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Sample records for variables influence outcomes

  1. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes.

    Science.gov (United States)

    Fedewa, Alicia L; Ahn, Soyeon; Reese, Robert J; Suarez, Marietta M; Macquoid, Ahjane; Davis, Matthew C; Prout, H Thompson

    2016-06-01

    The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  2. Influence of Flow Sequencing Attributed to Climate Change and Climate Variability on the Assessment of Water-dependent Ecosystem Outcomes

    Science.gov (United States)

    Wang, J.; Nathan, R.; Horne, A.

    2017-12-01

    Traditional approaches to characterize water-dependent ecosystem outcomes in response to flow have been based on time-averaged hydrological indicators, however there is increasing recognition for the need to characterize ecological processes that are highly dependent on the sequencing of flow conditions (i.e. floods and droughts). This study considers the representation of flow regimes when considering assessment of ecological outcomes, and in particular, the need to account for sequencing and variability of flow. We conducted two case studies - one in the largely unregulated Ovens River catchment and one in the highly regulated Murray River catchment (both located in south-eastern Australia) - to explore the importance of flow sequencing to the condition of a typical long-lived ecological asset in Australia, the River Red Gum forests. In the first, the Ovens River case study, the implications of representing climate change using different downscaling methods (annual scaling, monthly scaling, quantile mapping, and weather generator method) on the sequencing of flows and resulting ecological outcomes were considered. In the second, the Murray River catchment, sequencing within a historic drought period was considered by systematically making modest adjustments on an annual basis to the hydrological records. In both cases, the condition of River Red Gum forests was assessed using an ecological model that incorporates transitions between ecological conditions in response to sequences of required flow components. The results of both studies show the importance of considering how hydrological alterations are represented when assessing ecological outcomes. The Ovens case study showed that there is significant variation in the predicted ecological outcomes when different downscaling techniques are applied. Similarly, the analysis in the Murray case study showed that the drought as it historically occurred provided one of the best possible outcomes for River Red Gum

  3. Language and speech outcomes of children with hearing loss and additional disabilities: Identifying the variables that influence performance at 5 years of age

    Science.gov (United States)

    Cupples, Linda; Ching, Teresa Y.C.; Button, Laura; Leigh, Greg; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise

    2016-01-01

    Objective This study examined language and speech outcomes in young children with hearing loss and additional disabilities. Design Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). Study sample A population-based cohort of 146 5-year-old children with hearing loss and additional disabilities took part. Results Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. Conclusions The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data. PMID:27630013

  4. About hidden influence of predictor variables: Suppressor and mediator variables

    Directory of Open Access Journals (Sweden)

    Milovanović Boško

    2013-01-01

    Full Text Available In this paper procedure for researching hidden influence of predictor variables in regression models and depicting suppressor variables and mediator variables is shown. It is also shown that detection of suppressor variables and mediator variables could provide refined information about the research problem. As an example for applying this procedure, relation between Atlantic atmospheric centers and air temperature and precipitation amount in Serbia is chosen. [Projekat Ministarstva nauke Republike Srbije, br. 47007

  5. Variables influencing wearable sensor outcome estimates in individuals with stroke and incomplete spinal cord injury: a pilot investigation validating two research grade sensors.

    Science.gov (United States)

    Jayaraman, Chandrasekaran; Mummidisetty, Chaithanya Krishna; Mannix-Slobig, Alannah; McGee Koch, Lori; Jayaraman, Arun

    2018-03-13

    Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI). The main objective of this cross-sectional investigation was to evaluate the validity of physical activity estimates provided by standard proprietary algorithms for individuals with stroke and iSCI. Two research grade wearable sensors used in clinical settings were chosen and the outcome metrics estimated using standard proprietary algorithms were validated against designated golden standard measures (Cosmed K4B2 for energy expenditure and metabolic equivalent and manual tallying for step counts). The influence of sensor location, sensor type and activity characteristics were also studied. 28 participants (Healthy (n = 10); incomplete SCI (n = 8); stroke (n = 10)) performed a spectrum of activities in a laboratory setting using two wearable sensors (ActiGraph and Metria-IH1) at different body locations. Manufacturer provided standard proprietary algorithms estimated the step count, energy expenditure (EE) and metabolic equivalent (MET). These estimates were compared with the estimates from gold standard measures. For verifying validity, a series of Kruskal Wallis ANOVA tests (Games-Howell multiple comparison for post-hoc analyses) were conducted to compare the mean rank and absolute agreement of outcome metrics estimated by each of the devices in comparison with the designated gold standard measurements. The sensor type, sensor location

  6. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  7. Econometrics in outcomes research: the use of instrumental variables.

    Science.gov (United States)

    Newhouse, J P; McClellan, M

    1998-01-01

    We describe an econometric technique, instrumental variables, that can be useful in estimating the effectiveness of clinical treatments in situations when a controlled trial has not or cannot be done. This technique relies upon the existence of one or more variables that induce substantial variation in the treatment variable but have no direct effect on the outcome variable of interest. We illustrate the use of the technique with an application to aggressive treatment of acute myocardial infarction in the elderly.

  8. Influence of Cognitive Variables in the Iowa Gambling Task

    Directory of Open Access Journals (Sweden)

    Marino D., Julián C.

    2010-07-01

    Full Text Available The objective of this work was to analyze the influence of cognitive and personality variables in the Decision Making (DM construct, evaluated by the Iowa Gambling Task (IGT. For this propose, a battery of neuropsychological tests was applied to 116 individuals of both genders between 18 and 35 years olds. The results showed that the IGT performance was not associated to the cognitive variables evaluated, only it has been found moderated relationship between working memory and DM. These outcomes suggest that DM seems to be an independent construct of the “cool” cognitive functions and could be influenced for the emotional or motivational aspects related to “hot” cognitive process. Finally, the DM process seems to be more associated to the ability to avoid punishment than the capacity of evaluate long term benefits.

  9. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    Science.gov (United States)

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Instrumental variable estimation of treatment effects for duration outcomes

    NARCIS (Netherlands)

    G.E. Bijwaard (Govert)

    2007-01-01

    textabstractIn this article we propose and implement an instrumental variable estimation procedure to obtain treatment effects on duration outcomes. The method can handle the typical complications that arise with duration data of time-varying treatment and censoring. The treatment effect we

  11. Assessing the Impact of Socioeconomic Variables on Small Area Variations in Suicide Outcomes in England

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    Peter Congdon

    2012-12-01

    Full Text Available Ecological studies of suicide and self-harm have established the importance of area variables (e.g., deprivation, social fragmentation in explaining variations in suicide risk. However, there are likely to be unobserved influences on risk, typically spatially clustered, which can be modeled as random effects. Regression impacts may be biased if no account is taken of spatially structured influences on risk. Furthermore a default assumption of linear effects of area variables may also misstate or understate their impact. This paper considers variations in suicide outcomes for small areas across England, and investigates the impact on them of area socio-economic variables, while also investigating potential nonlinearity in their impact and allowing for spatially clustered unobserved factors. The outcomes are self-harm hospitalisations and suicide mortality over 6,781 Middle Level Super Output Areas.

  12. Influence of paternal age on perinatal outcomes.

    Science.gov (United States)

    Hurley, Emily G; DeFranco, Emily A

    2017-11-01

    There is an increasing trend to delay childbearing to advanced parental age. Increased risks of advanced maternal age and assisted reproductive technologies are widely accepted. There are limited data regarding advanced paternal age. To adequately counsel patients on risk, more research regarding advanced paternal age is necessary. We sought to determine the influence of paternal age on perinatal outcomes, and to assess whether this influence differs between pregnancies achieved spontaneously and those achieved with assisted reproductive technology. A population-based retrospective cohort study of all live births in Ohio from 2006 through 2012 was completed. Data were evaluated to determine if advanced paternal age is associated with an increased risk of adverse outcomes in pregnancies. The analysis was stratified by status of utilization of assisted reproductive technology. Generalized linear regression models assessed the association of paternal age on pregnancy complications in assisted reproductive technology and spontaneously conceived pregnancies, after adjusting for maternal age, race, multifetal gestation, and Medicaid status, using Stata software (Stata, Release 12; StataCorp, College Station, TX). Paternal age was documented in 82.2% of 1,034,552 live births in Ohio during the 7-year study period. Paternal age ranged from 12-87 years, with a median of 30 (interquartile range, 26-35) years. Maternal age ranged from 11-62 years, with a median of 27 (interquartile range, 22-31) years. The use of assisted reproductive technology in live births increased as paternal age increased: 0.1% 60 years, P risk factors, increased paternal age was not associated with a significant increase in the rate of preeclampsia, preterm birth, fetal growth restriction, congenital anomaly, genetic disorder, or neonatal intensive care unit admission. The influence of paternal age on pregnancy outcomes was similar in pregnancies achieved with and without assisted reproductive

  13. Influence of chemoreflexes on respiratory variability in healthy subjects

    NARCIS (Netherlands)

    van den Aardweg, Joost G.; Karemaker, John M.

    2002-01-01

    The background of this study was the hypothesis that respiratory variability is influenced by chemoreflex regulation, In search for periodicities in the variability due to instability of the respiratory control system, spectral analysis was applied to breath-to-breath variables in 19 healthy

  14. Side effects as influencers of treatment outcome.

    Science.gov (United States)

    Sharif, Zafar

    2008-01-01

    Research relative to the efficacy of a therapeutic agent commands a clinician's greatest interest, but treatment decisions are made based on optimizing efficacy and tolerability/safety considerations. Second-generation atypical antipsychotic drugs are a study in the importance of taking a careful look at the full benefit-risk profile of each drug. The disorders that atypical antipsychotics are approved to treat--schizophrenia, schizoaffective disorder, and bipolar disorder--are associated with an increased rate of certain medical comorbidities compared to the general population. Between-drug differences in efficacy are relatively modest for the atypicals, or between atypicals and conventionals, while differences in safety and tolerability are larger and more clinically relevant. The current article will provide a brief summary of safety-related issues that influence treatment outcome and choice of drug.

  15. What variables can influence clinical reasoning?

    Directory of Open Access Journals (Sweden)

    Vahid Ashoorion

    2012-01-01

    Full Text Available Background: Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Materials and Methods: Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. Results: There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34 (R 2 chnage = 0.46, P Value = 0.000. Conclusion: Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales is the only variable that can be used for clinical reasoning prediction.

  16. What variables can influence clinical reasoning?

    Science.gov (United States)

    Ashoorion, Vahid; Liaghatdar, Mohammad Javad; Adibi, Peyman

    2012-12-01

    Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34) (R(2) chnage = 0.46, P Value = 0.000). Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales) is the only variable that can be used for clinical reasoning prediction.

  17. The influence of socio-economic variables on adoption behaviour ...

    African Journals Online (AJOL)

    The influence of socio-economic variables on adoption behaviour towards Tadco improved rice parboiling technique among rice parboilers in Kura processing Areas ... Age and educational level were found to be associated with non adoption ...

  18. Frog eat frog: exploring variables influencing anurophagy.

    Science.gov (United States)

    Measey, G John; Vimercati, Giovanni; de Villiers, F André; Mokhatla, Mohlamatsane M; Davies, Sarah J; Edwards, Shelley; Altwegg, Res

    2015-01-01

    Background. Frogs are generalist predators of a wide range of typically small prey items. But descriptions of dietary items regularly include other anurans, such that frogs are considered to be among the most important of anuran predators. However, the only existing hypothesis for the inclusion of anurans in the diet of post-metamorphic frogs postulates that it happens more often in bigger frogs. Moreover, this hypothesis has yet to be tested. Methods. We reviewed the literature on frog diet in order to test the size hypothesis and determine whether there are other putative explanations for anurans in the diet of post-metamorphic frogs. In addition to size, we recorded the habitat, the number of other sympatric anuran species, and whether or not the population was invasive. We controlled for taxonomic bias by including the superfamily in our analysis. Results. Around one fifth of the 355 records included anurans as dietary items of populations studied, suggesting that frogs eating anurans is not unusual. Our data showed a clear taxonomic bias with ranids and pipids having a higher proportion of anuran prey than other superfamilies. Accounting for this taxonomic bias, we found that size in addition to being invasive, local anuran diversity, and habitat produced a model that best fitted our data. Large invasive frogs that live in forests with high anuran diversity are most likely to have a higher proportion of anurans in their diet. Conclusions. We confirm the validity of the size hypothesis for anurophagy, but show that there are additional significant variables. The circumstances under which frogs eat frogs are likely to be complex, but our data may help to alert conservationists to the possible dangers of invading frogs entering areas with threatened anuran species.

  19. Frog eat frog: exploring variables influencing anurophagy

    Directory of Open Access Journals (Sweden)

    G. John Measey

    2015-08-01

    Full Text Available Background. Frogs are generalist predators of a wide range of typically small prey items. But descriptions of dietary items regularly include other anurans, such that frogs are considered to be among the most important of anuran predators. However, the only existing hypothesis for the inclusion of anurans in the diet of post-metamorphic frogs postulates that it happens more often in bigger frogs. Moreover, this hypothesis has yet to be tested.Methods. We reviewed the literature on frog diet in order to test the size hypothesis and determine whether there are other putative explanations for anurans in the diet of post-metamorphic frogs. In addition to size, we recorded the habitat, the number of other sympatric anuran species, and whether or not the population was invasive. We controlled for taxonomic bias by including the superfamily in our analysis.Results. Around one fifth of the 355 records included anurans as dietary items of populations studied, suggesting that frogs eating anurans is not unusual. Our data showed a clear taxonomic bias with ranids and pipids having a higher proportion of anuran prey than other superfamilies. Accounting for this taxonomic bias, we found that size in addition to being invasive, local anuran diversity, and habitat produced a model that best fitted our data. Large invasive frogs that live in forests with high anuran diversity are most likely to have a higher proportion of anurans in their diet.Conclusions. We confirm the validity of the size hypothesis for anurophagy, but show that there are additional significant variables. The circumstances under which frogs eat frogs are likely to be complex, but our data may help to alert conservationists to the possible dangers of invading frogs entering areas with threatened anuran species.

  20. Variables that influence junior secondary school students‟ attitude ...

    African Journals Online (AJOL)

    The positive relationship between the rate of learning, attitude to and achievement in science has been documented in literature. It is therefore pertinent to assess the variables that tend to influence students' attitude to Agricultural Science. The study assessed the influence of gender, location of school and sex composition ...

  1. Environmental Variables That Influence Patient Satisfaction: A Review of the Literature.

    Science.gov (United States)

    MacAllister, Lorissa; Zimring, Craig; Ryherd, Erica

    2016-10-01

    Patient's perception of care-referred to as patient satisfaction-is of great interest in the healthcare industry, as it becomes more directly tied to the revenue of the health system providers. The perception of care has now become important in addition to the actual health outcome of the patient. The known influencers for the patient perception of care are the patient's own characteristics as well as the quality of service received. In patient surveys, the physical environment is noted as important for being clean and quiet but is not considered a critical part of patient satisfaction or other health outcomes. Patient perception of care is currently measured as patient satisfaction, a systematic collection of perceptions of social interactions from an individual person as well as their interaction with the environment. This exploration of the literature intends to explore the rigorous, statistically tested research conducted that has a spatial predictor variable and a health or behavior outcome, with the intent to begin to further test the relationships of these variables in the future studies. This literature review uses the patient satisfaction framework of components of influence and identifies at least 10 known spatial environmental variables that have been shown to have a direct connection to the health and behavior outcome of a patient. The results show that there are certain features of the spatial layout and environmental design in hospital or work settings that influence outcomes and should be noted in the future research. © The Author(s) 2016.

  2. Crossing safety barriers: influence of children's morphological and functional variables.

    Science.gov (United States)

    Cordovil, Rita; Vieira, Filomena; Barreiros, João

    2012-05-01

    Thirty-three children between 3 and 6 years of age were asked to climb four different types of safety barriers. Morphological and functional variables of the children, which were expected to influence climbing or passing through skills, were collected. The influence of those variables on children's success rate and time to cross was tested. No barrier offered a total restraining efficacy. The horizontal bars barrier was crossed by 97% of the children. In the group of children that succeeded in crossing the four barriers, mean time to cross the most difficult barrier was 15 s. Age was the best predictor for success in crossing most barriers but morphology and strength were important predictors of time to cross. The influence of anthropometric variables in time to cross was dependent upon the characteristics of the barrier. A good design of safety barriers should consider children's age, morphology and strength. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. Topographic variability influences the carbon sequestration potential of arable soils

    DEFF Research Database (Denmark)

    Chirinda, Ngoni; Elsgaard, Lars; Thomsen, Ingrid Kaag

    2012-01-01

    There is presently limited knowledge on the influence of field spatial variability on the carbon (C) sink-source relationships in arable landscapes. This is accompanied by the fact that our understanding of soil profile C dynamics is also limited. This study aimed at investigating how spatial...... results indicated that variability across arable landscapes makes footslope soils both a larger sink of buried soil C and a bigger potential CO2 source than upslope soils....

  4. Prognostic indicators influencing short term outcomes among ...

    African Journals Online (AJOL)

    Background: Head injury causes significant morbidity and mortalityand accounts for about 10 million cases globally. In Tanzaniait's the most common type of injury contributing about 32% to 50% of all trauma patients. Favorable outcomes for head injury patients depends on initial evaluation and proper timely intervention.

  5. Relative Influence Of Sociodemographic Variables On Oral Health ...

    African Journals Online (AJOL)

    This paper reports the results of a study to investigate the relative influence of some sociodemographic variables on oral hygiene and health of primary school children in Ibadan, Nigeria. The pupils were from two different socioeconomic strata of the society and their ages ranged between 7 and 16 years. They were ...

  6. Influence of environmental factors on birth weight variability of ...

    African Journals Online (AJOL)

    The present investigation was carried out to study the influence of environmental factors on the birth weight variability of two breeds of sheep. Animals used in this research were taken from the Pirot and Svrljig indigenous sheep breeds. The data were collected from 1999 to 2009 and were analyzed to determine the effect of ...

  7. The Influence of Independent and Intervening Variables on Adoption ...

    African Journals Online (AJOL)

    that each investigated intervening variable has influence on adoption of ... testing of the model in different social cultural settings and crops to see its ...... Mexico. Crook, T. R., Tood, S.Y., Combs, J. G., Woehr,. D. J. and Ketchen, D. J. (2011).

  8. Variability in estuarine water temperature gradients and influence on ...

    African Journals Online (AJOL)

    Structure and variability of water temperature gradients and potential influence on distribution of two tropical zooplankters (the mysid Mesopodopsis africana and the copepod Acartia natalensis) and their temperate congenerics (M. wooldridgei and A. longipatella) was investigated over a 10-year period in the Mgazi Estuary, ...

  9. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences.

    Science.gov (United States)

    Hanauer, David I; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach's alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. © 2015 D. I. Hanauer and G. Hatfull. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  10. The influence of climate variables on dengue in Singapore.

    Science.gov (United States)

    Pinto, Edna; Coelho, Micheline; Oliver, Leuda; Massad, Eduardo

    2011-12-01

    In this work we correlated dengue cases with climatic variables for the city of Singapore. This was done through a Poisson Regression Model (PRM) that considers dengue cases as the dependent variable and the climatic variables (rainfall, maximum and minimum temperature and relative humidity) as independent variables. We also used Principal Components Analysis (PCA) to choose the variables that influence in the increase of the number of dengue cases in Singapore, where PC₁ (Principal component 1) is represented by temperature and rainfall and PC₂ (Principal component 2) is represented by relative humidity. We calculated the probability of occurrence of new cases of dengue and the relative risk of occurrence of dengue cases influenced by climatic variable. The months from July to September showed the highest probabilities of the occurrence of new cases of the disease throughout the year. This was based on an analysis of time series of maximum and minimum temperature. An interesting result was that for every 2-10°C of variation of the maximum temperature, there was an average increase of 22.2-184.6% in the number of dengue cases. For the minimum temperature, we observed that for the same variation, there was an average increase of 26.1-230.3% in the number of the dengue cases from April to August. The precipitation and the relative humidity, after analysis of correlation, were discarded in the use of Poisson Regression Model because they did not present good correlation with the dengue cases. Additionally, the relative risk of the occurrence of the cases of the disease under the influence of the variation of temperature was from 1.2-2.8 for maximum temperature and increased from 1.3-3.3 for minimum temperature. Therefore, the variable temperature (maximum and minimum) was the best predictor for the increased number of dengue cases in Singapore.

  11. Variables influencing medical student learning in the operating room.

    Science.gov (United States)

    Schwind, Cathy J; Boehler, Margaret L; Rogers, David A; Williams, Reed G; Dunnington, Gary; Folse, Roland; Markwell, Stephen J

    2004-02-01

    The operating room (OR) is an important venue where surgeons do much of medical student teaching and yet there has been little work evaluating variables that influence learning in this unique environment. We designed this study to identify variables that affected medical student learning in the OR. We developed a questionnaire based on surgery faculty observations of learning in the OR. The medical students completed the questionnaire on 114 learning episodes in the OR. Pearson correlation coefficient was used to establish the strength of association between various variables and the student's overall perception of learning. The students evaluated 27 variables that might impact their learning in the OR. Strong correlations were identified between the attending physician's attitude, interactions and teaching ability in the OR and the environment being conducive to learning. Surgical faculty behavior is a powerful determinant of student perceptions of what provides for a favorable learning environment in the OR.

  12. Does gender influence outcomes in critically ill patients?

    OpenAIRE

    Angele, Martin K; Pratschke, Sebastian; Chaudry, Irshad H

    2012-01-01

    Investigators continue to debate whether gender plays any role in patient outcome following injury/critical illness. We submit that age and hormonal milieu at the time of injury, rather than gender, are the critical factors influencing patient outcome under those conditions.

  13. Infertility and Weight Reduction: Influence and Outcome

    International Nuclear Information System (INIS)

    Khaskheli, M. N.; Baloch, S.; Baloch, A. S.

    2013-01-01

    Objective: To assess the effect of weight reduction in obese infertile women on conception rate spontaneously as well as with ovulation induction and pregnancy outcome. Study Design: Observational experimental study. Place and Duration of Study: Different private clinics at Mirpurkhas, Thana Bola Khan and Hyderabad, Sindh, Pakistan, from March 2008 to February 2011. Methodology: Infertile women who were obese with the body mass index (BMI) > 30 kg/ m2 and failed to conceive within 2-5 years after taking treatment of infertility for many cycles were inducted. These women underwent life style change program related to exercise and diet for 6 months and in the next 6 months they were observed for spontaneous conception. Those women who failed to conceive were prescribed ovulation induction (clomifene citrate) for the next 6 months and were observed for conception. After conception, they visited regularly during antenatal period till delivery. The data was collected and analyzed on SPSS version 17. Results: The mean decrease in the body index observed was 9.6 +- 1.23 kg/m2, spontaneous conception rate was (n = 35, 41.17%) and miscarriage rate was (n = 9, 16.66%). Conclusion: Weight reduction leads to high spontaneous conception rate as well as with ovulation induction therapy and improves the pregnancy outcome. (author)

  14. Evaluation of standardized and applied variables in predicting treatment outcomes of polytrauma patients.

    Science.gov (United States)

    Aksamija, Goran; Mulabdic, Adi; Rasic, Ismar; Muhovic, Samir; Gavric, Igor

    2011-01-01

    Polytrauma is defined as an injury where they are affected by at least two different organ systems or body, with at least one life-threatening injuries. Given the multilevel model care of polytrauma patients within KCUS are inevitable weaknesses in the management of this category of patients. To determine the dynamics of existing procedures in treatment of polytrauma patients on admission to KCUS, and based on statistical analysis of variables applied to determine and define the factors that influence the final outcome of treatment, and determine their mutual relationship, which may result in eliminating the flaws in the approach to the problem. The study was based on 263 polytrauma patients. Parametric and non-parametric statistical methods were used. Basic statistics were calculated, based on the calculated parameters for the final achievement of research objectives, multicoleration analysis, image analysis, discriminant analysis and multifactorial analysis were used. From the universe of variables for this study we selected sample of n = 25 variables, of which the first two modular, others belong to the common measurement space (n = 23) and in this paper defined as a system variable methods, procedures and assessments of polytrauma patients. After the multicoleration analysis, since the image analysis gave a reliable measurement results, we started the analysis of eigenvalues, that is defining the factors upon which they obtain information about the system solve the problem of the existing model and its correlation with treatment outcome. The study singled out the essential factors that determine the current organizational model of care, which may affect the treatment and better outcome of polytrauma patients. This analysis has shown the maximum correlative relationships between these practices and contributed to development guidelines that are defined by isolated factors.

  15. Influence of climate variability on large rivers runoff

    Directory of Open Access Journals (Sweden)

    B. Nurtaev

    2015-06-01

    Full Text Available In accordance with IPCC Report the influence of climate change on the water cycle will increase hydrologic variability by means of changing of precipitation patterns, melting of ice and change of runoff. Precipitation has increased in high northern latitudes and decreased in southern latitudes. This study presents an analysis of river runoffs trends in different climatic zones of the world in condition of climate change.

  16. Risk factors influencing the treatment outcome in diabetic macular oedema

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    1996-01-01

    Full Text Available A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p<0.05. The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively. Wavelength of the laser (argon or krypton used for treatment did not significantly influence the outcome.

  17. Personality traits in bipolar disorder and influence on outcome.

    Science.gov (United States)

    Sparding, Timea; Pålsson, Erik; Joas, Erik; Hansen, Stefan; Landén, Mikael

    2017-05-03

    The aim was to investigate the personality profile of bipolar disorder I and II, and healthy controls, and to study whether personality influences the course of bipolar disorder. One hundred ten patients with bipolar disorder I, 85 patients with bipolar disorder II, and 86 healthy individuals had their personality profile assessed using the Swedish universities Scales of Personality (SSP), an instrument developed to explore personality-related vulnerabilities and correlates of psychiatric disorders. Patients were followed prospectively for 2 years. To assess the impact of Neuroticism, Aggressiveness, and Disinhibition on illness course, we performed logistic regressions with the outcome variables mood episodes (depressive, hypo/manic, mixed), suicide attempts, violence, and the number of sick leave days. Bipolar disorder I and II demonstrated higher global measures of Neuroticism, Aggressiveness, and Disinhibition as compared with healthy controls. A third of the patients scored ≥1 SD above the population-based normative mean on the global neuroticism measure. The two subtypes of bipolar disorder were, however, undistinguishable on all of the personality traits. In the unadjusted model, higher neuroticism at baseline predicted future depressive episodes and suicide attempts/violent behavior, but this association disappeared when adjusting for baseline depressive symptoms as assessed with MADRS. A significant minority of the patients scored ≥1 SD above the population mean on the global measures of Neuroticism, Aggressiveness and Disinhibition; scores this high are usually evident clinically. Yet, the personality profile does not seem to have prognostic value over a 2-year period.

  18. Influence of attrition variables on iron ore flotation

    Directory of Open Access Journals (Sweden)

    Fabiana Fonseca Fortes

    Full Text Available Abstract The presence of slimes is harmful to the flotation process: the performance and consumption of reagents are negatively affected. Traditionally, the desliming stage has been responsible for removing slimes. However, depending on the porosity of the mineral particles, desliming may not be sufficient to maximize the concentration results. An attrition process before the desliming operation can improve the removal of slime, especially when slimes cover the surface and/or are confined to the cavities/pores of the mineral particles. Attrition is present in the flowcharts of the beneficiation process of phosphate and industrial sand (silica sand. Research has been undertaken for its application to produce pre-concentrates of zircon and iron ore. However, there is still little knowledge of the influence of the attrition variables on the beneficiation process of iron ore. This study presents a factorial design and analysis of the effects of these variables on the reverse flotation of iron ore. The standard of the experimental procedures for all tests included the attrition of pulp, under the conditions of dispersion, desliming and flotation. The parameter analysed (variable response was the metallurgical recovery in reverse flotation tests. The planning and analysis of the full factorial experiment indicated that with 95% reliability, the rotation speed of the attrition cell impeller was the main variable in the attrition process of the iron ore. The percentage of solid variables in the pulp and the time of the attrition, as well as their interactions, were not indicated to be significant.

  19. An examination of the variables influencing the fuel retail industry

    Directory of Open Access Journals (Sweden)

    K. Sartorius

    2007-12-01

    Full Text Available Purpose/objectives: The objective of the study is to contribute to a better understanding of the key variables that influence the profitability of this sector, as well as to develop a reliable model to predict retail fuel sales volumes in an urban setting. Problem investigated: South African fuel retail outlets are confronted by a wide range of variables that constrain profit and a significant number of outlets are not profitable. In the event of further deregulation, it is conceivable that many fuel stations will go out of business. Methodology: A combination of a quantitative and a case study methodology, in conjunction with a literature review, was used to test the principal research questions. Findings/implications: The results suggest that location significantly influences urban retail fuel sales volumes whilst fuel station size and the fuel price play a lesser role. Other significant factors, however, also influence fuel station profitability. The demand for petrol appears to be relatively inelastic in the short term and more elastic over the long term. Conversely, the demand for diesel appears to be completely inelastic. Value: The article promotes a better understanding of the cost dynamics of the fuel industry. In this regard, the model constructed to predict urban fuel station turnover indicated high levels of reliability. Furthermore, few comparable studies have been published in accounting journals. Conclusion: The study concludes that urban petrol stations selling more than 370 000 liters of fuel per month are likely to be profitable and that location is a key variable influencing sales. In the event of deregulation, many operators are likely to be eliminated because of high levels of competition and low profit margins. An even greater number of fuel stations, therefore, will be reliant on non forecourt activities to survive.

  20. Cytogenetic variability in pinus sylvestris L. populations experiencing anthropogenic influence

    International Nuclear Information System (INIS)

    Oudalova, A.; Geras'kin, S.; Vasiliev, D.; Dikarev, V.

    2004-01-01

    Techno-genic pollution has become one of the most significant ecological factors determining biosphere existence and development. An analysis of genetic consequences of the radiation accidents in the South Urals and Chernobyl has shown that mutation and recombination processes are considerably accelerated in plant and animal's populations experiencing techno-genic influence. This implies that there are complicated adaptation processes leading to changes in genetic structure of populations and increasing genetic load. Pinus sylvestris L. populations growing at the territory of the 'radon' Leningrad regional radioactive waste reprocessing enterprise and Sosnovy Bor town were monitored 6 years (1997-2002) by a set of cyto-genetical and morphological tests. Cytogenetic damage levels within intercalary meristem of needle as well as in root meristem of seedlings were found to significantly exceed corresponding controls. A higher radioresistance of the Scots pine seeds analyzed was demonstrated with an acute γ-radiation that also revealed a selection process directed at an enhancement of repair efficiency and resulting in a shift of mean values of radioresistance in populations towards higher values. An enlargement of variance of studied cytogenetic parameters was found in the populations experiencing techno-genic influence. This indicates, with an account of phenomenon of the enhanced radioresistance, that there are processes of cyto-genetical adaptation in the investigated regions. An analysis of the structure of ecological-genetical variability was carried out with the purpose of separating two components in the inter-population variability - the first is engaged to the genetically determined variability of biological characteristics intrinsic for this species, and the second is responsible for the variability originating from anthropogenic contamination of the natural habitat. Changes of these two types of variability were studied in dependence on time and techno

  1. Cytogenetic variability in pinus sylvestris L. populations experiencing anthropogenic influence

    Energy Technology Data Exchange (ETDEWEB)

    Oudalova, A.; Geras' kin, S.; Vasiliev, D.; Dikarev, V. [Russian Institute of Agricultural Radiology and Agroecology, Obninsk (Russian Federation)

    2004-07-01

    Techno-genic pollution has become one of the most significant ecological factors determining biosphere existence and development. An analysis of genetic consequences of the radiation accidents in the South Urals and Chernobyl has shown that mutation and recombination processes are considerably accelerated in plant and animal's populations experiencing techno-genic influence. This implies that there are complicated adaptation processes leading to changes in genetic structure of populations and increasing genetic load. Pinus sylvestris L. populations growing at the territory of the 'radon' Leningrad regional radioactive waste reprocessing enterprise and Sosnovy Bor town were monitored 6 years (1997-2002) by a set of cyto-genetical and morphological tests. Cytogenetic damage levels within intercalary meristem of needle as well as in root meristem of seedlings were found to significantly exceed corresponding controls. A higher radioresistance of the Scots pine seeds analyzed was demonstrated with an acute {gamma}-radiation that also revealed a selection process directed at an enhancement of repair efficiency and resulting in a shift of mean values of radioresistance in populations towards higher values. An enlargement of variance of studied cytogenetic parameters was found in the populations experiencing techno-genic influence. This indicates, with an account of phenomenon of the enhanced radioresistance, that there are processes of cyto-genetical adaptation in the investigated regions. An analysis of the structure of ecological-genetical variability was carried out with the purpose of separating two components in the inter-population variability - the first is engaged to the genetically determined variability of biological characteristics intrinsic for this species, and the second is responsible for the variability originating from anthropogenic contamination of the natural habitat. Changes of these two types of variability were studied in dependence on

  2. Instrumented Impact Testing: Influence of Machine Variables and Specimen Position

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; McCowan, C. N.; Santoyo, R. A.

