process of a Brown Coal Spontaneous Ignition on Dumps with Using of Modern Numeric Methods

    Science.gov (United States)

    Klouda, Petr; Moni, Vlastimil; Řehoř, Michal; Blata, Jan; Helebrant, František

    2018-06-01

    The article is a summary of information about evaluation of a risk degree for a brown coal spontaneous ignition which is realized on the base of a database analysis of information about the development of stative quantities and desorbated gases in the stored bodies of the brown coal. The data were gained from the long term complex measurements which were realized at chosen companies during the coal mining in the previous parts of the project. In the last part of the project, we examined results of temperature models from thermographs with results of gasses and coal samples from the mines. Then, the influence of atmospheric conditions (insolation, water downfall, changes of barometric pressure etc.), the influence of coal mass degradation, the influence of physical and chemical factors, and the influence of other defective factors on the process of the coal spontaneous ignition. The gasmetry was assess with gas in-situ samples and laboratory gas models of indicative gasses for the spontaneous ignition, which were taken from the method of the thermic oxidation with the aim of the correlation finding for an epicentre of temperature within the spontaneous ignition.

  11. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  12. Volumetry based biomarker speed of growth: Quantifying the change of total tumor volume in whole-body magnetic resonance imaging over time improves risk stratification of smoldering multiple myeloma patients.

    Science.gov (United States)

    Wennmann, Markus; Kintzelé, Laurent; Piraud, Marie; Menze, Bjoern H; Hielscher, Thomas; Hofmanninger, Johannes; Wagner, Barbara; Kauczor, Hans-Ulrich; Merz, Maximilian; Hillengass, Jens; Langs, Georg; Weber, Marc-André

    2018-05-18

    The purpose of this study was to improve risk stratification of smoldering multiple myeloma patients, introducing new 3D-volumetry based imaging biomarkers derived from whole-body MRI. Two-hundred twenty whole-body MRIs from 63 patients with smoldering multiple myeloma were retrospectively analyzed and all focal lesions >5mm were manually segmented for volume quantification. The imaging biomarkers total tumor volume, speed of growth (development of the total tumor volume over time), number of focal lesions, development of the number of focal lesions over time and the recent imaging biomarker '>1 focal lesion' of the International Myeloma Working Group were compared, taking 2-year progression rate, sensitivity and false positive rate into account. Speed of growth, using a cutoff of 114mm 3 /month, was able to isolate a high-risk group with a 2-year progression rate of 82.5%. Additionally, it showed by far the highest sensitivity in this study and in comparison to other biomarkers in the literature, detecting 63.2% of patients who progress within 2 years. Furthermore, its false positive rate (8.7%) was much lower compared to the recent imaging biomarker '>1 focal lesion' of the International Myeloma Working Group. Therefore, speed of growth is the preferable imaging biomarker for risk stratification of smoldering multiple myeloma patients.

  13. Impact of numerical information on risk knowledge regarding human papillomavirus (HPV vaccination among schoolgirls: a randomised controlled trial [Effekt von Zahlenangaben auf das Risikowissen von Schülerinnen zur Humanen Papillomavirus (HPV-Impfung: eine randomisiert-kontrollierte Studie

    Directory of Open Access Journals (Sweden)

    Steckelberg, Anke

    2013-10-01

    Full Text Available [english] Introduction: In Germany the implementation of human papillomavirus (HPV vaccination for women aged 12–17 years was accompanied by various campaigns. Evidence-based information including numerical data was not provided. However, standard information leads to overestimation of cancer risk and effects of HPV vaccination. Confidence in children’s ability to deal with numerical data is low, especially in disadvantaged pupils. The aim of the present study was to compare the effects of a standard leaflet with an information leaflet supplemented with numerical data on ‘risk knowledge’ regarding HPV vaccination among schoolgirls.Methods: Randomised-controlled short-term trial. All 108 schoolgirls of seven school classes were asked to participate and 105 agreed. Participants were vocational schoolgirls who were preparing for grade 10 graduation and who were members of the target group for HPV vaccination. The control group was asked to read a standard leaflet on HPV vaccination of the German Women’s Health Network. The intervention group received the same leaflet, but it was supplemented with numerical information on cancer risk and assumed effects of the HPV vaccination on cancer prevention. As baseline characteristics we surveyed: age, vaccination status, attitude towards HPV vaccination and aspects regarding migration background. The primary end point was ‘risk knowledge’. Questionnaire surveys were performed under experimental conditions. Individual randomisation, participants, and intention-to-treat data analyses were blinded. The study was approved by the Ministry of Education and Culture of Schleswig-Holstein and the ethics committee of the Hamburg Chamber of Physicians.Results: We analysed ‘risk knowledge’ for all 105 randomised participants. Baseline characteristics of the two groups were comparable. Numerical risk information recipients were more likely to give correct answers compared to standard information

  14. The need to estimate risks

    International Nuclear Information System (INIS)

    Pochin, E.E.

    1980-01-01

    In an increasing number of situations, it is becoming possible to obtain and compare numerical estimates of the biological risks involved in different alternative sources of action. In some cases these risks are similar in kind, as for example when the risk of including fatal cancer of the breast or stomach by x-ray screening of a population at risk, is compared with the risk of such cancers proving fatal if not detected by a screening programme. In other cases in which it is important to attempt a comparison, the risks are dissimilar in type, as when the safety of occupations involving exposure to radiation or chemical carcinogens is compared with that of occupations in which the major risks are from lung disease or from accidental injury and death. Similar problems of assessing the relative severity of unlike effects occur in any attempt to compare the total biological harm associated with a given output of electricity derived from different primary fuel sources, with its contributions both of occupation and of public harm. In none of these instances is the numerical frequency of harmful effects alone an adequate measure of total biological detriment, nor is such detriment the only factor which should influence decisions. Estimations of risk appear important however, since otherwise public health decisions are likely to be made on more arbitrary grounds, and public opinion will continue to be affected predominantly by the type rather than also by the size of risk. (author)

  15. Jump frequency may contribute to risk of jumper's knee: a study of interindividual and sex differences in a total of 11,943 jumps video recorded during training and matches in young elite volleyball players.

    Science.gov (United States)

    Bahr, Martin A; Bahr, Roald

    2014-09-01

    Male sex, total training volume (number of hours per week) and match exposure (number of sets played per week) are risk factors for jumper's knee among young elite volleyball players. However, it is not known whether jump frequency differs among players on the same squad. To examine interindividual and sex differences in jump frequency during training and matches in young elite volleyball players. Observational study. Norwegian elite volleyball boarding school training programme. Student-athletes (26 boys and 18 girls, 16-18 years). Individual jump counts were recorded based on visual analysis of video recordings obtained from 1 week of volleyball training (9 training sessions for boys and 10 for girls, 14.1 h and 17.8 h of training, respectively) and 10 matches (5.9 h for boys (16 sets) and 7.7 h for girls (21 sets). A total of 11,943 jumps were recorded, 4138 during matches and 7805 during training. As training attendance and jump frequency varied substantially between players, the total exposure in training ranged from 50 to 666 jumps/week among boys and from 11 to 251 jumps/week among girls. On average, this corresponded to 35.7 jumps/h for boys and 13.7 jumps/h for girls (Student t test, p=0.002). Total jump exposure during matches ranged between 1 and 339 jumps among boys and between 0 and 379 jumps among girls, corresponding to an average jump frequency of 62.2 jumps/h for boys and 41.9 jumps/h for girls (Student t test, pvolleyball players. Total jump volume may represent a more important risk factor for jumper's knee than total training volume, warranting further research attention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Prevention of heterotopic bone formation with early post operative irradiation in high risk patients undergoing total hip arthroplasty: comparison of 10.00 Gy vs 20.00 Gy schedules

    International Nuclear Information System (INIS)

    Anthony, P.; Keys, H.; Evarts, C.M.; Rubin, P.; Lush, C.

    1987-01-01

    Prior studies have demonstrated the effectiveness of postoperative radiation therapy (RT) to the hip area following total hip replacement (THR) surgery in preventing the development of heterotopic bone formation in patients considered to be at high risk for development of this complication. Previously, patients received 20.00 Gy in 10 fractions (fx) over 2 weeks, beginning as soon postop as medically feasible (usually post-op day 2). In an effort to reduce hospital stay and risk of secondary malignancy, a prospective treatment program was initiated April 1982 using a reduced dose of 10.00 Gy in 5 fx over 5-7 days. As of February 1984, 46 consecutive hips determined to be at high risk were treated with this reduced dose. Prior studies have demonstrated that heterotopic bone is always radiographically evident by 8 weeks. Of the 46 hips, 41 had been evaluated with the minimum required 8 week follow-up X ray. Twenty-five of these hips, 61%, had a mean long term follow-up of 12 months. It historical control group, consisting of 54 consecutive high risk post-THR's, was shown to have a 68.5% incidence of heterotopic bone. The 20.00 Gy group, when RT was started by post-op day 5, demonstrated a 3.2% incidence, compared to 4.9% in the 10.00 Gy group. Complication rates were also comparable in the two RT groups, 19.4% and 7.3% respectively; 10.00 Gy is apparently as effective as 20.00 Gy in preventing heterotopic bone formation in high risk post-THR patients

  17. Nível sérico de IgE total em alergia respiratória: estudo em pacientes com alto risco de infecção por helmintos Total IgE level in respiratory allergy: study of patients at high risk for helminthic infection

    Directory of Open Access Journals (Sweden)

    Décio Medeiros

    2006-08-01

    and anti-Ascaris IgE, and 0.26 (p = 0.01 between eosinophil count and anti-Ascaris IgE. The final multiple linear regression model pointed out that anti-Ascaris IgE contributed to a total serum IgE level with a coefficient of determination (adjusted R² of 0.25 (F = 12.35; p < 0.001. This effect occurred regardless of eosinophil count and of the presence of intestinal helminthic infection. CONCLUSION: In patients with respiratory allergy and increased total serum IgE levels living in areas where there is a high risk for helminthic infections, the quantification of anti-Ascaris IgE can be more useful and more insightful than the parasitological stool examination.

  18. Pre-transplant soluble CD30 in combination with total DSA but not pre-transplant C1q-DSA predicts antibody-mediated graft loss in presensitized high-risk kidney transplant recipients.

    Science.gov (United States)

    Schaefer, S M; Süsal, C; Opelz, G; Döhler, B; Becker, L E; Klein, K; Sickmüller, S; Waldherr, R; Macher-Goeppinger, S; Schemmer, P; Beimler, J; Zeier, M; Morath, C

    2016-02-01

    Presensitized kidney transplant recipients are at high-risk for early antibody-mediated rejection. We studied the impact of pre- and post-transplant donor-specific human leukocyte antigen (HLA) antibodies (DSA) and T-cell-activation on the occurrence of antibody-mediated rejection episodes (AMR) and graft loss (AMR-GL) in a unique cohort of 80 desensitized high-risk kidney transplant recipients. Patients with pre-transplant DSA demonstrated more AMR episodes than patients without DSA, but did not show a significantly increased rate of AMR-GL. The rates of AMR and AMR-GL were not significantly increased in patients with complement split product (C1q)-binding pre-transplant DSA. Pre-transplant C1q-DSA became undetectable post-transplant in 11 of 13 (85%) patients; 2 (18%) of these 11 patients showed AMR but no AMR-GL. In contrast, the post-transplant presence of C1q-DSA was associated with significantly higher rates of AMR (86 vs 33 vs 0%; P transplant DSA without C1q-binding or the absence of DSA. Patients with both pre-transplant DSA and evidence of pre-transplant T-cell-activation as indicated by soluble CD30-positivity showed a significantly increased risk for AMR-GL [HR = 11.1, 95% confidence interval (CI) = 1.68-73.4; log-rank P = 0.013]. In these high-risk patients, AMR-GL was associated with total DSA in combination with T-cell-activation pre-transplant, and de novo or persistent C1q-binding DSA post-transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Estimating risks for water-quality exceedances of total-copper from highway and urban runoff under predevelopment and current conditions with the Stochastic Empirical Loading and Dilution Model (SELDM)

    Science.gov (United States)

    Granato, Gregory E.; Jones, Susan C.; Dunn, Christopher N.; Van Weele, Brian

    2017-01-01

    The stochastic empirical loading and dilution model (SELDM) was used to demonstrate methods for estimating risks for water-quality exceedances of event-mean concentrations (EMCs) of total-copper. Monte Carlo methods were used to simulate stormflow, total-hardness, suspended-sediment, and total-copper EMCs as stochastic variables. These simulations were done for the Charles River Basin upstream of Interstate 495 in Bellingham, Massachusetts. The hydrology and water quality of this site were simulated with SELDM by using data from nearby, hydrologically similar sites. Three simulations were done to assess the potential effects of the highway on receiving-water quality with and without highway-runoff treatment by a structural best-management practice (BMP). In the low-development scenario, total copper in the receiving stream was simulated by using a sediment transport curve, sediment chemistry, and sediment-water partition coefficients. In this scenario, neither the highway runoff nor the BMP effluent caused concentration exceedances in the receiving stream that exceed the once in three-year threshold (about 0.54 percent). In the second scenario, without the highway, runoff from the large urban areas in the basin caused exceedances in the receiving stream in 2.24 percent of runoff events. In the third scenario, which included the effects of the urban runoff, neither the highway runoff nor the BMP effluent increased the percentage of exceedances in the receiving stream. Comparison of the simulated geometric mean EMCs with data collected at a downstream monitoring site indicates that these simulated values are within the 95-percent confidence interval of the geometric mean of the measured EMCs.

  20. Work-Home Interference, Perceived Total Workload, and the Risk of Future Sickness Absence Due to Stress-Related Mental Diagnoses Among Women and Men: a Prospective Twin Study.