    2008-09-15

    An investigation has been conducted on the influence of impact machine variables and specimen positioning on characteristic forces and absorbed energies from instrumented Charpy tests. Brittle and ductile fracture behavior has been investigated by testing NIST reference samples of low, high and super-high energy levels. Test machine variables included tightness of foundation, anvil and striker bolts, and the position of the center of percussion with respect to the center of strike. For specimen positioning, we tested samples which had been moved away or sideways with respect to the anvils. In order to assess the influence of the various factors, we compared mean values in the reference (unaltered) and altered conditions; for machine variables, t-test analyses were also performed in order to evaluate the statistical significance of the observed differences. Our results indicate that the only circumstance which resulted in variations larger than 5 percent for both brittle and ductile specimens is when the sample is not in contact with the anvils. These findings should be taken into account in future revisions of instrumented Charpy test standards.

  3. Instrumented Impact Testing: Influence of Machine Variables and Specimen Position

    International Nuclear Information System (INIS)

    Lucon, E.; McCowan, C. N.; Santoyo, R. A.

    2008-01-01

    An investigation has been conducted on the influence of impact machine variables and specimen positioning on characteristic forces and absorbed energies from instrumented Charpy tests. Brittle and ductile fracture behavior has been investigated by testing NIST reference samples of low, high and super-high energy levels. Test machine variables included tightness of foundation, anvil and striker bolts, and the position of the center of percussion with respect to the center of strike. For specimen positioning, we tested samples which had been moved away or sideways with respect to the anvils. In order to assess the influence of the various factors, we compared mean values in the reference (unaltered) and altered conditions; for machine variables, t-test analyses were also performed in order to evaluate the statistical significance of the observed differences. Our results indicate that the only circumstance which resulted in variations larger than 5 percent for both brittle and ductile specimens is when the sample is not in contact with the anvils. These findings should be taken into account in future revisions of instrumented Charpy test standards.

  4. The influence of lower leg configurations on muscle force variability.

    Science.gov (United States)

    Ofori, Edward; Shim, Jaeho; Sosnoff, Jacob J

    2018-04-11

    The maintenance of steady contractions is required in many daily tasks. However, there is little understanding of how various lower limb configurations influence the ability to maintain force. The purpose of the current investigation was to examine the influence of joint angle on various lower-limb constant force contractions. Nineteen adults performed knee extension, knee flexion, and ankle plantarflexion isometric force contractions to 11 target forces, ranging from 2 to 95% maximal voluntary contraction (MVC) at 2 angles. Force variability was quantified with mean force, standard deviation, and the coefficient of variation of force output. Non-linearities in force output were quantified with approximate entropy. Curve fitting analyses were performed on each set of data from each individual across contractions to further examine whether joint angle interacts with global functions of lower-limb force variability. Joint angle had significant effects on the model parameters used to describe the force-variability function for each muscle contraction (p force output were more explained by force level in smaller angle conditions relative to the larger angle conditions (p force production. Biomechanical factors, such as joint angle, along with neurophysiological factors should be considered together in the discussion of the dynamics of constant force production. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Influence of economical variables on a supercritical biodiesel production process

    International Nuclear Information System (INIS)

    Marchetti, J.M.

    2013-01-01

    Highlights: • Biodiesel production from supercritical process. • Economical analysis. • Influence of market variables. - Abstract: Biodiesel has becoming more and more relevant in today’s society and economy due to its environmental advantages such as biodegradability, lower CO and CO 2 emissions as well as less particulate pollutants. In this work the study of market and economic variables is presented and their effects compared when biodiesel is being produced using a supercritical technology. The production process is based on a supercritical technology with no catalyst and no co-solvent. Price for the raw materials, such as price for the alcohol as well as the oil has been studied. Also, selling price for biodiesel as well as glycerin has been analyzed and compared with prices from other biodiesel production technologies. Economic decisions such as percentage of failure in the production process, investment in research and development, and advertisement have been evaluated; also it has been considered the influence of the tax incentives on the global economy of the production process. Small variations on some of the major market variables would produce significant effects over the global economy of the plant, making it non profitable in some cases

  6. DEMOGRAPHIC VARIABLES INFLUENCING INDIVIDUAL ENTREPRENEURIAL ORIENTATION AND STRATEGIC THINKING CAPABILITY

    Directory of Open Access Journals (Sweden)

    Lara Jelenc

    2016-03-01

    Full Text Available Strategic thinking capability is interesting part of the cognitive development of each entrepreneur. This paper develops on notion that there a number of demographic variables that shape the behavior of each particular elements of entrepreneurial orientation and strategic component of each entrepreneur. The demographic variable that have significant role will take the role of moderator in further research. Since both constructs are multidimensional, the demographic variables are not influencing them in the same way. The empirical research has been performed on IT firms in Croatia in 2014. Individual entrepreneurial orientation is measured by the construct developed by Bolton and Lane’s (2012 individual entrepreneurial orientation instrument. The instrument is grounded in the seminal work of Miller (1983, Covin and Slevin (1986; 1988; 1989, Lumpkin and Dess (1996 and Covin and Wales (2011; consisting of three dimensions – risk-taking, innovation, and proactiveness. Strategic thinking was measured by Pisapia’s (2009 Strategic thinking questionnaire (STQ. The STQ asked respondents to rate how often they use systems thinking, reframing, and reflecting skills. Within the framework of individual entrepreneurial orientation the following demographic variables shape the trends: age, gender, education abroad and previous experience. Entrepreneurs between 40-60 years old are less prone to risk, female entrepreneurs are more proactive than men, education abroad provides with the additional proactiveness and the entrepreneur with previous experience is prone to higher risk, proactiveness and innovativeness. Within the framework of strategic thinking capability the following demographic variables shape the trends: age, gender, education and experience. Entrepreneurs older than 60 score high on system thinking as well as females, females also score higher on reframing. Entrepreneurs with PhD degree score lower on reframing, while managers working more

  7. [The influence of physical exercise on heart rate variability].

    Science.gov (United States)

    Gajek, Jacek; Zyśko, Dorota; Negrusz-Kawecka, Marta; Halawa, Bogumił

    2003-03-01

    Heart rate variability is controlled by the influence of autonomic nervous system, whereas one part of the system modulates the activity of the other. There is evidence of increased sympathetic activity in patients (pts) with essential hypertension. The aim of the study was to assess the persisting influence of increased sympathetic activity 30 min after moderate physical exercise on heart rate variability in patients with arterial hypertension. The study was performed in 19 patients (10 women, mean age 52.7 +/- 9.5 years and 9 men, mean age 37.7 +/- 8.8 years) with stage I (6 pts) and stage II (13 pts) arterial hypertension. All studied pts had sinus rhythm, were free of diabetes, coronary heart disease and congestive heart failure. 24-hour Holter monitoring was performed and for 30 min before the exercise test the pts stayed in supine rest. The exercise tests were performed between 10 and 11 a.m. Immediately after the exercise all pts stayed in supine position for 30 min. The heart rate variability parameters were studied using Holter monitoring system Medilog Optima Jet and were then analysed statistically. The mean energy expenditure during the exercise was 5.8 +/- 1.1 METs and the maximal heart rate was 148.1 +/- 20.3 bpm. All studied HRV parameters were significantly different in the assessed time period compared to the baseline values (p < 0.001). Significant correlation was found between the age of the studied patients and the mean RR interval, what can be considered as a hyperkinetic (hyperadrenergic) circulatory status and shorter RR interval in younger pts. Significant negative correlation between the age and SDNN parameter (r = -0.65, p < 0.001), 30 min after the exercise mirrors the prolonged adrenergic influence in older pts. The present study shows that the influence of moderate physical exercise on heart rate variability in pts with essential hypertension is extended over 30 min period after exercise and is more pronounced in older pts. The studies

  8. Clinical Operations Variables are Associated With Blood Pressure Outcomes.

    Science.gov (United States)

    Kressin, Nancy R; Lasser, Karen E; Paasche-Orlow, Michael; Allison, Jeroan; Ash, Arlene S; Adams, William G; Shanahan, Christopher W; Legler, Aaron; Pizer, Steven D

    2015-06-01

    Uncontrolled blood pressure (BP), among patients diagnosed and treated for the condition, remains an important clinical challenge; aspects of clinical operations could potentially be adjusted if they were associated with better outcomes. To assess clinical operations factors' effects on normalization of uncontrolled BP. Observational cohort study. Patients diagnosed with hypertension from a large urban clinical practice (2005-2009). We obtained clinical data on BP, organized by person-month, and administrative data on primary care provider (PCP) staffing. We assessed the resolution of an episode of uncontrolled BP as a function of time-varying covariates including practice-level appointment volume, individual clinicians' appointment volume, overall practice-level PCP staffing, and number of unique PCPs. Among the 7409 unique patients representing 50,403 person-months, normalization was less likely for the patients in whom the episode starts during months when the number of unique PCPs were high [the top quintile of unique PCPs was associated with a 9 percentage point lower probability of normalization (Ppercentage point reduction in the probability of normalization (P=0.01)]. Neither clinician appointment volume nor practice clinician staffing levels were significantly associated with the probability of normalization. Findings suggest that clinical operations factors can affect clinical outcomes like BP normalization, and point to the importance of considering outcome effects when organizing clinical care.

  9. Amino acid metabolic signaling influences Aedes aegypti midgut microbiome variability.

    Directory of Open Access Journals (Sweden)

    Sarah M Short

    2017-07-01

    Full Text Available The mosquito midgut microbiota has been shown to influence vector competence for multiple human pathogens. The microbiota is highly variable in the field, and the sources of this variability are not well understood, which limits our ability to understand or predict its effects on pathogen transmission. In this work, we report significant variation in female adult midgut bacterial load between strains of A. aegypti which vary in their susceptibility to dengue virus. Composition of the midgut microbiome was similar overall between the strains, with 81-92% of reads coming from the same five bacterial families, though we did detect differences in the presence of some bacterial families including Flavobacteriaceae and Entobacteriaceae. We conducted transcriptomic analysis on the two mosquito strains that showed the greatest difference in bacterial load, and found that they differ in transcript abundance of many genes implicated in amino acid metabolism, in particular the branched chain amino acid degradation pathway. We then silenced this pathway by targeting multiple genes using RNA interference, which resulted in strain-specific bacterial proliferation, thereby eliminating the difference in midgut bacterial load between the strains. This suggests that the branched chain amino acid (BCAA degradation pathway controls midgut bacterial load, though the mechanism underlying this remains unclear. Overall, our results indicate that amino acid metabolism can act to influence the midgut microbiota. Moreover, they suggest that genetic or physiological variation in BCAA degradation pathway activity may in part explain midgut microbiota variation in the field.

  10. Factors Influencing the Outcomes in Extradural Haematoma Patients

    African Journals Online (AJOL)

    neurosurgical emergencies and are one of the most common causes of mortality and disability after traumatic brain injury. This study aimed at evaluating the current management and factors that influence outcome in patients treated for extradural hematoma in an African setting. Methods: A total of 224 consecutive patients ...

  11. Activity limitations and factors influencing functional outcome of ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... life and satisfaction with life1,22. A recent study conducted among community dwelling stroke survivors found functional ability and independence to be the strongest predictor of, and were responsible for the greatest variance on participation22. For determining the factors influencing outcome with the use ...

  12. Incidental emotions influence risk preference and outcome evaluation.

    Science.gov (United States)

    Zhao, Ding; Gu, Ruolei; Tang, Ping; Yang, Qiwei; Luo, Yue-Jia

    2016-10-01

    Incidental emotions, which are irrelevant to the current decision, play a significant role in the decision-making process. In this study, to investigate the influence of incidental emotions on behavioral, psychological, and electrophysiological responses in the process of decision making, participants were required to perform a monetary gambling task. During the selection stage, an emotional picture, which was chosen from the Chinese Affective Picture System and fell into one of three categories: negative, neutral, and positive, was presented between two alternatives (small/large amount of bet). The pictures were provided to induce incidental emotions. ERPs and self-rating emotional experiences to outcome feedback were recorded during the task. Behavioral results showed that positive incidental emotions elicited risk preference, but emotional experiences to outcome feedback were not influenced by incidental emotions. The feedback-related negativity amplitudes were larger in the positive emotion condition than in the negative and neutral emotion conditions for small outcomes (including wins and losses), whereas there was no difference between the three conditions for large outcomes. In addition, the amplitudes of P3 were reduced overall in the negative emotion condition. We suggest that incidental emotions have modulated both the option assessment stage (manifested in behavioral choices) and the outcome evaluation stage (manifested in ERP amplitudes) of decision making unconsciously (indicated by unchanged subjective emotional experiences). The current findings have expanded our understanding of the role of incidental emotion in decision making. © 2016 Society for Psychophysiological Research.

  13. Bilingualism and age are continuous variables that influence executive function.

    Science.gov (United States)

    Incera, Sara; McLennan, Conor T

    2018-05-01

    We analyzed the effects of bilingualism and age on executive function. We examined these variables along a continuum, as opposed to dichotomizing them. We investigated the impact that bilingualism and age have on two measures of executive control (Stroop and Flanker). The mouse-tracking paradigm allowed us to examine the continuous dynamics of the responses as participants completed each trial. First, we found that the Stroop effect was reduced with younger age and higher levels of bilingualism; however, no Bilingualism by Age interaction emerged. Second, after controlling for baseline, the Flanker effect was not influenced by bilingualism or age. These results support the notion that bilingualism is one way of enhancing some aspects of executive function - specifically those related to the Stroop task - across the adult life span. In sum, different levels of bilingualism, and different ages, result in varying degrees of executive function as measured by the Stroop task.

  14. Variability in muscle dysmorphia symptoms: the influence of weight training.

    Science.gov (United States)

    Thomas, Liam S; Tod, David A; Lavallee, David E

    2011-03-01

    The purpose of this study was to examine the influence of a weight training session on muscle dysmorphia symptoms in young men who regularly weight trained. Using a within-subjects crossover design, 30 men (mean ± SD; 20.93 ± 2.60 years, 86.87 ± 10.59 kg, and 1.76 ± 0.01 m) were randomly allocated to 1 of 2 groups, and completed the Muscle Dysmorphic Disorder Inventory twice, once each on 2 separate days. One day 1, group 1 completed the questionnaire after a weight training session and group 2 on a rest day. One day 2, group 1 completed the questionnaire on a rest day and group 2 after a weight training session. The mean score for drive for size was significantly higher on a rest day (18.00) than on a training day (15.87; p = 0.001, d = 1.03). The mean score for appearance intolerance was significantly higher on a rest day (10.10) compared with that on a training day (8.97; p = 0.001, d = 0.69). The mean score for functional impairment was significantly higher on a rest day (10.20) than on a training day (9.47; p = 0.037, d = 0.40). These results provide evidence that muscle dysmorphia symptoms have state-like properties and may be influenced by situational variables. The results may indicate that strength and conditioning specialists and mental health professionals need to observe clients over time and take into account environmental variables before making decisions about the presence or absence of the condition.

  15. The television, school, and family smoking prevention and cessation project. VIII. Student outcomes and mediating variables.

    Science.gov (United States)

    Flay, B R; Miller, T Q; Hedeker, D; Siddiqui, O; Britton, C F; Brannon, B R; Johnson, C A; Hansen, W B; Sussman, S; Dent, C

    1995-01-01

    This paper presents the student outcomes of a large-scale, social-influences-based, school and media-based tobacco use prevention and cessation project in Southern California. The study provided an experimental comparison of classroom delivery with television delivery and the combination of the two in a 2 x 2 plus 1 design. Schools were randomly assigned to conditions. Control groups included "treatment as usual" and an "attention control" with the same outcome expectancies as the treatment conditions. Students were surveyed twice in grade 7 and once in each of grades 8 and 9. The interventions occurred during grade 7. We observed significant effects on mediating variables such as knowledge and prevalence estimates, and coping effort. The knowledge and prevalence estimates effects decayed partially but remained significant up to a 2-year follow-up. The coping effort effect did not persist at follow-ups. There were significant main effects of both classroom training and TV programming on knowledge and prevalence estimates and significant interactions of classroom and TV programming on knowledge (negative), disapproval of parental smoking, and coping effort. There were no consistent program effects on refusal/self-efficacy, smoking intentions, or behavior. Previous reports demonstrated successful development and pilot testing of program components and measures and high acceptance of the program by students and parents. The lack of behavioral effects may have been the result of imperfect program implementation or low base rates of intentions and behavior.

  16. Shape of Thyroid Cartilage Influences Outcome of Montgomery Medialization Thyroplasty: A Gender Issue.

    Science.gov (United States)

    Desuter, Gauthier; Henrard, Sylvie; Van Lith-Bijl, Julie T; Amory, Avigaëlle; Duprez, Thierry; van Benthem, Peter Paul; Sjögren, Elisabeth

    2017-03-01

    This study aimed to determine whether the shape of the thyroid cartilage and gender influence voice outcomes after a Montgomery thyroplasty implant system (MTIS). A retrospective cohort study was performed on 20 consecutive patients who underwent MTIS. Voice outcome variables were the relative decrease in Voice Handicap Index (%) and the absolute increase in maximum phonation time (MPT) (in seconds). Material variables were the angle between the thyroid cartilage laminae (α-angle), the size of the prosthesis, and a combination of both (the α-ratio). Continuous variables were analyzed using medians and were compared between groups using the Mann-Whitney U test. Factors associated with the outcome variables were assessed by multivariable linear regression. A Pearson coefficient was calculated between material variables. The absolute increase in MPT between the pre- and postoperative period was significantly different between men and women, with a median absolute increase of 11.0 seconds for men and of 1.3 seconds for women (P gender issue that needs to be further studied and eventually tackled. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. Variability in the Initial Costs of Care and One-Year Outcomes of Observation Services

    Directory of Open Access Journals (Sweden)

    Abbass, Ibrahim

    2015-05-01

    Full Text Available Introduction: The use of observation units (OUs following emergency departments (ED visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs and the one-year outcomes. Methods: The author retrospectively investigated medical insurance claims of 22,962 privately insured patients (2009-2011 admitted to 41 OUs. Outcomes included the one-year chest pain/cardiovascular related costs and primary and secondary outcomes. Primary outcomes included myocardial infarction, congestive heart failure, stroke or cardiac arrest, while secondary outcomes included revascularization procedures, ED revisits for angina pectoris or chest pain and hospitalization due to cardiovascular diseases. The author aggregated the adjusted costs and prevalence rates of outcomes for patients over OUs, and computed the weighted coefficients of variation (WCV to compare variations across OUs. Results: There was minimal variability in the initial costs of care (WCV=2.2%, while the author noticed greater variability in the outcomes. Greater variability were associated with the adjusted cardiovascular-related costs of medical services (WCV=17.6% followed by the adjusted prevalence odds ratio of patients experiencing primary outcomes (WCV=16.3% and secondary outcomes (WCV=10%. Conclusion: Higher variability in the outcomes suggests the need for more standardization of the observation services for chest pain patients. [West J Emerg Med. 2015;16(3:395–400.

  18. Inferior outcomes for black children with high risk acute lymphoblastic leukemia and the impact of socioeconomic variables.

    Science.gov (United States)

    Walsh, Alexandra; Chewning, Joseph; Li, Xuelin; Dai, Chen; Whelan, Kimberly; Madan-Swain, Avi; Waterbor, John; Baskin, Monica L; Goldman, Frederick D

    2017-02-01

    While significant improvements have been made for children with acute lymphoblastic leukemia (ALL) in the United States over the past 20 years, black patients continue to have inferior outcomes. The full impact of socioeconomic variables on outcomes in this minority population is not entirely understood. Disease characteristics, demographic, and socioeconomic status (SES) variables were collected on black (n = 44) and white (n = 178) patients diagnosed at the University of Alabama at Birmingham. Cox proportional hazard regression was used to evaluate the influence of SES and insurance status on survival. As a cohort, 5-year overall survival (OS) was 87% (82-91%), with a median follow-up of 99 months. In univariable analysis, black race was not significantly associated with a higher risk of death or relapse and death. White and black patients with standard-risk leukemia had excellent outcomes, with 97% (91-99%) and 96% (75-99%) 5-year OS, respectively. In contrast, for high-risk disease, white patients had a statistically significant improved 5-year OS rates compared with black patients (79% [68-87%] vs. 52% [28-72%]). Black children were more likely to have public insurance, and, in multivariable analysis, this was associated with a trend toward an improved outcome. Black patients also had poorer census tract-level SES parameters, but these variables were not associated with survival. Our study demonstrates significantly inferior outcomes for black children with high-risk leukemia. These outcome disparities were not related to SES variables, including poverty or private insurance coverage, suggesting the involvement of other factors and highlighting the need for a prospective investigative analysis. © 2016 Wiley Periodicals, Inc.

  19. Do isolated packaging variables influence consumers' attention and preferences?

    Science.gov (United States)

    García-Madariaga, Jesús; Blasco López, Maria-Francisca; Burgos, Ingrit Moya; Virto, Nuria Recuero

    2018-04-25

    Developments in neuroscience have provided the opportunity to know unconscious consumer reactions and acknowledge direct measures of cognitive constructs like attention. Given the ever-increasing concern over packaging's contribution to creating a positive first impression, the current research seeks to examine consumers' attention and declarative preferences regarding the three main different packaging attributes as isolated variables: images, texts and colours. The experiment exposed participants (N = 40) to 63 stimuli, which were based on modifications of the three main packaging attributes of three products of three different food categories. This study used electroencephalogram (EEG) and eye-tracking (ET) to measure attention, and a declarative test was employed to examine preference. First, the results presented herein show that the presence of visual elements, either images or texts on packages, increased the participants' level of attention. Second, the results reveal that colour modifications do not have a significant effect on participants' neurophysiological attention levels. Third, the results demonstrated that the neurophysiological effects among the participants do not necessarily coincide with their subjective evaluations of preference. Hence, this study increases awareness of the relevance of combining traditional market research tools that rely on explicit consumer responses with neuroscientific techniques. These findings indicate, first of all, that more research is needed to ascertain the extent to which consumers' neurophysiological outcomes correspond to their declarative preferences and second, that neurophysiological methods should be given more attention in research. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Tropical influence on Euro-Asian autumn rainfall variability

    Energy Technology Data Exchange (ETDEWEB)

    Mariotti, A. [University of Maryland, College Park, MD (United States); ENEA, Rome (Italy); Ballabrera-Poy, J. [University of Maryland, ESSIC, College Park, MD (United States); Zeng, N. [University of Maryland, ESSIC, College Park, MD (United States); University of Maryland, Department of Meteorology,, College Park, MD (United States)

    2005-04-01

    The connection between autumn rainfall variability in the Euro-Asian domain and tropical climate is documented using state-of-the-art global observational datasets and re-analyses. Results suggest a robust statistical relationship between the El Nino Southern Oscillation (ENSO) and autumn rainfall in parts of southwest Europe, northern Africa and southwest Asia. The correlation between area-mean anomalies over this region (P{sub ea}) and the NINO3.4 index is 0.68, stationary over the last 50 years. Global ENSO-like tropical climate anomalies are observed in conjunction with P{sub ea} anomalies confirming the relationship found with the NINO3.4 index. Overall, the connection with Indo-Pacific variability is stronger than that with the eastern Pacific.While rainfall anomalies in southwest Europe and southwest Asia appear to largely co-vary as one pattern under the influence of ENSO, our results suggest that different mechanisms may be contributing to the observed anomalies. In the North Atlantic/European region, it is speculated that while a PNA-like mode maybe the prevailing teleconnection mechanism for high P{sub ea}, for low P{sub ea} tropical Atlantic ENSO related SST anomalies may be playing a more relevant role forcing northeastward propagating Rossby waves. Over southwest Asia, a more direct connection to the Indo-Pacific region is suggested by the upper air anomaly observed over southern Asia, possibly the Rossby wave response to enhanced heating in the Indian Ocean. (orig.)

  1. Natural and Anthropogenic Influences on Atmospheric Aerosol Variability

    Energy Technology Data Exchange (ETDEWEB)

    Asmi, A.

    2012-07-01

    Aerosol particles are everywhere in the atmosphere. They are a key factor in many important processes in the atmosphere, including cloud formation, scattering of incoming solar radiation and air chemistry. The aerosol particles have relatively short lifetimes in lower atmosphere, typically from days to weeks, and thus they have a high spatial and temporal variability. This thesis concentrates on the extent and reasons of sub-micron aerosol particle variability in the lower atmosphere, using both global atmospheric models and analysis of observational data. Aerosol number size distributions in the lower atmosphere are affected strongly by the new particle formation. Perhaps more importantly, a strong influence new particle formation is also evident in the cloud condensation nuclei (CCN) concentrations, suggesting a major role of the sulphuric acid driven new particle formation in the climate system. In this thesis, the sub-micron aerosol number size distributions in the European regional background air were characterized for the first time from consistent, homogenized and comparable datasets. Some recent studies have suggested that differences in aerosol emissions between weekdays could also affect the weather via aerosol-cloud interactions. In this thesis, the weekday-to-weekday variation of CCN sized aerosol number concentrations in Europe were found to be much smaller than expected from earlier studies, based on particle mass measurements. This result suggests that a lack of week-day variability in meteorology is not necessarily a sign of weak aerosol-cloud interactions. An analysis of statistically significant trends in past decades of measured aerosol number concentrations from Europe, North America, Pacific islands and Antarctica generally show decreases in concentrations. The analysis of these changes show that a potential explanation for the decreasing trends is the general reduction of anthropogenic emissions, especially SO{sub 2}, although a combination of

  2. Glucose variability negatively impacts long-term functional outcome in patients with traumatic brain injury.

    Science.gov (United States)

    Matsushima, Kazuhide; Peng, Monica; Velasco, Carlos; Schaefer, Eric; Diaz-Arrastia, Ramon; Frankel, Heidi

    2012-04-01

    Significant glycemic excursions (so-called glucose variability) affect the outcome of generic critically ill patients but has not been well studied in patients with traumatic brain injury (TBI). The purpose of this study was to evaluate the impact of glucose variability on long-term functional outcome of patients with TBI. A noncomputerized tight glucose control protocol was used in our intensivist model surgical intensive care unit. The relationship between the glucose variability and long-term (a median of 6 months after injury) functional outcome defined by extended Glasgow Outcome Scale (GOSE) was analyzed using ordinal logistic regression models. Glucose variability was defined by SD and percentage of excursion (POE) from the preset range glucose level. A total of 109 patients with TBI under tight glucose control had long-term GOSE evaluated. In univariable analysis, there was a significant association between lower GOSE score and higher mean glucose, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL but not POE 80 to 110. After adjusting for possible confounding variables in multivariable ordinal logistic regression models, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL were significantly associated with lower GOSE score. Glucose variability was significantly associated with poorer long-term functional outcome in patients with TBI as measured by the GOSE score. Well-designed protocols to minimize glucose variability may be key in improving long-term functional outcome. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  4. Variables influencing the frictional behaviour of in vivo human skin

    NARCIS (Netherlands)

    Veijgen, N.K.; Masen, Marc Arthur; van der Heide, Emile

    2013-01-01

    In the past decades, skin friction research has focused on determining which variables are important to affect the frictional behaviour of in vivo human skin. Until now, there is still limited knowledge on these variables. This study has used a large dataset to identify the effect of variables on

  5. Variables influencing the frictional behaviour of in vivo human skin

    NARCIS (Netherlands)

    Veijgen, N.K.; Masen, M.A.; Heide, E. van der

    2013-01-01

    In the past decades, skin friction research has focused on determining which variables are important to affect the frictional behaviour of in vivo human skin. Until now, there is still limited knowledge on these variables.This study has used a large dataset to identify the effect of variables on the

  6. Parental Decisional Regret after Primary Distal Hypospadias Repair: Family and Surgery Variables, and Repair Outcomes.

    Science.gov (United States)

    Ghidini, Filippo; Sekulovic, Sasa; Castagnetti, Marco

    2016-03-01

    Decisional regret is defined as distress after making a health care choice and can be an issue for parents electing distal hypospadias repair for their sons. We assessed the influence on decisional regret of variables related to the family, surgery and outcomes. Charts for 372 patients undergoing primary distal hypospadias repair between 2005 and 2012 were reviewed, and validated questionnaires, including the Decisional Regret Scale, Pediatric Penile Perception Score and Dysfunctional Voiding and Incontinence Scoring System, were administered to parents. Data were available for 172 of 372 families (response rate 46.2%). Of 323 parents 128 (39.6%) presented with moderately strong decisional regret, with good agreement within couples. Predictors of decisional regret included intermediate parental educational level (OR 3.19, 95% CI 1.52-6.69), patient not being the first born (OR 2.01, 95% CI 1.07-3.78), family history of hypospadias (OR 4.42, 95% CI 1.96-9.97), initial desire to avoid surgery (OR 2.07, 95% CI 1.04-4.12), younger age at followup (OR 0.81, 95% CI 0.72-0.91), presence of lower urinary tract symptoms (OR 4.92, 95% CI 1.53-15.81) and lower Pediatric Penile Perception Score (OR 0.86, 95% CI 0.75-0.99). Decisional regret was unrelated to parental desire to avoid circumcision, surgical variables, development of complications and duration of followup. Decisional regret is a problem in a significant proportion of parents electing distal hypospadias repair for their sons. In our experience family variables seemed to be predictors of decisional regret, while surgical variables did not. Predictors of decisional regret included worse parental perception of penile appearance and the presence of lower urinary tract symptoms. However, the latter could be unrelated to surgery. Irrespective of the duration of followup, decisional regret seems decreased in parents of older patients. Copyright © 2016 American Urological Association Education and Research, Inc

  7. The Effects of Job Autonomy on Work Outcomes: Self Efficacy as an Intervening Variable

    OpenAIRE

    Susanti Saragih

    2011-01-01

    The purpose of this research was to examine the relationship between job autonomy and work outcomes (job performance, job satisfaction and job stress), self efficacy as a mediating variable. This research also investigated the impact of job satisfaction on job performance and job stress on job performance. Va-riables in this research were measured via a survey of 190 banking salespersons in D.I. Yogyakarta and Solo. Structural Equation Modeling (SEM) were used to examine the effects of job au...

  8. Variable reporting of functional outcomes and return to play in superior labrum anterior and posterior tear.

    Science.gov (United States)

    Steinhaus, Michael E; Makhni, Eric C; Lieber, Adam C; Kahlenberg, Cynthia A; Gulotta, Lawrence V; Romeo, Anthony A; Verma, Nikhil N

    2016-11-01

    Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair. Two reviewers assessed each study, and those meeting inclusion criteria were examined for pertinent data. Outcomes included objective (range of motion, strength, clinical examinations, and imaging) and subjective (patient-reported outcomes, satisfaction, activities of daily living, and return to play) measures. Of the 56 included studies, 43% documented range of motion, 14% reported strength, and 16% noted postoperative imaging. There was significant variation in use of patient-reported outcomes measures, with the 3 most commonly noted measures reported in 20% to 55% of studies. Return to play was noted in 75% of studies, and 23% reported time to return, with greater rates in elite athletes. Eleven studies (20%) did not report follow-up or noted data with <12 months of follow-up. The SLAP literature is characterized by substantial variability in outcomes reporting, with time to return to play noted in few studies. Efforts to standardize outcomes reporting would facilitate comparisons across the literature and improve our understanding of the prognosis of this injury. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. A Survey of U.S. Atlanta and Nagano Olympians: Variables Perceived to Influence Performance.

    Science.gov (United States)

    Gould, Daniel; Greenleaf, Christy; Chung, Yongchul; Guinan, Diane

    2002-01-01

    Examined the frequency and magnitude of specific variables perceived to have affected U.S. Olympic athletes' performance. Respondents perceived that performance was influenced by: performance variables (e.g., preparation for distraction); team variables (e.g., strong cohesion); coaching variables (e.g., coaching expectations); family-friend…

  10. High Variability in Outcome Reporting Patterns in High-Impact ACL Literature.

    Science.gov (United States)

    Makhni, Eric C; Padaki, Ajay S; Petridis, Petros D; Steinhaus, Michael E; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

    2015-09-16

    ACL (anterior cruciate ligament) reconstruction is one of the most commonly performed and studied procedures in modern sports medicine. A multitude of objective and subjective patient outcome measures exists; however, nonstandardized reporting patterns of these metrics may create challenges in objectively analyzing pooled results from different studies. The goal of this study was to document the variability in outcome reporting patterns in high-impact orthopaedic studies of ACL reconstruction. All clinical studies pertaining to ACL reconstruction in four high-impact-factor orthopaedic journals over a five-year period were reviewed. Biomechanical, basic science, and imaging studies were excluded, as were studies with fewer than fifty patients, yielding 119 studies for review. Incorporation of various objective and subjective outcomes was noted for each study. Substantial variability in reporting of both objective and subjective measures was noted in the study cohort. Although a majority of studies reported instrumented laxity findings, there was substantial variability in the type and method of laxity reporting. Most other objective outcomes, including range of motion, strength, and complications, were reported in <50% of all studies. Return to pre-injury level of activity was infrequently reported (24% of studies), as were patient satisfaction and pain assessment following surgery (8% and 13%, respectively). Of the patient-reported outcomes, the International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were most often reported (71%, 63%, and 42%, respectively). Substantial variability in outcome reporting patterns exists among high-impact studies of ACL reconstruction. Such variability may create challenges in interpreting results and pooling them across different studies. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  11. Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection : A cohort analysis to define a case-mix variable

    NARCIS (Netherlands)

    Sandberg, Evelien M.; Driessen, Sara R C; Bak, Evelien A.T.; van Geloven, Nan; Berger, Judith P.; Smeets, Mathilde J.G.H.; Rhemrev, Johann P T; Jansen, F.W.

    2018-01-01

    Background: Pelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis

  12. [Influence of Attachment Style on the Outcome of Bariatric Surgery - A Pilot Study].

    Science.gov (United States)

    Appel, Johanna Elisabeth; Ift, Franziska; Kißler, Hermann; Kloos, Christof; Lehmann, Thomas; Strauß, Bernhard; Wick, Katharina

    2016-12-01

    Background: Bariatric surgery can lower body weight and comorbidities. Different factors might influence the outcome of this treatment. This pilot study examines whether patients' attachment style can influence surgical outcome. Methods: The sample consisted of 32 patients (f=24; m=8; BMI preoperative=47,8 kg/m 2 ±5,2; age=53±9,84) who underwent a laparoscopic sleeve gastrectomy. The following variables were assessed pre- and postoperatively via questionnaires: quality of life (BAROS), self esteem (SES), depression, anxiety, psychological distress (SCL-90R), feelings of hunger, cognitive control, irritated eating behaviour (FEV) and weight related variables (BMI, EWL%, EBL%, TBL). Attachment style was determined postoperatively using the BPQE. Results: None of the participating patients suffered from a binge eating disorder. There was no significant difference of the BMI at any time between the 12 securely attached (SA) patients and the 19 insecurely attachted (IA) patients. Compared to the SA patients IA patients preoperatively showed lower outcomes in variables concerning eating behaviour and mental health. Comparing the 2 groups postoperatively the IA patients achieved lower levels in variables concerning mental health than SA patients and did not reach the preoperative values of the SA patients. Both groups benefited from surgery related to weight loss, mental health and eating behaviour. There was no difference found in the development from pre- to postoperative between SA and IA patients. Discussion & Conclusion: Patients profit by a bariatric intervention independent of their attachment style. By evaluating the attachment style, it could be possible to individually optimize pre- and postoperative patients support in order to gain more effective surgery results. Follow up studies extended to multi-site assessment are required. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Regional softwood sawmill processing variables as influenced by productive capacity

    Science.gov (United States)

    P. H. Steele; F. G. Wagner; K. E. Skog

    The relationship between annual softwood sawmill production and lumber processing variables was examined using data from Sawmill Improvement Program (SIP) studies of 650 softwood mills. The variables were lumber recovery factor (LRF); headrig and resaw kerf width; total sawing variation, rough green size, and oversizing-undersizing for 4/4 and 8/4 lumber; planer...

  14. Does the Rotator Cuff Tear Pattern Influence Clinical Outcomes After Surgical Repair?

    Science.gov (United States)

    Watson, Scott; Allen, Benjamin; Robbins, Chris; Bedi, Asheesh; Gagnier, Joel J; Miller, Bruce

    2018-03-01

    Limited literature exists regarding the influence of rotator cuff tear morphology on patient outcomes. To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair. Cohort study; Level of evidence, 3. Patients undergoing arthroscopic repair of known full-thickness rotator cuff tears were observed prospectively at regular intervals from baseline to 1 year. The tear pattern was classified at the time of surgery as crescent, U-shaped, or L-shaped. Primary outcome measures were the Western Ontario Rotator Cuff Index (WORC), the American Shoulder and Elbow Surgeons (ASES), and a visual analog scale (VAS) for pain. The tear pattern was evaluated as the primary predictor while controlling for variables known to affect rotator cuff outcomes. Mixed-methods regression and analysis of variance (ANOVA) were used to examine the effects of tear morphology on patient-reported outcomes after surgical repair from baseline to 1 year. A total of 82 patients were included in the study (53 male, 29 female; mean age, 58 years [range, 41-75 years]). A crescent shape was the most common tear pattern (54%), followed by U-shaped (25%) and L-shaped tears (21%). There were no significant differences in outcome scores between the 3 groups at baseline. All 3 groups showed statistically significant improvement from baseline to 1 year, but analysis failed to show any predictive effect in the change in outcome scores from baseline to 1 year for the WORC, ASES, or VAS when tear pattern was the primary predictor. Further ANOVA also failed to show any significant difference in the change in outcome scores from baseline to 1 year for the WORC ( P = .96), ASES ( P = .71), or VAS ( P = .86). Rotator cuff tear pattern is not a predictor of functional outcomes after arthroscopic rotator cuff repair.

  15. Education and Health Matters: School Nurse Interventions, Student Outcomes, and School Variables

    Science.gov (United States)

    Wolfe, Linda C.

    2013-01-01

    This paper presents findings from a quantitative, correlational study that examined selected school nursing services, student academic outcomes, and school demographics. Ex post facto data from the 2011-2012 school year of Delaware public schools were used in the research. The selected variables were school nurse interventions provided to students…

  16. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables

    Science.gov (United States)

    Rafiei, Sima; Pourreza, Abolghasem

    2013-01-01

    Background: Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. Methods: This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Results: Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Conclusion: Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities. PMID:24596840

  17. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables.

    Science.gov (United States)

    Rafiei, Sima; Pourreza, Abolghasem

    2013-06-01

    Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities.

  18. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables

    Directory of Open Access Journals (Sweden)

    Abolghasem Pourreza

    2013-05-01

    Full Text Available Background Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. Methods This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Results Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Conclusion Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities.

  19. Blood Pressure Variability and Outcome in Patients with Acute Nonlobar Intracerebral Hemorrhage following Intensive Antihypertensive Treatment

    Directory of Open Access Journals (Sweden)

    Jin Pyeong Jeon

    2018-01-01

    Conclusions: The MAC of SBP is associated with hematoma growth, and SD and COV are correlated with 3-month poor outcome in patients with supratentorial nonlobar ICH. Therefore, sustained SBP control, with a reduction in SBP variability is essential to reinforce the beneficial effect of intensive antihypertensive treatment.

  20. Influence of environmental factors on birth weight variability of ...

    African Journals Online (AJOL)

    Administrator

    2011-05-30

    May 30, 2011 ... significant (P < 0.05). Type of birth also had effect on the body weight of lambs at birth in both Pirot and ... Key words: Environmental factors, birth weight variability, indigenous sheep. ... breeding plans to improve production.

  1. High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.

    Science.gov (United States)

    Al Shafouri, N; Narvey, M; Srinivasan, G; Vallance, J; Hansen, G

    2015-01-01

    In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to -0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

  2. Age and sex influences on running mechanics and coordination variability.

    Science.gov (United States)

    Boyer, Katherine A; Freedman Silvernail, Julia; Hamill, Joseph

    2017-11-01

    The purpose of this study was to examine the impact of age on running mechanics separately for male and female runners and to quantify sex differences in running mechanics and coordination variability for older runners. Kinematics and kinetics were captured for 20 younger (10 male) and 20 older (10 male) adults running overground at 3.5 m · s -1 . A modified vector coding technique was used to calculate segment coordination variability. Lower extremity joint angles, moments and segment coordination variability were compared between age and sex groups. Significant sex-age interaction effects were found for heel-strike hip flexion and ankle in/eversion angles and peak ankle dorsiflexion angle. In older adults, mid-stance knee flexion angle, ankle inversion and abduction moments and hip abduction and external rotation moments differed by sex. Older compared with younger females had reduced coordination variability in the thigh-shank transverse plane couple but greater coordination variability for the shank rotation-foot eversion couple in early stance. These results suggest there may be a non-equivalent aging process in the movement mechanics for males and females. The age and sex differences in running mechanics and coordination variability highlight the need for sex-based analyses for future studies examining injury risk with age.

  3. Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

    Science.gov (United States)

    Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

    2011-10-01

    Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

  4. Sensitivity of adaptive enrichment trial designs to accrual rates, time to outcome measurement, and prognostic variables

    Directory of Open Access Journals (Sweden)

    Tianchen Qian

    2017-12-01

    Full Text Available Adaptive enrichment designs involve rules for restricting enrollment to a subset of the population during the course of an ongoing trial. This can be used to target those who benefit from the experimental treatment. Trial characteristics such as the accrual rate and the prognostic value of baseline variables are typically unknown when a trial is being planned; these values are typically assumed based on information available before the trial starts. Because of the added complexity in adaptive enrichment designs compared to standard designs, it may be of special concern how sensitive the trial performance is to deviations from assumptions. Through simulation studies, we evaluate the sensitivity of Type I error, power, expected sample size, and trial duration to different design characteristics. Our simulation distributions mimic features of data from the Alzheimer's Disease Neuroimaging Initiative cohort study, and involve two subpopulations based on a genetic marker. We investigate the impact of the following design characteristics: the accrual rate, the time from enrollment to measurement of a short-term outcome and the primary outcome, and the prognostic value of baseline variables and short-term outcomes. To leverage prognostic information in baseline variables and short-term outcomes, we use a semiparametric, locally efficient estimator, and investigate its strengths and limitations compared to standard estimators. We apply information-based monitoring, and evaluate how accurately information can be estimated in an ongoing trial.

  5. Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable.

    Science.gov (United States)

    Sandberg, Evelien M; Driessen, Sara R C; Bak, Evelien A T; van Geloven, Nan; Berger, Judith P; Smeets, Mathilde J G H; Rhemrev, Johann P T; Jansen, Frank Willem

    2018-01-01

    Pelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis influences surgical outcomes of LH and to determine if it should be considered as case-mix variable. A total of 2655 LH's were analyzed, of which 397 (15.0%) with concomitant endometriosis. For blood loss and operative time, no measurable association was found for stages I ( n  = 106) and II ( n  = 103) endometriosis compared to LH without endometriosis. LH with stages III ( n  = 93) and IV ( n  = 95) endometriosis were associated with more intra-operative blood loss ( p  = case-mix variables in future quality measurement tools.

  6. Influence of job frustration, narcissism and demographic variables ...

    African Journals Online (AJOL)

    The study examines the hypothesised relationship among job frustration, narcissism, demographic variables and professional ethical behaviour among Nigerian Police officers. One hundred policemen drawn from four police divisions of Benin Area Command of Edo State participated in the study. There were 18 females ...

  7. Influence of Variable Fluid Properties and Radiative Heat loss on ...

    African Journals Online (AJOL)

    Consequently, comparative analysis is also performed on the wall shear stress and local heat transfer of the present study with the available results.The results show that the inclusion variable viscosity and thermal conductivity, and radiative heat loss mechanism cause significant effects on the fluid flow velocity, temperature ...

  8. Genetic influence on inflammation variables in the elderly

    DEFF Research Database (Denmark)

    de Maat, Moniek P M; Bladbjerg, Else Marie; Hjelmborg, Jacob v. B.

    2004-01-01

    factors, and the aim of this study was to determine the heritability of these inflammation variables and of the acute phase regulating cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) at older ages. METHODS AND RESULTS: The heritability of CRP, fibrinogen, sICAM-1, IL-6, and TNF...

  9. Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.

    Science.gov (United States)

    Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F

    2015-01-01

    Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], Ppatient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by

  10. Variable selection in multiple linear regression: The influence of ...

    African Journals Online (AJOL)

    provide an indication of whether the fit of the selected model improves or ... and calculate M(−i); quantify the influence of case i in terms of a function, f(•), of M and ..... [21] Venter JH & Snyman JLJ, 1997, Linear model selection based on risk ...

  11. Variables That Influence the Environmental Behavior of Adults

    Science.gov (United States)

    Levy, Anat; Orion, Nir; Leshem, Yossi

    2018-01-01

    This study focuses on understanding the factors that encourage adults' environmental behavior. This mixed approach methodology study used 10 Likert type questionnaires to collect data about nine cognitive and affective components that might influence environmental behavior. The qualitative data was collected through open questions and interviews.…

  12. The influence of cultural norms and customs variables on birth ...

    African Journals Online (AJOL)

    This study established the influence of social pressure on women to prove their fertility, breastfeeding practices, postpartum abstinence practices and preferences for male children on birth spacing practices. A total of two hundred and thirty teachers and nurses randomly selected from state schools and hospitals in Ibadan ...

  13. The sleeping patterns of Head Start children and the influence on developmental outcomes.

    Science.gov (United States)

    Schlieber, M; Han, J

    2018-05-01

    Sleep has a significant influence on children's development. The objective of this study was to investigate Head Start children's sleeping patterns and the impact on cognitive and behavioural outcomes. Using the 2009 cohort of the Head Start Family and Child Experiences Survey (N = 2,868), information on sleeping patterns was assessed through parent interviews. Cognitive outcomes were assessed using direct assessments (Peabody Picture Vocabulary Test-IV, the Expressive One-Word Picture Vocabulary Test, and Subtests of the Woodcock-Johnson III) in addition to teacher report. Behavioural outcomes were assessed through parent and teacher reports. A multiple regression analysis was performed for each outcome variable. Descriptive findings showed that 89% of children had a regular bedtime at least 4 days per week and that the average amount of sleep per night was 10.41 hr. White mothers were more likely than other racial groups to adhere to a consistent bedtime, and maternal employment predicted less hour of sleep per night. Multiple regression analyses revealed that disrupted sleep had a negative influence on cognitive outcomes, especially in areas of mathematical problem solving, receptive language, teacher-reported literacy behaviours, and approaches to learning. Disrupted sleep was associated with the risk of misbehaviour by increasing teacher and parent ratings on aggressive behaviours, hyperactivity, and withdrawing in addition to decreased scores on overall social skills. Having an inconsistent bedtime negatively predicted expressive vocabulary and teacher-reported literacy behaviours. The findings of this study support the influential role of sleep on children's development. Sleeping through the night and having a consistent bedtime were found to be predictive of many areas of cognitive and behavioural development. Head Start staff can provide the supports to increase parental knowledge on appropriate child sleep practices. © 2017 John Wiley & Sons Ltd.

  14. What Variables are Associated with Successful Weight Loss Outcomes for Bariatric Surgery After One Year?

    Science.gov (United States)

    Robinson, Athena H.; Adler, Sarah; Stevens, Helen B.; Darcy, Alison M.; Morton, John M.; Safer, Debra L.

    2014-01-01

    Background Prior evidence indicates that predictors of weight loss outcomes after gastric bypass surgery fall within 5 domains: 1) presurgical factors; 2) postsurgical psychosocial variables (e.g., support group attendance); 3) postsurgical eating patterns; 4) postsurgical physical activity; and 5) follow-up at postsurgical clinic. However, little data exist on which specific behavioral predictors are most associated with successful outcomes (e.g., ≥50% excess weight loss) when considering the 5 domains simultaneously. Objectives Specify the behavioral variables, and their respective cutoff points, most associated with successful weight loss outcomes. Setting On-line survey. Methods Signal Detection Analysis evaluated associations between 84 pre-and postsurgical behavioral variables (within the 5 domains) and successful weight loss at ≥1 year in 274 post-gastric bypass surgery patients. Results Successful weight loss was highest (92.6%) among those reporting dietary adherence of >3 on a 9 point scale (median=5) who grazed no more than once-per-day. Among participants reporting dietary adherence <3 and grazing daily or less, success rates more than doubled when highest lifetime Body Mass Index was <53.7 kg/m2. Success rates also doubled for participants with dietary adherence =3 if attending support groups. No variables from the physical activity or postsurgical follow-up domains were significant, nor were years since surgery. The overall model’s sensitivity =.62, specificity =.92. Conclusions To our knowledge, this is the first study to simultaneously consider the relative contribution of behavioral variables within 5 domains and offer clinicians an assessment algorithm identifying cut-off points for behaviors most associated with successful postsurgical weight loss. Such data may inform prospective study designs and postsurgical interventions. PMID:24913590

  15. Biofilm diatom community structure: Influence of temporal and substratum variability

    Digital Repository Service at National Institute of Oceanography (India)

    Patil, J.S.; Anil, A.C.

    ). The structure and composition of the fouling com- munity exhibit wide temporal and regional varia- tions, which are also influenced by the substratum. Dona Paula Bay, the site of this investigation, is highly dynamic in terms of its physico...-off and nutrient loading in coastal environments. In general, the waters are highly disturbed during the monsoon (June–September) and calm during the pre-monsoon (February–May) and post-monsoon (October–January) periods. Such changes are instrumental...

  16. Student understanding of control of variables: Deciding whether or not a variable influences the behavior of a system

    Science.gov (United States)

    Boudreaux, Andrew; Shaffer, Peter S.; Heron, Paula R. L.; McDermott, Lillian C.

    2008-02-01

    The ability of adult students to reason on the basis of the control of variables was the subject of an extended investigation. This paper describes the part of the study that focused on the reasoning required to decide whether or not a given variable influences the behavior of a system. The participants were undergraduates taking introductory Physics and K-8 teachers studying physics and physical science in inservice institutes and workshops. Although most of the students recognized the need to control variables, many had significant difficulty with the underlying reasoning. The results indicate serious shortcomings in the preparation of future scientists and in the education of a scientifically literate citizenry. There are also strong implications for the professional development of teachers, many of whom are expected to teach control of variables to young students.

  17. Influence of Velocity on Variability in Gait Kinematics

    DEFF Research Database (Denmark)

    Yang, Sylvia X M; Larsen, Peter K; Alkjær, Tine

    2014-01-01

    the concurrence of joint angles throughout a gait cycle at three different velocities (3.0, 4.5, 6.0 km/h). Six datasets at each velocity were collected from 16 men. A variability range VR throughout the gait cycle at each velocity for each joint angle for each person was calculated. The joint angles at each...... velocity were compared pairwise, and whenever this showed values within the VR of this velocity, the case was positive. By adding the positives throughout the gait cycle, phases with high and low concurrences were located; peak concurrence was observed at mid-stance phase. Striving for the same velocity...

  18. Does geographical variability influence five-year MACCE rates in the multicentre SYNTAX revascularisation trial?

    Science.gov (United States)

    Roy, Andrew K; Chevalier, Bernard; Lefèvre, Thierry; Louvard, Yves; Segurado, Ricardo; Sawaya, Fadi; Spaziano, Marco; Neylon, Antoinette; Serruys, Patrick A; Dawkins, Keith D; Kappetein, Arie Pieter; Mohr, Friedrich-Wilhelm; Colombo, Antonio; Feldman, Ted; Morice, Marie-Claude

    2017-09-20

    The use of multiple geographical sites for randomised cardiovascular trials may lead to important heterogeneity in treatment effects. This study aimed to determine whether treatment effects from different geographical recruitment regions impacted significantly on five-year MACCE rates in the SYNTAX trial. Five-year SYNTAX results (n=1,800) were analysed for geographical variability by site and country for the effect of treatment (CABG vs. PCI) on MACCE rates. Fixed, random, and linear mixed models were used to test clinical covariate effects, such as diabetes, lesion characteristics, and procedural factors. Comparing five-year MACCE rates, the pooled odds ratio (OR) between study sites was 0.58 (95% CI: 0.47-0.71), and countries 0.59 (95% CI: 0.45-0.73). By homogeneity testing, no individual site (X2=93.8, p=0.051) or country differences (X2=25.7, p=0.080) were observed. For random effects models, the intraclass correlation was minimal (ICC site=5.1%, ICC country=1.5%, p<0.001), indicating minimal geographical heterogeneity, with a hazard ratio of 0.70 (95% CI: 0.59-0.83). Baseline risk (smoking, diabetes, PAD) did not influence regional five-year MACCE outcomes (ICC 1.3%-5.2%), nor did revascularisation of the left main vs. three-vessel disease (p=0.241), across site or country subgroups. For CABG patients, the number of arterial (p=0.49) or venous (p=0.38) conduits used also made no difference. Geographic variability has no significant treatment effect on MACCE rates at five years. These findings highlight the generalisability of the five-year outcomes of the SYNTAX study.

  19. Genetic Variation in the Dopamine System Influences Intervention Outcome in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Rochellys Diaz Heijtz

    2018-02-01

    Interpretation: Naturally occurring genetic variation in the dopamine system can influence treatment outcomes in children with cerebral palsy. A polygenic dopamine score might be valid for treatment outcome prediction and for designing individually tailored interventions for children with cerebral palsy.

  20. Study of Formulation Variables Influencing Polymeric Microparticles by Experimental Design

    Directory of Open Access Journals (Sweden)

    Jitendra B. Naik

    2014-04-01

    Full Text Available The objective of this study was to prepare diclofenac sodium loaded microparticles by single emulsion [oil-in-water (o/w] solvent evaporation method. The 22 experimental design methodology was used to evaluate the effect of two formulation variables on microspheres properties using the Design-Expert® software and evaluated for their particle size, morphology, and encapsulation efficiency and in vitro drug release. The graphical and mathematical analysis of the design showed that the independent variables were a significant effect on the encapsulation efficiency and drug release of microparticles. The low magnitudes of error and significant values of R2 prove the high prognostic ability of the design. The microspheres showed high encapsulation efficiency with an increase in the amount of polymer and decrease in the amount of PVA in the formulation. The particles were found to be spherical with smooth surface. Prolonged drug release and enhancement of encapsulation efficiency of polymeric microparticles can be successfully obtained with an application of experimental design technique.

  1. Influences of variables on ship collision probability in a Bayesian belief network model

    International Nuclear Information System (INIS)

    Hänninen, Maria; Kujala, Pentti

    2012-01-01

    The influences of the variables in a Bayesian belief network model for estimating the role of human factors on ship collision probability in the Gulf of Finland are studied for discovering the variables with the largest influences and for examining the validity of the network. The change in the so-called causation probability is examined while observing each state of the network variables and by utilizing sensitivity and mutual information analyses. Changing course in an encounter situation is the most influential variable in the model, followed by variables such as the Officer of the Watch's action, situation assessment, danger detection, personal condition and incapacitation. The least influential variables are the other distractions on bridge, the bridge view, maintenance routines and the officer's fatigue. In general, the methods are found to agree on the order of the model variables although some disagreements arise due to slightly dissimilar approaches to the concept of variable influence. The relative values and the ranking of variables based on the values are discovered to be more valuable than the actual numerical values themselves. Although the most influential variables seem to be plausible, there are some discrepancies between the indicated influences in the model and literature. Thus, improvements are suggested to the network.

  2. Visit-to-visit cholesterol variability correlates with coronary atheroma progression and clinical outcomes.

    Science.gov (United States)

    Clark, Donald; Nicholls, Stephen J; St John, Julie; Elshazly, Mohamed B; Kapadia, Samir R; Tuzcu, E Murat; Nissen, Steven E; Puri, Rishi

    2018-04-21

    Utilizing serial intravascular ultrasonography (IVUS), we aimed to exam the association of intra-individual lipid variability, coronary atheroma progression, and clinical outcomes. We performed a post hoc patient-level analysis of nine clinical trials involving 4976 patients with coronary artery disease who underwent serial coronary IVUS in the setting of a range of medical therapies. We assessed the associations between progression in percent atheroma volume (ΔPAV), clinical outcomes, and visit-to-visit lipid variability including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol (TC)/HDL-C, and apolipoprotein B (ApoB). Variability of lipid parameters was measured using intra-individual standard deviation over 3, 6, 12, 18, and 24 months. Atherogenic lipoprotein variability significantly associated with ΔPAV [odds ratio (95% confidence interval; P-value), LDL-C: 1.09 (1.02, 1.17, P = 0.01); non-HDL-C: 1.10 (1.02, 1.18, P = 0.01); TC/HDL-C: 1.14 (1.06, 1.24, P = 0.001); ApoB: 1.13 (1.03, 1.24, P = 0.01)]. Survival curves revealed significant stepwise relationships between cumulative major adverse cardiovascular events and increasing quartiles of atherogenic lipoprotein variability at 24-months follow-up (log-rank P C). Stronger associations were noted between achieved lipoprotein levels and ΔPAV [LDL-C: 1.27 (1.17, 1.39; P C: 1.32 (1.21, 1.45; P C: 1.31 (1.19, 1.45; P < 0.001); ApoB: 1.20 (1.07, 1.35; P = 0.003)]. Greater visit-to-visit variability in atherogenic lipoprotein levels significantly associates with coronary atheroma progression and clinical outcomes, although the association between achieved atherogenic lipoproteins and atheroma progression appears stronger. These data highlight the importance of achieving low and consistent atherogenic lipoprotein levels to promote plaque regression and improve clinical outcomes.

  3. Influencing variables on life satisfaction of Korean elders in institutions.

    Science.gov (United States)

    Sung, Ki-Wol

    2003-12-01

    The number of elders in institutions has increased as family supporting systems have changed in Korea. The purpose of this study were to understand the life satisfaction among elders in institutions and to identify the factors influencing on life satisfaction. The instruments used were Yun(1982)'s scale modified Memorial University of Newfoundland Scale for Happiness(MUNSH) in life satisfaction, ADL and IADL in activity level, Self-rating Depression Scale(SDS) in depression and Norbeck Social Support Questionnaire(NSSQ) scale in social support. Also, Perceived health status was measured by Visual Graphic Rating Scale. The subject of this study is 107 cognitively intact and ambulatory elders in 7 institutions in Daegu city and Kyungpook province. The data have been collected from May 1 to June 30, 2001. For the analysis of collected data, frequency analysis, mean, standard deviation, Pearson's correlation and stepwise multiple regression analysis were used for statistical analysis by SPSSwin(version 9.0) program. Life satisfaction for the elders in institutions showed negative correlation with SDS, and positive correlation with activity level. The regression form of the stepwise multiple regression analysis to investigate the influencing factors of life satisfaction for the elders in institutions was expressed by y = 90.988-0.733x1-0.188x2-0.069x3-0.565x4 (x1: SDS x2: Social support x3: Activity level x4: Monthly pocket Money) and 57.9% of variance in life satisfaction was explained by the model. The factors influencing on life satisfaction among the elders in institutions were SDS, social support, activity level and monthly pocket money. According to the results of this study, depression, social support and activity level are considered the prime causal factors for life satisfaction.

  4. Influence of Climate Variability on US Regional Homicide Rates

    Science.gov (United States)

    Harp, R. D.; Karnauskas, K. B.

    2017-12-01

    Recent studies have found consistent evidence of a relationship between temperature and criminal behavior. However, despite agreement in the overall relationship, little progress has been made in distinguishing between two proposed explanatory theories. The General Affective Aggression Model (GAAM) suggests that high temperatures create periods of higher heat stress that enhance individual aggressiveness, whereas the Routine Activities Theory (RAT) theorizes that individuals are more likely to be outdoors interacting with others during periods of pleasant weather with a resulting increase in both interpersonal interactions and victim availability. Further, few studies have considered this relationship within the context of climate change in a quantitative manner. In an effort to distinguish between the two theories, and to examine the statistical relationships on a broader spatial scale than previously, we combined data from the Supplementary Homicide Report (SHR—compiled by the Federal Bureau of Investigation) and the North American Regional Reanalysis (NARR—compiled by the National Centers for Environmental Protection, a branch of the National Oceanic and Atmospheric Administration). US homicide data described by the SHR was compared with seven relevant observed climate variables (temperature, dew point, relative humidity, accumulated precipitation, accumulated snowfall, snow cover, and snow depth) provided by the NARR atmospheric reanalysis. Relationships between homicide rates and climate variables, as well as reveal regional spatial patterns will be presented and discussed, along with the implications due to future climate change. This research lays the groundwork for the refinement of estimates of an oft-overlooked climate change impact, which has previously been estimated to cause an additional 22,000 murders between 2010 and 2099, including providing important constraints for empirical models of future violent crime incidences in the face of global

  5. Sex and family history of cardiovascular disease influence heart rate variability during stress among healthy adults.

    Science.gov (United States)

    Emery, Charles F; Stoney, Catherine M; Thayer, Julian F; Williams, DeWayne; Bodine, Andrew

    2018-07-01

    Studies of sex differences in heart rate variability (HRV) typically have not accounted for the influence of family history (FH) of cardiovascular disease (CVD). This study evaluated sex differences in HRV response to speech stress among men and women (age range 30-49 years) with and without a documented FH of CVD. Participants were 77 adults (mean age = 39.8 ± 6.2 years; range: 30-49 years; 52% female) with positive FH (FH+, n = 32) and negative FH (FH-, n = 45) of CVD, verified with relatives of participants. Cardiac activity for all participants was recorded via electrocardiogram during a standardized speech stress task with three phases: 5-minute rest, 5-minute speech, and 5-minute recovery. Outcomes included time domain and frequency domain indicators of HRV and heart rate (HR) at rest and during stress. Data were analyzed with repeated measures analysis of variance, with sex and FH as between subject variables and time/phase as a within subject variable. Women exhibited higher HR than did men and greater HR reactivity in response to the speech stress. However, women also exhibited greater HRV in both the time and frequency domains. FH+ women generally exhibited elevated HRV, despite the elevated risk of CVD associated with FH+. Although women participants exhibited higher HR at rest and during stress, women (both FH+ and FH-) also exhibited elevated HRV reactivity, reflecting greater autonomic control. Thus, enhanced autonomic function observed in prior studies of HRV among women is also evident among FH+ women during a standardized stress task. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. The influence of psychosocial variables on adolescent suicidal ideation.