    Science.gov (United States)

    Svedberg, Pia; Mather, Lisa; Bergström, Gunnar; Lindfors, Petra; Blom, Victoria

    2018-02-01

    Work-home interference has been proposed as an important explanation for sickness absence (SA). Previous studies show mixed results, have not accounted for familial factors (genetics and shared everyday environment), or investigated diagnosis specific SA. The aim was to study whether work-home interference and perceived total workload predict SA due to stress-related mental diagnoses, or SA due to other mental diagnoses, among women and men, when adjusting for various confounders and familial factors. This study included 11,916 twins, 19-47 years (49% women). Data on work-to-home and home-to-work conflicts, perceived total workload, and relevant confounders were derived from a 2005 survey, and national register data on SA spells until 2013 were obtained. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Discordant twin pair design was applied to adjust for familial factors. Each one unit increase in work-to-home and home-to-work conflicts, and perceived total workload was associated with higher odds for SA due to stress-related mental diagnoses and to SA due to other mental diagnoses among women, when adjusting for sociodemographic factors (ORs 1.15-1.31). Including health or familial factors, no associations remained. For men, each one unit increase in work-to-home conflicts was associated with higher odds for SA due to stress-related diagnoses (ORs 1.23-1.35), independently of confounders. Work-to-home conflict was independently associated with future SA due to stress-related diagnoses among men only. Health- and work-related factors seem to be important confounders when researching work-home interference, perceived total workload, and SA. Not including such confounders involves risking drawing incorrect conclusions. Further studies are needed to confirm sex differences and whether genetic factors are important for the associations studied.

  1. Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.

    Science.gov (United States)

    Budhathoki, Sanjeev; Hidaka, Akihisa; Yamaji, Taiki; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

    2018-03-07

    To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Nine public health centre areas across Japan. 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Incidence of overall or site specific cancer. Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Numerical methods using Matlab

    CERN Document Server

    Lindfield, George

    2012-01-01

    Numerical Methods using MATLAB, 3e, is an extensive reference offering hundreds of useful and important numerical algorithms that can be implemented into MATLAB for a graphical interpretation to help researchers analyze a particular outcome. Many worked examples are given together with exercises and solutions to illustrate how numerical methods can be used to study problems that have applications in the biosciences, chaos, optimization, engineering and science across the board. Numerical Methods using MATLAB, 3e, is an extensive reference offering hundreds of use

  3. The Ratio of Regulatory (FOXP3+) to Total (CD3+) T Cells Determined by Epigenetic Cell Counting and Cardiovascular Disease Risk: A Prospective Case-cohort Study in Non-diabetics.

    Science.gov (United States)

    Barth, Sebastian Dietmar; Kaaks, Rudolf; Johnson, Theron; Katzke, Verena; Gellhaus, Katharina; Schulze, Janika Josephin; Olek, Sven; Kühn, Tilman

    2016-09-01

    Experimental and clinical evidence indicate that inflammatory processes in atherogenesis and the development of cardiovascular complications are promoted by a loss of regulatory T cell (Treg)-mediated immunological tolerance to plaque antigens. Yet, the association between alterations of systemic Treg frequency and cardiovascular disease incidence remains uncertain. A nested case-cohort study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg, comprising a random subcohort (n=778) and primary cases of myocardial infarction (MI, n=276) and ischemic stroke (n=151). Pre-diagnostic FOXP3+ Treg and total CD3+ T-lymphocyte (tTL) frequencies in blood were measured by epigenetic-based, quantitative real-time PCR-assisted cell counting. Multivariate, Prentice-weighted Cox regression analyses revealed that lower Treg/tTL ratios were not associated with the risk of either MI (lowest vs. highest sex-specific quartile; hazard ratio: 0.72, 95% confidence interval: 0.46 to 1.13; P trend =0.51) or stroke (HR: 0.90, 95% CI: 0.51 to 1.60; P trend =0.78). There were no correlations of Treg/tTL ratios with C-reactive protein, HbA1c, and various lipid parameters. Among middle-aged adults from the general population, imbalances in the relative frequency of Tregs within the total T cell compartment do not confer an increased risk of MI or stroke. Copyright © 2016 Forschungsgesellschaft für Arbeitsphysiologie und Arbeitschutz e.V. Published by Elsevier B.V. All rights reserved.

  4. Distribution of Serum Total Homocysteine and Its Association with Diabetes and Cardiovascular Risk Factors of the Insulin Resistance Syndrome in Mexican American Men: The Third National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Gillum Richard

    2003-08-01

    Full Text Available Abstract Background Few data have been published on the association of variables of the insulin resistance syndrome and serum total homocysteine (tHcy, a putative risk factor for cardiovascular morbidity, in representative samples of total populations or in Hispanic Americans. Methods To describe the distributions of serum tHcy concentration and variables associated with insulin resistance in Mexican American men and to assess their association, data from a cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey were analyzed. Analyses were restricted to Mexican American men aged 40–74 years with data on glycated hemoglobin (%, body mass index (BMI, body fat distribution, HDL cholesterol, fasting serum insulin, serum triglycerides and serum tHcy concentrations. Results Cumulative distributions of serum tHcy shifted to the right with increasing age. Log serum tHcy was not associated with prevalence of diagnosed diabetes mellitus or glycated hemoglobin percent or other risk factors other than age. Log serum tHcy concentration showed borderline significant (p = 0.049 positive association with fasting serum insulin concentration independent of age and BMI, only in men aged 60–74. Conclusion No consistent association of tHcy with diabetes prevalence or variables of the insulin resistance syndrome were found in Mexican American men aged 40–74 years. Further research is needed on the associations of serum tHcy concentration with insulin resistance and other components of the insulin resistance syndrome in persons of varying ethnicity.

  5. Numerical distance protection

    CERN Document Server

    Ziegler, Gerhard

    2011-01-01

    Distance protection provides the basis for network protection in transmission systems and meshed distribution systems. This book covers the fundamentals of distance protection and the special features of numerical technology. The emphasis is placed on the application of numerical distance relays in distribution and transmission systems.This book is aimed at students and engineers who wish to familiarise themselves with the subject of power system protection, as well as the experienced user, entering the area of numerical distance protection. Furthermore it serves as a reference guide for s

  6. Numerical problems in physics

    CERN Document Server

    Singh, Devraj

    2015-01-01

    Numerical Problems in Physics, Volume 1 is intended to serve the need of the students pursuing graduate and post graduate courses in universities with Physics and Materials Science as subject including those appearing in engineering, medical, and civil services entrance examinations. KEY FEATURES: * 29 chapters on Optics, Wave & Oscillations, Electromagnetic Field Theory, Solid State Physics & Modern Physics * 540 solved numerical problems of various universities and ompetitive examinations * 523 multiple choice questions for quick and clear understanding of subject matter * 567 unsolved numerical problems for grasping concepts of the various topic in Physics * 49 Figures for understanding problems and concept

  7. Constructing a framework for risk analyses of climate change effects on the water budget of differently sloped vineyards with a numeric simulation using the Monte Carlo method coupled to a water balance model

    Directory of Open Access Journals (Sweden)

    Marco eHofmann

    2014-12-01

    Full Text Available Grapes for wine production are a highly climate sensitive crop and vineyard water budget is a decisive factor in quality formation. In order to conduct risk assessments for climate change effects in viticulture models are needed which can be applied to complete growing regions. We first modified an existing simplified geometric vineyard model of radiation interception and resulting water use to incorporate numerical Monte Carlo simulations and the physical aspects of radiation interactions between canopy and vineyard slope and azimuth. We then used four regional climate models to assess for possible effects on the water budget of selected vineyard sites up 2100. The model was developed to describe the partitioning of short-wave radiation between grapevine canopy and soil surface, respectively green cover, necessary to calculate vineyard evapotranspiration. Soil water storage was allocated to two sub reservoirs. The model was adopted for steep slope vineyards based on coordinate transformation and validated against measurements of grapevine sap flow and soil water content determined down to 1.6 m depth at three different sites over two years. The results showed good agreement of modelled and observed soil water dynamics of vineyards with large variations in site specific soil water holding capacity and viticultural management. Simulated sap flow was in overall good agreement with measured sap flow but site-specific responses of sap flow to potential evapotranspiration were observed. The analyses of climate change impacts on vineyard water budget demonstrated the importance of site-specific assessment due to natural variations in soil water holding capacity. The improved model was capable of describing seasonal and site-specific dynamics in soil water content and could be used in an amended version to estimate changes in the water budget of entire grape growing areas due to evolving climatic changes.

  8. Constructing a framework for risk analyses of climate change effects on the water budget of differently sloped vineyards with a numeric simulation using the Monte Carlo method coupled to a water balance model.

    Science.gov (United States)

    Hofmann, Marco; Lux, Robert; Schultz, Hans R

    2014-01-01

    Grapes for wine production are a highly climate sensitive crop and vineyard water budget is a decisive factor in quality formation. In order to conduct risk assessments for climate change effects in viticulture models are needed which can be applied to complete growing regions. We first modified an existing simplified geometric vineyard model of radiation interception and resulting water use to incorporate numerical Monte Carlo simulations and the physical aspects of radiation interactions between canopy and vineyard slope and azimuth. We then used four regional climate models to assess for possible effects on the water budget of selected vineyard sites up 2100. The model was developed to describe the partitioning of short-wave radiation between grapevine canopy and soil surface, respectively, green cover, necessary to calculate vineyard evapotranspiration. Soil water storage was allocated to two sub reservoirs. The model was adopted for steep slope vineyards based on coordinate transformation and validated against measurements of grapevine sap flow and soil water content determined down to 1.6 m depth at three different sites over 2 years. The results showed good agreement of modeled and observed soil water dynamics of vineyards with large variations in site specific soil water holding capacity (SWC) and viticultural management. Simulated sap flow was in overall good agreement with measured sap flow but site-specific responses of sap flow to potential evapotranspiration were observed. The analyses of climate change impacts on vineyard water budget demonstrated the importance of site-specific assessment due to natural variations in SWC. The improved model was capable of describing seasonal and site-specific dynamics in soil water content and could be used in an amended version to estimate changes in the water budget of entire grape growing areas due to evolving climatic changes.

  9. Remarks on numerical semigroups

    International Nuclear Information System (INIS)

    Torres, F.

    1995-12-01

    We extend results on Weierstrass semigroups at ramified points of double covering of curves to any numerical semigroup whose genus is large enough. As an application we strengthen the properties concerning Weierstrass weights state in [To]. (author). 25 refs

  10. Numerical semigroups and applications

    CERN Document Server

    Assi, Abdallah

    2016-01-01

    This work presents applications of numerical semigroups in Algebraic Geometry, Number Theory, and Coding Theory. Background on numerical semigroups is presented in the first two chapters, which introduce basic notation and fundamental concepts and irreducible numerical semigroups. The focus is in particular on free semigroups, which are irreducible; semigroups associated with planar curves are of this kind. The authors also introduce semigroups associated with irreducible meromorphic series, and show how these are used in order to present the properties of planar curves. Invariants of non-unique factorizations for numerical semigroups are also studied. These invariants are computationally accessible in this setting, and thus this monograph can be used as an introduction to Factorization Theory. Since factorizations and divisibility are strongly connected, the authors show some applications to AG Codes in the final section. The book will be of value for undergraduate students (especially those at a higher leve...

  11. Advances in Numerical Methods

    CERN Document Server

    Mastorakis, Nikos E

    2009-01-01

    Features contributions that are focused on significant aspects of current numerical methods and computational mathematics. This book carries chapters that advanced methods and various variations on known techniques that can solve difficult scientific problems efficiently.

  12. Introductory numerical analysis

    CERN Document Server

    Pettofrezzo, Anthony J

    2006-01-01

    Written for undergraduates who require a familiarity with the principles behind numerical analysis, this classical treatment encompasses finite differences, least squares theory, and harmonic analysis. Over 70 examples and 280 exercises. 1967 edition.

  13. Introduction to numerical analysis

    CERN Document Server

    Hildebrand, F B

    1987-01-01

    Well-known, respected introduction, updated to integrate concepts and procedures associated with computers. Computation, approximation, interpolation, numerical differentiation and integration, smoothing of data, other topics in lucid presentation. Includes 150 additional problems in this edition. Bibliography.

  14. Numerical analysis of bifurcations

    International Nuclear Information System (INIS)

    Guckenheimer, J.

    1996-01-01

    This paper is a brief survey of numerical methods for computing bifurcations of generic families of dynamical systems. Emphasis is placed upon algorithms that reflect the structure of the underlying mathematical theory while retaining numerical efficiency. Significant improvements in the computational analysis of dynamical systems are to be expected from more reliance of geometric insight coming from dynamical systems theory. copyright 1996 American Institute of Physics

  15. Numerical computations with GPUs

    CERN Document Server

    Kindratenko, Volodymyr

    2014-01-01

    This book brings together research on numerical methods adapted for Graphics Processing Units (GPUs). It explains recent efforts to adapt classic numerical methods, including solution of linear equations and FFT, for massively parallel GPU architectures. This volume consolidates recent research and adaptations, covering widely used methods that are at the core of many scientific and engineering computations. Each chapter is written by authors working on a specific group of methods; these leading experts provide mathematical background, parallel algorithms and implementation details leading to

  16. Caracterización del riesgo familiar total en familias con adultos mayores con discapacidad, Patio Bonito, Localidad Kennedy, Bogotá, 20051 Characterization of total family risk in families with disabled elder adults, Patio Bonito, Kennedy District, Bogotá, 2005 Caracterização do risco familiar total em famílias com idosos deficientes, Patio Bonito, Localidade Kennedy, Bogotá, 2005

    Directory of Open Access Journals (Sweden)

    VELÁSQUEZ GUTIÉRREZ VILMA FLORISA

    2009-07-01

    Full Text Available Este artículo presenta los resultados del estudio cuyo objetivo fue caracterizar el riesgo familiar total en familias de adultos mayores con discapacidad, mediante un estudio descriptivo con abordaje cuantitativo, la muestra fue de 72 familias y se utilizó el instrumento RFT 7-70 (1. Los resultados muestran predominio de familias con riesgo alto (52,8% y medio (34,7%, alta correlación entre las subcategorías: servicios de salud y ambiente socioeconómico (0,50, prácticas de salud y estilos de vida (0,49, prácticas de salud y morbilidad (0,46, ambiente sicoafectivo y composción familiar (0,46, servicios de salud y prácticas de salud (0,43, estilo de vida y morbilidad familiar (0,42, servicios de salud y ambiente psicoafectivo (0,42, estilo de vida y ambiente psicoafectivo (0,40. En conclusión, los factores de riesgo biológicos, sociales y del medio ambiente interactúan, mostrando alta vulnerabilidad en las familias pobres de adultos mayores con discapacidad, que requieren mejorar la accesibilidad e intervención de los servicios de salud, sociales y redes de apoyo, brindando atención integrada, con enfoque intersectorial, interinstitucional y familiar. Es necesario el compromiso de las familias, la comunidad, las instituciones y los profesionales de salud, que trabajen mancomunadamente en pro de mejorar la calidad de vida de las personas y familias más vulnerables.This article presents the results of the study whose objective was to characterize the total family risk in families with disabled elder adults, through a descriptive study with a quantitative approach, the sample was 72 families and RFT 7-70 (1 instrument was used. The results show a predominance of families with high (52,8% and medium risk (34,7%, high correlation between the subcategories: health services and socio-economic environment (0,50, health practices and lifestyles (0,49, health practices and morbidity (0,46, psycho-affective environment and