    Science.gov (United States)

    George, Ancel; van den Berg, Henriette S

    2012-07-01

    Increased rates of suicide among adolescents aged 15-24 years have led to suicides becoming the third leading cause of death in the Unites States. South African statistics show an equally worrying trend as suicide constitutes 11.5% of the total deaths for the age group 11-20 years (Stark et al. 2010). A national youth risk behaviour survey done in South Africa has re-emphasised the need for concern, as adolescent suicidal behaviour increased between 2002 and 2008 (Reddy et al. 2010). The objective was to investigate the influence of risk and protective factors (psychosocial and individual factors) on suicidal ideation. The Integrated Stress and Coping Process model was used as guiding theory for the inclusion of personal and contextual stressors and resources including coping strategies as potential risk and protective factors, in their relationship to suicidal ideation. A purposive, stratified sampling technique was used to study 381 adolescents in the Northern Cape Province. The instruments used were a suicidal ideation questionnaire; a biographical questionnaire; a self-esteem scale; and a survey examining stressors and resources relevant to adolescents. Suicidal ideation was significantly higher in the South African sample than in an American sample. Avoidant coping strategies (denial, emotional venting and restraint coping), negative life events and stressful romantic relationships contributed to higher levels of suicidal ideation while self-esteem and adaptive coping (acceptance and seeking social support for instrumental reasons) reduced these levels. A lack of self-esteem, ineffective coping and particular stressors contributed significantly to the vulnerability of adolescents. Future studies should explore a wider range of dispositional factors that influence effective coping and adjustment in addressing adolescent suicidal ideation.

  7. Social variables affecting mate preferences, copulation and reproductive outcome in a pack of free-ranging dogs.

    Directory of Open Access Journals (Sweden)

    Simona Cafazzo

    Full Text Available Mating and reproductive outcome is often determined by the simultaneous operation of different mechanisms like intra-sexual competition, mating preferences and sexual coercion. The present study investigated how social variables affected mating outcome in a pack of free-ranging dogs, a species supposed to have lost most features of the social system of wolves during domestication. We found that, although the pack comprised multiple breeding individuals, both male copulation success and female reproductive success were positively influenced by a linear combination of dominance rank, age and leadership. Our results also suggest that mate preferences affect mating outcome by reinforcing the success of most dominant individuals. In particular, during their oestrous period bitches clearly searched for the proximity of high-ranking males who displayed affiliative behaviour towards them, while they were more likely to reject the males who intimidated them. At the same time, male courting effort and male-male competition for receptive females appeared to be stronger in the presence of higher-ranking females, suggesting a male preference for dominant females. To our knowledge, these results provide the first clear evidence of social regulation of reproductive activities in domestic dogs, and suggest that some common organizing mechanisms may contribute to shape the social organization of both dogs and wolves.

  8. Breath acetone concentration; biological variability and the influence of diet

    International Nuclear Information System (INIS)

    Španěl, Patrik; Dryahina, Kseniya; Rejšková, Alžběta; Chippendale, Thomas W E; Smith, David

    2011-01-01

    Previous measurements of acetone concentrations in the exhaled breath of healthy individuals and the small amount of comparable data for individuals suffering from diabetes are briefly reviewed as a prelude to the presentation of new data on the sporadic and wide variations of breath acetone that occur in ostensibly healthy individuals. Data are also presented which show that following a ketogenic diet taken by eight healthy individuals their breath acetone concentrations increased up to five times over the subsequent 6 h. Similarly, the breath acetone increased six and nine times when a low carbohydrate diet was taken by two volunteers and remained high for the several days for which the diet was continued. These new data, together with the previous data, clearly indicate that diet and natural intra-individual biological and diurnal variability result in wide variations in breath acetone concentration. This places an uncertainty in the use of breath acetone alone to monitor blood glucose and glycaemic control, except and unless the individual acts as their own control and is cognizant of the need for dietary control. (note)

  9. Meta-modeling of occupancy variables and analysis of their impact on energy outcomes of office buildings

    International Nuclear Information System (INIS)

    Wang, Qinpeng; Augenbroe, Godfried; Kim, Ji-Hyun; Gu, Li

    2016-01-01

    Highlights: • A meta-analysis framework for a stochastic characterization of occupancy variables. • Sensitivity ranking of occupancy variability against all other sources of uncertainty. • Sensitivity of occupant presence for building energy consumption is low. • Accurate mean knowledge is sufficient for predicting building energy consumption. • Prediction of peak demand behavior requires stochastic occupancy modeling. - Abstract: Occupants interact with buildings in various ways via their presence (passive effects) and control actions (active effects). Therefore, understanding the influence of occupants is essential if we are to evaluate the performance of a building. In this paper, we model the mean profiles and variability of occupancy variables (presence and actions) separately. We will use a multi-variate Gaussian distribution to generate mean profiles of occupancy variables, while the variability will be represented by a multi-dimensional time series model, within a framework for a meta-analysis that synthesizes occupancy data gathered from a pool of buildings. We then discuss variants of occupancy models with respect to various outcomes of interest such as HVAC energy consumption and peak demand behavior via a sensitivity analysis. Results show that our approach is able to generate stochastic occupancy profiles, requiring minimum additional input from the energy modeler other than standard diversity profiles. Along with the meta-analysis, we enable the generalization of previous research results and statistical inferences to choose occupancy variables for future buildings. The sensitivity analysis shows that for aggregated building energy consumption, occupant presence has a smaller impact compared to lighting and appliance usage. Specifically, being accumulatively 55% wrong with regard to presence, only translates to 2% error in aggregated cooling energy in July and 3.6% error in heating energy in January. Such a finding redirects focus to the

  10. Does national expenditure on research and development influence stroke outcomes?

    Science.gov (United States)

    Kim, Young Dae; Jung, Yo Han; Norrving, Bo; Ovbiagele, Bruce; Saposnik, Gustavo

    2017-10-01

    Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = -0.708 in 2002 and r = -0.730 in 2008) or rGERD (r = -0.545 in 2002 and r = -0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.

  11. Influence of diabetes mellitus on heart failure risk and outcome

    Directory of Open Access Journals (Sweden)

    Van Belle Eric

    2003-01-01

    Full Text Available Abstract Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM with heart failure (HF The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients.

  12. Influence of nutritional variables and obesity on health and metabolism.

    Science.gov (United States)

    Azevedo, Fernanda Reis de; Brito, Bruna Cristina

    2012-01-01

    Obesity is a recurring theme in current scientific literature. This can easily be explained by its exponential increase in all layers of society. The popularity of this subject has also given rise to associated questions, which have achieved greater prominence in health-related publications. In order to assess what has been studied in the field of obesity and nutrition, an overview of all articles published on these subjects in some of the main Brazilian scientific journals over the past two years was performed. Among the subthemes selected for this study, those related to childhood obesity attracted attention due to their greater frequency. These were subdivided into: prevalence, intrauterine and breastfeeding influences that may lead to the development of this condition, impact on quality of life, cardiovascular system and metabolism, and possible prevention strategies. Furthermore, issues related to obesity in adults were explored, such as risk factors and new strategies for prevention, with special attention given to the many studies evaluating different aspects of bariatric surgery. Finally, the subject of malnutrition and the impact of the deficiency of specific micronutrients such as selenium, vitamin D, and vitamin B12 were assessed. Based on the results, it was possible to assess the actual importance of obesity and nutrition in health maintenance, and also the several lines of research regarding these issues. Thus, it is essential to create new methods, which must be quick and efficient, to update health professionals involved in the treatment of obesity.

  13. The Influence of trisomy 21 on facial form and variability.

    Science.gov (United States)

    Starbuck, John M; Cole, Theodore M; Reeves, Roger H; Richtsmeier, Joan T

    2017-11-01

    Triplication of chromosome 21 (trisomy 21) results in Down syndrome (DS), the most common live-born human aneuploidy. Individuals with DS have a unique facial appearance that can include form changes and altered variability. Using 3D photogrammatic images, 3D coordinate locations of 20 anatomical landmarks, and Euclidean Distance Matrix Analysis methods, we quantitatively test the hypothesis that children with DS (n = 55) exhibit facial form and variance differences relative to two different age-matched (4-12 years) control samples of euploid individuals: biological siblings of individuals with DS (n = 55) and euploid individuals without a sibling with DS (n = 55). Approximately 36% of measurements differ significantly between DS and DS-sibling samples, whereas 46% differ significantly between DS and unrelated control samples. Nearly 14% of measurements differ significantly in variance between DS and DS sibling samples, while 18% of measurements differ significantly in variance between DS and unrelated euploid control samples. Of those measures that showed a significant difference in variance, all were relatively increased in the sample of DS individuals. These results indicate that faces of children with DS are quantitatively more similar to their siblings than to unrelated euploid individuals and exhibit consistent, but slightly increased variation with most individuals falling within the range of normal variation established by euploid samples. These observations provide indirect evidence of the strength of the genetic underpinnings of the resemblance between relatives and the resistance of craniofacial development to genetic perturbations caused by trisomy 21, while underscoring the complexity of the genotype-phenotype map. © 2017 Wiley Periodicals, Inc.

  14. Long-term outcome of major depressive disorder in psychiatric patients is variable.

    Science.gov (United States)

    Holma, K Mikael; Holma, Irina A K; Melartin, Tarja K; Rytsälä, Heikki J; Isometsä, Erkki T

    2008-02-01

    The prevailing view of outcome of major depressive disorder (MDD), based on mostly inpatient cohorts sampled from tertiary centers, emphasizes chronicity and frequent recurrences. We investigated the long-term outcome of a regionally representative psychiatric MDD cohort comprising mainly outpatients. The Vantaa Depression Study included 163 patients with DSM-IV MDD (71.5% of those eligible) diagnosed using structured and semistructured interviews and followed up at 6 months, 18 months, and 5 years with a life chart between February 1, 1997, and April 30, 2004. The effects of comorbid disorders and other predictors on outcome were comprehensively investigated. Over the 5-year follow-up, 98.8% of patients achieved a symptom state below major depressive episode (MDE) criteria, and 88.4% reached full remission, with the median time to full remission being 11.0 months. Nearly one third (29.3%) had no recurrences, whereas 30.0% experienced 1, 12.9% experienced 2, and 27.9% experienced 3 or more recurrences. Preceding dysthymic disorder (p = .028), cluster C personality disorder (p = .041), and longer MDE duration prior to entry (p = .011) were the most significant predictors of longer time in achieving full remission. Severity of MDD and comorbidity, especially social phobia, predicted probability of, shorter time to, and number of recurrences. Previous literature on mostly inpatient MDD may have, by generalizing from patients with the most severe psychopathology, overemphasized chronicity of MDD. The long-term outcome of MDD in psychiatric care is variable, with about one tenth of patients having poor, one third having intermediate, and one half having favorable outcomes. In addition to known predictors, cluster C personality disorders and social phobia warrant further attention as predictors of MDD outcome among outpatients.

  15. Optimism Moderates the Influence of Pain Catastrophizing on Shoulder Pain Outcome: A Longitudinal Analysis.

    Science.gov (United States)

    Coronado, Rogelio A; Simon, Corey B; Lentz, Trevor A; Gay, Charles W; Mackie, Lauren N; George, Steven Z

    2017-01-01

    Study Design Secondary analysis of prospectively collected data. Background An abundance of evidence has highlighted the influence of pain catastrophizing and fear avoidance on clinical outcomes. Less is known about the interaction of positive psychological resources with these pain-associated distress factors. Objective To assess whether optimism moderates the influence of pain catastrophizing and fear avoidance on 3-month clinical outcomes in patients with shoulder pain. Methods Data from 63 individuals with shoulder pain (mean ± SD age, 38.8 ± 14.9 years; 30 female) were examined. Demographic, psychological, and clinical characteristics were obtained at baseline. Validated measures were used to assess optimism (Life Orientation Test-Revised), pain catastrophizing (Pain Catastrophizing Scale), fear avoidance (Fear-Avoidance Beliefs Questionnaire physical activity subscale), shoulder pain intensity (Brief Pain Inventory), and shoulder function (Pennsylvania Shoulder Score function subscale). Shoulder pain and function were reassessed at 3 months. Regression models assessed the influence of (1) pain catastrophizing and optimism and (2) fear avoidance and optimism. The final multivariable models controlled for factors of age, sex, education, and baseline scores, and included 3-month pain intensity and function as separate dependent variables. Results Shoulder pain (mean difference, -1.6; 95% confidence interval [CI]: -2.1, -1.2) and function (mean difference, 2.4; 95% CI: 0.3, 4.4) improved over 3 months. In multivariable analyses, there was an interaction between pain catastrophizing and optimism (β = 0.19; 95% CI: 0.02, 0.35) for predicting 3-month shoulder function (F = 16.8, R 2 = 0.69, Poptimism lessened the influence of pain catastrophizing on function. There was no evidence of significant moderation of fear-avoidance beliefs for 3-month shoulder pain (P = .090) or function (P = .092). Conclusion Optimism decreased the negative influence of pain

  16. Disentangling the effects of genetic, prenatal and parenting influences on children's cortisol variability.

    Science.gov (United States)

    Marceau, Kristine; Ram, Nilam; Neiderhiser, Jenae M; Laurent, Heidemarie K; Shaw, Daniel S; Fisher, Phil; Natsuaki, Misaki N; Leve, Leslie D

    2013-11-01

    Developmental plasticity models hypothesize the role of genetic and prenatal environmental influences on the development of the hypothalamic-pituitary-adrenal (HPA) axis and highlight that genes and the prenatal environment may moderate early postnatal environmental influences on HPA functioning. This article examines the interplay of genetic, prenatal and parenting influences across the first 4.5 years of life on a novel index of children's cortisol variability. Repeated measures data were obtained from 134 adoption-linked families, adopted children and both their adoptive parents and birth mothers, who participated in a longitudinal, prospective US domestic adoption study. Genetic and prenatal influences moderated associations between inconsistency in overreactive parenting from child age 9 months to 4.5 years and children's cortisol variability at 4.5 years differently for mothers and fathers. Among children whose birth mothers had high morning cortisol, adoptive fathers' inconsistent overreactive parenting predicted higher cortisol variability, whereas among children with low birth mother morning cortisol adoptive fathers' inconsistent overreactive parenting predicted lower cortisol variability. Among children who experienced high levels of prenatal risk, adoptive mothers' inconsistent overreactive parenting predicted lower cortisol variability and adoptive fathers' inconsistent overreactive parenting predicted higher cortisol variability, whereas among children who experienced low levels of prenatal risk there were no associations between inconsistent overreactive parenting and children's cortisol variability. Findings supported developmental plasticity models and uncovered novel developmental, gene × environment and prenatal × environment influences on children's cortisol functioning.

  17. Perceived match or mismatch on the Gottman conflict styles: associations with relationship outcome variables.

    Science.gov (United States)

    Busby, Dean M; Holman, Thomas B

    2009-12-01

    Gottman has proposed that there are 3 functional styles of conflict management in couple relationships, labeled Avoidant, Validating, and Volatile, and 1 dysfunctional style, labeled Hostile. Using a sample of 1,983 couples in a committed relationship, we test the association of perceived matches or mismatches on these conflict styles with relationship outcome variables. The results indicate that 32% of the participants perceive there is a mismatch with their conflict style and that of their partner. The Volatile-Avoidant mismatch was particularly problematic and was associated with more stonewalling, relationship problems, and lower levels of relationship satisfaction and stability than the Validating matched style and than other mismatched styles. The most problematic style was the Hostile style. Contrary to existing assumptions by Gottman, the 3 matched functional styles were not equivalent, as the Validating Style was associated with substantially better results on relationship outcome measures than the Volatile and Avoidant styles.

  18. Environmental Literacy in Madeira Island (Portugal): The Influence of Demographic Variables

    Science.gov (United States)

    Spinola, Hélder

    2016-01-01

    Demographic factors are among those that influence environmental literacy and, particularly, environmentally responsible behaviours, either directly or due to an aggregation effect dependent on other types of variables. Present study evaluates a set of demographic variables as predictors for environmental literacy among 9th grade students from…

  19. Variability in urban soils influences the health and growth of native tree seedlings

    Science.gov (United States)

    Clara C. Pregitzer; Nancy F. Sonti; Richard A. Hallett

    2016-01-01

    Reforesting degraded urban landscapes is important due to the many benefits urban forests provide. Urban soils are highly variable, yet little is known about how this variability in urban soils influences tree seedling performance and survival. We conducted a greenhouse study to assess health, growth, and survival of four native tree species growing in native glacial...

  20. Influence of new societal factors on neovascular age-related macular degeneration outcomes.

    Science.gov (United States)

    Giocanti-Aurégan, Audrey; Chbat, Elige; Darugar, Adil; Morel, Christophe; Morin, Bruno; Conrath, John; Devin, François

    2018-02-01

    To assess the impact of unstudied societal factors for neovascular age-related macular degeneration (nAMD) on functional outcomes after anti-VEGFs. Charts of 94 nAMD patients treated in the Monticelli-Paradis Centre, Marseille, France, were reviewed. Phone interviews were conducted to assess societal factors, including transportation, living status, daily reading and social security scheme (SSS). Primary outcome was the impact of family support and disease burden on functional improvement in nAMD. Between baseline and month 24 (M24), 42.4% of the variability in best-corrected visual acuity (BCVA) was explained by the cumulative effect of the following societal factors: intermittent out-patient follow-up, marital status, daily reading, transportation type, commuting time. No isolated societal factor significantly correlated with ETDRS BCVA severity at M24. A trend to correlation was observed between the EDTRS score at M24 and the SSS (P = 0.076), economic burden (P = 0.075), time between diagnosis and treatment initiation (P = 0.070). A significant correlation was found for the disease burdensome on the patient (P = 0.034) and low vision rehabilitation (P = 0.014). Societal factors could influence functional outcomes in nAMD patients treated with anti-VEGFs. They could contribute to the healing process or sustain disease progression.

  1. Key variables influencing patterns of lava dome growth and collapse

    Science.gov (United States)

    Husain, T.; Elsworth, D.; Voight, B.; Mattioli, G. S.; Jansma, P. E.

    2013-12-01

    transition in the growth pattern, while a decrease in infusion rate results in larger crystals causing the material to stiffen leading to formation of spines. Material stiffness controls the growth direction of the viscous plug in the lava dome interior. Material strength and stiffness controled by rate of infusion influence lava dome growth more significantly than coefficient of frictional of the talus.

  2. Survival and Injury Outcome After TBI: Influence of Pre- and Post-Exposure to Caffeine

    Science.gov (United States)

    2012-10-01

    10-1-0757 TITLE: Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine PRINCIPAL INVESTIGATOR...Lusardi, Ph.D. Survival and Injury Outcome After TBI: Influence of Pre- and Post- Exposure to Caffeine 33 Legacy Emanual Hospital & Health Center...Phase 1: Study the prophylactic effects of caffeine exposure prior to FPI

  3. Manual and oral apraxia in acute stroke, frequency and influence on functional outcome

    DEFF Research Database (Denmark)

    Pedersen, P M; Jørgensen, H S; Kammersgaard, L P

    2001-01-01

    To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome.......To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome....

  4. The influence of obesity on functional outcome and quality of life after total knee arthroplasty.

    Science.gov (United States)

    Xu, S; Chen, J Y; Lo, N N; Chia, S L; Tay, D K J; Pang, H N; Hao, Y; Yeo, S J

    2018-05-01

    Aims This study investigated the influence of body mass index (BMI) on patients' function and quality of life ten years after total knee arthroplasty (TKA). Patients and Methods A total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey. Results Patients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579-83.

  5. Diastolic blood pressure variability in 24 hour-ABPM and outcomes of chronic kidney disease
.

    Science.gov (United States)

    Sahutoglu, Tuncay; Sakaci, Tamer

    2018-04-10

    Blood pressure variability (BPV) has been associated with increased morbidity and mortality. There are a few studies that reported worse outcomes of chronic kidney disease (CKD) with greater visit-to-visit BPV (VVV), but data with ambulatory blood pressure monitoring (ABPM) is scarce. Ambulatory hypertensive CKD (stage 2 - 4) patients (> 18 years old) with complete 24 hours of ABPM study (SpaceLabs), who were followed up between January 2012 and December 2016, were retrospectively analyzed for the baseline characteristics and outcomes of CKD. Coefficient of variation (CV) in diastolic blood pressure (DBP) was used as an index of BPV. Data of 191 patients (mean age 59.7 ± 12.4 years, 54.9% males, 42.1% diabetic, mean eGFR-EPI (Chronic Kidney Disease Epidemiology Collaboration) 51.7 ± 22.0 mL/min/1.73m2, mean follow-up 26.2 ± 10.4 months) were available for the analysis. On multivariate linear regression analysis, greater DBP-CV was associated with slower decline in eGFR-EPI per year (B -0.648, p = 0.000). Likewise, the hazard ratio (HR) for dialysis inception (occurred in 9.4%) was found significantly lower with increasing DBP-CV in unadjusted and fully adjusted Cox models (HR 0.730, 95% CI 0.618 - 0.861, p = 0.000, and HR 0.678, 95% CI 0.526 - 0.874, p = 0.003, respectively). These findings suggest that DBP variability in 24-hour ABPM may be a good prognostic factor for the outcomes of CKD. Further studies are needed to determine the impact of 24-hour ABPM BPV on CKD progression and its differences from VVV.
.

  6. Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome.

    Science.gov (United States)

    Varghese, George M; Janardhanan, Jeshina; Trowbridge, Paul; Peter, John V; Prakash, John A J; Sathyendra, Sowmya; Thomas, Kurien; David, Thambu S; Kavitha, M L; Abraham, Ooriapadickal C; Mathai, Dilip

    2013-11-01

    This study sought to document the clinical and laboratory manifestations, genetic variability, and outcomes of scrub typhus, an often severe infection caused by Orientia tsutsugamushi, in South India. Patients admitted to a large teaching hospital with IgM ELISA-confirmed scrub typhus were evaluated. Clinical examination with a thorough search for an eschar, laboratory testing, chest X-ray, and outcome were documented and analyzed. Additionally, a 410-bp region of the 56-kDa type-specific antigen gene of O. tsutsugamushi was sequenced and compared with isolates from other regions of Asia. Most of the 154 patients evaluated presented with fever and non-specific symptoms. An eschar was found in 86 (55%) patients. Mild hepatic involvement was seen in most, with other organ involvement including respiratory, cardiovascular, and renal. Multi-organ dysfunction was noted in 59 (38.3%), and the fatality rate was 7.8%. Hypotension requiring vasoactive agents was found to be an independent predictor of mortality (p<0.001). The phylogeny of 26 samples showed 17 (65%) clustering with the Kato-like group and eight (31%) with the Karp-like group. The presentation of scrub typhus can be variable, often non-specific, but with potentially severe multi-organ dysfunction. Prompt recognition is key to specific treatment and good outcomes. Further study of the circulating strains is essential for the development of a successful vaccine and sensitive point-of-care testing. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. High Intrapatient Variability of Tacrolimus Levels and Outpatient Clinic Nonattendance Are Associated With Inferior Outcomes in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Dawn L. Goodall, MSc

    2017-08-01

    Conclusions. This study shows that high tacrolimus IPV and clinic nonattendance are associated with inferior allograft survival. Interventions to minimize the causes of high variability, particularly nonadherence are essential to improve long-term allograft outcomes.

  8. Intraindividual variability in reaction time predicts cognitive outcomes 5 years later.

    Science.gov (United States)

    Bielak, Allison A M; Hultsch, David F; Strauss, Esther; Macdonald, Stuart W S; Hunter, Michael A

    2010-11-01

    Building on results suggesting that intraindividual variability in reaction time (inconsistency) is highly sensitive to even subtle changes in cognitive ability, this study addressed the capacity of inconsistency to predict change in cognitive status (i.e., cognitive impairment, no dementia [CIND] classification) and attrition 5 years later. Two hundred twelve community-dwelling older adults, initially aged 64-92 years, remained in the study after 5 years. Inconsistency was calculated from baseline reaction time performance. Participants were assigned to groups on the basis of their fluctuations in CIND classification over time. Logistic and Cox regressions were used. Baseline inconsistency significantly distinguished among those who remained or transitioned into CIND over the 5 years and those who were consistently intact (e.g., stable intact vs. stable CIND, Wald (1) = 7.91, p < .01, Exp(β) = 1.49). Average level of inconsistency over time was also predictive of study attrition, for example, Wald (1) = 11.31, p < .01, Exp(β) = 1.24. For both outcomes, greater inconsistency was associated with a greater likelihood of being in a maladaptive group 5 years later. Variability based on moderately cognitively challenging tasks appeared to be particularly sensitive to longitudinal changes in cognitive ability. Mean rate of responding was a comparable predictor of change in most instances, but individuals were at greater relative risk of being in a maladaptive outcome group if they were more inconsistent rather than if they were slower in responding. Implications for the potential utility of intraindividual variability in reaction time as an early marker of cognitive decline are discussed. (c) 2010 APA, all rights reserved

  9. Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

    International Nuclear Information System (INIS)

    Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C.

    2001-01-01

    There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT 3 and FT 4 levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

  10. Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C. [Wuerzburg Univ. (Germany). Abt. fuer Nuklearmedizin

    2001-09-01

    There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT{sub 3} and FT{sub 4} levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

  11. Environmental variables measured at multiple spatial scales exert uneven influence on fish assemblages of floodplain lakes

    Science.gov (United States)

    Dembkowski, Daniel J.; Miranda, Leandro E.

    2014-01-01

    We examined the interaction between environmental variables measured at three different scales (i.e., landscape, lake, and in-lake) and fish assemblage descriptors across a range of over 50 floodplain lakes in the Mississippi Alluvial Valley of Mississippi and Arkansas. Our goal was to identify important local- and landscape-level determinants of fish assemblage structure. Relationships between fish assemblage structure and variables measured at broader scales (i.e., landscape-level and lake-level) were hypothesized to be stronger than relationships with variables measured at finer scales (i.e., in-lake variables). Results suggest that fish assemblage structure in floodplain lakes was influenced by variables operating on three different scales. However, and contrary to expectations, canonical correlations between in-lake environmental characteristics and fish assemblage structure were generally stronger than correlations between landscape-level and lake-level variables and fish assemblage structure, suggesting a hierarchy of influence. From a resource management perspective, our study suggests that landscape-level and lake-level variables may be manipulated for conservation or restoration purposes, and in-lake variables and fish assemblage structure may be used to monitor the success of such efforts.

  12. Factors Influencing Visual Outcome after Surgery for Retinal ...

    African Journals Online (AJOL)

    Dr femi Oderinlo

    Three factors favourably affected visual outcome and were of statistical ... These changes are likely to affect the. 10,11 ... within the South Western geopolitical region of Nigeria is one of the ... tamponade (silicon oil or C F gas in a single case), or a combination ..... studies also had similar final anatomic success rates, 90.2%.

  13. Family and Community Influences on Educational Outcomes among Appalachian Youth

    Science.gov (United States)

    Brown, Ryan; Copeland, William E.; Costello, E. Jane; Erkanli, Alaattin; Worthman, Carol M.

    2009-01-01

    Recent research has shown how quantifiable aspects of community context affect a wide range of behaviors and outcomes. Due partially to the historical development of this field, currently published work focuses on urban rather than rural areas. We draw upon data from a longitudinal study of families and health in Appalachia--the Great Smoky…

  14. Farmers' Perceptions of Climate Variability and Factors Influencing Adaptation: Evidence from Anhui and Jiangsu, China.

    Science.gov (United States)

    Kibue, Grace Wanjiru; Liu, Xiaoyu; Zheng, Jufeng; Zhang, Xuhui; Pan, Genxing; Li, Lianqing; Han, Xiaojun

    2016-05-01

    Impacts of climate variability and climate change are on the rise in China posing great threat to agriculture and rural livelihoods. Consequently, China is undertaking research to find solutions of confronting climate change and variability. However, most studies of climate change and variability in China largely fail to address farmers' perceptions of climate variability and adaptation. Yet, without an understanding of farmers' perceptions, strategies are unlikely to be effective. We conducted questionnaire surveys of farmers in two farming regions, Yifeng, Jiangsu and Qinxi, Anhui achieving 280 and 293 responses, respectively. Additionally, we used climatological data to corroborate the farmers' perceptions of climate variability. We found that farmers' were aware of climate variability such that were consistent with climate records. However, perceived impacts of climate variability differed between the two regions and were influenced by farmers' characteristics. In addition, the vast majorities of farmers were yet to make adjustments in their farming practices as a result of numerous challenges. These challenges included socioeconomic and socio-cultural barriers. Results of logit modeling showed that farmers are more likely to adapt to climate variability if contact with extension services, frequency of seeking information, household heads' education, and climate variability perceptions are improved. These results suggest the need for policy makers to understand farmers' perceptions of climate variability and change in order to formulate policies that foster adaptation, and ultimately protect China's agricultural assets.

  15. The Influence of Entrepreneurship Subject on Students’ Interest in Entrepreneurship by Hidden Curriculum as Intervening Variable

    Directory of Open Access Journals (Sweden)

    Amin Kuncoro

    2016-06-01

    Full Text Available This research aims to know the influence of entrepreneurship subject on students’ interest in entrepreneurship at Institute of Mathaliul Falah (IPMAFA in Pati by hidden curriculum as intervening variable. The research used WarpsPls analysis to test model directly and directly. Samples of the study were 30 Islamic banking students who got entrepreneurship subject and Islamic community development who did not get the entrepreneurship subject. Findings show that the entrepreneurship subject influences students’ interest in entrepreneurship and the second model test results showed that hidden curriculum is not able to become the intervening variable for students’ interest in entrepreneurship subject on students’ interest in entrepreneurship.

  16. Study populations and casemix: influence on analysis of postoperative outcomes.

    Science.gov (United States)

    Isbister, W H

    2000-04-01

    The importance of patient casemix as a determinant of surgical outcome is now being recognized. The present study was undertaken in order to compare the presentation and outcomes in colorectal patients managed surgically by the same surgeon, in the same way, in different settings. Colorectal outcome data from the University Department of Surgery in Wellington and the King Faisal Specialist Hospital in Riyadh were analysed in order to determine casemix differences between the two hospitals. Data relating to the type of surgery, the surgeon, the patient's disease, the operation performed and the postoperative complications were compared. Specific colorectal clinical indicators were compared for two commonly performed operations for rectal cancer: anterior resection and abdomino-perineal resection of the rectum. Wellington patients were slightly older and there were more females. Emergency surgery was more frequent in Wellington. Left hemicolectomy, sigmoid colectomy, abscess drainage and pilonidal surgery were more common in Wellington whereas abdomino-perineal resection and anterior resection of the rectum, stoma closure, fistula surgery, seton insertion, restorative proctocolectomy and ileostomy were undertaken more frequently in Riyadh. More complex anal fistulas were managed in Riyadh. Condylomata accuminata, pilonidal abscess, anorectal abscess, rectal prolapse and diverticular disease were rarely seen in Riyadh. There were more postoperative pulmonary and cardiac complications in Wellington. Patients having anterior resection of the rectum were younger in Riyadh and there were proportionally more females. There were some obvious numerical outcome differences in postoperative atelectasis, wound infection, anastomotic leak and deep vein thrombosis rates but none of these reached statistical significance except atelectasis. In Riyadh the usual male-to-female ratio of patients undergoing abdomino-perineal resection was reversed but, again, none of the numerical

  17. Neoadjuvant chemoradiotherapy of rectal carcinoma. Baseline hematologic parameters influencing outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Hodek, Miroslav; Sirak, Igor; Paluska, Petr; Kopecky, Jindrich; Petera, Jiri; Vosmik, Milan [University Hospital in Hradec Kralove, Department of Oncology and Radiotherapy, Hradec Kralove (Czech Republic); Ferko, Alexander; Oerhalmi, Julius [University Hospital in Hradec Kralove, Department of Surgery, Hradec Kralove (Czech Republic); Hovorkova, Eva; Hadzi Nikolov, Dimitar [University Hospital in Hradec Kralove, Fingerland Department of Pathology, Hradec Kralove (Czech Republic)

    2016-09-15

    The link between the blood count and a systemic inflammatory response (SIR) is indisputable and well described. Pretreatment hematological parameters may predict the overall clinical outcomes in many types of cancer. Thus, this study aims to systematically evaluate the relationship between baseline blood count levels and treatment response in rectal cancer patients treated with neoadjuvant chemoradiotherapy. From 2009-2015, 173 patients with locally advanced rectal cancer were retrospectively enrolled in the study and analyzed. The baseline blood count was recorded in all patients 1 week before chemoradiation. Tumor response was evaluated through pathologic findings. Blood count levels which included RBC (red blood cells), Hb (hemoglobin), PLT (platelet count), neutrophil count, WBC (white blood cells), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio) were analyzed in relation to tumor downstaging, pCR (pathologic complete response), OS (overall survival), and DFS (disease-free survival). Hb levels were associated with a response in logistic regression analysis: pCR (p = 0.05; OR 1.04, 95 % CI 1.00-1.07); T downstaging (p = 0.006; OR 1.03, 95 % CI 1.01-1.05); N downstaging (p = 0.09; OR 1.02, 95 % CI 1.00-1.04); T or N downstaging (p = 0.007; OR 1.04, 95 % CI 1.01-1.07); T and N downstaging (p = 0.02; OR 1.02, 95 % CI 1.00-1.04); Hb and RBC were the most significant parameters influencing OS; PLT was a negative prognostic factor for OS and DFS (p = 0.008 for OS); an NLR value of 2.8 was associated with the greatest significance for OS (p = 0.03) and primary tumor downstaging (p = 0.02). Knowledge of pretreatment hematological parameters appears to be an important prognostic factor in patients with rectal carcinoma. (orig.) [German] Die Verbindung zwischen dem Blutbild und der systemischen Entzuendungsreaktion (''systemic inflammatory response'', SIR) ist unbestreitbar und gut beschrieben. Aufgrund der

  18. Metacognition as a Mediating Variable Between Neurocognition and Functional Outcome in First Episode Psychosis.

    Science.gov (United States)

    Davies, Geoff; Fowler, David; Greenwood, Kathryn

    2017-07-01

    Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and neurocognition has been found to account for functional disability to a greater extent than psychopathology. Much of the variance in functional outcome however still remains unexplained and metacognition may mediate the relationship between neurocognition, functional capacity, and self-reported social and occupational function. Eighty first episode psychosis participants were recruited and completed measures of neurocognition (memory, executive function, and intelligence quotient), metacognition (Beck Cognitive Insight Scale, Metacognitive Awareness Interview), psychopathology (PANSS), and both functional capacity (UPSA) and real-life social and occupational function (The Time Use Survey). Path analyses investigated the relationships between variables through structural equation modeling. A series of path models demonstrated that metacognition partially mediates the relationship between neurocognition and functional capacity, and fully mediates the relationship between functional capacity and social and occupational function. The present study findings identify that metacognition may be critical to translating cognitive and functional skills into real-world contexts, and this relationship is found at early stages of illness. Understanding how individuals translate cognitive and functional skills into the real-world (the competence-performance gap) may offer valuable guidance to intervention programs. This finding is important to models of recovery as it suggests that intervention programs that focus on enhancing metacognition abilities may have a greater impact than traditional rehabilitation programs focusing on cognitive abilities, on social and occupational outcomes. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

  19. Virtual Teaming and Collaboration Technology: A Study of Influences on Virtual Project Outcomes

    Science.gov (United States)

    Broils, Gary C.

    2014-01-01

    The purpose of this quantitative correlational study was to explore the relationships between the independent variables, contextual factors for virtual teams and collaboration technology, and the dependent variable, virtual project outcomes. The problem leading to the need for the study is a lower success rate for virtual projects compared to…

  20. Spatial interpolation of climate variables in Northern Germany—Influence of temporal resolution and network density

    Directory of Open Access Journals (Sweden)

    C. Berndt

    2018-02-01

    New hydrological insights: Geostatistical techniques provide a better performance for all climate variables compared to simple methods Radar data improves the estimation of rainfall with hourly temporal resolution, while topography is useful for weekly to yearly values and temperature in general. No helpful information was found for cloudiness, sunshine duration, and wind speed, while interpolation of humidity benefitted from additional temperature data. The influences of temporal resolution, spatial variability, and additional information appear to be stronger than station density effects. High spatial variability of hourly precipitation causes the highest error, followed by wind speed, cloud coverage and sunshine duration. Lowest errors occur for temperature and humidity.

  1. Variables influencing the use of derivatives in South Africa – the development of a conceptual model

    Directory of Open Access Journals (Sweden)

    Stefan Schwegler

    2011-03-01

    Full Text Available This paper, which is the first in a two-part series, sets out the development of a conceptual model on the variables influencing investors’ decisions to use derivatives in their portfolios. Investor-specific variables include: the investor’s needs, goals and return expectations, the investor’s knowledge of financial markets, familiarity with different asset classes including derivative instruments, and the investor’s level of wealth and level of risk tolerance. Market-specific variables include: the level of volatility, standardisation, regulation and liquidity in a market, the level of information available on derivatives, the transparency of price determination, taxes, brokerage costs and product availability.

  2. Hepatitus B virus infection : factors influencing the outcome

    NARCIS (Netherlands)

    J. van Hattum (Jan)

    1986-01-01

    textabstractThis study was designed to find correlations between the various courses of disease after hepatitis B virus (HBV) infection and factors that could conceivably have influenced the course of disease. The aim of the study was to find correlations between parameters of viral replication and

  3. Leader Affect and Leadership Effectiveness: How leader affective displays influence follower outcomes

    NARCIS (Netherlands)

    V.A. Visser (Victoria)

    2013-01-01

    textabstractThe aim of this dissertation is to uncover the relationship between leader affective displays and leadership effectiveness. Five empirical studies were conducted to test the influence of several leader affective displays on different follower outcomes that indicate leadership

  4. The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair

    NARCIS (Netherlands)

    F.M.V. Bastos Gonçalves (Frederico); H.J.M. Verhagen (Hence); K. Chinsakchai (Khamin); J.W. van Keulen (Jasper); M.T. Voûte (Michiel); H.J.A. Zandvoort (Herman); F.L. Moll (Frans); J.A. van Herwaarden (Joost)

    2012-01-01

    textabstractObjective: This study investigated the influence of significant aneurysm neck thrombus in clinical and morphologic outcomes after endovascular aneurysm repair (EVAR). Methods: The patient population was derived from a prospective EVAR database from two university institutions in The

  5. Who wants feedback? An investigation of the variables influencing residents' feedback-seeking behavior in relation to night shifts.

    Science.gov (United States)

    Teunissen, Pim W; Stapel, Diederik A; van der Vleuten, Cees; Scherpbier, Albert; Boor, Klarke; Scheele, Fedde

    2009-07-01

    The literature on feedback in clinical medical education has predominantly treated trainees as passive recipients. Past research has focused on how clinical supervisors can use feedback to improve a trainee's performance. On the basis of research in social and organizational psychology, the authors reconceptualized residents as active seekers of feedback. They investigated what individual and situational variables influence residents' feedback-seeking behavior on night shifts. Early in 2008, the authors sent obstetrics-gynecology residents in the Netherlands--both those in their first two years of graduate training and those gaining experience between undergraduate and graduate training--a questionnaire that assessed four predictor variables (learning and performance goal orientation, and instrumental and supportive leadership), two mediator variables (perceived feedback benefits and costs), and two outcome variables (frequency of feedback inquiry and monitoring). They used structural equation modeling software to test a hypothesized model of relationships between variables. The response rate was 76.5%. Results showed that residents who perceive more feedback benefits report a higher frequency of feedback inquiry and monitoring. More perceived feedback costs result mainly in more feedback monitoring. Residents with a higher learning goal orientation perceive more feedback benefits and fewer costs. Residents with a higher performance goal orientation perceive more feedback costs. Supportive physicians lead residents to perceive more feedback benefits and fewer costs. This study showed that some residents actively seek feedback. Residents' feedback-seeking behavior partially depends on attending physicians' supervisory style. Residents' goal orientations influence their perceptions of the benefits and costs of feedback-seeking.

  6. Planning performance in schizophrenia patients: a meta-analysis of the influence of task difficulty and clinical and sociodemographic variables.

    Science.gov (United States)

    Knapp, F; Viechtbauer, W; Leonhart, R; Nitschke, K; Kaller, C P

    2017-08-01

    Despite a large body of research on planning performance in adult schizophrenia patients, results of individual studies are equivocal, suggesting either no, moderate or severe planning deficits. This meta-analysis therefore aimed to quantify planning deficits in schizophrenia and to examine potential sources of the heterogeneity seen in the literature. The meta-analysis comprised outcomes of planning accuracy of 1377 schizophrenia patients and 1477 healthy controls from 31 different studies which assessed planning performance using tower tasks such as the Tower of London, the Tower of Hanoi and the Stockings of Cambridge. A meta-regression analysis was applied to assess the influence of potential moderator variables (i.e. sociodemographic and clinical variables as well as task difficulty). The findings indeed demonstrated a planning deficit in schizophrenia patients (mean effect size: ; 95% confidence interval 0.56-0.78) that was moderated by task difficulty in terms of the minimum number of moves required for a solution. The results did not reveal any significant relationship between the extent of planning deficits and sociodemographic or clinical variables. The current results provide first meta-analytic evidence for the commonly assumed impairments of planning performance in schizophrenia. Deficits are more likely to become manifest in problem items with higher demands on planning ahead, which may at least partly explain the heterogeneity of previous findings. As only a small fraction of studies reported coherent information on sample characteristics, future meta-analyses would benefit from more systematic reports on those variables.

  7. Influence of Cognitive Ability on Therapy Outcomes for Anomia in Adults with Chronic Poststroke Aphasia

    Science.gov (United States)

    Dignam, Jade; Copland, David; O'Brien, Kate; Burfein, Penni; Khan, Asaduzzaman; Rodriguez, Amy D.

    2017-01-01

    Purpose: The relationship between cognitive abilities and aphasia rehabilitation outcomes is complex and remains poorly understood. This study investigated the influence of language and cognitive abilities on anomia therapy outcomes in adults with aphasia. Method: Thirty-four adults with chronic aphasia participated in Aphasia Language Impairment…

  8. Cooperative context is a determinant of the social influence on outcome evaluation: An electrophysiological study.

    Science.gov (United States)

    Kimura, Kenta; Katayama, Jun'ichi

    2016-02-01

    The present study examined whether or not a cooperative context is a determinant of the social influence on the evaluation of two action outcomes: a monetary outcome and a conflict of opinion with other group members. In the present study, three-person groups were randomly assigned to be either a cooperative or individual group and asked to perform a gambling task. The monetary outcomes in the cooperative group were interrelated among group members, whereas those in the individual group did not influence each other. The present results showed that monetary outcomes elicited feedback-related negativity (FRN) and a conflict of opinion with other group members elicited FRN-like negativity, which reflect an evaluation of the motivational significance of action outcomes. The FRN elicited by monetary outcomes was reduced when participants shared decisions with other group members only in the cooperative group, indicating that the cooperative context reduced the motivational significance of monetary outcomes through the diffusion of responsibility. The FRN-like negativity elicited by a conflict of opinion showed a different pattern between the cooperative and individual groups, indicating that the cooperative context can influence the evaluation of a conflict of opinion, possibly via the modulation of group cohesiveness or conflict processing. The present results suggest that a cooperative context, rather than the social setting, is a determinant of the social influence on outcome evaluation. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. The Influence of Negligence, Intention, and Outcome on Children's Moral Judgments

    Science.gov (United States)

    Nobes, Gavin; Panagiotaki, Georgia.; Pawson, Chris

    2009-01-01

    Piaget (1932) and subsequent researchers have reported that young children's moral judgments are based more on the outcomes of actions than on the agents' intentions. The current study investigated whether negligence might also influence these judgments and explain children's apparent focus on outcome. Children (3-8 years of age) and adults (N =…

  10. INFLUENCE OF PERSONALITY ON THE OUTCOME OF TREATMENT IN DEPRESSION : SYSTEMATIC REVIEW AND META-ANALYSIS

    NARCIS (Netherlands)

    Newton-Howes, Giles; Tyrer, Peter; Johnson, Tony; Mulder, Roger; Kool, Simone; Dekker, Jack; Schoevers, Robert

    There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with

  11. Temporal variability of fish larvae assemblages: influence of natural and anthropogenic disturbances

    Directory of Open Access Journals (Sweden)

    David A. Reynalte-Tataje

    Full Text Available Natural and induced disturbances greatly influence the temporal distribution of ichthyoplankton abundance. This study assesses and compares the temporal variability of fish larvae assemblages in controlled and free environments to determine the influence of environment variables on the main taxa in these systems. The study was conducted at the Chapecó (without dam impact and Ligeiro (with dam impact river mouths, which are located in the upper Uruguay River. Samples were made between October 2001 and March 2004 during three reproductive periods. The larvae assemblages were composed of small and medium-sized Characiformes and Siluriformes. The variation in the distribution of larvae was mainly temporal (>85%. When the three reproductive periods were compared, it was observed in the second period, characterized by a larger water flow and a lower temperature, that there was a reduction in abundance, a lower number of taxa, an absence of stages in post-flexion and a high dissimilarity in larvae assemblage structure. In general, the environmental variables of water flow and temperature most influenced the distribution of egg and larvae abundance. In the studied area, a smaller temporal variability was observed in the structure of larvae assemblages at the sampling sites in the Chapecó River mouth than in in the Ligeiro River mouth under the influence of dams.

  12. The Influence of Matching Populations on Kinematic and Kinetic Variables in Runners with Iliotibial Band Syndrome

    Science.gov (United States)

    Grau, Stefan; Maiwald, Christian; Krauss, Inga; Axmann, Detlef; Horstmann, Thomas

    2008-01-01

    The purpose of this study was to assess how participant matching influences biomechanical variables when comparing healthy runners and runners with iliotibial band syndrome (ITBS). We examined 52 healthy runners (CO) and 18 with ITBS, using three-dimensional kinematics and pressure distribution. The study population was matched in three ways and…

  13. Variables Influencing Stimulus Overselectivity and "Tunnel Vision" in Developmentally Delayed Children.

    Science.gov (United States)

    Rincover, Arnold; Ducharme, Joseph M.

    1987-01-01

    Three variables (diagnosis, location of cues, and mental age of learners) influencing stimulus control and stimulus overselectivity were assessed with eight autistic children (mean age 12 years) and eight average children matched for mean age. Among results were that autistic subjects tended to respond overselectively only in the extra-stimulus…

  14. INFLUENCE OF AMNIOTIC FLUID INDEX ON FOETAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Raja Lakshmi

    2015-03-01

    Full Text Available BACKGROUND AND OBJECTIVE: In these days of smaller families and the obstetrician having to share the onus of giving a healthy child capable of independent existence as well as to ensure that the population is limited for further progress of this developing country, the estimation o f foetal maturity assumes greatest practical importance. As means to achieving the end, estimates of foetal maturity have been done by various clinical and laboratory methods of which assessment of amniotic fluid index assumes importance. The objective is to study the correlation of amniotic fluid index on foetal outcome at term gestation . MATERIALS AND METHODS: The study was carried out on two hundred antenatal women who attended the institute of obstetrics and gynaecology at a Government Hospital for Wome n and Children in Visakhapatnam from Jan 2014 to Jan 2015. It is a comparative prospective study comparing 100 cases of Oligohydramnios (amniotic fluid index 5 cm as control group. RESU LTS : Perinatal outcome was inferred by noting the various parameters and Statistical Analysis was done by applying the chisquare (x2 test and the value of probability was taken . CONCLUSION: The goal of antepartum fetal surveillance is to identify the fetu s at increased risk. Amniotic fluid volume has been proved as an indirect measure of feto - placental function and hence the estimation of amniotic fluid volume assists the obstetrician in risk assessment

  15. Multiple interacting factors influence adherence, and outcomes associated with surgical safety checklists: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Anna R Gagliardi

    Full Text Available The surgical safety checklist (SSC is meant to enhance patient safety but studies of its impact conflict. This study explored factors that influenced SSC adherence to suggest how its impact could be optimized.Participants were recruited purposively by profession, region, hospital type and time using the SSC. They were asked to describe how the SSC was adopted, associated challenges, perceived impact, and suggestions for improving its use. Grounded theory and thematic analysis were used to collect and analyse data. Findings were interpreted using an implementation fidelity conceptual framework.Fifty-one participants were interviewed (29 nurses, 13 surgeons, 9 anaesthetists; 18 small, 14 large and 19 teaching hospitals; 8 regions; 31 had used the SC for ≤12 months, 20 for 13+ months. The SSC was inconsistently reviewed, and often inaccurately documented as complete. Adherence was influenced by multiple issues. Extensive modification to accommodate existing practice patterns eliminated essential interaction at key time points to discuss patient management. Staff were often absent or not paying attention. They did not feel it was relevant to their work given limited evidence of its effectiveness, and because they were not engaged in its implementation. Organizations provided little support for implementation, training, monitoring and feedback, which are needed to overcome these, and other individual and team factors that challenged SSC adherence. Responses were similar across participants with different characteristics.Multiple processes and factors influenced SSC adherence. This may explain why, in studies evaluating SSC impact, outcomes were variable. Recommendations included continuing education, time for pilot-testing, and engaging all staff in SSC review. Others may use the implementation fidelity framework to plan SSC implementation or evaluate SSC adherence. Further research is needed to establish which SSC components can be modified

  16. Influence of sleep apnea severity on blood pressure variability of patients with hypertension.

    Science.gov (United States)

    Steinhorst, Ana P; Gonçalves, Sandro C; Oliveira, Ana T; Massierer, Daniela; Gus, Miguel; Fuchs, Sandra C; Moreira, Leila B; Martinez, Denis; Fuchs, Flávio D

    2014-05-01

    Obstructive sleep apnea (OSA) is a risk factor for the development of hypertension and cardiovascular disease. Apnea overloads the autonomic cardiovascular control system and may influence blood pressure variability, a risk for vascular damage independent of blood pressure levels. This study investigates the hypothesis that blood pressure variability is associated with OSA. In a cross-sectional study, 107 patients with hypertension underwent 24-h ambulatory blood pressure monitoring and level III polysomnography to detect sleep apnea. Pressure variability was assessed by the first derivative of blood pressure over time, the time rate index, and by the standard deviation of blood pressure measurements. The association between the apnea-hypopnea index and blood pressure variability was tested by univariate and multivariate methods. The 57 patients with apnea were older, had higher blood pressure, and had longer duration of hypertension than the 50 patients without apnea. Patients with apnea-hypopnea index (AHI) ≥ 10 had higher blood pressure variability assessed by the standard deviation than patients with AHI variability assessed by the time rate index presented a trend for association during sleep (P = 0.07). Daytime blood pressure variability was not associated with the severity of sleep apnea. Sleep apnea increases nighttime blood pressure variability in patients with hypertension and may be another pathway linking sleep abnormalities to cardiovascular disease.

  17. Atlantic multidecadal oceanic variability and its influence on the atmosphere in a climate model

    Energy Technology Data Exchange (ETDEWEB)

    Msadek, Rym; Frankignoul, Claude [Universite Pierre et Marie Curie, Paris 6, LOCEAN/IPSL, Paris (France)

    2009-07-15

    The mechanisms controlling the decadal to multidecadal variability of the Atlantic Meridional Overturning Circulation (MOC) and its influence on the atmosphere are investigated using a control simulation with the IPSL-CM4 climate model. The multidecadal fluctuations of the MOC are mostly driven by deep convection in the subpolar gyre, which occurs south of Iceland in the model. The latter is primarily influenced by the anomalous advection of salinity due to changes in the East Atlantic Pattern (EAP), which is the second mode of atmospheric variability in the North Atlantic region. The North Atlantic Oscillation is the dominant mode, but it plays a secondary role in the MOC fluctuations. During summer, the MOC variability is shown to have a significant impact on the atmosphere in the North Atlantic-European sector. The MOC influence is due to an interhemispheric sea surface temperature (SST) anomaly with opposite signs in the two hemispheres but largest amplitude in the northern one. The SST pattern driven by the MOC mostly resembles the model Atlantic Multidecadal Oscillation (AMO) and bears some similarity with the observed one. It is shown that the AMO reflects both the MOC influence and the local atmospheric forcing. Hence, the MOC influence on climate is best detected using lagged relations between climatic fields. The atmospheric response resembles the EAP, in a phase that might induce a weak positive feedback on the MOC. (orig.)

  18. [Influence of disc height on outcome of posterolateral fusion].

    Science.gov (United States)

    Drain, O; Lenoir, T; Dauzac, C; Rillardon, L; Guigui, P

    2008-09-01

    Experimentally, posterolateral fusion only provides incomplete control of flexion-extension, rotation and lateral inclination forces. The stability deficit increases with increasing height of the anterior intervertebral space, which for some warrants the adjunction of an intersomatic arthrodesis in addition to the posterolateral graft. Few studies have been devoted to the impact of disc height on the outcome of posterolateral fusion. The purpose of this work was to investigate the spinal segment immobilized by the posterolateral fusion: height of the anterior intervertebral space, the clinical and radiographic impact of changes in disc height, and the short- and long-term impact of disc height measured preoperatively on clinical and radiographic outcome. In order to obtain a homogeneous group of patients, the series was limited to patients undergoing posterolateral arthrodesis for degenerative spondylolisthesis, in combination with radicular release. This was a retrospective analysis of a consecutive series of 66 patients with mean 52 months follow-up (range 3-63 months). A dedicated self-administered questionnaire was used to collect data on pre- and postoperative function, the SF-36 quality of life score, and patient satisfaction. Pre- and postoperative (early, one year, last follow-up) radiographic data were recorded: olisthesic level, disc height, intervertebral angle, intervertebral mobility (angular, anteroposterior), and global measures of sagittal balance (thoracic kyphosis, lumbar lordosis, T9 sagittal tilt, pelvic version, pelvic incidence, sacral slope). SpineView was used for all measures. Univariate analysis searched for correlations between variation in disc height and early postoperative function and quality of fusion at last follow-up. Multivariate analysis was applied to the following preoperative parameters: intervertebral angle, disc height, intervertebral mobility, sagittal balance parameters, use of osteosynthesis or not. At the olisthesic

  19. Clinico-pathological factors influencing surgical outcome in drug resistant epilepsy secondary to mesial temporal sclerosis.

    Science.gov (United States)

    Savitr Sastri, B V; Arivazhagan, A; Sinha, Sanjib; Mahadevan, Anita; Bharath, R D; Saini, J; Jamuna, R; Kumar, J Keshav; Rao, S L; Chandramouli, B A; Shankar, S K; Satishchandra, P

    2014-05-15

    Mesial temporal sclerosis (MTS) is the most common cause of drug resistant epilepsy amenable for surgical treatment and seizure control. This study analyzed the outcome of patients with MTS following anterior temporal lobectomy and amygdalohippocampectomy (ATL-AH) over 10 years and correlated the electrophysiological and radiological factors with the post operative seizure outcome. Eighty seven patients were included in the study. Sixty seven (77.2%) patients had an Engel Class 1 outcome, 9 (11.4%) had Class 2 outcome. Engel's class 1 outcome was achieved in 89.9% at 1 year, while it reduced slightly to 81.9% at 2 years and 76.2% at 5 year follow up. Seventy seven (88.5%) patients had evidence of hippocampal sclerosis on histopathology. Dual pathology was observed in 19 of 77 specimens with hippocampal sclerosis, but did not influence the outcome. Factors associated with an unfavorable outcome included male gender (p=0.04), and a higher frequency of pre-operative seizures (p=0.005), whereas the presence of febrile seizures (p=0.048) and loss of hippocampal neurons in CA4 region on histopathology (p=0.040) were associated with favorable outcome. The effect of CA4 loss on outcome is probably influenced by neuronal loss in other subfields as well since isolated CA4 loss was rare. Abnormal post operative EEG at the end of 1 week was found to be a significant factor predicting unfavorable outcome (p=0.005). On multivariate analysis, the pre-operative seizure frequency was the only significant factor affecting outcome. The present study observed excellent seizure free outcome in a carefully selected cohort of patients with MTS with refractory epilepsy. The presence of dual pathology did not influence the outcome. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Framing matters: contextual influences on interracial interaction outcomes.

    Science.gov (United States)

    Babbitt, Laura G; Sommers, Samuel R

    2011-09-01

    Previous studies indicate that interracial interactions frequently have negative outcomes but have typically focused on social contexts. The current studies examined the effect of manipulating interaction context. In Study 1, Black and White participants worked together with instructions that created either a social focus or a task focus. With a task focus, interracial pairs were more consistently synchronized, Black participants showed less executive function depletion, and White participants generally showed reduced implicit bias. Follow-up studies suggested that prejudice concerns help explain these findings: White participants reported fewer concerns about appearing prejudiced when they imagined an interracial interaction with a task focus rather than a social focus (Study 2a), and Black participants reported less vigilance against prejudice in an imagined interracial interaction with a task focus rather than a social focus (Study 2b). Taken together, these studies illustrate the importance of interaction context for the experiences of both Blacks and Whites.

  1. Rainfall variability and its influence on surface flow regimes. Examples from the central highlands of Ethiopia

    Energy Technology Data Exchange (ETDEWEB)

    Osman, M. [Debre Zeit (Ethiopia); Sauerborn, P. [Seminar fuer Geographie und ihre Didaktik, Univ. zu Koeln, Koeln (Germany)

    2002-07-01

    The article shows results of an international and interdisciplinary project with the title 'Rainfall and its Erosivity in Ethiopia'. Rainfall variability affects the water resource management of Ethiopia. The influence of rainfall variability on flow regimes was investigated using five gauging stations with data availability from 1982-1997. It was confirmed that the variability in rainfall has a direct implication for surface runoff. Surface runoff declined at most of the gauging stations investigated. Therefore, effective water resource management is recommended for the study area. Future research should focus on watershed management which includes land-use and land cover. The question posed here is whether the variability in rainfall significantly affected surface flow in the study area. (orig.)

  2. Hierarchy of treatment variables affecting outcome of 131I therapy in thyroid cancer patients with lung metastases.

    Science.gov (United States)

    Kozak, Oksana V; Sukach, Georgiy G; Korchinskaya, Oksana I; Trembach, Alexander M; Turicina, Viktoria L; Voit, Natalia U

    2005-06-01

    To assess the correlations between the first 131I activity value, time interval between the courses of radioiodine treatment and the overall number of courses required for total destruction of lung metastases in patients with differentiated thyroid cancer with metastatic lesions in lungs. 27 patients with differentiated thyroid cancer with metastases in lungs have been treated with radioiodine after surgical intervention. Activities administered amounted from 1600 to 7980 MBq. The number of radioiodine courses before total ablation of all metastatic lesions amounted from 1 to 10. Time interval between the 1st and the 2nd courses amounted from 3.5 to 11.5 months (6 months in average). The regression analysis of the data has been made. The exponential model fits the actual number of courses as a function of the first-second activity value and time interval between the courses. The first activity has a decisive influence on the number of courses required for total metastases ablation. The greater was the first activity value, the lesser was the overall number of courses. Increasing time interval between 1st and 2nd courses to 10 months seems to result in reducing the number of courses. Nevertheless even in the case of high activities the probability to undergone less then 3 courses is low. According to the proposed model in thyroid cancer patients with metastases in lungs the first activity should be not lesser than 6000 MBq, time interval between treatments--approximately 10 months. The results of our study suggest that individual factors such as histology, the number and the size of metastases in lymph nodes could not contribute more to the final outcome than the treatment variables, namely the first-second activity and time interval, nor could they affect the hierarchy of the effects revealed for the treatment variables.

  3. To resuscitate or not to resuscitate: a logistic regression analysis of physician-related variables influencing the decision.

    Science.gov (United States)

    Einav, Sharon; Alon, Gady; Kaufman, Nechama; Braunstein, Rony; Carmel, Sara; Varon, Joseph; Hersch, Moshe

    2012-09-01

    To determine whether variables in physicians' backgrounds influenced their decision to forego resuscitating a patient they did not previously know. Questionnaire survey of a convenience sample of 204 physicians working in the departments of internal medicine, anaesthesiology and cardiology in 11 hospitals in Israel. Twenty per cent of the participants had elected to forego resuscitating a patient they did not previously know without additional consultation. Physicians who had more frequently elected to forego resuscitation had practised medicine for more than 5 years (p=0.013), estimated the number of resuscitations they had performed as being higher (p=0.009), and perceived their experience in resuscitation as sufficient (p=0.001). The variable that predicted the outcome of always performing resuscitation in the logistic regression model was less than 5 years of experience in medicine (OR 0.227, 95% CI 0.065 to 0.793; p=0.02). Physicians' level of experience may affect the probability of a patient's receiving resuscitation, whereas the physicians' personal beliefs and values did not seem to affect this outcome.

  4. Outcomes of splenectomy in patients with common variable immunodeficiency (CVID): a survey of 45 patients

    Science.gov (United States)

    Wong, G K; Goldacker, S; Winterhalter, C; Grimbacher, B; Chapel, H; Lucas, M; Alecsandru, D; McEwen, D; Quinti, I; Martini, H; Schmidt, R E; Ernst, D; Espanol, T; Vidaller, A; Carbone, J; Fernandez-Cruz, E; Lougaris, V; Plebani, A; Kutukculer, N; Gonzalez-Granado, L I; Contreras, R; Kiani-Alikhan, S; Ibrahim, M A A; Litzman, J; Jones, A; Gaspar, H B; Hammarstrom, L; Baumann, U; Warnatz, K; Huissoon, A P

    2013-01-01

    Splenectomy has been used in patients with common variable immunodeficiency disorders (CVID), mainly in the context of refractory autoimmune cytopenia and suspected lymphoma, but there are understandable concerns about the potential of compounding an existing immunodeficiency. With increasing use of rituximab as an alternative treatment for refractory autoimmune cytopenia, the role of splenectomy in CVID needs to be re-examined. This retrospective study provides the largest cohesive data set to date describing the outcome of splenectomy in 45 CVID patients in the past 40 years. Splenectomy proved to be an effective long-term treatment in 75% of CVID patients with autoimmune cytopenia, even in some cases when rituximab had failed. Splenectomy does not worsen mortality in CVID and adequate immunoglobulin replacement therapy appears to play a protective role in overwhelming post-splenectomy infections. Future trials comparing the effectiveness and safety of rituximab and splenectomy are needed to provide clearer guidance on the second-line management of autoimmune cytopenia in CVID. PMID:23480186

  5. Influence of acute stress on decision outcomes and heuristics.

    Science.gov (United States)

    Hepler, Teri J; Kovacs, Attila J

    2017-03-01

    The purpose of this study was to examine the take-the-first (TTF) heuristic and decision outcomes in sports under conditions of no, mental, and physical stress. Participants (N.=68) performed 8 video decision-making trials under each of 3 stress conditions: no stress (counting backwards), mental stress (mental serial subtraction), and physical stress (running on treadmill at 13 RPE). Prior to each decision-making trial, participants were exposed to 30 seconds of stress. The decision-making task required participants to watch a video depicting an offensive situation in basketball and then decide what the player with the ball should do next. No differences were found between the 3 stress conditions on TTF frequency, number of options generated, quality of first generated option, or final decision quality. However, participants performing under conditions of no stress and physical stress generated their first option and made their final decision faster than they did when making decisions under mental stress. Overall, results suggest that mental stress impairs decision speed and that TTF is an ecologically rationale heuristic in dynamic, time-pressured situations.

  6. [Influence of anesthesia procedure on malignant tumor outcome].

    Science.gov (United States)

    Fukui, K; Werner, C; Pestel, G

    2012-03-01

    Malignant tumors are the second major cause of death in Germany. The essential therapy of operable cancer is surgical removal of primary tumors combined with adjuvant therapy. However, several consequences of surgery may promote metastasis, such as shedding of tumor cells into the circulation, decrease in tumor-induced antiangiogenesis factors, excessive release of growth factors for wound healing and suppression of immunity induced by surgical stress. In the last decade it has become clear that cell-mediated immunity controls the development of metastasis. Various perioperative factors, such as surgical stress, certain anesthetic and analgesic drugs and pain can suppress the patients' immune system perioperatively. On the other hand, by modifications of the anesthesia technique (e.g. regional anesthesia) and perioperative management to minimize immunosuppression, anesthesiologists can play a considerable role for a better outcome in patients having malignant tumors. Sufficient clinical evidence is not yet available to prove or disprove the hypothesis that anesthesia practice can improve cancer prognosis. Despite difficulties in study design, several prospective randomized trials are currently running and the results are awaited to elucidate this topic.