  17. Caracterización del riesgo familiar total en familias con adultos mayores con discapacidad, Patio Bonito, Localidad Kennedy, Bogotá, 2005 Caracterização do risco familiar total em famílias com idosos deficientes, Patio Bonito, Localidade Kennedy, Bogotá, 2005 Characterization of total family risk in families with disabled elder adults, Patio Bonito, Kennedy District, Bogotá, 2005

    Directory of Open Access Journals (Sweden)

    VILMA FLORISA VELÁSQUEZ GUTIÉRREZ

    2009-07-01

    ção familiar (0,46, serviços de saúde e práticas de saúde (0,43, estilo de vida e morbidade familiar (0,42, serviços de saúde e ambiente psico-afetivo (0,40. Em conclusão, os fatores de risco biológicos, sociais e meio-ambientais interagem e mostram uma alta vulnerabilidade nas famílias pobres de idosos deficientes que precisam de maior acessibilidade e intervenção dos serviços médicos, sociais e de redes de apóio, oferecendo atenção integrada, com abordagem intersectorial, interinstitucional e familiar. O compromisso das famílias, a comunidade, as instituições e os profissionais de saúde é necessário para adiantar um trabalho conjunto visando melhorar a qualidade de vida das pessoas e famílias mais vulneráveis.This article presents the results of the study whose objective was to characterize the total family risk in families with disabled elder adults, through a descriptive study with a quantitative approach, the sample was 72 families and RFT 7-70 (1 instrument was used. The results show a predominance of families with high (52,8% and medium risk (34,7%, high correlation between the subcategories: health services and socio-economic environment (0,50, health practices and lifestyles (0,49, health practices and morbidity (0,46, psycho-affective environment and family structure (0,46, health services and health practices (0,43, lifestyle and family morbidity (0,42, health services and psycho-affective environment (0,42, lifestyle and psycho-affective environment (0,40. In conclusion, the biological, social and environmental risk factors interact, showing a high vulnerability level in poor families with disabled elder adults that require improvement in access to and in intervention from health and social services and support networks, providing integrated care, with intersectorial, inter-institutional and with a family approach. The commitment of families, community, institutions and health professionals is necessary, who should work jointly to improve

  18. The added value of percentage of free to total prostate-specific antigen, PCA3, and a kallikrein panel to the ERSPC risk calculator for prostate cancer in prescreened men.

    Science.gov (United States)

    Vedder, Moniek M; de Bekker-Grob, Esther W; Lilja, Hans G; Vickers, Andrew J; van Leenders, Geert J L H; Steyerberg, Ewout W; Roobol, Monique J

    2014-12-01

    Prostate-specific antigen (PSA) testing has limited accuracy for the early detection of prostate cancer (PCa). To assess the value added by percentage of free to total PSA (%fPSA), prostate cancer antigen 3 (PCA3), and a kallikrein panel (4k-panel) to the European Randomised Study of Screening for Prostate Cancer (ERSPC) multivariable prediction models: risk calculator (RC) 4, including transrectal ultrasound, and RC 4 plus digital rectal examination (4+DRE) for prescreened men. Participants were invited for rescreening between October 2007 and February 2009 within the Dutch part of the ERSPC study. Biopsies were taken in men with a PSA level ≥3.0 ng/ml or a PCA3 score ≥10. Additional analyses of the 4k-panel were done on serum samples. Outcome was defined as PCa detectable by sextant biopsy. Receiver operating characteristic curve and decision curve analyses were performed to compare the predictive capabilities of %fPSA, PCA3, 4k-panel, the ERSPC RCs, and their combinations in logistic regression models. PCa was detected in 119 of 708 men. The %fPSA did not perform better univariately or added to the RCs compared with the RCs alone. In 202 men with an elevated PSA, the 4k-panel discriminated better than PCA3 when modelled univariately (area under the curve [AUC]: 0.78 vs. 0.62; p=0.01). The multivariable models with PCA3 or the 4k-panel were equivalent (AUC: 0.80 for RC 4+DRE). In the total population, PCA3 discriminated better than the 4k-panel (univariate AUC: 0.63 vs. 0.56; p=0.05). There was no statistically significant difference between the multivariable model with PCA3 (AUC: 0.73) versus the model with the 4k-panel (AUC: 0.71; p=0.18). The multivariable model with PCA3 performed better than the reference model (0.73 vs. 0.70; p=0.02). Decision curves confirmed these patterns, although numbers were small. Both PCA3 and, to a lesser extent, a 4k-panel have added value to the DRE-based ERSPC RC in detecting PCa in prescreened men. We studied the added

  19. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  20. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  1. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  2. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  3. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  4. Numerical Transducer Modeling

    DEFF Research Database (Denmark)

    Henriquez, Vicente Cutanda

    This thesis describes the development of a numerical model of the propagation of sound waves in fluids with viscous and thermal losses, with application to the simulation of acoustic transducers, in particular condenser microphones for measurement. The theoretical basis is presented, numerical...... manipulations are developed to satisfy the more complicated boundary conditions, and a model of a condenser microphone with a coupled membrane is developed. The model is tested against measurements of ¼ inch condenser microphones and analytical calculations. A detailed discussion of the results is given....

  5. On numerical Bessel transformation

    International Nuclear Information System (INIS)

    Sommer, B.; Zabolitzky, J.G.

    1979-01-01

    The authors present a computer program to calculate the three dimensional Fourier or Bessel transforms and definite integrals with Bessel functions. Numerical integration of systems containing Bessel functions occurs in many physical problems, e.g. electromagnetic form factor of nuclei, all transitions involving multipole expansions at high momenta. Filon's integration rule is extended to spherical Bessel functions. The numerical error is of the order of the Simpson error term of the function which has to be transformed. Thus one gets a stable integral even at large arguments of the transformed function. (Auth.)

  6. Industrial numerical analysis

    International Nuclear Information System (INIS)

    McKee, S.; Elliott, C.M.

    1986-01-01

    The applications of mathematics to industrial problems involves the formulation of problems which are amenable to mathematical investigation, mathematical modelling, the solution of the mathematical problem and the inter-pretation of the results. There are 12 chapters describing industrial problems where mathematics and numerical analysis can be applied. These range from the numerical assessment of the flatness of engineering surfaces and plates, the design of chain links, control problems in tidal power generation and low thrust satellite trajectory optimization to mathematical models in welding. One chapter, on the ageing of stainless steels, is indexed separately. (UK)

  7. Numerical methods in nuclear engineering. Part 1

    International Nuclear Information System (INIS)

    Phillips, G.J.

    1983-08-01

    These proceedings, published in two parts contain the full text of 56 papers and summaries of six papers presented at the conference. They cover the use of numerical methods in thermal hydraulics, reactor physics, neutron diffusion, subchannel analysis, risk assessment, transport theory, and fuel behaviour

  8. Numerical analysis using Sage

    CERN Document Server

    Anastassiou, George A

    2015-01-01

    This is the first numerical analysis text to use Sage for the implementation of algorithms and can be used in a one-semester course for undergraduates in mathematics, math education, computer science/information technology, engineering, and physical sciences. The primary aim of this text is to simplify understanding of the theories and ideas from a numerical analysis/numerical methods course via a modern programming language like Sage. Aside from the presentation of fundamental theoretical notions of numerical analysis throughout the text, each chapter concludes with several exercises that are oriented to real-world application.  Answers may be verified using Sage.  The presented code, written in core components of Sage, are backward compatible, i.e., easily applicable to other software systems such as Mathematica®.  Sage is  open source software and uses Python-like syntax. Previous Python programming experience is not a requirement for the reader, though familiarity with any programming language is a p...

  9. Numerical Estimation in Preschoolers

    Science.gov (United States)

    Berteletti, Ilaria; Lucangeli, Daniela; Piazza, Manuela; Dehaene, Stanislas; Zorzi, Marco

    2010-01-01

    Children's sense of numbers before formal education is thought to rely on an approximate number system based on logarithmically compressed analog magnitudes that increases in resolution throughout childhood. School-age children performing a numerical estimation task have been shown to increasingly rely on a formally appropriate, linear…

  10. Numerical analysis targets

    International Nuclear Information System (INIS)

    Sollogoub, Pierre

    2001-01-01

    Numerical analyses are needed in different steps of the overall design process. Complex models or non-linear reactor core behaviour are important for qualification and/or comparison of results obtained. Adequate models and test should be defined. Fuel assembly, fuel row, and the complete core should be tested for seismic effects causing LOCA and flow-induced vibrations (FIV)

  11. Development of numerical concepts

    Directory of Open Access Journals (Sweden)

    Sabine Peucker

    2013-06-01

    Full Text Available The development of numerical concepts is described from infancy to preschool age. Infants a few days old exhibit an early sensitivity for numerosities. In the course of development, nonverbal mental models allow for the exact representation of small quantities as well as changes in these quantities. Subitising, as the accurate recognition of small numerosities (without counting, plays an important role. It can be assumed that numerical concepts and procedures start with insights about small numerosities. Protoquantitative schemata comprise fundamental knowledge about quantities. One-to-one-correspondence connects elements and numbers, and, for this reason, both quantitative and numerical knowledge. If children understand that they can determine the numerosity of a collection of elements by enumerating the elements, they have acquired the concept of cardinality. Protoquantitative knowledge becomes quantitative if it can be applied to numerosities and sequential numbers. The concepts of cardinality and part-part-whole are key to numerical development. Developmentally appropriate learning and teaching should focus on cardinality and part-part-whole concepts.

  12. Analysis of numerical methods

    CERN Document Server

    Isaacson, Eugene

    1994-01-01

    This excellent text for advanced undergraduates and graduate students covers norms, numerical solution of linear systems and matrix factoring, iterative solutions of nonlinear equations, eigenvalues and eigenvectors, polynomial approximation, and other topics. It offers a careful analysis and stresses techniques for developing new methods, plus many examples and problems. 1966 edition.

  13. Paradoxes in numerical calculations

    Czech Academy of Sciences Publication Activity Database

    Brandts, J.; Křížek, Michal; Zhang, Z.

    2016-01-01

    Roč. 26, č. 3 (2016), s. 317-330 ISSN 1210-0552 R&D Projects: GA ČR GA14-02067S Institutional support: RVO:67985840 Keywords : round-off errors * numerical instability * recurrence formulae Subject RIV: BA - General Mathematics Impact factor: 0.394, year: 2016

  14. NIF total neutron yield diagnostic

    International Nuclear Information System (INIS)

    Cooper, Gary W.; Ruiz, Carlos L.

    2001-01-01

    We have designed a total neutron yield diagnostic for the National Ignition Facility (NIF) which is based on the activation of In and Cu samples. The particular approach that we have chosen is one in which we calibrate the entire counting system and which we call the ''F factor'' method. In this method, In and/or Cu samples are exposed to known sources of DD and DT neutrons. The activated samples are then counted with an appropriate system: a high purity Ge detector for In and a NaI coincidence system for Cu. We can then calculate a calibration factor, which relates measured activity to total neutron yield. The advantage of this approach is that specific knowledge of such quantities as cross sections and detector efficiencies is not needed. Unless the actual scattering environment of the NIF can be mocked up in the calibration experiment, the F factor will have to be modified using the results of a numerical simulation of the NIF scattering environment. In this article, the calibration factor methodology will be discussed and experimental results for the calibration factors will be presented. Total NIF neutron yields of 10 9 --10 19 can be measured with this method assuming a 50 cm stand-off distance can be employed for the lower yields

  15. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  16. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  17. Healthy Eating and Risks of Total and Cause-Specific Death among Low-Income Populations of African-Americans and Other Adults in the Southeastern United States: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Danxia Yu

    2015-05-01

    Full Text Available A healthy diet, as defined by the US Dietary Guidelines for Americans (DGA, has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals. It is unknown whether this association can be extrapolated to African-Americans and low-income populations.We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study, a prospective study that recruited 84,735 American adults, aged 40-79 y, from 12 southeastern US states during 2002-2009, mostly through community health centers that serve low-income populations. The present analysis included 50,434 African-Americans, 24,054 white individuals, and 3,084 individuals of other racial/ethnic groups, among whom 42,759 participants had an annual household income less than US$15,000. Usual dietary intakes were assessed using a validated food frequency questionnaire at baseline. Adherence to the DGA was measured by the Healthy Eating Index (HEI, 2010 and 2005 editions (HEI-2010 and HEI-2005, respectively. During a mean follow-up of 6.2 y, 6,906 deaths were identified, including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases. A higher HEI-2010 score was associated with lower risks of disease death, with adjusted hazard ratios (HRs of 0.80 (95% CI, 0.73-0.86 for all-disease mortality, 0.81 (95% CI, 0.70-0.94 for cardiovascular disease mortality, 0.81 (95% CI, 0.69-0.95 for cancer mortality, and 0.77 (95% CI, 0.67-0.88 for other disease mortality, when comparing the highest quintile with the lowest (all p-values for trend 0.50. Several component scores in the HEI-2010, including whole grains, dairy, seafood and plant proteins, and ratio of unsaturated to saturated fatty acids, showed significant inverse associations with total mortality. HEI-2005 score was also associated with lower disease mortality, with a HR of 0.86 (95

  18. Superradiance or total reflection?

    CERN Document Server

    László, András

    2014-01-01

    Numerical evolution of massless scalar fields on Kerr background is studied. The initial data specifications are chosen to have compact support separated from the ergoregion and to yield nearly monochromatic incident wave packets. The initial data is also tuned to maximize the effect of superradiance. Evidences are shown indicating that instead of the anticipated energy extraction from black hole the incident radiation fail to reach the ergoregion rather it suffers a nearly perfect reflection.