  7. VARIABLES THAT INFLUENCE STUDENTS’ CHOICE OF DISTANCE EDUCATION LATO SENSU GRADUATE BUSINESS PROGRAMS

    Directory of Open Access Journals (Sweden)

    Eduardo Mendes Nascimento

    2014-03-01

    Full Text Available Based on Scriven’s User-Focused Evaluation Theory, the general objective in this study was to identify and analyze the degree of importance Brazilian students attribute to the variables that influence them when choosing distance education lato sensu graduate business programs. The research is classified as descriptive and an electronic questionnaire was used to survey the data, involving 354 students from distance education lato sensu graduate business programs distributed across different Brazilian locations. The questionnaire included 16 variables, which the students were expected to score from 0 to 10. The results indicated that 04 variables obtained a mean score superior to 9, and that flexibility was the main factor the respondents considered in the choice of a distance education program. This evidences that the possibility to structure the program according to their available time is fundamental for the students. Nevertheless, having a trained teaching staff (second most influential variable and a curriculum appropriate to their pedagogical needs (fourth are also essential characteristics. Finally, the respondents indicated the cost as the third most important variable. Some authors even consider it decisive in the students’ choice as distance education programs are frequently cheaper than in-class programs. In addition, it was verified that women score the investigated internal variables higher than men. In addition, the location of the support hub appeared as a determinant variable in the choice of the program.

  8. Influences On Pupils’ Mathematical Outcome: A Description Of Challenges

    Directory of Open Access Journals (Sweden)

    Lara Said

    2006-12-01

    Full Text Available Measures of instructional behaviour are specific process indicators reflecting teacher effectiveness. The Mathematics in Primary Schools (MIPS study poses the question of: ‘How is pupil progress and teachers’ instructional behaviour, within schools, related?’ This is conducted by tracking pupil progress in primary school mathematics from Year 1 to Year 2 and by collating a number of contextual/process variables situated at the pupil/classroom and school levels. The paper, which adopts, a multi-stage, stratified sample involves 1,786 pupils, 99 teachers and 40 schools, within the statistical framework of a 3-level hierarchical linear model. This paper also reports the findings of the pilot study. Although the paper is limited by the inability to use multilevel statistical techniques due to: the relatively small sample size of the pilot study and, the, as yet, unstandardised pupil scores on Maths 6 (NFER, the utility of this paper lies in the description of challenges faced when engaging in school effectiveness research.

  9. Influence of variables on the consolidation and unconfined compressive strength of crushed salt: Technical report

    International Nuclear Information System (INIS)

    Pfeifle, T.W.; Senseny, P.E.; Mellegard, K.D.

    1987-01-01

    Eight hydrostatic compression creep tests were performed on crushed salt specimens fabricated from Avery Island dome salt. Following the creep test, each specimen was tested in unconfined compression. The experiments were performed to assess the influence of the following four variables on the consolidation and unconfined strength of crushed salt: grain size distribution, temperature, time, and moisture content. The experiment design comprised a half-fraction factorial matrix at two levels. The levels of each variable investigated were grain size distribution, uniform-graded and well-graded (coefficient of uniformity of 1 and 8); temperature 25 0 C and 100 0 C; time, 3.5 x 10 3 s and 950 x 10 3 s (approximately 60 minutes and 11 days, respectively); and moisture content, dry and wet (85% relative humidity for 24 hours). The hydrostatic creep stress was 10 MPa. The unconfined compression tests were performed at an axial strain rate of 1 x 10 -5 s -1 . Results show that the variables time and moisture content have the greatest influence on creep consolidation, while grain size distribution and, to a somewhat lesser degree, temperature have the greatest influence on total consolidation. Time and moisture content and the confounded two-factor interactions between either grain size distribution and time or temperature and moisture content have the greatest influence on unconfined strength. 7 refs., 7 figs., 11 tabs

  10. What variables influence the ability of an AFO to improve function and when are they indicated?

    Science.gov (United States)

    Malas, Bryan S

    2011-05-01

    Children with spina bifida often present with functional deficits of the lower limb associated with neurosegmental lesion levels and require orthotic management. The most used orthosis for children with spina bifida is the ankle-foot orthosis (AFO). The AFO improves ambulation and reduces energy cost while walking. Despite the apparent benefits of using an AFO, limited evidence documents the influence of factors predicting the ability of an AFO to improve function and when they are indicated. These variables include AFO design, footwear, AFO-footwear combination, and data acquisition. When these variables are not adequately considered in clinical decision-making, there is a risk the AFO will be abandoned prematurely or the patient's stability, function, and safety compromised. The purposes of this study are to (1) describe the functional deficits based on lesion levels; (2) identify and describe variables that influence the ability of an AFO to control deformities; and (3) describe what variables are indicated for the AFO to control knee flexion during stance, hyperpronation, and valgus stress at the knee. A selective literature review was undertaken searching MEDLINE and Cochrane databases using terms related to "orthosis" and "spina bifida." Based on previous studies and gait analysis data, suggestions can be made regarding material selection/geometric configuration, sagittal alignment, footplate length, and trim lines of an AFO for reducing knee flexion, hyperpronation, and valgus stress at the knee. Further research is required to determine what variables allow an AFO to improve function.

  11. Playing up and playing down cultural identity: Introducing cultural influence and cultural variability.

    Science.gov (United States)

    Ferguson, Gail M; Nguyen, Jacqueline; Iturbide, Maria I

    2017-01-01

    Cultural variability (CV) is introduced as an overlooked dimension of cultural identity development pertaining to emphasizing and de-emphasizing the influence of a single cultural identity (i.e., cultural influence [CI]) on daily interactions and behaviors. The Cultural IDentity Influence Measure (CIDIM) is introduced as a novel measure of CI and CV, and hypothesis-driven validation is conducted in two samples along with exploration of associations between CV and well-being. A multicultural sample of 242 emerging adults participated in a daily diary study (Mage = 19.95 years, SDage = 1.40) by completing up to eight daily online surveys containing the CIDIM, criterion measures (ethnic identity, other group orientation, ethnic identity salience and daily variability in salience, social desirability), and measures of personal and interpersonal well-being. A second validation sample (n = 245) completed a 1-time survey with the CIDIM and a subset of criterion measures. Results using both samples show evidence of CI and CV and demonstrate the validity, reliability, and domain-sensitivity of the CIDIM. Further, CV made unique and positive contributions to predicting interaction quality after accounting for ethnic salience and variability in ethnic salience. An analytic approach utilizing standard deviations produced near-identical results to multilevel modeling and is recommended for parsimony. Ethnic minority and majority individuals make daily adjustments to play up and play down the influence of cultural identity on their social interactions and behaviors, and these adjustments predict interpersonal well-being. Cultural influence and cultural variability contribute to our emerging understanding of cultural identity as dynamic and agentic. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Does Age Influence Cardiac Resynchronization Therapy Use and Outcome?

    Science.gov (United States)

    Heidenreich, Paul A; Tsai, Vivian; Bao, Haikun; Curtis, Jeptha; Goldstein, Mary; Curtis, Lesley; Hernandez, Adrian; Peterson, Pamela; Turakhia, Mintu P; Masoudi, Frederick A

    2015-06-01

    This study sought to describe the use of CRT-D and its association with survival for older patients. Many patients who receive cardiac resynchronization therapy with defibrillator (CRT-D) in practice are older than those included in clinical trials. We identified patients undergoing ICD implantation in the National Cardiovascular Disease Registry (NCDR) ICD registry from 2006 to 2009, who also met clinical trial criteria for CRT, including left ventricular ejection fraction (LVEF) ≤35%, QRS ≥120 ms, and New York Heart Association (NYHA) functional class III or IV. NCDR registry data were linked to the social security death index to determine the primary outcome of time to death from any cause. We identified 70,854 patients from 1,187 facilities who met prior trial criteria for CRT-D. The mean age of the 58,147 patients receiving CRT-D was 69.4 years with 6.4% of patients age 85 or older. CRT use was 80% or higher among candidates in all age groups. Follow-up was available for 42,285 patients age ≥65 years at 12 months. Receipt of CRT-D was associated with better survival at 1 year (82.1% vs. 77.1%, respectively) and 4 years (54.0% vs. 46.2% , respectively) than in those receiving only an ICD (p different for different age groups (p = 0.86 for interaction). More than 80% of older patients undergoing ICD implantation who were candidates for a CRT-D received the combined device. Mortality in older patients undergoing ICD implantation was high but was lower for those receiving CRT-D. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Influence of Variable Acceleration on Parametric Roll Motion of a Container Ship

    Directory of Open Access Journals (Sweden)

    Emre PEŞMAN

    2016-09-01

    Full Text Available Ship operators increase or decrease thrust force of ships to avoid parametric roll motion. These operations cause varying acceleration values. In this study, influence of variable acceleration and deceleration of ships on roll motion is investigated in longitudinal waves. The method which is referred as simple model is utilized for analysis. Simple Model is one degree of freedom nonlinear parametric roll motion equation which contains changing velocity and restoring moment in waves with respect to time. Ship velocities in waves are predicted by XFlow software for various thrust forces. Results indicate that variable acceleration has significant effect on parametric roll phenomenon.

  14. Factors influencing the use of outcome measures in physical therapy practice.

    Science.gov (United States)

    Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

    2012-02-01

    Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

  15. Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome

    DEFF Research Database (Denmark)

    Stolarz-Skrzypek, Katarzyna; Thijs, Lutgarde; Richart, Tom

    2010-01-01

    Ambulatory blood pressure (BP) monitoring provides information not only on the BP level but also on the diurnal changes in BP. In the present review, we summarized the main findings of the International Database on Ambulatory BP in relation to Cardiovascular Outcome (IDACO) with regard to risk...

  16. Analysis on Corporate Governance Influences toward Banking Efficiency with Bank Category as Moderator Variable

    Directory of Open Access Journals (Sweden)

    Lidiyawati Lidiyawati

    2015-05-01

    Full Text Available Corporate governance system of Sharia financial institution that based on Islamic law may result more  variables principles then conventional owns. The restriction of usury are highly speculative transaction, embedded prohibited matter are main features in Sharia business institution. Sharia Supervisory Board, as board that supervises banking practices conforms to Sharia stipulations, hold strong important role within Islamic banking. Both important points above had direct effects on efficiency which attained by Islamic banking compared with conventional banking. This study examines the influence of corporate governance implementation toward efficiency banking sector with bank category as moderator variable. This study hypothesize that corporate governance has significant influences toward bank’s efficiencies, the influence of corporate governance toward Islamic bank efficiencies is higher than conventional bank, and level of Islamicbank efficiencies is higher than conventional bank. Measurement of efficiencies is using Stochastic Frontier Approach program, and then using SPSS in procces hypothetical model. The results of the study do not support the hypothesis. Examined result shows that statically corporate governance is not influenced by bank efficiency achievement. Corporate governance influences over Islamic bank has not show higher significance than conventional and Islamic bank efficiencies remain steady. Data limitations, complexity of the efficiency measures and the complexity of the operation of Islamic banks may explain the finding.

  17. The influence of environmental variables on platelet concentration in horse platelet-rich plasma.

    Science.gov (United States)

    Rinnovati, Riccardo; Romagnoli, Noemi; Gentilini, Fabio; Lambertini, Carlotta; Spadari, Alessandro

    2016-07-04

    Platelet-rich plasma (PRP) commonly refers to blood products which contain a higher platelet (PLT) concentration as compared to normal plasma. Autologous PRP has been shown to be safe and effective in promoting the natural processes of soft tissue healing or reconstruction in humans and horses. Variability in PLT concentration has been observed in practice between PRP preparations from different patients or from the same individual under different conditions. A change in PLT concentration could modify PRP efficacy in routine applications. The aim of this study was to test the influence of environmental, individual and agonistic variables on the PLT concentration of PRP in horses. Six healthy Standardbred mares were exposed to six different variables with a one-week washout period between variables, and PRP was subsequently obtained from each horse. The variables were time of withdrawal during the day (morning/evening), hydration status (overhydration/dehydration) treatment with anti-inflammatory drugs and training periods on a treadmill. The platelet concentration was significantly higher in horses treated with a non-steroidal anti-inflammatory drug (P = 0.03). The leukocyte concentration increased 2-9 fold with respect to whole blood in the PRP which was obtained after exposure to all the variable considered. Environmental variation in platelet concentration should be taken into consideration during PRP preparation.

  18. Influence of process variables on permeability and anisotropy of Biso-coated HTGR fuel particles

    International Nuclear Information System (INIS)

    Stinton, D.P.; Lackey, W.J.; Thiele, B.A.

    1977-11-01

    The effect of several important process variables on the fraction of defective particles and anisotropy of the low-temperature isotropic (LTI) coating layer was determined for Biso-coated HTGR fuel particles. Process variables considered are deposition temperature, hydrocarbon type, diluent type, and percent diluent. The effect of several other variables such as coating rate and density that depend on the process variables were also considered in this analysis. The fraction of defective particles was controlled by the dependent variables coating rate and LTI density. Coating rate was also the variable controlling the anisotropy of the LTI layer. Diluent type and diluent concentration had only a small influence on the deposition rate of the LTI layer. High-quality particles in terms of anisotropy and permeability can be produced by use of a porous plate gas distributor if the coating rate is between 3 and 5 μm/min and the coating density is between about 1.75 and 1.95 g/cm 3

  19. Influence of flexibility and variability of working hours on health and well-being.

    Science.gov (United States)

    Costa, Giovanni; Sartori, Samantha; Akerstedt, Torbjorn

    2006-01-01

    Flexible working hours can have several meanings and can be arranged in a number of ways to suit the worker and/or employer. Two aspects of "flexible" arrangement of working hours were considered: one more subjected to company control and decision (variability) and one more connected to individual discretion and autonomy (flexibility). The aim of the study was to analyze these two dimensions in relation to health and well-being, taking into consideration the interaction with some relevant background variables related to demographics plus working and social conditions. The dataset of the Third European Survey on working conditions, conducted in 2000 and involving 21,505 workers, was used. Nineteen health disorders and four psycho-social conditions were tested by means of multiple logistic regression analysis, in which mutually adjusted odds ratios were calculated for age, gender, marital status, number of children, occupation, mode of employment, shift work, night work, time pressure, mental and physical workload, job satisfaction, and participation in work organization. The flexibility and variability of working hours appeared inversely related to health and psycho-social well-being: the most favorable effects were associated with higher flexibility and lower variability. The analysis of the interactions with the twelve intervening variables showed that physical work, age, and flexibility are the three most important factors affecting health and well-being. Flexibility resulted as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Moreover, shift and night work confirmed to

  20. Variables Influencing Credit Card Balances of Students at a Midwestern University

    Science.gov (United States)

    Mattson, Lucretia; Sahlhoff, Kathleen; Blackstone, Judith; Peden, Blaine; Nahm, Abraham Y.

    2004-01-01

    This research used a Web-based survey of students at a Midwest regional university to measure the extent of credit card use by first-year students and seniors. The results indicate that the variables influencing credit card use and the carrying of a balance from one month to the next include the number of cards held by the student, the student's…

  1. Soft Tissue Sarcoma: A Prognostic Variables and Treatment Outcomes after Chemo - Radiotherapy and Conservative Surgery

    International Nuclear Information System (INIS)

    Abaza, A.; El-Shanshoury, H.

    2015-01-01

    Soft tissue sarcomas (STS) constitute a group of rare and heterogeneous cancers, that diverse a wide spectrum of histology and varied clinical behavior. The aim was to study, retrospectively the clinico-epidemiologic manifestation, response to therapy and prognostic factors of retroperitoneal (RPS), extremity and other STS patients treated with conservative surgery plus chemo - radiotherapy (CRT) attending the Pediatric Oncology Clinic, National Cancer Institute (NCI), Cairo University during 6 years period (inclusive). Files of 66 STS patients were revised for history, staging, investigations, treatment modalities and outcome of therapy. Their ages ranged from 6 months to 21 years. The male to female ratio was 1.87:1. Most of the patients belong to stage 3 and 1. Radiotherapy (RTH) and surgery remains the backbone of the multi - modality treatment plan. Complete remission (CR) was obtained in 80.3% of STS patients. Meanwhile, 6% of cases had disease progression and 6% died. The 2 - years overall survival rate (OS) and Disease - free survivals (DFS) we re 74.2% and 57.6% respectively. However, 20.8% of patients develop relapse>2 years after the end of treatment. Age at diagnosis, stage of the disease, tumor mass, pathological subtype and the RTH used were statistically significant prognostic variables affecting survival. Finally, the use of RTH in the treatment of STS gives positive impact on the survival of patients. Recommendation regarding further studies would be required to identify methods of increasing the radiation dose selectively. Also, using the newly developed radiation technologies to make dose escalation and sparing normal tissue

  2. Neutropenia in Patients with Common Variable Immunodeficiency: a Rare Event Associated with Severe Outcome.

    Science.gov (United States)

    Guffroy, Aurélien; Mourot-Cottet, Rachel; Gérard, Laurence; Gies, Vincent; Lagresle, Chantal; Pouliet, Aurore; Nitschké, Patrick; Hanein, Sylvain; Bienvenu, Boris; Chanet, Valérie; Donadieu, Jean; Gardembas, Martine; Karmochkine, Marina; Nove-Josserand, Raphaele; Martin, Thierry; Poindron, Vincent; Soulas-Sprauel, Pauline; Rieux-Laucat, Fréderic; Fieschi, Claire; Oksenhendler, Eric; André-Schmutz, Isabelle; Korganow, Anne-Sophie

    2017-10-01

    Common variable immunodeficiency (CVID) is characterized by infections and hypogammaglobulinemia. Neutropenia is rare during CVID. The French DEFI study enrolled patients with primary hypogammaglobulinemia. Patients with CVID and neutropenia were retrospectively analyzed. Among 473 patients with CVID, 16 patients displayed neutropenia (lowest count [0-1400]*10 6 /L). Sex ratio (M/F) was 10/6. Five patients died during the follow-up (11 years) with an increased percentage of deaths compared to the whole DEFI group (31.3 vs 3.4%, P < 0.05). Neutropenia was diagnosed for 10 patients before 22 years old. The most frequent symptoms, except infections, were autoimmune cytopenia, i.e., thrombopenia or anemia (11/16). Ten patients were affected with lymphoproliferative diseases. Two patients were in the infection only group and the others belonged to one or several other CVID groups. The median level of IgG was 2.6 g/L [0.35-4.4]. Most patients presented increased numbers of CD21 low CD38 low B cell, as already described in CVID autoimmune cytopenia group. Neutropenia was considered autoimmune in 11 cases. NGS for 52 genes of interest was performed on 8 patients. No deleterious mutations were found in LRBA, CTLA4, and PIK3. More than one potentially damaging variant in other genes associated with CVID were present in most patients arguing for a multigene process. Neutropenia is generally associated with another cytopenia and presumably of autoimmune origin during CVID. In the DEFI study, neutropenia is coupled with more severe clinical outcomes. It appears as an "alarm bell" considering patients' presentation and the high rate of deaths. Whole exome sequencing diagnosis should improve management.

  3. Regulating task-monitoring systems in response to variable reward contingencies and outcomes in cocaine addicts.

    Science.gov (United States)

    Morie, Kristen P; De Sanctis, Pierfilippo; Garavan, Hugh; Foxe, John J

    2016-03-01

    We investigated anticipatory and consummatory reward processing in cocaine addiction. In addition, we set out to assess whether task-monitoring systems were appropriately recalibrated in light of variable reward schedules. We also examined neural measures of task-monitoring and reward processing as a function of hedonic tone, since anhedonia is a vulnerability marker for addiction that is obviously germane in the context of reward processing. High-density event-related potentials were recorded while participants performed a speeded response task that systematically varied anticipated probabilities of reward receipt. The paradigm dissociated feedback regarding task success (or failure) from feedback regarding the value of reward (or loss), so that task-monitoring and reward processing could be examined in partial isolation. Twenty-three active cocaine abusers and 23 age-matched healthy controls participated. Cocaine abusers showed amplified anticipatory responses to reward predictive cues, but crucially, these responses were not as strongly modulated by reward probability as in controls. Cocaine users also showed blunted responses to feedback about task success or failure and did not use this information to update predictions about reward. In turn, they showed clearly blunted responses to reward feedback. In controls and users, measures of anhedonia were associated with reward motivation. In cocaine users, anhedonia was also associated with diminished monitoring and reward feedback responses. Findings imply that reward anticipation and monitoring deficiencies in addiction are associated with increased responsiveness to reward cues but impaired ability to predict reward in light of task contingencies, compounded by deficits in responding to actual reward outcomes.

  4. Progression paths in children's problem solving: The influence of dynamic testing, initial variability, and working memory.

    Science.gov (United States)

    Resing, Wilma C M; Bakker, Merel; Pronk, Christine M E; Elliott, Julian G

    2017-01-01

    The current study investigated developmental trajectories of analogical reasoning performance of 104 7- and 8-year-old children. We employed a microgenetic research method and multilevel analysis to examine the influence of several background variables and experimental treatment on the children's developmental trajectories. Our participants were divided into two treatment groups: repeated practice alone and repeated practice with training. Each child received an initial working memory assessment and was subsequently asked to solve figural analogies on each of several sessions. We examined children's analogical problem-solving behavior and their subsequent verbal accounts of their employed solving processes. We also investigated the influence of verbal and visual-spatial working memory capacity and initial variability in strategy use on analogical reasoning development. Results indicated that children in both treatment groups improved but that gains were greater for those who had received training. Training also reduced the influence of children's initial variability in the use of analogical strategies with the degree of improvement in reasoning largely unrelated to working memory capacity. Findings from this study demonstrate the value of a microgenetic research method and the use of multilevel analysis to examine inter- and intra-individual change in problem-solving processes. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The influence of solar system oscillation on the variability of the total solar irradiance

    Science.gov (United States)

    Yndestad, Harald; Solheim, Jan-Erik

    2017-02-01

    Total solar irradiance (TSI) is the primary quantity of energy that is provided to the Earth. The properties of the TSI variability are critical for understanding the cause of the irradiation variability and its expected influence on climate variations. A deterministic property of TSI variability can provide information about future irradiation variability and expected long-term climate variation, whereas a non-deterministic variability can only explain the past. This study of solar variability is based on an analysis of two TSI data series, one since 1700 A.D. and one since 1000 A.D.; a sunspot data series since 1610 A.D.; and a solar orbit data series from 1000 A.D. The study is based on a wavelet spectrum analysis. First, the TSI data series are transformed into a wavelet spectrum. Then, the wavelet spectrum is transformed into an autocorrelation spectrum to identify stationary, subharmonic and coincidence periods in the TSI variability. The results indicate that the TSI and sunspot data series have periodic cycles that are correlated with the oscillations of the solar position relative to the barycenter of the solar system, which is controlled by gravity force variations from the large planets Jupiter, Saturn, Uranus and Neptune. A possible explanation for solar activity variations is forced oscillations between the large planets and the solar dynamo. We find that a stationary component of the solar variability is controlled by the 12-year Jupiter period and the 84-year Uranus period with subharmonics. For TSI and sunspot variations, we find stationary periods related to the 84-year Uranus period. Deterministic models based on the stationary periods confirm the results through a close relation to known long solar minima since 1000 A.D. and suggest a modern maximum period from 1940 to 2015. The model computes a new Dalton-type sunspot minimum from approximately 2025 to 2050 and a new Dalton-type period TSI minimum from approximately 2040 to 2065.

  6. Identification of variables and their influence on the human resources planning in the territorial level

    Energy Technology Data Exchange (ETDEWEB)

    Martínez Vivar, R.; Sánchez Rodríguez, A.; Pérez Campdesuñer, R.; García Vidal, G.

    2016-07-01

    The purpose of this paper lies in the use of experimental way through empirical tools for identification of the set of variables and their interrelationships and influences on the human resources planning at the territorial level. The methodology used to verify the existence of the variables that affect the planning of human resources at the territorial level consists of two phases: a qualitative study of the variables that influence the planning of human resources, where the explicit variables are measured and / or implied raised in the literature analyzing the main contributions and limitations expressed by each of the authors consulted. Then it proceeds to confirmatory phase (quantitative) to prove the existence of the dimensions of the planning of human resources in the territorial level through the use of multivariate statistics through the combination of expert analysis and techniques of factorial grouping. Identification is achieved by using empirical methods, variables that affect human resources planning at the territorial level, as well as their grouping essential dimensions, while the description of a theoretical model that integrates the dimensions is made essential and relationships that affect human resource planning at the regional level, which is characterized by the existence of systemic and prospective nature. The literature shows two streams that address a wide range of approaches to human resources planning. The first is oriented from the business object and the second part of the management in highlighting a limited territorial level to address this latest theoretical development, an element that has contributed to the fragmented treatment of human resources planning and management in general at this level. The originality of this paper is part of the creation and adaptation, on a scientific basis of a theoretical model developed from the conceptual contribution of this process at the territorial level where the key variables that affect this

  7. Does Histologic Subtype Influence the Post-Operative Outcome in Spinal Meningioma?

    Science.gov (United States)

    Zham, Hanieh; Moradi, Afshin; Rakhshan, Azadeh; Zali, Alireza; Rahbari, Ali; Raee, Mohammadreza; Ashrafi, Farzad; Ahadi, Mahsa; Larijani, Leila; Baikpour, Masoud; Khayamzadeh, Maryam

    2016-04-01

    Postoperative outcome of spinal meningiomas is an important issue in surgery decision-making. There are limited and conflicting data in the literature about the prognostic factors influencing recovery, especially about the histopathologic subtypes. This study was carried out to evaluate the effect of some of these factors on postoperative outcome. This study was performed on 39 patients operated for spinal meningioma between October 1998 and January 2012; their histopathologic subtype was determined according to WHO criteria. The follow up period ranged between 8 - 120 months. The influence of histopathologic subtype, grade, age, sex, surgical approach, local adhesion and anatomical location was assessed according to Frankel classification of neurologic deficit. From a total number of 39 spinal meningiomas, 34 cases were WHO grade I, from which 15 cases were psammomatous, 7 cases were meningothelial, 9 cases were transitional and 3 cases were fibroblastic. Five cases were grade II, 3 of which had clear cell appearance and the remaining 2 had chordoid appearance. The mean age was 51.6 (22 to 76) years; 25 cases were female and 14 cases were male. This study revealed that grade II meningioma cases had poor prognosis in all 5 cases and psammomatous subtype had poor postoperative outcome in 40% of cases while the other subtypes had good outcome in all cases (P = 0.026). Cervical location of the tumor was also related with poor outcome in 37.5% of the cases, while 22.5% had poor outcome in other locations (P = 0.029). Age below and above 45 years and sex had no significant influence on the outcome. Spinal meningiomas of psammomatous type and grade II spinal meningiomas are associated with less favorable postoperative neurologic outcome. Cervical location has also a negative correlation with a good outcome.

  8. The Influence of Output Variability from Renewable Electricity Generation on Net Energy Calculations

    Directory of Open Access Journals (Sweden)

    Hannes Kunz

    2014-01-01

    Full Text Available One key approach to analyzing the feasibility of energy extraction and generation technologies is to understand the net energy they contribute to society. These analyses most commonly focus on a simple comparison of a source’s expected energy outputs to the required energy inputs, measured in the form of energy return on investment (EROI. What is not typically factored into net energy analysis is the influence of output variability. This omission ignores a key attribute of biological organisms and societies alike: the preference for stable returns with low dispersion versus equivalent returns that are intermittent or variable. This biologic predilection for stability, observed and refined in academic financial literature, has a direct relationship to many new energy technologies whose outputs are much more variable than traditional energy sources. We investigate the impact of variability on net energy metrics and develop a theoretical framework to evaluate energy systems based on existing financial and biological risk models. We then illustrate the impact of variability on nominal energy return using representative technologies in electricity generation, with a more detailed analysis on wind power, where intermittence and stochastic availability of hard-to-store electricity will be factored into theoretical returns.

  9. The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

    Science.gov (United States)

    Levy, Becca R.; Leifheit-Limson, Erica

    2009-01-01

    Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

  10. Moderating Influence of Critical Psychological States on Work Engagement and Personal Outcomes in the Telecom Sector

    Directory of Open Access Journals (Sweden)

    Harold Andrew Patrick

    2014-06-01

    Full Text Available Organizations want their employees to be engaged with their work, exhibiting proactive behavior, initiative, and responsibility for personal development. Existing literature has a dearth of studies that evaluate all the three key variables that lead to optimal employee performance—critical psychological states (CPSs, work engagement, and personal outcomes. The present study attempts to fill that gap by linking the variable CPSs (which measures experienced meaningfulness, responsibility, and knowledge of results with the other two. The study surveyed 359 sales personnel in the Indian telecom industry and adopted standardized, valid, and reliable instruments to measure their work engagement, CPSs, and personal outcomes. Analysis was done using structural equation modeling (SEM. Findings indicated that CPSs significantly moderate the relationship between personal outcomes and work engagement.

  11. Cerebrovascular accidents after percutaneous coronary interventions from 2002 to 2014: Incidence, outcomes, and associated variables.

    Science.gov (United States)

    Didier, Romain; Gaglia, Michael A; Koifman, Edward; Kiramijyan, Sarkis; Negi, Smita I; Omar, Al Fazir; Gai, Jiaxing; Torguson, Rebecca; Pichard, Augusto D; Waksman, Ron

    2016-02-01

    Cerebrovascular accident (CVA) and transient ischemic attack (TIA) related to percutaneous coronary intervention (PCI) are relatively rare complications, but they are associated with high morbidity and mortality. Given the evolution of both CVA risk and PCI techniques over time, this study was conducted to evaluate trends in CVA and TIA associated with PCI and to identify variables associated with neurologic events. Consecutive patients undergoing PCI at the Washington Hospital Center between January 2002 and June 2015 were included. Prespecified data were prospectively collected, including baseline and procedural characteristics, in-hospital outcomes, and 1-year mortality. The subjects who had a CVA or TIA during or immediately after PCI were compared with those without procedure-associated CVA or TIA. Overall, 25,626 patients were included in the study. The mean age was 65.0 ± 12.4 years, 16,949 (65.2%) were male, and 7,436 (28.6%) were African American. From 2002 to 2015, 110 neurologic events post-PCI were diagnosed (0.43%); this included 86 CVAs (0.34%) and 24 TIAs (0.09%). The annual rate of postprocedural neurologic events was 0.42% ± 0.12%. There were significant changes in baseline risk factors over time, with increasing age, incidence of insulin-dependent diabetes, and chronic kidney disease. Patients with neurologic events were more often African American (43.6% vs 28.6%, P < .001) with prior history of CVA (24.5% vs 7.8%, P < .001), chronic renal insufficiency (26.6% vs 15.2%, P < .001), and insulin-dependent diabetes (19.1% vs 12.4%, P = .03). Acute myocardial infarction (56% vs 30.4%, P < .001) and cardiogenic shock (20.2% vs 3%, P < .001) were also more common among patients with neurologic events post-PCI. After multivariable adjustment, use of an intraaortic balloon pump was strongly associated with neurologic events (odds ratio [OR] 4.9, 95% CI 2.7-8.8, P < .001), as was prior CVA (OR 2.4, 95% CI 1.4-4.4, P = .002) and African American race (OR

  12. A national evaluation of Safe Schools/Healthy Students: outcomes and influences.

    Science.gov (United States)

    Derzon, James H; Yu, Ping; Ellis, Bruce; Xiong, Sharon; Arroyo, Carmen; Mannix, Danyelle; Wells, Michael E; Hill, Gary; Rollison, Julia

    2012-05-01

    The Safe Schools/Healthy Students (SS/HS) Initiative has awarded over $2 billion in grants to more than 350 school districts in partnership with local mental health, law enforcement, and juvenile justice agencies. To estimate the impact of grantee characteristics, grant operations, and near-term outcomes in reducing violence and substance use, promoting mental health, and enhancing school safety, logged odds ratios (LORs) were calculated contrasting Year 3 with Baseline performance from grantee-provided data on seven outcome measures. After comparing grantee performance across outcomes and outcomes across grantees, the LORs were entered as dependent variables in a series of meta-regressions in which grantee characteristics, grant operations, and near-term outcomes were tested after controlling for pre-grant characteristics. Findings indicate that the SS/HS Initiative significantly improved most outcomes, that within-grantee performance varied greatly by outcome, and that random-effects meta-regression appreciably decreased the variance available for modeling. The approach demonstrates that the SS/HS Initiative is effective and that locally collected performance data can be used to estimate grantee success in improving youth outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. A Correlational Study on Critical Thinking in Nursing as an Outcome Variable for Success

    Science.gov (United States)

    Porter, Rebecca Jean

    2018-01-01

    Critical thinking is a required curricular outcome for nursing education; however, the literature shows a gap related to valid and reliable tools to measure critical thinking specific to nursing and relating that critical thinking measurement to meaningful outcomes. This study examined critical thinking scores, as measured by Assessment…

  14. Spatial patterns of North Atlantic Oscillation influence on mass balance variability of European glaciers

    Directory of Open Access Journals (Sweden)

    B. Marzeion

    2012-06-01

    Full Text Available We present and validate a set of minimal models of glacier mass balance variability. The most skillful model is then applied to reconstruct 7735 individual time series of mass balance variability for all glaciers in the European Alps and Scandinavia. Subsequently, we investigate the influence of atmospheric variability associated with the North Atlantic Oscillation (NAO on the glaciers' mass balances.