  19. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

    Hessel, Stephane; Jacquard, Albert

    2012-01-01

    This bibliographical note presents a book, in which the authors make a plea for a total nuclear disarmament. They think that humanity cannot be found in competition, but in emulation, and examine how we can get rid of the nuclear bomb. They discuss the background of nuclear energy, state that nuclear weapons have always been useless and extremely dangerous, consider arms race as crazy and as a crime against humanity, recall that nuclear weapons already made numerous victims (Hiroshima, Nagasaki, nuclear tests), that they are a sword of Damocles over 7 billions human beings, that nuclear winter would be an apocalypse, that the Non Proliferation Treaty is a decoy. They discuss the political role of nuclear weapons, and outline that the only solution is their abolition. They discuss what has already been done and what is still to be done, and formulate a strategy for the future

  20. Combining Narrative and Numerical Simulation

    DEFF Research Database (Denmark)

    Hansen, Mette Sanne; Ladeby, Klaes Rohde; Rasmussen, Lauge Baungaard

    2011-01-01

    for decision makers to systematically test several different outputs of possible solutions in order to prepare for future consequences. The CSA can be a way to evaluate risks and address possible unforeseen problems in a more methodical way than either guessing or forecasting. This paper contributes...... to the decision making in operations and production management by providing new insights into modelling and simulation based on the combined narrative and numerical simulation approach as a tool for strategy making. The research question asks, “How can the CSA be applied in a practical context to support strategy...... making?” The paper uses a case study where interviews and observations were carried out in a Danish corporation. The CSA is a new way to address decision making and has both practical value and further expands the use of strategic simulation as a management tool....

  1. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  2. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  3. Numerical model CCC

    International Nuclear Information System (INIS)

    Bodvarsson, G.S.; Lippmann, M.J.

    1980-01-01

    The computer program CCC (conduction-convection-consolidation), developed at Lawrence Berkeley Laboratory, solves numerically the heat and mass flow equations for a fully saturated medium, and computes one-dimensional consolidation of the simulated systems. The model employs the Integrated Finite Difference Method (IFDM) in discretizing the saturated medium and formulating the governing equations. The sets of equations are solved either by an iterative solution technique (old version) or an efficient sparse solver (new version). The deformation of the medium is calculated using the one-dimensional consolidation theory of Terzaghi. In this paper, the numerical code is described, validation examples given and areas of application discussed. Several example problems involving flow through fractured media are also presented

  4. Numerical ecology with R

    CERN Document Server

    Borcard, Daniel; Legendre, Pierre

    2018-01-01

    This new edition of Numerical Ecology with R guides readers through an applied exploration of the major methods of multivariate data analysis, as seen through the eyes of three ecologists. It provides a bridge between a textbook of numerical ecology and the implementation of this discipline in the R language. The book begins by examining some exploratory approaches. It proceeds logically with the construction of the key building blocks of most methods, i.e. association measures and matrices, and then submits example data to three families of approaches: clustering, ordination and canonical ordination. The last two chapters make use of these methods to explore important and contemporary issues in ecology: the analysis of spatial structures and of community diversity. The aims of methods thus range from descriptive to explanatory and predictive and encompass a wide variety of approaches that should provide readers with an extensive toolbox that can address a wide palette of questions arising in contemporary mul...

  5. Numerical simulation in astrophysics

    International Nuclear Information System (INIS)

    Miyama, Shoken

    1985-01-01

    There have been many numerical simulations of hydrodynamical problems in astrophysics, e.g. processes of star formation, supernova explosion and formation of neutron stars, and general relativistic collapse of star to form black hole. The codes are made to be suitable for computing such problems. In astrophysical hydrodynamical problems, there are the characteristics: problems of self-gravity or external gravity acting, objects of scales very large or very short, objects changing by short period or long time scale, problems of magnetic force and/or centrifugal force acting. In this paper, we present one of methods of numerical simulations which may satisfy these requirements, so-called smoothed particle methods. We then introduce the methods briefly. Then, we show one of the applications of the methods to astrophysical problem (fragmentation and collapse of rotating isothermal cloud). (Mori, K.)

  6. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  7. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  8. Hybrid undulator numerical optimization

    Energy Technology Data Exchange (ETDEWEB)

    Hairetdinov, A.H. [Kurchatov Institute, Moscow (Russian Federation); Zukov, A.A. [Solid State Physics Institute, Chernogolovka (Russian Federation)

    1995-12-31

    3D properties of the hybrid undulator scheme arc studied numerically using PANDIRA code. It is shown that there exist two well defined sets of undulator parameters which provide either maximum on-axis field amplitude or minimal higher harmonics amplitude of the basic undulator field. Thus the alternative between higher field amplitude or pure sinusoidal field exists. The behavior of the undulator field amplitude and harmonics structure for a large set of (undulator gap)/(undulator wavelength) values is demonstrated.

  9. Comments on numerical simulations

    International Nuclear Information System (INIS)

    Sato, T.

    1984-01-01

    The author comments on a couple of things about numerical simulation. One is just about the philosophical discussion that is, spontaneous or driven. The other thing is the numerical or technical one. Frankly, the author didn't want to touch on the technical matter because this should be a common sense one for those who are working at numerical simulation. But since many people take numerical simulation results at their face value, he would like to remind you of the reality hidden behind them. First, he would point out that the meaning of ''driven'' in driven reconnection is different from that defined by Schindler or Akasofu. The author's definition is closer to Axford's definition. In the spontaneous case, for some unpredicted reason an excess energy of the system is suddenly released at a certain point. However, one does not answer how such an unstable state far beyond a stable limit is realized in the magnetotail. In the driven case, there is a definite energy buildup phase starting from a stable state; namely, energy in the black box increases from a stable level subject to an external source. When the state has reached a certain position, the energy is released suddenly. The difference between driven and spontaneous is whether the cause (plasma flow) to trigger reconnection is specified or reconnection is triggered unpredictably. Another difference is that in driven reconnection the reconnection rate is dependent on the speed of the external plasma flow, but in spontaneous reconnection the rate is dependent on the internal condition such as the resistivity

  10. Numerical simulation of plasmas

    International Nuclear Information System (INIS)

    Dnestrovskii, Y.N.; Kostomarov, D.P.

    1986-01-01

    This book contains a modern consistent and systematic presentation of numerical computer simulation of plasmas in controlled thermonuclear fusion. The authors focus on the Soviet research in mathematical modelling of Tokamak plasmas, and present kinetic hydrodynamic and transport models with special emphasis on the more recent hybrid models. Compared with the first edition (in Russian) this book has been greatly revised and updated. (orig./WL)

  11. Numerical analysis II essentials

    CERN Document Server

    REA, The Editors of; Staff of Research Education Association

    1989-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Numerical Analysis II covers simultaneous linear systems and matrix methods, differential equations, Fourier transformations, partial differential equations, and Monte Carlo methods.

  12. Handbook of numerical analysis

    CERN Document Server

    Ciarlet, Philippe G

    Mathematical finance is a prolific scientific domain in which there exists a particular characteristic of developing both advanced theories and practical techniques simultaneously. Mathematical Modelling and Numerical Methods in Finance addresses the three most important aspects in the field: mathematical models, computational methods, and applications, and provides a solid overview of major new ideas and results in the three domains. Coverage of all aspects of quantitative finance including models, computational methods and applications Provides an overview of new ideas an

  13. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  14. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  15. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  16. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  17. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  18. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

    Wangen, Helge; Havelin, Leif I.; Fenstad, Anne M

    2017-01-01

    Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty....... Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

  19. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  20. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  1. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  2. Análise dos fatores de risco na correção cirúrgica do defeito septal atrioventricular de forma total Risk factors analysis in the surgical repair of complete atrioventricular septal defect

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi

    1993-06-01

    Full Text Available Pacientes com defeito septal atrioventricular de forma total (DSAVT freqüentemente apresentam insuficiência cardíaca intratável e hipertensão arterial pulmonar nos primeiros meses de vida, e apenas uma minoria sobrevive sem tratamento cirúrgico precoce. Por essa razão, indica-se a correção definitiva para alterar favoravelmente a história natural da doença. Entretanto, vários fatores são responsáveis pela alta mortalidade cirúrgica. O presente trabalho estuda a experiência na correção cirúrgica do DSAVT com o objetivo de identificar alguns fatores de risco estatisticamente significativos para a ocorrência de morte operatória. Analisaram-se, retrospectivamente, 52 pacientes submetidos, entre janeiro de 1974 e dezembro de 1990, a cirurgia definitiva para correção de DSAVT no Royal Brompton and National Heart and Lung Institute, sendo estudadas as seguintes variáveis: idade, peso, sexo, ano da operação, presença de síndrome de Down, grau de regurgitação da valva AV, bandagem prévia do tronco pulmonar, presença de anomalias associadas, pressão sistólica pulmonar, duplo orifício mitral, classificação do defeito segundo Rastelli, emprego de parada circulatória e técnica de correção (1 x 2 retalhos. Todos os fatores foram avaliados isoladamente, mediante a análise univariada. Para determinar quais os fatores que, independentemente da ação de outros, contribuíram significativamente para maior mortalidade cirúrgica, foi utilizada a análise multivariada com regressão logística. A análise multivariada demonstrou que o baixo peso na época da operação e a técnica de correção com um retalho aumentam significativamente a mortalidade cirúrgica.Patients with complete atrioventricular septal defects (CAVSD frequently present with severe heart failure which cannot be controllable medically and pulmonary hypertension in infancy. Just a small number survives without early surgical treatment. For this reason

  3. Total colourings of graphs

    CERN Document Server

    Yap, Hian-Poh

    1996-01-01

    This book provides an up-to-date and rapid introduction to an important and currently active topic in graph theory. The author leads the reader to the forefront of research in this area. Complete and easily readable proofs of all the main theorems, together with numerous examples, exercises and open problems are given. The book is suitable for use as a textbook or as seminar material for advanced undergraduate and graduate students. The references are comprehensive and so it will also be useful for researchers as a handbook.

  4. Numerical Analysis Objects

    Science.gov (United States)

    Henderson, Michael

    1997-08-01

    The Numerical Analysis Objects project (NAO) is a project in the Mathematics Department of IBM's TJ Watson Research Center. While there are plenty of numerical tools available today, it is not an easy task to combine them into a custom application. NAO is directed at the dual problems of building applications from a set of tools, and creating those tools. There are several "reuse" projects, which focus on the problems of identifying and cataloging tools. NAO is directed at the specific context of scientific computing. Because the type of tools is restricted, problems such as tools with incompatible data structures for input and output, and dissimilar interfaces to tools which solve similar problems can be addressed. The approach we've taken is to define interfaces to those objects used in numerical analysis, such as geometries, functions and operators, and to start collecting (and building) a set of tools which use these interfaces. We have written a class library (a set of abstract classes and implementations) in C++ which demonstrates the approach. Besides the classes, the class library includes "stub" routines which allow the library to be used from C or Fortran, and an interface to a Visual Programming Language. The library has been used to build a simulator for petroleum reservoirs, using a set of tools for discretizing nonlinear differential equations that we have written, and includes "wrapped" versions of packages from the Netlib repository. Documentation can be found on the Web at "http://www.research.ibm.com/nao". I will describe the objects and their interfaces, and give examples ranging from mesh generation to solving differential equations.

  5. Numerical differential protection

    CERN Document Server

    Ziegler, Gerhard

    2012-01-01

    Differential protection is a fast and selective method of protection against short-circuits. It is applied in many variants for electrical machines, trans?formers, busbars, and electric lines.Initially this book covers the theory and fundamentals of analog and numerical differential protection. Current transformers are treated in detail including transient behaviour, impact on protection performance, and practical dimensioning. An extended chapter is dedicated to signal transmission for line protection, in particular, modern digital communication and GPS timing.The emphasis is then pla

  6. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  7. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  8. Numerical schemes for explosion hazards

    International Nuclear Information System (INIS)

    Therme, Nicolas

    2015-01-01

    In nuclear facilities, internal or external explosions can cause confinement breaches and radioactive materials release in the environment. Hence, modeling such phenomena is crucial for safety matters. Blast waves resulting from explosions are modeled by the system of Euler equations for compressible flows, whereas Navier-Stokes equations with reactive source terms and level set techniques are used to simulate the propagation of flame front during the deflagration phase. The purpose of this thesis is to contribute to the creation of efficient numerical schemes to solve these complex models. The work presented here focuses on two major aspects: first, the development of consistent schemes for the Euler equations, then the buildup of reliable schemes for the front propagation. In both cases, explicit in time schemes are used, but we also introduce a pressure correction scheme for the Euler equations. Staggered discretization is used in space. It is based on the internal energy formulation of the Euler system, which insures its positivity and avoids tedious discretization of the total energy over staggered grids. A discrete kinetic energy balance is derived from the scheme and a source term is added in the discrete internal energy balance equation to preserve the exact total energy balance at the limit. High order methods of MUSCL type are used in the discrete convective operators, based solely on material velocity. They lead to positivity of density and internal energy under CFL conditions. This ensures that the total energy cannot grow and we can furthermore derive a discrete entropy inequality. Under stability assumptions of the discrete L8 and BV norms of the scheme's solutions one can prove that a sequence of converging discrete solutions necessarily converges towards the weak solution of the Euler system. Besides it satisfies a weak entropy inequality at the limit. Concerning the front propagation, we transform the flame front evolution equation (the so called

  9. Confidence in Numerical Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Hemez, Francois M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-02-23

    This PowerPoint presentation offers a high-level discussion of uncertainty, confidence and credibility in scientific Modeling and Simulation (M&S). It begins by briefly evoking M&S trends in computational physics and engineering. The first thrust of the discussion is to emphasize that the role of M&S in decision-making is either to support reasoning by similarity or to “forecast,” that is, make predictions about the future or extrapolate to settings or environments that cannot be tested experimentally. The second thrust is to explain that M&S-aided decision-making is an exercise in uncertainty management. The three broad classes of uncertainty in computational physics and engineering are variability and randomness, numerical uncertainty and model-form uncertainty. The last part of the discussion addresses how scientists “think.” This thought process parallels the scientific method where by a hypothesis is formulated, often accompanied by simplifying assumptions, then, physical experiments and numerical simulations are performed to confirm or reject the hypothesis. “Confidence” derives, not just from the levels of training and experience of analysts, but also from the rigor with which these assessments are performed, documented and peer-reviewed.

  10. Confidence in Numerical Simulations

    International Nuclear Information System (INIS)

    Hemez, Francois M.

    2015-01-01

    This PowerPoint presentation offers a high-level discussion of uncertainty, confidence and credibility in scientific Modeling and Simulation (M&S). It begins by briefly evoking M&S trends in computational physics and engineering. The first thrust of the discussion is to emphasize that the role of M&S in decision-making is either to support reasoning by similarity or to ''forecast,'' that is, make predictions about the future or extrapolate to settings or environments that cannot be tested experimentally. The second thrust is to explain that M&S-aided decision-making is an exercise in uncertainty management. The three broad classes of uncertainty in computational physics and engineering are variability and randomness, numerical uncertainty and model-form uncertainty. The last part of the discussion addresses how scientists ''think.'' This thought process parallels the scientific method where by a hypothesis is formulated, often accompanied by simplifying assumptions, then, physical experiments and numerical simulations are performed to confirm or reject the hypothesis. ''Confidence'' derives, not just from the levels of training and experience of analysts, but also from the rigor with which these assessments are performed, documented and peer-reviewed.

  11. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  12. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  13. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  14. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  15. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  16. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  17. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  18. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  19. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  20. Essential numerical computer methods

    CERN Document Server

    Johnson, Michael L

    2010-01-01

    The use of computers and computational methods has become ubiquitous in biological and biomedical research. During the last 2 decades most basic algorithms have not changed, but what has is the huge increase in computer speed and ease of use, along with the corresponding orders of magnitude decrease in cost. A general perception exists that the only applications of computers and computer methods in biological and biomedical research are either basic statistical analysis or the searching of DNA sequence data bases. While these are important applications they only scratch the surface of the current and potential applications of computers and computer methods in biomedical research. The various chapters within this volume include a wide variety of applications that extend far beyond this limited perception. As part of the Reliable Lab Solutions series, Essential Numerical Computer Methods brings together chapters from volumes 210, 240, 321, 383, 384, 454, and 467 of Methods in Enzymology. These chapters provide ...

  1. Numerical relativity beyond astrophysics

    Science.gov (United States)

    Garfinkle, David

    2017-01-01

    Though the main applications of computer simulations in relativity are to astrophysical systems such as black holes and neutron stars, nonetheless there are important applications of numerical methods to the investigation of general relativity as a fundamental theory of the nature of space and time. This paper gives an overview of some of these applications. In particular we cover (i) investigations of the properties of spacetime singularities such as those that occur in the interior of black holes and in big bang cosmology. (ii) investigations of critical behavior at the threshold of black hole formation in gravitational collapse. (iii) investigations inspired by string theory, in particular analogs of black holes in more than 4 spacetime dimensions and gravitational collapse in spacetimes with a negative cosmological constant.

  2. Testability of numerical systems

    International Nuclear Information System (INIS)

    Soulas, B.

    1992-01-01

    In order to face up to the growing complexity of systems, the authors undertook to define a new approach for the qualification of systems. This approach is based on the concept of Testability which, supported by system modelization, validation and verification methods and tools, would allow Integrated Qualification process, applied throughout the life-span of systems. The general principles of this approach are introduced in the general case of numerical systems; in particular, this presentation points out the difference between the specification activity and the modelization and validation activity. This approach is illustrated firstly by the study of a global system and then by case of communication protocol as the software point of view. Finally MODEL which support this approach is described. MODEL tool is a commercial tool providing modelization and validation techniques based on Petri Nets with triple extension: Predicate/Transition, Timed and Stochastic Petri Nets

  3. Numerical relativity beyond astrophysics.

    Science.gov (United States)

    Garfinkle, David

    2017-01-01

    Though the main applications of computer simulations in relativity are to astrophysical systems such as black holes and neutron stars, nonetheless there are important applications of numerical methods to the investigation of general relativity as a fundamental theory of the nature of space and time. This paper gives an overview of some of these applications. In particular we cover (i) investigations of the properties of spacetime singularities such as those that occur in the interior of black holes and in big bang cosmology. (ii) investigations of critical behavior at the threshold of black hole formation in gravitational collapse. (iii) investigations inspired by string theory, in particular analogs of black holes in more than 4 spacetime dimensions and gravitational collapse in spacetimes with a negative cosmological constant.

  4. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  5. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  6. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  7. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  8. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  9. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  10. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  11. Computing the Alexander Polynomial Numerically

    DEFF Research Database (Denmark)

    Hansen, Mikael Sonne

    2006-01-01

    Explains how to construct the Alexander Matrix and how this can be used to compute the Alexander polynomial numerically.......Explains how to construct the Alexander Matrix and how this can be used to compute the Alexander polynomial numerically....

  12. NASA total quality management 1990 accomplishments report

    Science.gov (United States)

    1991-01-01

    NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

  13. Total quality management program planning

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  14. Survey of numerical safety targets for nuclear power plants

    International Nuclear Information System (INIS)

    Kelley, A.P. Jr.; Buttemer, D.R.

    1981-04-01

    The construction of a nuclear power plant implies, as does the construction of any major public work, the acceptance of a finite degree of risk. This risk can be reduced by an increased investment in engineered safeguards. However, at some level of risk, overinvestment in safety can render the project uneconomical. Because of the desirability of fixing safety standards on an absolute basis, there has long been an interest in establishing numerical risk criteria for the design, construction, and operation of nuclear power plants. Interest in the subject of numerical safety goals has recently been intensified by the Three Mile Island Action Plan. The USNRC has been directed by Congress to develop a national safety goal for reactor regulation. This report summarizes actions which have been historically, and are currently, taking place toward establishing national numerical risk targets for reactor regulation. Emphasis is placed upon actions taken, or currently being taken, by federal regulatory agencies and directly associated advisory bodies

  15. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  16. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  17. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  18. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  19. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  20. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  1. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  2. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  3. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  4. Numerical model SMODERP

    Science.gov (United States)

    Kavka, P.; Jeřábek, J.; Strouhal, L.

    2016-12-01

    The contribution presents a numerical model SMODERP that is used for calculation and prediction of surface runoff and soil erosion from agricultural land. The physically based model includes the processes of infiltration (Phillips equation), surface runoff routing (kinematic wave based equation), surface retention, surface roughness and vegetation impact on runoff. The model is being developed at the Department of Irrigation, Drainage and Landscape Engineering, Civil Engineering Faculty, CTU in Prague. 2D version of the model was introduced in last years. The script uses ArcGIS system tools for data preparation. The physical relations are implemented through Python scripts. The main computing part is stand alone in numpy arrays. Flow direction is calculated by Steepest Descent algorithm and in multiple flow algorithm. Sheet flow is described by modified kinematic wave equation. Parameters for five different soil textures were calibrated on the set of hundred measurements performed on the laboratory and filed rainfall simulators. Spatially distributed models enable to estimate not only surface runoff but also flow in the rills. Development of the rills is based on critical shear stress and critical velocity. For modelling of the rills a specific sub model was created. This sub model uses Manning formula for flow estimation. Flow in the ditches and streams are also computed. Numerical stability of the model is controled by Courant criterion. Spatial scale is fixed. Time step is dynamic and depends on the actual discharge. The model is used in the framework of the project "Variability of Short-term Precipitation and Runoff in Small Czech Drainage Basins and its Influence on Water Resources Management". Main goal of the project is to elaborate a methodology and online utility for deriving short-term design precipitation series, which could be utilized by a broad community of scientists, state administration as well as design planners. The methodology will account for

  5. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  6. Numerical aerodynamic simulation (NAS)

    International Nuclear Information System (INIS)

    Peterson, V.L.; Ballhaus, W.F. Jr.; Bailey, F.R.

    1984-01-01

    The Numerical Aerodynamic Simulation (NAS) Program is designed to provide a leading-edge computational capability to the aerospace community. It was recognized early in the program that, in addition to more advanced computers, the entire computational process ranging from problem formulation to publication of results needed to be improved to realize the full impact of computational aerodynamics. Therefore, the NAS Program has been structured to focus on the development of a complete system that can be upgraded periodically with minimum impact on the user and on the inventory of applications software. The implementation phase of the program is now under way. It is based upon nearly 8 yr of study and should culminate in an initial operational capability before 1986. The objective of this paper is fivefold: 1) to discuss the factors motivating the NAS program, 2) to provide a history of the activity, 3) to describe each of the elements of the processing-system network, 4) to outline the proposed allocation of time to users of the facility, and 5) to describe some of the candidate problems being considered for the first benchmark codes

  7. Communicating quantitative risks and benefits in promotional prescription drug labeling or print advertising.

    Science.gov (United States)

    West, Suzanne L; Squiers, Linda B; McCormack, Lauren; Southwell, Brian G; Brouwer, Emily S; Ashok, Mahima; Lux, Linda; Boudewyns, Vanessa; O'Donoghue, Amie; Sullivan, Helen W

    2013-05-01

    Under the Food, Drug, and Cosmetic Act, all promotional materials for prescription drugs must strike a fair balance in presentation of risks and benefits. How to best present this information is not clear. We sought to determine if the presentation of quantitative risk and benefit information in drug advertising and labeling influences consumers', patients', and clinicians' information processing, knowledge, and behavior by assessing available empirical evidence. We used PubMed for a literature search, limiting to articles published in English from 1990 forward. Two reviewers independently reviewed the titles and abstracts for inclusion, after which we reviewed the full texts to determine if they communicated risk/benefit information either: (i) numerically (e.g., percent) versus non-numerically (e.g., using text such as "increased risk") or (ii) numerically using different formats (e.g., "25% of patients", "one in four patients", or use of pictographs). We abstracted information from included articles into standardized evidence tables. The research team identified a total of 674 relevant publications, of which 52 met our inclusion criteria. Of these, 37 focused on drugs. Presenting numeric information appears to improve understanding of risks and benefits relative to non-numeric presentation; presenting both numeric and non-numeric information when possible may be best practice. No single specific format or graphical approach emerged as consistently superior. Numeracy and health literacy also deserve more empirical attention as moderators. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  9. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  10. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  11. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Intake of Caffeinated Soft Drinks before and during Pregnancy, but Not Total Caffeine Intake, Is Associated with Increased Cerebral Palsy Risk in the Norwegian Mother and Child Cohort Study

    DEFF Research Database (Denmark)

    Tollånes, Mette C.; Strandberg-Larsen, Katrine; Eichelberger, Kacey Y.

    2016-01-01

    BACKGROUND: Postnatal administration of caffeine may reduce the risk of cerebral palsy (CP) in vulnerable low-birth-weight neonates. The effect of antenatal caffeine exposure remains unknown. OBJECTIVE: We investigated the association of intake of caffeine by pregnant women and risk of CP...... in their children. METHODS: The study was based on The Norwegian Mother and Child Cohort Study, comprising >100,000 live-born children, of whom 222 were subsequently diagnosed with CP. Mothers reported their caffeine consumption in questionnaires completed around pregnancy week 17 (102,986 mother-child pairs), week...... 22 (87,987 mother-child pairs), and week 30 (94,372 mother-child pairs). At week 17, participants were asked about present and prepregnancy consumption. We used Cox regression models to estimate associations between exposure [daily servings (1 serving = 125 mL) of caffeinated coffee, tea, and soft...

  13. A novel numerical approach for workspace determination of parallel mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Yiqun; Niu, Junchuan; Liu, Zhihui; Zhang, Fuliang [Shandong University, Shandong (China)

    2017-06-15

    In this paper, a novel numerical approach is proposed for workspace determination of parallel mechanisms. Compared with the classical numerical approaches, this presented approach discretizes both location and orientation of the mechanism simultaneously, not only one of the two. This technique makes the presented numerical approach applicable in determining almost all types of workspaces, while traditional numerical approaches are only applicable in determining the constant orientation workspace and orientation workspace. The presented approach and its steps to determine the inclusive orientation workspace and total orientation workspace are described in detail. A lower-mobility parallel mechanism and a six-degrees-of-freedom Stewart platform are set as examples, the workspaces of these mechanisms are estimated and visualized by the proposed numerical approach. Furthermore, the efficiency of the presented approach is discussed. The examples show that the presented approach is applicable in determining the inclusive orientation workspace and total orientation workspace of parallel mechanisms with high efficiency.

  14. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  15. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  16. Introduction to precise numerical methods

    CERN Document Server

    Aberth, Oliver

    2007-01-01

    Precise numerical analysis may be defined as the study of computer methods for solving mathematical problems either exactly or to prescribed accuracy. This book explains how precise numerical analysis is constructed. The book also provides exercises which illustrate points from the text and references for the methods presented. All disc-based content for this title is now available on the Web. · Clearer, simpler descriptions and explanations ofthe various numerical methods· Two new types of numerical problems; accurately solving partial differential equations with the included software and computing line integrals in the complex plane.

  17. Representation of Numerical and Non-Numerical Order in Children

    Science.gov (United States)

    Berteletti, Ilaria; Lucangeli, Daniela; Zorzi, Marco

    2012-01-01

    The representation of numerical and non-numerical ordered sequences was investigated in children from preschool to grade 3. The child's conception of how sequence items map onto a spatial scale was tested using the Number-to-Position task (Siegler & Opfer, 2003) and new variants of the task designed to probe the representation of the alphabet…

  18. Communicating risk using absolute risk reduction or prolongation of life formats

    DEFF Research Database (Denmark)

    Harmsen, Charlotte Gry; Kristiansen, Ivar Sønbø; Larsen, Pia Veldt

    2014-01-01

    . The COMRADE questionnaire was used to measure patients' confidence in their decision and satisfaction with the risk communication. RESULTS: Of the 240 patients included for analyses, 112 were allocated to POL information and 128 to ARR. Patients redeeming a statin prescription totalled six (5.4%) when...... informed using POL, and 32 (25.0%) when using ARR. The level of confidence in decision and satisfaction with risk communication did not differ between the risk formats. CONCLUSION: Patients redeemed statin prescriptions less often when their GP communicated treatment effectiveness using POL compared......BACKGROUND: It is important that patients are well-informed about risks and benefits of therapies to help them decide whether to accept medical therapy. Different numerical formats can be used in risk communication but It remains unclear how the different formats affect decisions made by real...

  19. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  20. Numerical Asymptotic Solutions Of Differential Equations

    Science.gov (United States)

    Thurston, Gaylen A.

    1992-01-01

    Numerical algorithms derived and compared with classical analytical methods. In method, expansions replaced with integrals evaluated numerically. Resulting numerical solutions retain linear independence, main advantage of asymptotic solutions.

  1. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  2. The relationship between total testosterone levels and prostate cancer: a review of the continuing controversy.