    We find a spatial coherence in the glaciers' sensitivity to NAO forcing which is caused by regionally similar mechanisms relating the NAO forcing to the mass balance: in southwestern Scandinavia, winter precipitation causes a correlation of mass balances with the NAO. In northern Scandinavia, temperature anomalies outside the core winter season cause an anti-correlation between NAO and mass balances. In the western Alps, both temperature and winter precipitation anomalies lead to a weak anti-correlation of mass balances with the NAO, while in the eastern Alps, the influences of winter precipitation and temperature anomalies tend to cancel each other, and only on the southern side a slight anti-correlation of mass balances with the NAO prevails.

  15. The influence of talker and foreign-accent variability on spoken word identification.

    Science.gov (United States)

    Bent, Tessa; Holt, Rachael Frush

    2013-03-01

    In spoken word identification and memory tasks, stimulus variability from numerous sources impairs performance. In the current study, the influence of foreign-accent variability on spoken word identification was evaluated in two experiments. Experiment 1 used a between-subjects design to test word identification in noise in single-talker and two multiple-talker conditions: multiple talkers with the same accent and multiple talkers with different accents. Identification performance was highest in the single-talker condition, but there was no difference between the single-accent and multiple-accent conditions. Experiment 2 further explored word recognition for multiple talkers in single-accent versus multiple-accent conditions using a mixed design. A detriment to word recognition was observed in the multiple-accent condition compared to the single-accent condition, but the effect differed across the language backgrounds tested. These results demonstrate that the processing of foreign-accent variation may influence word recognition in ways similar to other sources of variability (e.g., speaking rate or style) in that the inclusion of multiple foreign accents can result in a small but significant performance decrement beyond the multiple-talker effect.

  16. Influences of rainfall variables and antecedent discharge on urban effluent concentrations and loads in wet weather.

    Science.gov (United States)

    Xu, Zuxin; Xiong, Lijun; Li, Huaizheng; Liao, Zhengliang; Yin, Hailong; Wu, Jun; Xu, Jin; Chen, Hao

    2017-04-01

    For storm drainages inappropriately connected with sewage, wet weather discharge is a major factor that adversely affects receiving waters. A study of the wet weather influences of rainfall-discharge variables on storm drainages connected with sewage was conducted in the downtown Shanghai area (374 ha). Two indicators, event mean concentration (EMC) and event pollutant load per unit area (EPL), were used to describe the pollution discharge during 20 rain events. The study showed that the total rainfall and discharge volume were important factors that affect the EMCs and EPLs of the chemical oxygen demand, total phosphorus, and especially those of NH 4 + -N. The pollutant concentrations at the beginning of the discharge and the discharge period were also major factors that influence the EMCs of these three pollutants. Regression relationships between the rainfall-discharge variables and discharge volume/ EPLs (R 2 = 0.824-0.981) were stronger than the relationships between the rainfall-discharge variables and EMCs. These regression equations can be considered reliable in the system, with a relative validation error of less than ±10% for the discharge volume, and less than ±20% for the EPLs. The results presented in this paper provide guidance for effectively controlling pollution in similar storm drainages.

  17. The influence of meteorological variables on the development of deep venous thrombosis.

    Science.gov (United States)

    Brown, Helen K; Simpson, A John; Murchison, John T

    2009-10-01

    The influence of weather on deep venous thrombosis (DVT) incidence remains controversial. We aimed to characterize the temporal association between DVT and meteorological variables including atmospheric pressure. Data relating to hospital admissions with DVT in Scotland were collected retrospectively for a 20 year period for which corresponding meteorological recordings were available. Weather variables were calculated as weighted daily averages to adjust for variations in population density. Seasonal variation in DVT and short-term effects of weather variables on the relative risk of developing DVT were assess using Poisson regression modelling. The models allowed for the identification of lag periods between variation in the weather and DVT presentation. A total of 37,336 cases of DVT were recorded. There was significant seasonal variation in DVT with a winter peak. Seasonal variation in wind speed and temperature were significantly associated with seasonal variation in DVT. When studying more immediate meteorological influences, low atmospheric pressure, high wind speed and high rainfall were significantly associated with an increased risk of DVT approximately 9-10 days later. The effect was most strikingly demonstrated for atmospheric pressure, every 10 millibar decrease in pressure being associated with a 2.1% increase in relative risk of DVT. Alterations in weather have a small but significant impact upon the incidence of DVT. DVT is particularly associated with reduction in atmospheric pressure giving weight to the hypothesis that reduced cabin pressure in long haul flights contributes to DVT. These findings have implications for our understanding of the pathogenesis of DVT.

  18. Multi-taxa integrated landscape genetics for zoonotic infectious diseases: deciphering variables influencing disease emergence.

    Science.gov (United States)

    Leo, Sarah S T; Gonzalez, Andrew; Millien, Virginie

    2016-05-01

    Zoonotic disease transmission systems involve sets of species interacting with each other and their environment. This complexity impedes development of disease monitoring and control programs that require reliable identification of spatial and biotic variables and mechanisms facilitating disease emergence. To overcome this difficulty, we propose a framework that simultaneously examines all species involved in disease emergence by integrating concepts and methods from population genetics, landscape ecology, and spatial statistics. Multi-taxa integrated landscape genetics (MTILG) can reveal how interspecific interactions and landscape variables influence disease emergence patterns. We test the potential of our MTILG-based framework by modelling the emergence of a disease system across multiple species dispersal, interspecific interaction, and landscape scenarios. Our simulations showed that both interspecific-dependent dispersal patterns and landscape characteristics significantly influenced disease spread. Using our framework, we were able to detect statistically similar inter-population genetic differences and highly correlated spatial genetic patterns that imply species-dependent dispersal. Additionally, species that were assigned coupled-dispersal patterns were affected to the same degree by similar landscape variables. This study underlines the importance of an integrated approach to investigating emergence of disease systems. MTILG is a robust approach for such studies and can identify potential avenues for targeted disease management strategies.

  19. Changes of extreme precipitation and nonlinear influence of climate variables over monsoon region in China

    KAUST Repository

    Gao, Tao

    2017-07-19

    The El Niño-Southern Oscillation (ENSO), Indian Ocean Dipole (IOD), North Atlantic Oscillation (NAO), Atlantic Multidecadal Oscillation (AMO) and Pacific decadal oscillation (PDO) are well understood to be major drivers for the variability of precipitation extremes over monsoon regions in China (MRC). However, research on monsoon extremes in China and their associations with climate variables is limited. In this study, we examine the space-time variations of extreme precipitation across the MRC, and assess the time-varying influences of the climate drivers using Bayesian dynamic linear regression and their combined nonlinear effects through fitting generalized additive models. Results suggest that the central-east and south China is dominated by less frequent but more intense precipitation. Extreme rainfalls show significant positive trends, coupled with a significant decline of dry spells, indicating an increasing chance of occurrence of flood-induced disasters in the MRC during 1960–2014. Majority of the regional indices display some abrupt shifts during the 1990s. The influences of climate variables on monsoon extremes exhibit distinct interannual or interdecadal variations. IOD, ENSO and AMO have strong impacts on monsoon and extreme precipitation, especially during the 1990s, which is generally consistent with the abrupt shifts in precipitation regimes around this period. Moreover, ENSO mainly affects moderate rainfalls and dry spells, while IOD has a more significant impact on precipitation extremes. These findings could be helpful for improving the forecasting of monsoon extremes in China and the evaluations of climate models.

  20. LB01.06: VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR OUTCOMES IN FELODIPINE EVENT REDUCTION STUDY.

    Science.gov (United States)

    Zhang, Y; Zhang, X; Liu, L; Zanchetti, A

    2015-06-01

    Many antihypertensive outcome trials have shown that visit-to-visit blood pressure variability is correlated closely with clinical outcomes in hypertensive patients. The objective of the study was to investigate the relationship between visit-to-visit blood pressure variability (BPV) and the major cardiovascular outcomes in the Chinese hypertensive patients. Felodipine Event Reduction (FEVER) study was a double-blind, randomized trial on 9711 Chinese hypertensive patients, in whom cardiovascular outcomes were significantly reduced by more intense therapy achieving a mean of 138 mmHg SBP compared with less-intense therapy achieving a mean of 142 mmHg. Visit-to-visit BPV during the follow-up period [defined as standard deviation (SD), coefficient of variation (CV), and average real variability(ARV)] was derived from casual cuff BP measures after six months follow-up until the end of the study. Hazard ratios (HRs), for the incidence of CVD associated with SD, CV, and ARV of SBP and DBP were calculated using Cox proportional hazard models. Overall predictive power [area under receiver operating characteristic (AUC ROC) curve] of the level of blood pressure, blood pressure variability and other baseline characteristics was calculated. In FEVER study, visit-to-visit variability in SBP were significant predictors of subsequent stroke [eg, hazard ratios [HR] for ARV, SD and CV was 1.071 (95% CI: 1.025-1.118), 1.373 (95% CI: 1.159-1.626) and 0.572 (95% CI: 0.451-0,726)]. Visit-to-visit variability in DBP were also showed similar trend [eg, HR for ARV, SD and CV was 1.066 (95% CI: 0.992-1.145), 1.931 (95% CI: 1.435-2.598) and 0.558 (95% CI: 0.438-0,710)]. However, using the analysis of AUC ROC analysis, the risk importance sequence of the stroke events in this cohort was level of SBP, age, level of DBP ARV, SD, sex, CV and treatment. Visit-to-visit blood pressure variability has some effects on the cardiovascular outcomes in the Chinese hypertensive patents in the cohort in

  1. Influence of peer review on the reporting of primary outcome(s) and statistical analyses of randomised trials.

    Science.gov (United States)

    Hopewell, Sally; Witt, Claudia M; Linde, Klaus; Icke, Katja; Adedire, Olubusola; Kirtley, Shona; Altman, Douglas G

    2018-01-11

    Selective reporting of outcomes in clinical trials is a serious problem. We aimed to investigate the influence of the peer review process within biomedical journals on reporting of primary outcome(s) and statistical analyses within reports of randomised trials. Each month, PubMed (May 2014 to April 2015) was searched to identify primary reports of randomised trials published in six high-impact general and 12 high-impact specialty journals. The corresponding author of each trial was invited to complete an online survey asking authors about changes made to their manuscript as part of the peer review process. Our main outcomes were to assess: (1) the nature and extent of changes as part of the peer review process, in relation to reporting of the primary outcome(s) and/or primary statistical analysis; (2) how often authors followed these requests; and (3) whether this was related to specific journal or trial characteristics. Of 893 corresponding authors who were invited to take part in the online survey 258 (29%) responded. The majority of trials were multicentre (n = 191; 74%); median sample size 325 (IQR 138 to 1010). The primary outcome was clearly defined in 92% (n = 238), of which the direction of treatment effect was statistically significant in 49%. The majority responded (1-10 Likert scale) they were satisfied with the overall handling (mean 8.6, SD 1.5) and quality of peer review (mean 8.5, SD 1.5) of their manuscript. Only 3% (n = 8) said that the editor or peer reviewers had asked them to change or clarify the trial's primary outcome. However, 27% (n = 69) reported they were asked to change or clarify the statistical analysis of the primary outcome; most had fulfilled the request, the main motivation being to improve the statistical methods (n = 38; 55%) or avoid rejection (n = 30; 44%). Overall, there was little association between authors being asked to make this change and the type of journal, intervention, significance of the

  2. Perceptions of variability in facial emotion influence beliefs about the stability of psychological characteristics.

    Science.gov (United States)

    Weisbuch, Max; Grunberg, Rebecca L; Slepian, Michael L; Ambady, Nalini

    2016-10-01

    Beliefs about the malleability versus stability of traits (incremental vs. entity lay theories) have a profound impact on social cognition and self-regulation, shaping phenomena that range from the fundamental attribution error and group-based stereotyping to academic motivation and achievement. Less is known about the causes than the effects of these lay theories, and in the current work the authors examine the perception of facial emotion as a causal influence on lay theories. Specifically, they hypothesized that (a) within-person variability in facial emotion signals within-person variability in traits and (b) social environments replete with within-person variability in facial emotion encourage perceivers to endorse incremental lay theories. Consistent with Hypothesis 1, Study 1 participants were more likely to attribute dynamic (vs. stable) traits to a person who exhibited several different facial emotions than to a person who exhibited a single facial emotion across multiple images. Hypothesis 2 suggests that social environments support incremental lay theories to the extent that they include many people who exhibit within-person variability in facial emotion. Consistent with Hypothesis 2, participants in Studies 2-4 were more likely to endorse incremental theories of personality, intelligence, and morality after exposure to multiple individuals exhibiting within-person variability in facial emotion than after exposure to multiple individuals exhibiting a single emotion several times. Perceptions of within-person variability in facial emotion-rather than perceptions of simple diversity in facial emotion-were responsible for these effects. Discussion focuses on how social ecologies shape lay theories. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Auditory development in early amplified children: factors influencing auditory-based communication outcomes in children with hearing loss.

    Science.gov (United States)

    Sininger, Yvonne S; Grimes, Alison; Christensen, Elizabeth

    2010-04-01

    The purpose of this study was to determine the influence of selected predictive factors, primarily age at fitting of amplification and degree of hearing loss, on auditory-based outcomes in young children with bilateral sensorineural hearing loss. Forty-four infants and toddlers, first identified with mild to profound bilateral hearing loss, who were being fitted with amplification were enrolled in the study and followed longitudinally. Subjects were otherwise typically developing with no evidence of cognitive, motor, or visual impairment. A variety of subject factors were measured or documented and used as predictor variables, including age at fitting of amplification, degree of hearing loss in the better hearing ear, cochlear implant status, intensity of oral education, parent-child interaction, and the number of languages spoken in the home. These factors were used in a linear multiple regression analysis to assess their contribution to auditory-based communication outcomes. Five outcome measures, evaluated at regular intervals in children starting at age 3, included measures of speech perception (Pediatric Speech Intelligibility and Online Imitative Test of Speech Pattern Contrast Perception), speech production (Arizona-3), and spoken language (Reynell Expressive and Receptive Language). The age at fitting of amplification ranged from 1 to 72 mo, and the degree of hearing loss ranged from mild to profound. Age at fitting of amplification showed the largest influence and was a significant factor in all outcome models. The degree of hearing loss was an important factor in the modeling of speech production and spoken language outcomes. Cochlear implant use was the other factor that contributed significantly to speech perception, speech production, and language outcomes. Other factors contributed sparsely to the models. Prospective longitudinal studies of children are important to establish relationships between subject factors and outcomes. This study clearly

  4. Analysis of the influences on plumage condition in laying hens: How suitable is a whole body plumage score as an outcome?

    Science.gov (United States)

    Campe, A; Hoes, C; Koesters, S; Froemke, C; Bougeard, S; Staack, M; Bessei, W; Manton, A; Scholz, B; Schrader, L; Thobe, P; Knierim, U

    2018-02-01

    An important indicator of the health and behavior of laying hens is their plumage condition. Various scoring systems are used, and various risk factors for feather damage have been described. Often, a summarized score of different body parts is used to describe the overall condition of the plumage of a bird. However, it has not yet been assessed whether such a whole body plumage score is a suitable outcome variable when analyzing the risk factors for plumage deterioration. Data collected within a German project on farms keeping laying hens in aviaries were analyzed to investigate whether and the extent to which information is lost when summarizing the scores of the separate body parts. Two models were fitted using multiblock redundancy analysis, in which the first model included the whole body score as one outcome variable, while the second model included the scores of the individual body parts as multiple outcome variables. Although basically similar influences could be discovered with both models, the investigation of the individual body parts allowed for consideration of the influences on each body part separately and for the identification of additional influences. Furthermore, ambivalent influences (a factor differently associated with 2 different outcomes) could be detected with this approach, and possible dilutive effects were avoided. We conclude that influences might be underestimated or even missed when modeling their explanatory power for an overall score only. Therefore, multivariate methods that allow for the consideration of individual body parts are an interesting option when investigating influences on plumage condition. © 2017 Poultry Science Association Inc.

  5. Influence of pre-existing inflammation on the outcome of acute coronary syndrome

    DEFF Research Database (Denmark)

    Odeberg, J.; Freitag, M.; Forssell, Henrik

    2016-01-01

    Objectives: Inflammation is a well-established risk factor for the development of coronary artery disease (CAD) and acute coronary syndrome (ACS). However, less is known about its influence on the outcome of ACS. The aim of this study was to determine if blood biomarkers of inflammation were...... that a pre-existing low-grade inflammation may dispose towards MI over UA....

  6. The influence of perceived characteristics of management development programs on employee outcomes.

    NARCIS (Netherlands)

    Ardts, J.C.A.; van der Velde, M.E.G.; Maurer, T.

    2010-01-01

    Employees’ perceptions of Management Development (MD) programs is the topic of this study. The purpose is to examine the influence of three important perceived characteristics of MD programs on relevant MD outcomes. The MD characteristics are: availability of role models, perceived control, and

  7. The Influence of Investment in Workplace Learning on Learning Outcomes and Organizational Performance

    Science.gov (United States)

    Park, Yoonhee; Jacobs, Ronald L.

    2011-01-01

    Although the importance of workplace learning has been recognized in research and practice, there is little empirical support that describes how workplace learning, including both formal and informal learning, is linked to organizational performance. This study investigated the influence of investment in workplace learning on learning outcomes and…

  8. The Level of Alexithymia in Alcohol-Dependent Patients Does Not Influence Outcomes after Inpatient Treatment

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J.A.M. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  9. The level of alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment.

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J.A.M. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    BACKGROUND: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  10. The level of Alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment

    NARCIS (Netherlands)

    de Haan, Hein A.; Schellekens, Arnt F.A.; van der Palen, Jacobus Adrianus Maria; Verkes, Robbert-Jan; Buitelaar, Jan K.; de Jong, Cor A.J.

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  11. Influence of gender on EVAR outcomes with new low-profile devices

    DEFF Research Database (Denmark)

    Bendermacher, B L W; Grootenboer, Nathalie; Cuypers, Ph W

    2013-01-01

    Women have not benefitted to the same extent as men of endovascular abdominal aortic repair (EVAR). Besides differences in hormones and the higher rate of undiagnosed cardiovascular disease, there are anatomical differences between men and women influencing the outcome of endovascular treatment o...

  12. The Influence of Contextual Factors on the Sustainability of Professional Development Outcomes

    Science.gov (United States)

    Sandholtz, Judith Haymore; Ringstaff, Cathy

    2016-01-01

    This study investigated how contextual factors influenced the sustainability of outcomes from a 3-year, state-funded professional development program that provided science assistance for K-2 teachers in small, rural school districts. The research used a case-study approach with a purposive sample of five elementary schools that varied in…

  13. Influence of PAHs among other coastal environmental variables on total and PAH-degrading bacterial communities.

    Science.gov (United States)

    Sauret, Caroline; Tedetti, Marc; Guigue, Catherine; Dumas, Chloé; Lami, Raphaël; Pujo-Pay, Mireille; Conan, Pascal; Goutx, Madeleine; Ghiglione, Jean-François

    2016-03-01

    We evaluated the relative impact of anthropogenic polycyclic aromatic hydrocarbons (PAHs) among biogeochemical variables on total, metabolically active, and PAH bacterial communities in summer and winter in surface microlayer (SML) and subsurface seawaters (SSW) across short transects along the NW Mediterranean coast from three harbors, one wastewater effluent, and one nearshore observatory reference site. At both seasons, significant correlations were found between dissolved total PAH concentrations and PAH-degrading bacteria that formed a gradient from the shore to nearshore waters. Accumulation of PAH degraders was particularly high in the SML, where PAHs accumulated. Harbors and wastewater outfalls influenced drastically and in a different way the total and active bacterial community structure, but they only impacted the communities from the nearshore zone (PAH concentrations on the spatial and temporal dynamic of total and active communities in this area, but this effect was putted in perspective by the importance of other biogeochemical variables.

  14. The influence of blood pressure management on neurological outcome in endovascular therapy for acute ischaemic stroke.

    Science.gov (United States)

    Rasmussen, M; Espelund, U S; Juul, N; Yoo, A J; Sørensen, L H; Sørensen, K E; Johnsen, S P; Andersen, G; Simonsen, C Z

    2018-06-01

    Observational studies have suggested that low blood pressure and blood pressure variability may partially explain adverse neurological outcome after endovascular therapy with general anaesthesia (GA) for acute ischaemic stroke. The aim of this study was to further examine whether blood pressure related parameters during endovascular therapy are associated with neurological outcome. The GOLIATH trial randomised 128 patients to either GA or conscious sedation for endovascular therapy in acute ischaemic stroke. The primary outcome was 90 day modified Rankin Score. The haemodynamic protocol aimed at keeping the systolic blood pressure >140 mm Hg and mean blood pressure >70 mm Hg during the procedure. Blood pressure related parameters of interest included 20% reduction in mean blood pressure; mean blood pressure blood pressure blood pressure; mean blood pressure at the time of groin puncture; postreperfusion mean blood pressure; blood pressure variability; and use of vasopressors. Sensitivity analyses were performed in the subgroup of reperfused patients. Procedural average mean and systolic blood pressures were higher in the conscious sedation group (Pblood pressure blood pressure blood pressure variability, and use of vasopressors were all higher in the GA group (Pblood pressure related parameters and the modified Rankin Score in the overall patient population, and in the subgroup of patients with full reperfusion. We found no statistically significant association between blood pressure related parameters during endovascular therapy and neurological outcome. NCT 02317237. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  15. Social distance influences the outcome evaluation of cooperation and conflict: Evidence from event-related potentials.

    Science.gov (United States)

    Chen, Yezi; Lu, Jiamei; Wang, Yiwen; Feng, Zhouqi; Yuan, Bo

    2017-04-24

    Previous research shows that social distance plays an important role in promoting cooperation and that subtle cues that reduce social distance increase the tendency to cooperate. However, it is unclear how social distance influences our outcome evaluation of cooperative and conflict feedback. The present study investigated the influence of social distance on cooperative and conflict behavior and the evaluation process of the cooperative and conflict outcomes, using the event-related potentials (ERPs) technique. We recorded ERPs from 14 normal adults playing a social game task against a friend and a stranger. The results showed that the FRN (Feedback Related Negativity) and P300 were affected by the opponent's choice to cooperate or aggress; however, only the P300 was affected by social distance. Specifically, when the opponent chose to cooperate, the feedback elicited a smaller FRN and a larger P300 amplitude; and compared with playing against friends, the P300 had a larger amplitude when participants gaming with strangers. Our results indicate that at the early stage of the evaluation of cooperation and conflict outcomes, individuals may initially and quickly encode the valence of outcomes, judging whether an outcome is consistent with their expectations. However, at the late stage, which involves a top-down cognitive appraisal process, some social factors, such as social distance, may moderate processing of attention resource allocation of feedback about outcomes, and of higher-level motivation/affective appraisal. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Influence of management history and landscape variables on soil organic carbon and soil redistribution

    Science.gov (United States)

    Venteris, E.R.; McCarty, G.W.; Ritchie, J.C.; Gish, T.

    2004-01-01

    Controlled studies to investigate the interaction between crop growth, soil properties, hydrology, and management practices are common in agronomy. These sites (much as with real world farmland) often have complex management histories and topographic variability that must be considered. In 1993 an interdisiplinary study was started for a 20-ha site in Beltsville, MD. Soil cores (271) were collected in 1999 in a 30-m grid (with 5-m nesting) and analyzed as part of the site characterization. Soil organic carbon (SOC) and 137Cesium (137Cs) were measured. Analysis of aerial photography from 1992 and of farm management records revealed that part of the site had been maintained as a swine pasture and the other portion as cropped land. Soil properties, particularly soil redistribution and SOC, show large differences in mean values between the two areas. Mass C is 0.8 kg m -2 greater in the pasture area than in the cropped portion. The pasture area is primarily a deposition site, whereas the crop area is dominated by erosion. Management influence is suggested, but topographic variability confounds interpretation. Soil organic carbon is spatially structured, with a regionalized variable of 120 m. 137Cs activity lacks spatial structure, suggesting disturbance of the profile by animal activity and past structures such as swine shelters and roads. Neither SOC nor 137Cs were strongly correlated to terrain parameters, crop yields, or a seasonal soil moisture index predicted from crop yields. SOC and 137Cs were weakly correlated (r2 ???0.2, F-test P-value 0.001), suggesting that soil transport controls, in part, SOC distribution. The study illustrates the importance of past site history when interpreting the landscape distribution of soil properties, especially those strongly influenced by human activity. Confounding variables, complex soil hydrology, and incomplete documentation of land use history make definitive interpretations of the processes behind the spatial distributions

  17. Influence of magnet eddy current on magnetization characteristics of variable flux memory machine

    Science.gov (United States)

    Yang, Hui; Lin, Heyun; Zhu, Z. Q.; Lyu, Shukang

    2018-05-01

    In this paper, the magnet eddy current characteristics of a newly developed variable flux memory machine (VFMM) is investigated. Firstly, the machine structure, non-linear hysteresis characteristics and eddy current modeling of low coercive force magnet are described, respectively. Besides, the PM eddy current behaviors when applying the demagnetizing current pulses are unveiled and investigated. The mismatch of the required demagnetization currents between the cases with or without considering the magnet eddy current is identified. In addition, the influences of the magnet eddy current on the demagnetization effect of VFMM are analyzed. Finally, a prototype is manufactured and tested to verify the theoretical analyses.

  18. Patient-Therapist Identification in Relation to Both Patient and Therapist Variables and Therapy Outcome

    Science.gov (United States)

    Melnick, Barry

    1972-01-01

    The results of the study confirmed the hypothesis that greater patient identification with the therapist, as defined by increased similarity between the patient's and therapist's semantic differential ratings, moderately correlated with more successful therapy outcome. (Author)

  19. The Influence of Unsportsmanlike Fouls on Basketball Teams' Performance According to Context-Related Variables.

    Science.gov (United States)

    Gómez, Miguel-Ángel; Ortega Toro, Enrique; Furley, Philip

    2016-07-01

    The aim of the current study was to analyze the temporal effects that unsportsmanlike fouls may have on basketball teams' scoring performance under consideration of context-related variables. The authors analyzed 130 unsportsmanlike fouls from 362 elite basketball games (men's and women's Olympic Games, European and World Championships). The context-related variables studied were score-line, quality of opposition, timeout situation, minutes remaining, and player status. The data were analyzed with linear-regression models. The results showed that both teams (the team that made the foul and the opponent) had similar positive scoring performances during 1 and 3 ball possessions after the unsportsmanlike foul (short-term effect). However, 5 ball possessions after the foul (midterm effect), the team that made the foul had a scoring disadvantage (-0.96) and the opponent team an advantage (0.78). The context-related variable quality of opposition was significant only during 1 ball possession, with negative effects for the team that made the foul and positive effects for the opponent. The final outcome showed a positive effect for score-line when the unsportsmanlike foul was made (0.96) and for quality of opposition (0.64).

  20. Physical activity levels of community-dwelling older adults are influenced by winter weather variables.

    Science.gov (United States)

    Jones, G R; Brandon, C; Gill, D P

    2017-07-01

    Winter weather conditions may negatively influence participation of older adults in daily physical activity (PA). Assess the influence of winter meteorological variables, day-time peak ambient temperature, windchill, humidity, and snow accumulation on the ground to accelerometer measured PA values in older adults. 50 community-dwelling older adults (77.4±4.7yrs; range 71-89; 12 females) living in Southwestern Ontario (Latitude 42.9°N Longitude 81.2° W) Canada, wore a waist-borne accelerometer during active waking hours (12h) for 7 consecutive days between February and April 2007. Hourly temperature, windchill, humidity, and snowfall accumulation were obtained from meteorological records and time locked to hourly accelerometer PA values. Regression analysis revealed significant relationships between time of day, ambient daytime high temperature and a humidity for participation in PA. Windchill temperature added no additional influence over PA acclamation already influenced by ambient day-time temperature and the observed variability in PA patterns relative to snow accumulation over the study period was too great to warrant its inclusion in the model. Most PA was completed in the morning hours and increased as the winter month's transitioned to spring (February through April). An equation was developed to adjust for winter weather conditions using temperature, humidity and time of day. Accurate PA assessment during the winter months must account for the ambient daytime high temperatures, humidity, and time of day. These older adults were more physically active during the morning hours and became more active as the winter season transitioned to spring. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Reciprocal Interaction of 24-Hour Blood Pressure Variability and Systolic Blood Pressure on Outcome in Stroke Thrombolysis.

    Science.gov (United States)

    Kellert, Lars; Hametner, Christian; Ahmed, Niaz; Rauch, Geraldine; MacLeod, Mary J; Perini, Francesco; Lees, Kennedy R; Ringleb, Peter A

    2017-07-01

    Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed. The primary measure of BP variability was successive variability. Data were preprocessed using coarsened exact matching. We assessed early neurological improvement, symptomatic intracerebral hemorrhage (SICH), and long-term functional outcome (modified Rankin Scale [mRS] at 90 days) by binary and ordinal regression analyses. Attempts to explain successive variation for analysis of BPV with patients characteristics at admission found systolic BP (5.5% variance) to be most influential, yet 92% of BPV variance remained unexplained. Independently from systolic BP, successive variation for analysis of BPV was associated with poor functional outcome mRS score of 0 to 2 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90-0.98), disadvantage across the shift of mRS (OR, 1.04; 95% CI, 1.01-1.08), mortality (OR, 1.10; 95% CI, 1.01-1.08), SICH SITS (OR, 1.14; 95% CI, 1.06-1.23), and SICH ECASS (OR, 1.24; 95% CI, 1.10-1.40; ECASS [European Cooperative Acute Stroke Study 2]). Analyzing successive variation for analysis of BPV as a function of pre-treatment, systolic BP significantly improved the prediction of functional outcome (mRS score of 0-1, mRS score of 0-2, neurological improvement, mRS-shift: all P interaction accounting for pre-treatment BP and the acute BP course (ie, BPV) to achieve best possible outcome for the patient. © 2017 American Heart Association, Inc.

  2. Increasing work-time influence: consequences for flexibility, variability, regularity and predictability.

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Aust, Birgit; Diderichsen, Finn

    2012-01-01

    This quasi-experimental study investigated how an intervention aiming at increasing eldercare workers' influence on their working hours affected the flexibility, variability, regularity and predictability of the working hours. We used baseline (n = 296) and follow-up (n = 274) questionnaire data and interviews with intervention-group participants (n = 32). The work units in the intervention group designed their own intervention comprising either implementation of computerised self-scheduling (subgroup A), collection of information about the employees' work-time preferences by questionnaires (subgroup B), or discussion of working hours (subgroup C). Only computerised self-scheduling changed the working hours and the way they were planned. These changes implied more flexible but less regular working hours and an experience of less predictability and less continuity in the care of clients and in the co-operation with colleagues. In subgroup B and C, the participants ended up discussing the potential consequences of more work-time influence without actually implementing any changes. Employee work-time influence may buffer the adverse effects of shift work. However, our intervention study suggested that while increasing the individual flexibility, increasing work-time influence may also result in decreased regularity of the working hours and less continuity in the care of clients and co-operation with colleagues.