    Science.gov (United States)

    Klap, Julia; Schmid, Marianne; Loughlin, Kevin R

    2015-02-01

    For many years it was believed that higher total testosterone contributed to prostate cancer and caused rapid cancer growth. International guidelines consider that adequate data are not available to determine whether there is additional risk of prostate cancer from testosterone replacement. Numerous studies with multiple designs and contradictory conclusions have investigated the relationship between total testosterone and prostate cancer development. To establish current knowledge in this field we reviewed the literature on total testosterone and the subsequent risk of prostate cancer as well as the safety of exogenous testosterone administration in patients with a history of prostate cancer. We searched the literature to identify articles from 1994 to 2014 related to the relationship between total testosterone and prostate cancer. Emphasis was given to prospective studies, series with observational data and randomized, controlled trials. Case reports were excluded. Articles on testosterone replacement safety were selected by patient population (under active surveillance or with a prostate cancer history). We organized our results according to the relationship between total testosterone and prostate cancer, including 1) the possible link between low total testosterone and prostate cancer, 2) the effect of high levels and 3) the absence of any link. Finally, we summarized studies of the risk of exogenous testosterone administration in patients already diagnosed with prostate cancer, treated or on active surveillance. We selected 45 articles of the relationship between total testosterone and prostate cancer, of which 18 and 17 showed a relationship to low and high total testosterone, respectively, and 10 showed no relation. Total testosterone was defined according to the definition in each article. Contradictory findings have been reported, largely due to the disparate methodologies used in many studies. Most studies did not adhere to professional society guidelines

  3. How to Circumvent Church Numerals

    DEFF Research Database (Denmark)

    Goldberg, Mayer; Torgersen, Mads

    2002-01-01

    In this work we consider a standard numeral system in the lambda-calculus, and the elementary arithmetic and Boolean functions and predicates defined on this numeral system, and show how to construct terms that "circumvent" or "defeat" these functions: The equality predicate is satisfied when com...

  4. Numerical Gram-Schmidt orthonormalization

    International Nuclear Information System (INIS)

    Werneth, Charles M; Dhar, Mallika; Maung, Khin Maung; Sirola, Christopher; Norbury, John W

    2010-01-01

    A numerical Gram-Schmidt orthonormalization procedure is presented for constructing an orthonormal basis function set from a non-orthonormal set, when the number of basis functions is large. This method will provide a pedagogical illustration of the Gram-Schmidt procedure and can be presented in classes on numerical methods or computational physics.

  5. Failure of aseptic revision total knee arthroplasties.

    Science.gov (United States)

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-02-01

    In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

  6. Numerical simulation of laser resonators

    International Nuclear Information System (INIS)

    Yoo, J. G.; Jeong, Y. U.; Lee, B. C.; Rhee, Y. J.; Cho, S. O.

    2004-01-01

    We developed numerical simulation packages for laser resonators on the bases of a pair of integral equations. Two numerical schemes, a matrix formalism and an iterative method, were programmed for finding numeric solutions to the pair of integral equations. The iterative method was tried by Fox and Li, but it was not applicable for high Fresnel numbers since the numerical errors involved propagate and accumulate uncontrollably. In this paper, we implement the matrix method to extend the computational limit further. A great number of case studies are carried out with various configurations of stable and unstable r;esonators to compute diffraction losses, phase shifts, intensity distributions and phases of the radiation fields on mirrors. Our results presented in this paper show not only a good agreement with the results previously obtained by Fox and Li, but also the legitimacy of our numerical procedures for high Fresnel numbers.

  7. Foundations of children's numerical and mathematical skills: the roles of symbolic and nonsymbolic representations of numerical magnitude.

    Science.gov (United States)

    Lyons, Ian M; Ansari, Daniel

    2015-01-01

    Numerical and mathematical skills are critical predictors of academic success. The last three decades have seen a substantial growth in our understanding of how the human mind and brain represent and process numbers. In particular, research has shown that we share with animals the ability to represent numerical magnitude (the total number of items in a set) and that preverbal infants can process numerical magnitude. Further research has shown that similar processing signatures characterize numerical magnitude processing across species and developmental time. These findings suggest that an approximate system for nonsymbolic (e.g., dot arrays) numerical magnitude representation serves as the basis for the acquisition of cultural, symbolic (e.g., Arabic numerals) representations of numerical magnitude. This chapter explores this hypothesis by reviewing studies that have examined the relation between individual differences in nonsymbolic numerical magnitude processing and symbolic math abilities (e.g., arithmetic). Furthermore, we examine the extent to which the available literature provides strong evidence for a link between symbolic and nonsymbolic representations of numerical magnitude at the behavioral and neural levels of analysis. We conclude that claims that symbolic number abilities are grounded in the approximate system for the nonsymbolic representation of numerical magnitude are not strongly supported by the available evidence. Alternative models and future research directions are discussed. © 2015 Elsevier Inc. All rights reserved.

  8. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Cordtz, Rene Lindholm; Zobbe, Kristian; Højgaard, Pil

    2018-01-01

    OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients...

  9. Relativistic positioning systems: Numerical simulations

    Science.gov (United States)

    Puchades Colmenero, Neus

    The position of users located on the Earth's surface or near it may be found with the classic positioning systems (CPS). Certain information broadcast by satellites of global navigation systems, as GPS and GALILEO, may be used for positioning. The CPS are based on the Newtonian formalism, although relativistic post-Newtonian corrections are done when they are necessary. This thesis contributes to the development of a different positioning approach, which is fully relativistic from the beginning. In the relativistic positioning systems (RPS), the space-time position of any user (ship, spacecraft, and so on) can be calculated with the help of four satellites, which broadcast their proper times by means of codified electromagnetic signals. In this thesis, we have simulated satellite 4-tuples of the GPS and GALILEO constellations. If a user receives the signals from four satellites simultaneously, the emission proper times read -after decoding- are the user "emission coordinates". In order to find the user "positioning coordinates", in an appropriate almost inertial reference system, there are two possibilities: (a) the explicit relation between positioning and emission coordinates (broadcast by the satellites) is analytically found or (b) numerical codes are designed to calculate the positioning coordinates from the emission ones. Method (a) is only viable in simple ideal cases, whereas (b) allows us to consider realistic situations. In this thesis, we have designed numerical codes with the essential aim of studying two appropriate RPS, which may be generalized. Sometimes, there are two real users placed in different positions, which receive the same proper times from the same satellites; then, we say that there is bifurcation, and additional data are needed to choose the real user position. In this thesis, bifurcation is studied in detail. We have analyzed in depth two RPS models; in both, it is considered that the satellites move in the Schwarzschild's space

  10. Assessment of cardiovascular risk.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-10-01

    Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification can then be directed towards the individuals who will derive the greatest benefit. To assist the clinician in calculating the effects of these multiple interacting risk factors, a number of risk estimation systems have been developed. This review address several issues regarding total CVD risk assessment: Why should total CVD risk be assessed? What risk estimation systems are available? How well do these systems estimate risk? What are the advantages and disadvantages of the current systems? What are the current limitations of risk estimation systems and how can they be resolved? What new developments have occurred in CVD risk estimation?

  11. Numerical Verification Of Equilibrium Chemistry

    International Nuclear Information System (INIS)

    Piro, Markus; Lewis, Brent; Thompson, William T.; Simunovic, Srdjan; Besmann, Theodore M.

    2010-01-01

    A numerical tool is in an advanced state of development to compute the equilibrium compositions of phases and their proportions in multi-component systems of importance to the nuclear industry. The resulting software is being conceived for direct integration into large multi-physics fuel performance codes, particularly for providing boundary conditions in heat and mass transport modules. However, any numerical errors produced in equilibrium chemistry computations will be propagated in subsequent heat and mass transport calculations, thus falsely predicting nuclear fuel behaviour. The necessity for a reliable method to numerically verify chemical equilibrium computations is emphasized by the requirement to handle the very large number of elements necessary to capture the entire fission product inventory. A simple, reliable and comprehensive numerical verification method is presented which can be invoked by any equilibrium chemistry solver for quality assurance purposes.

  12. BCJ numerators from reduced Pfaffian

    Energy Technology Data Exchange (ETDEWEB)

    Du, Yi-Jian [Center for Theoretical Physics, School of Physics and Technology, Wuhan University,No. 299 Bayi Road, Wuhan 430072 (China); Teng, Fei [Department of Physics and Astronomy, University of Utah,115 South 1400 East, Salt Lake City, UT 84112 (United States)

    2017-04-07

    By expanding the reduced Pfaffian in the tree level Cachazo-He-Yuan (CHY) integrands for Yang-Mills (YM) and nonlinear sigma model (NLSM), we can get the Bern-Carrasco-Johansson (BCJ) numerators in Del Duca-Dixon-Maltoni (DDM) form for arbitrary number of particles in any spacetime dimensions. In this work, we give a set of very straightforward graphic rules based on spanning trees for a direct evaluation of the BCJ numerators for YM and NLSM. Such rules can be derived from the Laplace expansion of the corresponding reduced Pfaffian. For YM, the each one of the (n−2)! DDM form BCJ numerators contains exactly (n−1)! terms, corresponding to the increasing trees with respect to the color order. For NLSM, the number of nonzero numerators is at most (n−2)!−(n−3)!, less than those of several previous constructions.

  13. Numerical Analysis of Multiscale Computations

    CERN Document Server

    Engquist, Björn; Tsai, Yen-Hsi R

    2012-01-01

    This book is a snapshot of current research in multiscale modeling, computations and applications. It covers fundamental mathematical theory, numerical algorithms as well as practical computational advice for analysing single and multiphysics models containing a variety of scales in time and space. Complex fluids, porous media flow and oscillatory dynamical systems are treated in some extra depth, as well as tools like analytical and numerical homogenization, and fast multipole method.

  14. Numerical calculations near spatial infinity

    International Nuclear Information System (INIS)

    Zenginoglu, Anil

    2007-01-01

    After describing in short some problems and methods regarding the smoothness of null infinity for isolated systems, I present numerical calculations in which both spatial and null infinity can be studied. The reduced conformal field equations based on the conformal Gauss gauge allow us in spherical symmetry to calculate numerically the entire Schwarzschild-Kruskal spacetime in a smooth way including spacelike, null and timelike infinity and the domain close to the singularity

  15. Numerical modelling of mine workings.

    CSIR Research Space (South Africa)

    Lightfoot, N

    1999-03-01

    Full Text Available to cover most of what is required for a practising rock mechanics engineer to be able to use any of these five programs to solve practical mining problems. The chapters on specific programs discuss their individual strengths and weaknesses and highlight... and applications of numerical modelling in the context of the South African gold and platinum mining industries. This includes an example that utilises a number of different numerical 3 modelling programs to solve a single problem. This particular example...

  16. On joint numerical radius II

    Czech Academy of Sciences Publication Activity Database

    Drnovšek, R.; Müller, Vladimír

    2014-01-01

    Roč. 62, č. 9 (2014), s. 1197-1204 ISSN 0308-1087 R&D Projects: GA ČR GA201/09/0473; GA AV ČR IAA100190903 Institutional support: RVO:67985840 Keywords : joint numerical range * numerical radius Subject RIV: BA - General Mathematics Impact factor: 0.738, year: 2014 http://www.tandfonline.com/doi/abs/10.1080/03081087.2013.816303

  17. Total shoulder replacement in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

    1996-01-01

    A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal......, range of movement, abduction force, or function. The risk of clinical asymptomatic loosening is a relatively late complication that is eventually followed by pronounced bone destruction related to the loose component. Long-term radiographic control of total shoulders with rheumatoid arthritis...... is recommended. Hemiarthroplasty with a cemented humeral prosthesis may be a better treatment in the end stage of rheumatoid arthritis of the shoulder....

  18. Numerical Hydrodynamics in General Relativity

    Directory of Open Access Journals (Sweden)

    Font José A.

    2003-01-01

    Full Text Available The current status of numerical solutions for the equations of ideal general relativistic hydrodynamics is reviewed. With respect to an earlier version of the article, the present update provides additional information on numerical schemes, and extends the discussion of astrophysical simulations in general relativistic hydrodynamics. Different formulations of the equations are presented, with special mention of conservative and hyperbolic formulations well-adapted to advanced numerical methods. A large sample of available numerical schemes is discussed, paying particular attention to solution procedures based on schemes exploiting the characteristic structure of the equations through linearized Riemann solvers. A comprehensive summary of astrophysical simulations in strong gravitational fields is presented. These include gravitational collapse, accretion onto black holes, and hydrodynamical evolutions of neutron stars. The material contained in these sections highlights the numerical challenges of various representative simulations. It also follows, to some extent, the chronological development of the field, concerning advances on the formulation of the gravitational field and hydrodynamic equations and the numerical methodology designed to solve them.

  19. Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty.

    NARCIS (Netherlands)

    Heide, H.J. van der; Kraan, P.M. van der; Rijnberg, W.J.; Buma, P.; Schreurs, B.W.

    2010-01-01

    As cytokines are involved in wound healing and other inflammatory processes, it could be valuable to measure their levels at the operative site. This study was conducted to investigate whether different cytokines are measurable in drainage fluid and, when measurable, whether we can find a difference

  20. A Numerical Model for Trickle Bed Reactors

    Science.gov (United States)

    Propp, Richard M.; Colella, Phillip; Crutchfield, William Y.; Day, Marcus S.

    2000-12-01

    Trickle bed reactors are governed by equations of flow in porous media such as Darcy's law and the conservation of mass. Our numerical method for solving these equations is based on a total-velocity splitting, sequential formulation which leads to an implicit pressure equation and a semi-implicit mass conservation equation. We use high-resolution finite-difference methods to discretize these equations. Our solution scheme extends previous work in modeling porous media flows in two ways. First, we incorporate physical effects due to capillary pressure, a nonlinear inlet boundary condition, spatial porosity variations, and inertial effects on phase mobilities. In particular, capillary forces introduce a parabolic component into the recast evolution equation, and the inertial effects give rise to hyperbolic nonconvexity. Second, we introduce a modification of the slope-limiting algorithm to prevent our numerical method from producing spurious shocks. We present a numerical algorithm for accommodating these difficulties, show the algorithm is second-order accurate, and demonstrate its performance on a number of simplified problems relevant to trickle bed reactor modeling.

  1. Code development for eigenvalue total sensitivity analysis and total uncertainty analysis

    International Nuclear Information System (INIS)

    Wan, Chenghui; Cao, Liangzhi; Wu, Hongchun; Zu, Tiejun; Shen, Wei

    2015-01-01

    Highlights: • We develop a new code for total sensitivity and uncertainty analysis. • The implicit effects of cross sections can be considered. • The results of our code agree well with TSUNAMI-1D. • Detailed analysis for origins of implicit effects is performed. - Abstract: The uncertainties of multigroup cross sections notably impact eigenvalue of neutron-transport equation. We report on a total sensitivity analysis and total uncertainty analysis code named UNICORN that has been developed by applying the direct numerical perturbation method and statistical sampling method. In order to consider the contributions of various basic cross sections and the implicit effects which are indirect results of multigroup cross sections through resonance self-shielding calculation, an improved multigroup cross-section perturbation model is developed. The DRAGON 4.0 code, with application of WIMSD-4 format library, is used by UNICORN to carry out the resonance self-shielding and neutron-transport calculations. In addition, the bootstrap technique has been applied to the statistical sampling method in UNICORN to obtain much steadier and more reliable uncertainty results. The UNICORN code has been verified against TSUNAMI-1D by analyzing the case of TMI-1 pin-cell. The numerical results show that the total uncertainty of eigenvalue caused by cross sections can reach up to be about 0.72%. Therefore the contributions of the basic cross sections and their implicit effects are not negligible

  2. Total body irradiation: current indications; L`irradiation corporelle totale: les indications actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, P.; Danhier, S.; Dubray, B.; Cosset, J.M. [Institut Curie, 75 - Paris (France)

    1998-05-01

    The choice of dose and fractionation for total body irradiation is made difficult by the large number of considerations to be taken into account. The outcome of bone marrow transplantation after total body irradiation can be understood in terms of tumor cell killing, engraftment, and normal tissue damage, each of these endpoints being influenced by irradiation-, disease-, transplant-, and patient- related factors. Interpretation of clinical data is further hampered by the overwhelming influence of logistic constraints, the small numbers of randomized studies, and the concomitant variations in total dose and fraction size or dose rate. So far, three cautious conclusions can be drawn in order to tentatively adapt the total body irradiation schedule to clinically-relevant situations. Firstly, the organs at risk for normal tissue damage (lung, liver, lens, kidney) are protected by delivering small doses per fraction at low dose rate. This suggests that, when toxicity is at stake (e.g. in children), fractionated irradiation should be preferred, provided that inter-fraction intervals are long enough. Secondly, fractionated irradiation should be avoided in case of T-cell depleted transplant, given the high risk of graft rejection in this setting. An alternative would be to increase total (or fractional) dose of fractionated total body irradiation, but this approach is likely to induce more normal tissue toxicity. Thirdly, clinical data have shown higher relapse rates in chronic myeloid leukemia after fractionated or low dose rate total body irradiation, suggesting that fractionated irradiation should not be recommended, unless total (or fractional) dose is increased. Total body irradiation-containing regimens, primarily cyclophosphamide / total body irradiation, are either equivalent to or better than the chemotherapy-only regimens, primarily busulfan / cyclophosphamide. Busulfan / cyclophosphamide certainly represents a reasonable alternative, especially in patients who

  3. Numerical methods in multibody dynamics

    CERN Document Server

    Eich-Soellner, Edda

    1998-01-01

    Today computers play an important role in the development of complex mechanical systems, such as cars, railway vehicles or machines. Efficient simulation of these systems is only possible when based on methods that explore the strong link between numerics and computational mechanics. This book gives insight into modern techniques of numerical mathematics in the light of an interesting field of applications: multibody dynamics. The important interaction between modeling and solution techniques is demonstrated by using a simplified multibody model of a truck. Different versions of this mechanical model illustrate all key concepts in static and dynamic analysis as well as in parameter identification. The book focuses in particular on constrained mechanical systems. Their formulation in terms of differential-algebraic equations is the backbone of nearly all chapters. The book is written for students and teachers in numerical analysis and mechanical engineering as well as for engineers in industrial research labor...

  4. Extensible numerical library in JAVA

    International Nuclear Information System (INIS)

    Aso, T.; Okazawa, H.; Takashimizu, N.

    2001-01-01

    The authors present the current status of the project for developing the numerical library in JAVA. The authors have presented how object-oriented techniques improve usage and also development of numerical libraries compared with the conventional way at previous conference. The authors need many functions for data analysis which is not provided within JAVA language, for example, good random number generators, special functions and so on. Authors' development strategy is focused on easiness of implementation and adding new features by users themselves not only by developers. In HPC field, there are other focus efforts to develop numerical libraries in JAVA. However, their focus is on the performance of execution, not easiness of extension. Following the strategy, the authors have designed and implemented more classes for random number generators and so on

  5. Numerical analysis of electromagnetic fields

    CERN Document Server

    Zhou Pei Bai

    1993-01-01

    Numerical methods for solving boundary value problems have developed rapidly. Knowledge of these methods is important both for engineers and scientists. There are many books published that deal with various approximate methods such as the finite element method, the boundary element method and so on. However, there is no textbook that includes all of these methods. This book is intended to fill this gap. The book is designed to be suitable for graduate students in engineering science, for senior undergraduate students as well as for scientists and engineers who are interested in electromagnetic fields. Objective Numerical calculation is the combination of mathematical methods and field theory. A great number of mathematical concepts, principles and techniques are discussed and many computational techniques are considered in dealing with practical problems. The purpose of this book is to provide students with a solid background in numerical analysis of the field problems. The book emphasizes the basic theories ...

  6. Numerical models for differential problems

    CERN Document Server

    Quarteroni, Alfio

    2017-01-01

    In this text, we introduce the basic concepts for the numerical modelling of partial differential equations. We consider the classical elliptic, parabolic and hyperbolic linear equations, but also the diffusion, transport, and Navier-Stokes equations, as well as equations representing conservation laws, saddle-point problems and optimal control problems. Furthermore, we provide numerous physical examples which underline such equations. We then analyze numerical solution methods based on finite elements, finite differences, finite volumes, spectral methods and domain decomposition methods, and reduced basis methods. In particular, we discuss the algorithmic and computer implementation aspects and provide a number of easy-to-use programs. The text does not require any previous advanced mathematical knowledge of partial differential equations: the absolutely essential concepts are reported in a preliminary chapter. It is therefore suitable for students of bachelor and master courses in scientific disciplines, an...

  7. Numerical simulation of flood barriers

    Science.gov (United States)

    Srb, Pavel; Petrů, Michal; Kulhavý, Petr

    This paper deals with testing and numerical simulating of flood barriers. The Czech Republic has been hit by several very devastating floods in past years. These floods caused several dozens of causalities and property damage reached billions of Euros. The development of flood measures is very important, especially for the reduction the number of casualties and the amount of property damage. The aim of flood control measures is the detention of water outside populated areas and drainage of water from populated areas as soon as possible. For new flood barrier design it is very important to know its behaviour in case of a real flood. During the development of the barrier several standardized tests have to be carried out. Based on the results from these tests numerical simulation was compiled using Abaqus software and some analyses were carried out. Based on these numerical simulations it will be possible to predict the behaviour of barriers and thus improve their design.

  8. Numeral Incorporation in Japanese Sign Language

    Science.gov (United States)

    Ktejik, Mish

    2013-01-01

    This article explores the morphological process of numeral incorporation in Japanese Sign Language. Numeral incorporation is defined and the available research on numeral incorporation in signed language is discussed. The numeral signs in Japanese Sign Language are then introduced and followed by an explanation of the numeral morphemes which are…

  9. Numerical precision control and GRACE

    International Nuclear Information System (INIS)

    Fujimoto, J.; Hamaguchi, N.; Ishikawa, T.; Kaneko, T.; Morita, H.; Perret-Gallix, D.; Tokura, A.; Shimizu, Y.

    2006-01-01

    The control of the numerical precision of large-scale computations like those generated by the GRACE system for automatic Feynman diagram calculations has become an intrinsic part of those packages. Recently, Hitachi Ltd. has developed in FORTRAN a new library HMLIB for quadruple and octuple precision arithmetic where the number of lost-bits is made available. This library has been tested with success on the 1-loop radiative correction to e + e - ->e + e - τ + τ - . It is shown that the approach followed by HMLIB provides an efficient way to track down the source of numerical significance losses and to deliver high-precision results yet minimizing computing time

  10. Matlab programming for numerical analysis

    CERN Document Server

    Lopez, Cesar

    2014-01-01

    MATLAB is a high-level language and environment for numerical computation, visualization, and programming. Using MATLAB, you can analyze data, develop algorithms, and create models and applications. The language, tools, and built-in math functions enable you to explore multiple approaches and reach a solution faster than with spreadsheets or traditional programming languages, such as C/C++ or Java. Programming MATLAB for Numerical Analysis introduces you to the MATLAB language with practical hands-on instructions and results, allowing you to quickly achieve your goals. You will first become

  11. Numeric invariants from multidimensional persistence

    Energy Technology Data Exchange (ETDEWEB)

    Skryzalin, Jacek [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Carlsson, Gunnar [Stanford Univ., Stanford, CA (United States)

    2017-05-19

    In this paper, we analyze the space of multidimensional persistence modules from the perspectives of algebraic geometry. We first build a moduli space of a certain subclass of easily analyzed multidimensional persistence modules, which we construct specifically to capture much of the information which can be gained by using multidimensional persistence over one-dimensional persistence. We argue that the global sections of this space provide interesting numeric invariants when evaluated against our subclass of multidimensional persistence modules. Lastly, we extend these global sections to the space of all multidimensional persistence modules and discuss how the resulting numeric invariants might be used to study data.

  12. Thinking through cancer risk: characterizing smokers' process of risk determination.

    Science.gov (United States)

    Hay, Jennifer; Shuk, Elyse; Cruz, Gustavo; Ostroff, Jamie

    2005-10-01

    The perception of cancer risk motivates cancer risk reduction behaviors. However, common measurement strategies for cancer risk perceptions, which involve numerical likelihood estimates, do not adequately capture individuals' thoughts and feelings about cancer risk. To guide the development of novel measurement strategies, the authors used semistructured interviews to examine the thought processes used by smokers (N = 15) as they considered their cancer risk. They used grounded theory to guide systematic data coding and develop a heuristic model describing smokers' risk perception process that includes a cognitive, primarily rational process whereby salient personal risk factors for cancer are considered and combined, and an affective/attitudinal process, which shifts risk perceptions either up or down. The model provides a tentative explanation concerning how people hold cancer risk perceptions that diverge from rational assessment of their risks and will be useful in guiding the development of non-numerical measurements strategies for cancer risk perceptions.

  13. Changes in total and differential white cell counts, total lymphocyte ...

    African Journals Online (AJOL)

    Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, ...

  14. Residents' numeric inputting error in computerized physician order entry prescription.

    Science.gov (United States)

    Wu, Xue; Wu, Changxu; Zhang, Kan; Wei, Dong

    2016-04-01

    Computerized physician order entry (CPOE) system with embedded clinical decision support (CDS) can significantly reduce certain types of prescription error. However, prescription errors still occur. Various factors such as the numeric inputting methods in human computer interaction (HCI) produce different error rates and types, but has received relatively little attention. This study aimed to examine the effects of numeric inputting methods and urgency levels on numeric inputting errors of prescription, as well as categorize the types of errors. Thirty residents participated in four prescribing tasks in which two factors were manipulated: numeric inputting methods (numeric row in the main keyboard vs. numeric keypad) and urgency levels (urgent situation vs. non-urgent situation). Multiple aspects of participants' prescribing behavior were measured in sober prescribing situations. The results revealed that in urgent situations, participants were prone to make mistakes when using the numeric row in the main keyboard. With control of performance in the sober prescribing situation, the effects of the input methods disappeared, and urgency was found to play a significant role in the generalized linear model. Most errors were either omission or substitution types, but the proportion of transposition and intrusion error types were significantly higher than that of the previous research. Among numbers 3, 8, and 9, which were the less common digits used in prescription, the error rate was higher, which was a great risk to patient safety. Urgency played a more important role in CPOE numeric typing error-making than typing skills and typing habits. It was recommended that inputting with the numeric keypad had lower error rates in urgent situation. An alternative design could consider increasing the sensitivity of the keys with lower frequency of occurrence and decimals. To improve the usability of CPOE, numeric keyboard design and error detection could benefit from spatial

  15. Numerical optimization of die geometry in open die forging

    DEFF Research Database (Denmark)

    Christiansen, Peter; Hattel, Jesper Henri; Bay, Niels

    2013-01-01

    This paper deals with numerical optimization of open die forging of large metallic ingots made by casting implying risk of defects, e.g. central pores. Different material hardening properties and die geometries are combined in order to investigate, which geometry gives rise to maximum closure...

  16. Numerical investigations of gravitational collapse

    Energy Technology Data Exchange (ETDEWEB)

    Csizmadia, Peter; Racz, Istvan, E-mail: iracz@rmki.kfki.h [RMKI, Budapest, Konkoly Thege Miklos ut 29-33, H-1121 (Hungary)

    2010-03-01

    Some properties of a new framework for simulating generic 4-dimensional spherically symmetric gravitating systems are discussed. The framework can be used to investigate spacetimes that undergo complete gravitational collapse. The analytic setup is chosen to ensure that our numerical method is capable to follow the time evolution everywhere, including the black hole region.

  17. Numerical modeling of economic uncertainty

    DEFF Research Database (Denmark)

    Schjær-Jacobsen, Hans

    2007-01-01

    Representation and modeling of economic uncertainty is addressed by different modeling methods, namely stochastic variables and probabilities, interval analysis, and fuzzy numbers, in particular triple estimates. Focusing on discounted cash flow analysis numerical results are presented, comparisons...... are made between alternative modeling methods, and characteristics of the methods are discussed....

  18. Numerical relativity and asymptotic flatness

    International Nuclear Information System (INIS)

    Deadman, E; Stewart, J M

    2009-01-01

    It is highly plausible that the region of spacetime far from an isolated gravitating body is, in some sense, asymptotically Minkowskian. However theoretical studies of the full nonlinear theory, initiated by Bondi et al (1962 Proc. R. Soc. A 269 21-51), Sachs (1962 Proc. R. Soc. A 270 103-26) and Newman and Unti (1962 J. Math. Phys. 3 891-901), rely on careful, clever, a priori choices of a chart (and tetrad) and so are not readily accessible to the numerical relativist, who chooses her/his chart on the basis of quite different grounds. This paper seeks to close this gap. Starting from data available in a typical numerical evolution, we construct a chart and tetrad which are, asymptotically, sufficiently close to the theoretical ones, so that the key concepts of the Bondi news function, Bondi mass and its rate of decrease can be estimated. In particular, these estimates can be expressed in the numerical relativist's chart as numerical relativity recipes.

  19. Numerical solution of Boltzmann's equation

    International Nuclear Information System (INIS)

    Sod, G.A.

    1976-04-01

    The numerical solution of Boltzmann's equation is considered for a gas model consisting of rigid spheres by means of Hilbert's expansion. If only the first two terms of the expansion are retained, Boltzmann's equation reduces to the Boltzmann-Hilbert integral equation. Successive terms in the Hilbert expansion are obtained by solving the same integral equation with a different source term. The Boltzmann-Hilbert integral equation is solved by a new very fast numerical method. The success of the method rests upon the simultaneous use of four judiciously chosen expansions; Hilbert's expansion for the distribution function, another expansion of the distribution function in terms of Hermite polynomials, the expansion of the kernel in terms of the eigenvalues and eigenfunctions of the Hilbert operator, and an expansion involved in solving a system of linear equations through a singular value decomposition. The numerical method is applied to the study of the shock structure in one space dimension. Numerical results are presented for Mach numbers of 1.1 and 1.6. 94 refs, 7 tables, 1 fig

  20. Numerical experiments with neural networks

    International Nuclear Information System (INIS)

    Miranda, Enrique.

    1990-01-01

    Neural networks are highly idealized models which, in spite of their simplicity, reproduce some key features of the real brain. In this paper, they are introduced at a level adequate for an undergraduate computational physics course. Some relevant magnitudes are defined and evaluated numerically for the Hopfield model and a short term memory model. (Author)

  1. Gaps in nonsymmetric numerical semigroups

    International Nuclear Information System (INIS)

    Fel, Leonid G.; Aicardi, Francesca

    2006-12-01

    There exist two different types of gaps in the nonsymmetric numerical semigroups S(d 1 , . . . , d m ) finitely generated by a minimal set of positive integers {d 1 , . . . , d m }. We give the generating functions for the corresponding sets of gaps. Detailed description of both gap types is given for the 1st nontrivial case m = 3. (author)

  2. Numerical simulation in plasma physics

    International Nuclear Information System (INIS)

    Samarskii, A.A.

    1980-01-01

    Plasma physics is not only a field for development of physical theories and mathematical models but also an object of application of the computational experiment comprising analytical and numerical methods adapted for computers. The author considers only MHD plasma physics problems. Examples treated are dissipative structures in plasma; MHD model of solar dynamo; supernova explosion simulation; and plasma compression by a liner. (Auth.)

  3. Numerical computation of MHD equilibria

    International Nuclear Information System (INIS)

    Atanasiu, C.V.

    1982-10-01

    A numerical code for a two-dimensional MHD equilibrium computation has been carried out. The code solves the Grad-Shafranov equation in its integral form, for both formulations: the free-boundary problem and the fixed boundary one. Examples of the application of the code to tokamak design are given. (author)

  4. Numerical Calabi-Yau metrics

    International Nuclear Information System (INIS)

    Douglas, Michael R.; Karp, Robert L.; Lukic, Sergio; Reinbacher, Rene

    2008-01-01

    We develop numerical methods for approximating Ricci flat metrics on Calabi-Yau hypersurfaces in projective spaces. Our approach is based on finding balanced metrics and builds on recent theoretical work by Donaldson. We illustrate our methods in detail for a one parameter family of quintics. We also suggest several ways to extend our results

  5. Numerical modeling of slow shocks

    International Nuclear Information System (INIS)

    Winske, D.

    1987-01-01

    This paper reviews previous attempt and the present status of efforts to understand the structure of slow shocks by means of time dependent numerical calculations. Studies carried out using MHD or hybrid-kinetic codes have demonstrated qualitative agreement with theory. A number of unresolved issues related to hybrid simulations of the internal shock structure are discussed in some detail. 43 refs., 8 figs

  6. The risk

    International Nuclear Information System (INIS)

    Olin, N.; Delmestre, A.; Baumont, G.; El Jammal, M.H.; Brucker, G.; Mettendorf, M.; Kervern, G.Y.; Amalberti, R.; Digoin, A.; Lagrange, V.; Duval, D.; Setbon, M.; Godard, O.; Lagadec, P.; Heriard Dubreuil, G.; Miserey, Y.; Delalonde, J.C.; Solomarska, E.

    2006-01-01

    In this issue is studied the risk analysis in nuclear industry. The different chapters are the risk, its perception and its control; the measure of the perception of risks; misunderstanding, a limit for transparency policy. About the running systems on risk, the practical applications of research on the science of danger are detailed; human factors approaches, errors and risk is tackled and also human factors at the centre of safety progress by taking expert methods and transforming them into practical tools for managers; an example is given through the technological risks analysis rule in Total industrial group, or how harmonizing the methods to increase the performance; Some thoughts about the risks and its perception, the principle of precaution, the emergencies and breaking situations on the borderline of chaos; the civil society at the heart of the governance of activities generating risks; two stories, one is about the difficulties to get information, including about the passage of the cloud from Chernobyl, the second one is the account of an inhabitant of Chernobyl. (N.C.)

  7. Total Phenol amd Flavonoid contents of Crude Extract and Fractions ...

    African Journals Online (AJOL)

    Phenolic compounds are numerous in plants and are essential part of human diet. Picralima nitida has been extensively used in African folk medicine especially in West Africa. The present study evaluated the total phenolic and flavonoid contents of the extract and fractions of Picralima nitida. The methanol extracts of P.

  8. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  9. Congruences of totally geodesic surfaces

    International Nuclear Information System (INIS)

    Plebanski, J.F.; Rozga, K.

    1989-01-01

    A general theory of congruences of totally geodesic surfaces is presented. In particular their classification, based on the properties of induced affine connections, is provided. In the four-dimensional case canonical forms of the metric tensor admitting congruences of two-dimensional totally geodesic surfaces of rank one are given. Finally, congruences of two-dimensional extremal surfaces are studied. (author)

  10. The risk factor of thyroid

    International Nuclear Information System (INIS)

    Kusama, Tomoko

    1979-01-01

    For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10 - 6 rem - 1 . This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10 - 6 yr - 1 . This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)

  11. The role of organization and culture in risk management

    International Nuclear Information System (INIS)

    Rodney, G.A.

    1992-01-01

    Technology-based organizations recognize that risk is an inherent element of their business. The challenge for managers is to determine an approach to risk that balances operational requirements with safety policies and regulations. The consequences of a safety approach that is not rigorous enough can be serious. Yet, attempting to achieve a totally risk-free operation literally can preclude much of the risk-taking that must characterize high-technology programs. Achieving true balance between performance and safety means first determining the level of risk that is acceptable to your organization. One of the first steps is to understand how the organizational structure and culture influence risk decisions. Organizational structure defines the manner in which the work force will participate in the risk decision-making process and whether they will have the necessary resources to estimate risk effectively. While numerous analysis techniques are available to predict and evaluate technical risks, it's more difficult to gauge the intangible impact of culture. Culture refers to the prevailing safety attitudes in the workplace and the methods used to evaluate risk. For this discussion, risk refers to safety and mission success. Application can be made to the nuclear industry

  12. Numerical simulation investigation on centrifugal compressor performance of turbocharger

    International Nuclear Information System (INIS)

    Li, Jie; Yin, Yuting; Li, Shuqi; Zhang, Jizhong

    2013-01-01

    In this paper, the mathematical model of the flow filed in centrifugal compressor of turbocharger was studied. Based on the theory of computational fluid dynamics (CFD), performance curves and parameter distributions of the compressor were obtained from the 3-D numerical simulation by using CFX. Meanwhile, the influences of grid number and distribution on compressor performance were investigated, and numerical calculation method was analyzed and validated, through combining with test data. The results obtained show the increase of the grid number has little influence on compressor performance while the grid number of single-passage is above 300,000. The results also show that the numerical calculation mass flow rate of compressor choke situation has a good consistent with test results, and the maximum difference of the diffuser exit pressure between simulation and experiment decrease to 3.5% with the assumption of 6 kPa additional total pressure loss at compressor inlet. The numerical simulation method in this paper can be used to predict compressor performance, and the difference of total pressure ratio between calculation and test is less than 7%, and the total-to-total efficiency also have a good consistent with test.

  13. Numerical characterization of nanopillar photonic crystal waveguides and directional couplers

    DEFF Research Database (Denmark)

    Chigrin, Dmitry N.; Lavrinenko, Andrei; Sotomayor Torres, Clivia M.

    2005-01-01

    We numerically characterize a novel type of a photonic crystal waveguide, which consists of several rows of periodically arranged dielectric cylinders. In such a nanopillar photonic crystal waveguide, light confinement is due to the total internal reflection. A nanopillar waveguide is a multimode...

  14. Numerical simulation investigation on centrifugal compressor performance of turbocharger

    Energy Technology Data Exchange (ETDEWEB)

    Li, Jie [China Iron and Steel Research Institute Group, Beijing (China); Yin, Yuting [China North Engine Research Institute, Datong (China); Li, Shuqi; Zhang, Jizhong [Science and Technology Diesel Engine Turbocharging Laboratory, Datong (China)

    2013-06-15

    In this paper, the mathematical model of the flow filed in centrifugal compressor of turbocharger was studied. Based on the theory of computational fluid dynamics (CFD), performance curves and parameter distributions of the compressor were obtained from the 3-D numerical simulation by using CFX. Meanwhile, the influences of grid number and distribution on compressor performance were investigated, and numerical calculation method was analyzed and validated, through combining with test data. The results obtained show the increase of the grid number has little influence on compressor performance while the grid number of single-passage is above 300,000. The results also show that the numerical calculation mass flow rate of compressor choke situation has a good consistent with test results, and the maximum difference of the diffuser exit pressure between simulation and experiment decrease to 3.5% with the assumption of 6 kPa additional total pressure loss at compressor inlet. The numerical simulation method in this paper can be used to predict compressor performance, and the difference of total pressure ratio between calculation and test is less than 7%, and the total-to-total efficiency also have a good consistent with test.

  15. Numerical Calculation of the Output Power of a MHD Generator

    Directory of Open Access Journals (Sweden)

    Adrian CARABINEANU

    2014-12-01

    Full Text Available Using Lazăr Dragoş’s analytic solution for the electric potential we perform some numerical calculations in order to find the characteristics of a Faraday magnetohydrodymamics (MHD power generator (total power, useful power and Joule dissipation power.

  16. Numerical simulation of installation of skirt foundations

    Energy Technology Data Exchange (ETDEWEB)

    Vangelsten, Bjoern Vidar

    1997-12-31

    Skirt foundation has been increasingly used for permanent offshore oil installations and anchors for drilling ships. Suction is commonly used in skirt foundation installing. If a large amount of suction is applied, the soil around the foundation may fail and the foundation become useless. This thesis studies failure due to high seepage gradients, aiming to provide a basis for reducing the risk of such failures. Skirt penetration model testing has shown that to solve the problem one must understand what is going on at the skirt tip during suction installation. A numerical model based on micro mechanics was developed as continuum hypothesis was seen to be unsuitable to describe the processes in the critical phases of the failure. The numerical model combines two-dimensional elliptical particles with the finite difference method for flow to model water flow in a granular material. The key idea is to formulate the permeability as a function of the porosity of the grain assembly and so obtain an interaction between the finite difference method on flow and the particle movement. A computer program, DYNELL, was developed and used to simulate: (1) weight penetration of a skirt wall, (2) combined suction and weight penetration of a skirt wall, and (3) critical gradient tests around a skirt wall to study failure mechanisms. The model calculations agree well with laboratory experiments. 16 refs., 124 figs., 21 tabs.

  17. Risk evaluation for structures

    International Nuclear Information System (INIS)

    Freudenthal, A.M.; Schueller, G.I.

    1976-01-01

    The basic principles of the risk analysis, which is based on classical statistics is discussed. The significance of the Asymptotic (Extreme Value) distributions as well as the method of basing the level of acceptable risk on economical optimization procedures is pointed out. The application of the risk analysis to special type structures such as fixed offshore platforms, television towers, reactor containments and the reliability of reactor components under creep and fatigue load is elaborated by carrying out numerical examples. (orig./HP) [de

  18. Totality eclipses of the Sun

    CERN Document Server

    Littmann, Mark; Willcox, Ken

    2008-01-01

    A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. - ;A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. Totality: Eclipses of the Sun is the best guide and reference book on solar eclipses ever written. It explains: how to observe them; how to photograph and videotape them; why they occur; their history and mythology; and future eclipses - when and where to see them. Totality also tells the remarkable story of how eclipses shocked scientists, revealed the workings of the Sun, and made Einstein famous. And the book shares the experiences and advice of many veteran eclipse observers. Totality: Eclipses of the Sun is profusely ill...

  19. Numerical simulation of Higgs models

    International Nuclear Information System (INIS)

    Jaster, A.

    1995-10-01

    The SU(2) Higgs and the Schwinger model on the lattice were analysed. Numerical simulations of the SU(2) Higgs model were performed to study the finite temperature electroweak phase transition. With the help of the multicanonical method the distribution of an order parameter at the phase transition point was measured. This was used to obtain the order of the phase transition and the value of the interface tension with the histogram method. Numerical simulations were also performed at zero temperature to perform renormalization. The measured values for the Wilson loops were used to determine the static potential and from this the renormalized gauge coupling. The Schwinger model was simulated at different gauge couplings to analyse the properties of the Kaplan-Shamir fermions. The prediction that the mass parameter gets only multiplicative renormalization was tested and verified. (orig.)

  20. Numerical methods for metamaterial design

    CERN Document Server

    2013-01-01

    This book describes a relatively new approach for the design of electromagnetic metamaterials.  Numerical optimization routines are combined with electromagnetic simulations to tailor the broadband optical properties of a metamaterial to have predetermined responses at predetermined wavelengths. After a review of both the major efforts within the field of metamaterials and the field of mathematical optimization, chapters covering both gradient-based and derivative-free design methods are considered.  Selected topics including surrogate-base optimization, adaptive mesh search, and genetic algorithms are shown to be effective, gradient-free optimization strategies.  Additionally, new techniques for representing dielectric distributions in two dimensions, including level sets, are demonstrated as effective methods for gradient-based optimization.  Each chapter begins with a rigorous review of the optimization strategy used, and is followed by numerous examples that combine the strategy with either electromag...