  3. Dynamics of melanoma tumor therapy with vesicular stomatitis virus: explaining the variability in outcomes using mathematical modeling.

    Science.gov (United States)

    Rommelfanger, D M; Offord, C P; Dev, J; Bajzer, Z; Vile, R G; Dingli, D

    2012-05-01

    Tumor selective, replication competent viruses are being tested for cancer gene therapy. This approach introduces a new therapeutic paradigm due to potential replication of the therapeutic agent and induction of a tumor-specific immune response. However, the experimental outcomes are quite variable, even when studies utilize highly inbred strains of mice and the same cell line and virus. Recognizing that virotherapy is an exercise in population dynamics, we utilize mathematical modeling to understand the variable outcomes observed when B16ova malignant melanoma tumors are treated with vesicular stomatitis virus in syngeneic, fully immunocompetent mice. We show how variability in the initial tumor size and the actual amount of virus delivered to the tumor have critical roles on the outcome of therapy. Virotherapy works best when tumors are small, and a robust innate immune response can lead to superior tumor control. Strategies that reduce tumor burden without suppressing the immune response and methods that maximize the amount of virus delivered to the tumor should optimize tumor control in this model system.

  4. The influence of solar wind variability on magnetospheric ULF wave power

    International Nuclear Information System (INIS)

    Pokhotelov, D.; Rae, I.J.; Mann, I.R.

    2015-01-01

    Magnetospheric ultra-low frequency (ULF) oscillations in the Pc 4-5 frequency range play an important role in the dynamics of Earth's radiation belts, both by enhancing the radial diffusion through incoherent interactions and through the coherent drift-resonant interactions with trapped radiation belt electrons. The statistical distributions of magnetospheric ULF wave power are known to be strongly dependent on solar wind parameters such as solar wind speed and interplanetary magnetic field (IMF) orientation. Statistical characterisation of ULF wave power in the magnetosphere traditionally relies on average solar wind-IMF conditions over a specific time period. In this brief report, we perform an alternative characterisation of the solar wind influence on magnetospheric ULF wave activity through the characterisation of the solar wind driver by its variability using the standard deviation of solar wind parameters rather than a simple time average. We present a statistical study of nearly one solar cycle (1996-2004) of geosynchronous observations of magnetic ULF wave power and find that there is significant variation in ULF wave powers as a function of the dynamic properties of the solar wind. In particular, we find that the variability in IMF vector, rather than variabilities in other parameters (solar wind density, bulk velocity and ion temperature), plays the strongest role in controlling geosynchronous ULF power. We conclude that, although time-averaged bulk properties of the solar wind are a key factor in driving ULF powers in the magnetosphere, the solar wind variability can be an important contributor as well. This highlights the potential importance of including solar wind variability especially in studies of ULF wave dynamics in order to assess the efficiency of solar wind-magnetosphere coupling.

  5. The influence of solar wind variability on magnetospheric ULF wave power

    Directory of Open Access Journals (Sweden)

    D. Pokhotelov

    2015-06-01

    Full Text Available Magnetospheric ultra-low frequency (ULF oscillations in the Pc 4–5 frequency range play an important role in the dynamics of Earth's radiation belts, both by enhancing the radial diffusion through incoherent interactions and through the coherent drift-resonant interactions with trapped radiation belt electrons. The statistical distributions of magnetospheric ULF wave power are known to be strongly dependent on solar wind parameters such as solar wind speed and interplanetary magnetic field (IMF orientation. Statistical characterisation of ULF wave power in the magnetosphere traditionally relies on average solar wind–IMF conditions over a specific time period. In this brief report, we perform an alternative characterisation of the solar wind influence on magnetospheric ULF wave activity through the characterisation of the solar wind driver by its variability using the standard deviation of solar wind parameters rather than a simple time average. We present a statistical study of nearly one solar cycle (1996–2004 of geosynchronous observations of magnetic ULF wave power and find that there is significant variation in ULF wave powers as a function of the dynamic properties of the solar wind. In particular, we find that the variability in IMF vector, rather than variabilities in other parameters (solar wind density, bulk velocity and ion temperature, plays the strongest role in controlling geosynchronous ULF power. We conclude that, although time-averaged bulk properties of the solar wind are a key factor in driving ULF powers in the magnetosphere, the solar wind variability can be an important contributor as well. This highlights the potential importance of including solar wind variability especially in studies of ULF wave dynamics in order to assess the efficiency of solar wind–magnetosphere coupling.

  6. Influence of Flat-Panel Fluoroscopic Equipment Variables on Cardiac Radiation Doses

    International Nuclear Information System (INIS)

    Nickoloff, Edward L.; Lu Zhengfeng; Dutta, Ajoy; So, James; Balter, Stephen; Moses, Jeffrey

    2007-01-01

    Purpose. To assess the influence of physician-selectable equipment variables on the potential radiation dose reductions during cardiac catheterization examinations using modern imaging equipment. Materials. A modern bi-plane angiography unit with flat-panel image receptors was used. Patients were simulated with 15-30 cm of acrylic plastic. The variables studied were: patient thickness, fluoroscopy pulse rates, record mode frame rates, image receptor field-of-view (FoV), automatic dose control (ADC) mode, SID/SSD geometry setting, automatic collimation, automatic positioning, and others. Results. Patient radiation doses double for every additional 3.5-4.5 cm of soft tissue. The dose is directly related to the imaging frame rate; a decrease from 30 pps to 15 pps reduces the dose by about 50%. The dose is related to [(FoV) -N ] where 2.0 < N < 3.0. Suboptimal positioning of the patient can nearly double the dose. The ADC system provides three selections that can vary the radiation level by 50%. For pediatric studies (2-5 years old), the selection of equipment variables can result in entrance radiation doses that range between 6 and 60 cGy for diagnostic cases and between 15 and 140 cGy for interventional cases. For adult studies, the equipment variables can produce entrance radiation doses that range between 13 and 130 cGy for diagnostic cases and between 30 and 400 cGy for interventional cases. Conclusions. Overall dose reductions of 70-90% can be achieved with pediatric patients and about 90% with adult patients solely through optimal selection of equipment variables

  7. Positive Outcome Expectancy Mediates the Relationship Between Peer Influence and Internet Gaming Addiction Among Adolescents in Taiwan.

    Science.gov (United States)

    Wu, Jo Yung Wei; Ko, Huei-Chen; Wong, Tsui-Yin; Wu, Li-An; Oei, Tian Po

    2016-01-01

    The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

  8. Case-Mix Variables and Predictors for Outcomes of Laparoscopic Hysterectomy: A Systematic Review.

    Science.gov (United States)

    Driessen, Sara R C; Sandberg, Evelien M; la Chapelle, Claire F; Twijnstra, Andries R H; Rhemrev, Johann P T; Jansen, Frank Willem

    2016-01-01

    The assessment of surgical quality is complex, and an adequate case-mix correction is missing in currently applied quality indicators. The purpose of this study is to give an overview of all studies mentioning statistically significant associations between patient characteristics and surgical outcomes for laparoscopic hysterectomy (LH). Additionally, we identified a set of potential case-mix characteristics for LH. This systematic review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. We searched PubMed and EMBASE from January 1, 2000 to August 1, 2015. All articles describing statistically significant associations between patient characteristics and adverse outcomes of LH for benign indications were included. Primary outcomes were blood loss, operative time, conversion, and complications. The methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The included articles were summed per predictor and surgical outcome. Three sets of case-mix characteristics were determined, stratified by different levels of evidence. Eighty-five of 1549 identified studies were considered eligible. Uterine weight and body mass index (BMI) were the most mentioned predictors (described, respectively, 83 and 45 times) in high quality studies. For longer operative time and higher blood loss, uterine weight ≥ 250 to 300 g and ≥500 g and BMI ≥ 30 kg/m(2) dominated as predictors. Previous operations, adhesions, and higher age were also considered as predictors for longer operative time. For complications and conversions, the patient characteristics varied widely, and uterine weight, BMI, previous operations, adhesions, and age predominated. Studies of high methodologic quality indicated uterine weight and BMI as relevant case-mix characteristics for all surgical outcomes. For future development of quality indicators of LH and to compare surgical outcomes adequately, a case

  9. The Influence of ENSO to the Rainfall Variability in North Sumatra Province

    Science.gov (United States)

    Irwandi, H.; Pusparini, N.; Ariantono, J. Y.; Kurniawan, R.; Tari, C. A.; Sudrajat, A.

    2018-04-01

    The El Niño Southern Oscillation (ENSO) is a global phenomenon that affects the variability of rainfall in North Sumatra. The influence of ENSO will be different for each region. This review will analyse the influence of ENSO activity on seasonal and annual rainfall variability. In this research, North Sumatra Province will be divided into 4 (four) regions based on topographical conditions, such as: East Coast (EC), East Slope (ES), Mountains (MT), and West Coast (WC). The method used was statistical and descriptive analysis. Data used in this research were rainfall data from 15 stations / climate observation posts which spread in North Sumatera region and also anomaly data of Nino 3.4 region from period 1981-2016. The results showed that the active El Niño had an effect on the decreasing the rainfall during the period of DJF, JJA and SON in East Coast, East Slope, and Mountains with the decreasing of average percentage of annual rainfall up to 7%. On the contrary, the active La Nina had an effect on the addition of rainfall during the period DJF and JJA in the East Coast and Mountains with the increasing of average percentage of annual rainfall up to 6%.

  10. Influence of Individual Values Dissimilarity in the Outcome of top Management Teams: a study in a management lab

    Directory of Open Access Journals (Sweden)

    Jorge Ramon D'Acosta Rivera

    2014-05-01

    Full Text Available Several studies relate organizational outcomes to the performance of top management teams (TMT. Some of these studies suggest that the process of strategic choice is influenced by the cognitive background and values of the executives in those teams, and have focused on the composition of TMT, using demographic variables as proxies for deep-level characteristics. The aim of this descriptive and exploratory study was to verify directly the influence of deep-level characteristics – the dissimilarities of TMT members’ individual values – on the team outcomes. This research was carried out using a quantitative method within a public university management lab environment located in the city of São Paulo, applying two value surveys validated in Brazil on TMT composed of Business Management and Accounting undergraduates submitted to a business game situation, resulting in a non-probabilistic sample formed of 32 teams comprising 186 students with valid responses. Through multiple linear regression technique, two statistically significant regression models were found. It was found that the improved performance of TMT occurs when members differ in the importance assigned to values related to openness to change and have similar appreciation of values related to rules and to security in life (conservation values and the pursuit of power (prestige, giving evidence that this can occur not only in a laboratory environment, but also in the business environment, where time pressures and competition are even more severe and, therefore, more subject to deep-level subjective characteristics.

  11. The influence of Seychelles Dome on the large scale Tropical Variability

    Science.gov (United States)

    Manola, Iris; Selten, Frank; Hazeleger, Wilco

    2013-04-01

    The Seychelles Dome (SD) is the thermocline ridge just South of the equator in the Western Indian Ocean basin. It is characterized by strong atmospheric convection and a shallow thermocline and is associated with large intraseasonal convection and SST variability (Harrison and Vecchi 2001). The SD is influenced by surface and subsurface processes, such as air-sea fluxes, Ekman upwelling from wind stress curl, ocean dynamics (vertical mixing) and oceanic Rossby waves from southeastern Indian Ocean. The favoring season for a strong SD is the boreal winter, where the thermocline is most shallow. Then the southeasterly trade winds converge with the northwesterly monsoonal winds over the intertropical convergence zone and cause cyclonic wind stress curl that drives Ekman divergence and a ridging of the thermocline. It is found that the subseasonal and interranual variability of the SD is influenced by large scale events, such as the Indian Ocean Dipole (IOD), the ENSO and the Madden-Julian Oscillation (MJO) (Tozuka et al., 2010, Lloyd and Vecchi, 2010). The SD is enhanced by cooling events in the Western Indian Ocean and easterly winds that raise the thermocline and increase the upwelling. This can be associated with a strong Walker circulation, like negative IOD conditions or La Nina-like conditions. So far the studies focus on the origins of the SD variability, but the influence of the SD itself on regional or large scale climate is largely unknown. In this study we focus on the influence of the SD variations on the large scale tropical circulation. We analyze the covariance of the SD variations and the tropical circulation in a 200 year control imulation of the climate model EC-EARTH and perform idealized SST forced simulations to study the character of the atmospheric response and its relation to ENSO, IOD and MJO. References -Harrison, D. E. and G. A. Vecchi, 2001: January 1999 Indian Ocean cooling event. Geophys. Res. Lett., 28, 3717-3720. -Lloyd, I. D., and G. A

  12. Variability in Migration Routes Influences Early Marine Survival of Juvenile Salmon Smolts.

    Directory of Open Access Journals (Sweden)

    Nathan B Furey

    Full Text Available Variability in animal migratory behavior is expected to influence fitness, but few empirical examples demonstrating this relationship exist. The initial marine phase in the migration of juvenile salmon smolts has been identified as a potentially critical life history stage to overall population productivity, yet how fine-scale migration routes may influence survival are unknown. Large-scale acoustic telemetry studies have estimated survival rates of outmigrant Pacific salmon smolts through the Strait of Georgia (SOG along the British Columbian coastline to the Pacific Ocean, but these data have not been used to identify and characterize fine-scale movements. Data collected on over 850 sockeye salmon (Oncorhynchus nerka and steelhead (Oncorhynchus mykiss smolts detected at an array in the Strait of Georgia in 2004-2008 and 2010-2013 were analyzed to characterize migration routes and link movements to subsequent survival at an array 250 km further along the marine migration pathway. Both species exhibited disproportionate use of the most eastern route in the Strait of Georgia (Malaspina Strait. While many smolts moved across the northern Strait of Georgia acoustic array with no indication of long-term milling or large-scale east-to-west movements, large proportions (20-40% of sockeye and 30-50% of steelhead exhibited a different behavior, apparently moving in a westward or counterclockwise pattern. Variability in migratory behavior for both species was linked to subsequent survival through the Strait of Georgia. Survival for both species was influenced by initial east-to-west location, and sockeye were further influenced by migration timing and duration of time spent near the northern Strait of Georgia array. Westward movements result in a net transport of smolts from Malaspina Strait to the Strait of Georgia, particularly for steelhead. Counterclockwise movements may be due to the currents in this area during the time of outmigration, and the

  13. Effects of surgeon variability on oncologic and functional outcomes in a population-based setting.

    Science.gov (United States)

    Carlsson, Sigrid; Berglund, Anders; Sjoberg, Daniel; Khatami, Ali; Stranne, Johan; Bergdahl, Svante; Lodding, Pär; Aus, Gunnar; Vickers, Andrew; Hugosson, Jonas

    2014-03-06

    Oncologic and functional outcomes after radical prostatectomy (RP) can vary between surgeons to a greater extent than is expected by chance. We sought to examine the effects of surgeon variation on functional and oncologic outcomes for patients undergoing RP for prostate cancer in a European center. The study comprised 1,280 men who underwent open retropubic RP performed by one of nine surgeons at an academic institution in Sweden between 2001 and 2008. Potency and continence outcomes were measured preoperatively and 18 months postoperatively by patient-administered questionnaires. Biochemical recurrence (BCR) was defined as a prostate-specific antigen (PSA) value > 0.2 ng/mL with at least one confirmatory rise. Multivariable random effect models were used to evaluate heterogeneity between surgeons, adjusting for case mix (age, PSA, pathological stage and grade), year of surgery, and surgical experience. Of 679 men potent at baseline, 647 provided data at 18 months with 122 (19%) reporting potency. We found no evidence for heterogeneity of potency outcomes between surgeons (P = 1). The continence rate for patients at 18 months was 85%, with 836 of the 979 patients who provided data reporting continence. There was statistically significant heterogeneity between surgeons (P = 0.001). We did not find evidence of an association between surgeons' adjusted probabilities of functional recovery and 5-year probability of freedom from BCR. Our data support previous studies regarding a large heterogeneity among surgeons in continence outcomes for patients undergoing RP. This indicates that some patients are receiving sub-optimal care. Quality assurance measures involving performance feedback, should be considered. When surgeons are aware of their outcomes, they can improve them to provide better care to patients.

  14. Influence of gender and types of sports training on QT variables in young elite athletes.

    Science.gov (United States)

    Omiya, Kazuto; Sekizuka, Hiromitsu; Kida, Keisuke; Suzuki, Kengo; Akashi, Yoshihiro J; Ohba, Haruo; Musha, Haruki

    2014-01-01

    Influence of gender and sports training on QT variables such as QT interval and dispersion (QT dispersion: QTD) in young elite athletes were evaluated. Subjects included 104 male and 97 female Japanese elite athletes (mean age 21.6 years). Sports included basketball, fencing, gymnastics, judo, swimming, tennis, track and field and volleyball. Age-matched healthy non-athletes (32 men and 20 women) were enrolled as controls. QT measurements were manually obtained from a 12-lead resting electrocardiogram and QTD was calculated as the difference between the longest and shortest QT intervals. A corrected QT interval (QTc) was obtained using Bazett's formula. Subjects were divided into two groups; an endurance training group and a static training group on the basis of their training types. Maximum and minimum QTc were significantly longer in female athletes than in male athletes (max: 414.2 vs. 404.5 ms, min: 375.1 vs. 359.2 ms, pgender and different characteristics of sports training may affect QT variables even in young elite athletes. Vigorous static exercise training may independently prolong QT variables.

  15. Progranulin gene variability influences the risk for bipolar I disorder, but not bipolar II disorder.

    Science.gov (United States)

    Galimberti, Daniela; Prunas, Cecilia; Paoli, Riccardo A; Dell'Osso, Bernardo; Fenoglio, Chiara; Villa, Chiara; Palazzo, Carlotta; Cigliobianco, Michela; Camuri, Giulia; Serpente, Maria; Scarpini, Elio; Altamura, A Carlo

    2014-11-01

    Recent data have shown that genetic variability in the progranulin (GRN) gene may contribute to the susceptibility to developing bipolar disorder (BD). However, in regard to patients with BD, no information is available on the role of genetic variability and plasma progranulin levels in different types of this disorder. In this study, we performed an association analysis of GRN in an Italian population consisting of 134 patients with BD and 232 controls to evaluate progranulin plasma levels. The presence of the polymorphic variant of the rs5848 single nucleotide polymorphism is protective for the development of bipolar I disorder (BD-I) (odds ratio = 0.55, 95% confidence interval: 0.33-0.93; p = 0.024) but not bipolar II disorder (BD-II) (p > 0.05). In addition, plasma progranulin levels are significantly decreased in BD [mean ± standard deviation (SD) 112 ± 35 versus 183 ± 93 ng/mL in controls; p < 0.001]. Regarding the influence of GRN variability on BD susceptibility, the predisposing genetic background differs between BD-I and BD-II, possibly implying that pathogenic mechanisms differ between the two subtypes of BD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. The influence of intention and outcome on evaluations of social interaction.

    Science.gov (United States)

    Wu, Xiaoying; Hua, Rui; Yang, Zhangxiang; Yin, Jun

    2018-01-01

    Reading and making sense of social interactions between individuals is an important part of our daily social lives. Given that actions tend to be interpreted in terms of intent within the observed outcome, we investigated how intent and outcome interactively influence evaluations of social interactions. Through visual animations, intent was operationalized as an agent's (i.e., actor's) act intentionally or unintentionally having an influence on another agent (i.e., affectee). In Experiment 1, the act was helpful and the consequences brought small or great benefits to the affectee. In Experiment 2, the act was harmful and brought small or great losses to the affectee. We found that for both helpful and harmful contexts, social interaction evaluations were influenced by an interaction between the intent and outcome of the act. Specifically, great help/harm (i.e., the great-benefits or great-losses condition) was rated as a stronger social interaction than small help/harm, and the difference was larger in the intentional condition than in the unintentional condition. Furthermore, regardless of the interaction valence, the effect of the intent was larger than the effect of the outcome when evaluating social interaction. This result suggests that observers consider the intent and outcome jointly when evaluating a given social interaction, and the intent has a privileged role in this process. These findings are consistent with the idea that the intent is often deemed to be the cause driving the effect of outcome, and they help us to understand how social interactions are constructed within the action understanding system. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. [Pain and workplace. Sociodemographic variables influence in therapeutic response and labor productivity].

    Science.gov (United States)

    Vicente-Herrero, M T; López-González, Á A; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; Terradillos García, M J; Aguilar Jiménez, E

    2016-09-01

    Pain is a major cause of medical consultation. The complexity of managing it is due to its long duration and intensity, and it sometimes requires a combination of multiple drugs. The objective of this study is to assess the use of drugs for pain in workers, the clinical response obtained, its influence on estimating work productivity, its relationship to sociodemographic variables, and the type of drug used. A cross-sectional study on 1,080 workers, aged 18-65 years, during periodic surveys to monitor their health in companies in the service sector in Spain. Treatments used, clinical efficacy, influence on work productivity and sociodemographic variables (age, gender) are evaluated. The Brief Pain Inventory questionnaire, validated for Spain, was used to assess pain, and the SPSS(®) 20.0 package for the statistical analysis. NSAIDs and simple analgesics have higher percentages of improvement in pain (P=.032 and P<.0001, respectively). Men respond better to NSAIDs, and women to simple analgesics. Improved productivity is higher in men than in women (P=.042). No significant differences were observed for age, pain improvement or productivity, except in those over 55 years. The analgesic prescription pain conditions must consider the age and gender of the patient, as well as the type of drug. The choice of drug should be based on the aetiology and aspects unrelated to the clinical variables, such as sociodemographic, work or psychosocial. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Variability of skin autofluorescence measurement over 6 and 12 weeks and the influence of benfotiamine treatment.

    Science.gov (United States)

    Stirban, Alin; Pop, Alexandra; Fischer, Annelie; Heckermann, Sascha; Tschoepe, Diethelm

    2013-09-01

    Measurements of skin autofluorescence (SAF) allow for a simple and noninvasive quantification of tissue advanced glycation end-products (AGEs), a marker linked to the risk of diabetes complications. The aim of this study was to test the repeatability of SAF over 6 and 12 weeks and to test whether benfotiamine, a thiamine prodrug suggested to reduce AGEs formation under hyperglycemic conditions, is able to attenuate SAF when administered over 6 weeks. In a double-blind, placebo-controlled, randomized, crossover study, 22 patients with type 2 diabetes mellitus (T2DM) received 900 mg/day benfotiamine or placebo for 6 weeks (washout period of 6 weeks between). At the beginning and at the end of each treatment period, SAF was assessed in the fasting state, as well as 2, 4, and 6 h following a mixed test meal. The respective intra-individual and inter-individual variability of fasting SAF was 6.9% and 24.5% within 6 weeks and 10.9% and 23.1% within 12 weeks. The respective variability calculated for triplicate comparisons was 9.9% and 27.7%. A short-term therapy with benfotiamine did not influence SAF significantly, nor did we find a significant postprandial SAF increase. In patients with T2DM, repeated, timely spaced SAF measurements have an intra-subject variability of below 11%. Using these data, sample sizes were calculated for interventional studies aiming at reducing SAF. Benfotiamine treatment for 6 weeks did not significantly influence SAF; for this, a longer-term therapy is probably needed.

  19. Fatiguing exercise intensity influences the relationship between parameters reflecting neuromuscular function and postural control variables.

    Directory of Open Access Journals (Sweden)

    Sébastien Boyas

    Full Text Available The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R(2≤0.82 of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R(2≤0.73 for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.

  20. Environmental and management influences on temporal variability of near saturated soil hydraulic properties.

    Science.gov (United States)

    Bodner, G; Scholl, P; Loiskandl, W; Kaul, H-P

    2013-08-01

    Structural porosity is a decisive property for soil productivity and soil environmental functions. Hydraulic properties in the structural range vary over time in response to management and environmental influences. Although this is widely recognized, there are few field studies that determine dominant driving forces underlying hydraulic property dynamics. During a three year field experiment we measured temporal variability of soil hydraulic properties by tension infiltrometry. Soil properties were characterized by hydraulic conductivity, effective macroporosity and Kosugi's lognormal pore size distribution model. Management related influences comprised three soil cover treatment (mustard and rye vs. fallow) and an initial mechanical soil disturbance with a rotary harrow. Environmental driving forces were derived from meteorological and soil moisture data. Soil hydraulic parameters varied over time by around one order of magnitude. The coefficient of variation of soil hydraulic conductivity K(h) decreased from 69.5% at saturation to 42.1% in the more unsaturated range (- 10 cm pressure head). A slight increase in the Kosugi parameter showing pore heterogeneity was observed under the rye cover crop, reflecting an enhanced structural porosity. The other hydraulic parameters were not significantly influenced by the soil cover treatments. Seedbed preparation with a rotary harrow resulted in a fourfold increase in macroporosity and hydraulic conductivity next to saturation, and homogenized the pore radius distribution. Re-consolidation after mechanical loosening lasted over 18 months until the soil returned to its initial state. The post-tillage trend of soil settlement could be approximated by an exponential decay function. Among environmental factors, wetting-drying cycles were identified as dominant driving force explaining short term hydraulic property changes within the season (r 2  = 0.43 to 0.59). Our results suggested that beside considering average

  1. Factors that influence the outcome of information technology projects in South Africa: An empirical investigation

    Directory of Open Access Journals (Sweden)

    Carl Marnewick

    2009-12-01

    Full Text Available Purpose: In developing countries such as South Africa, many organisations are reliant on information and communication technology (ICT to provide accurate, relevant and timely information. For organisations to obtain and sustain a competitive advantage, ICT systems are constantly implemented, upgraded, modified or replaced. These initiatives are often managed as projects. While there is an increasing amount of both financial resources and effort being spent on ICT, these projects are not always delivered within the predetermined project constraints. This implies additional time to complete, as well as additional costs, as resources are not released in time to participate in other projects. It is therefore important to understand the factors that influence the outcome of South African ICT projects relative to their original constraints. Problem Investigated: The goal of this article is to determine the factors that influence South African ICT projects, taking into consideration the fact that most current published research on this topic was done within the context of a developed country such as the USA and Europe. Design and/or methodology: The outcomes of ICT projects in South Africa as well as the factors that influence them were determined through an extensive survey. An analysis was done on the factors together with a correlation between the main factors contributing to project outcomes. The purpose of this was to establish if a factor's presence or absence influenced the eventual outcome. Findings: The factors that contribute to a successful outcome are often outside the direct control of the project manager and tend to be complex in nature. One factor that does stand out is that the alignment of projects with business objectives influences their perceived success. Originality/Value: The benefits of this article are that it firstly provides a South African perspective of current ICT project management practices, and secondly, it highlights

  2. Familial influences on the full range of variability in attention and activity levels during adolescence: A longitudinal twin study.

    Science.gov (United States)

    Peng, Chun-Zi; Grant, Julia D; Heath, Andrew C; Reiersen, Angela M; Mulligan, Richard C; Anokhin, Andrey P

    2016-05-01

    To investigate familial influences on the full range of variability in attention and activity across adolescence, we collected maternal ratings of 339 twin pairs at ages 12, 14, and 16, and estimated the transmitted and new familial influences on attention and activity as measured by the Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale. Familial influences were substantial for both traits across adolescence: genetic influences accounted for 54%-73% (attention) and 31%-73% (activity) of the total variance, and shared environmental influences accounted for 0%-22% of the attention variance and 13%-57% of the activity variance. The longitudinal stability of individual differences in attention and activity was largely accounted for by familial influences transmitted from previous ages. Innovations over adolescence were also partially attributable to familial influences. Studying the full range of variability in attention and activity may facilitate our understanding of attention-deficit/hyperactivity disorder's etiology and intervention.

  3. Age at disease onset and peak ammonium level rather than interventional variables predict the neurological outcome in urea cycle disorders.

    Science.gov (United States)

    Posset, Roland; Garcia-Cazorla, Angeles; Valayannopoulos, Vassili; Teles, Elisa Leão; Dionisi-Vici, Carlo; Brassier, Anaïs; Burlina, Alberto B; Burgard, Peter; Cortès-Saladelafont, Elisenda; Dobbelaere, Dries; Couce, Maria L; Sykut-Cegielska, Jolanta; Häberle, Johannes; Lund, Allan M; Chakrapani, Anupam; Schiff, Manuel; Walter, John H; Zeman, Jiri; Vara, Roshni; Kölker, Stefan

    2016-09-01

    Patients with urea cycle disorders (UCDs) have an increased risk of neurological disease manifestation. Determining the effect of diagnostic and therapeutic interventions on the neurological outcome. Evaluation of baseline, regular follow-up and emergency visits of 456 UCD patients prospectively followed between 2011 and 2015 by the E-IMD patient registry. About two-thirds of UCD patients remained asymptomatic until age 12 days [i.e. the median age at diagnosis of patients identified by newborn screening (NBS)] suggesting a potential benefit of NBS. In fact, NBS lowered the age at diagnosis in patients with late onset of symptoms (>28 days), and a trend towards improved long-term neurological outcome was found for patients with argininosuccinate synthetase and lyase deficiency as well as argininemia identified by NBS. Three to 17 different drug combinations were used for maintenance therapy, but superiority of any single drug or specific drug combination above other combinations was not demonstrated. Importantly, non-interventional variables of disease severity, such as age at disease onset and peak ammonium level of the initial hyperammonemic crisis (cut-off level: 500 μmol/L) best predicted the neurological outcome. Promising results of NBS for late onset UCD patients are reported and should be re-evaluated in a larger and more advanced age group. However, non-interventional variables affect the neurological outcome of UCD patients. Available evidence-based guideline recommendations are currently heterogeneously implemented into practice, leading to a high variability of drug combinations that hamper our understanding of optimised long-term and emergency treatment.

  4. Semiparametric methods for estimation of a nonlinear exposure‐outcome relationship using instrumental variables with application to Mendelian randomization

    Science.gov (United States)

    Staley, James R.

    2017-01-01

    ABSTRACT Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure‐outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure‐outcome relationship: a fractional polynomial method and a piecewise linear method. We divide the population into strata using the exposure distribution, and estimate a causal effect, referred to as a localized average causal effect (LACE), in each stratum of population. The fractional polynomial method performs metaregression on these LACE estimates. The piecewise linear method estimates a continuous piecewise linear function, the gradient of which is the LACE estimate in each stratum. Both methods were demonstrated in a simulation study to estimate the true exposure‐outcome relationship well, particularly when the relationship was a fractional polynomial (for the fractional polynomial method) or was piecewise linear (for the piecewise linear method). The methods were used to investigate the shape of relationship of body mass index with systolic blood pressure and diastolic blood pressure. PMID:28317167

  5. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality.

    Science.gov (United States)

    Harris, Patricia R E; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

    2014-01-01

    This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ≥18 hours of sinus rhythm were selected for HRV analysis (number [N] =193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms(2) predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4-3.8, P=0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power 0.3 ng/mL (HR =4.0; 95% CI =1.3-12.1; P=0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study.

  6. Does source of funding and conflict of interest influence the outcome and quality of spinal research?

    Science.gov (United States)

    Amiri, Amir Reza; Kanesalingam, Kavitha; Cro, Suzie; Casey, Adrian T H

    2014-02-01

    There has been longstanding controversy surrounding the influence of funding source on the conduct and outcome of medical research. In 2011, a systematic review of the use of recombinant bone morphogenetic protein-2 revealed underreporting of unfavorable outcomes in some industry-sponsored trials. We hypothesize that Industrial funding and the presence of potential conflict of interest will be associated with low levels of evidence (LOE) and greater proportions of favorable outcomes in spinal research. The aim of this study is to investigate the association between funding source and potential conflict of interest on the LOE and study outcome in the current spinal research. Systematic review of all the spinal publications in five leading spinal, orthopedics, neurosurgery, and general medical journals during 2010 (print and online). Supplements were included. Outcome and the LOE of research papers. Two reviewers independently assessed all publications. Commentaries, editorials, letters, open operating theatres, case reports, narrative reviews, and study protocols were excluded. The self-reported potential conflict of interest and type of funding was extracted from each paper. Funding type was classified as foundation, industry, public, intramural, multiple (including industry), multiple (without industry), and unfunded. The outcome of each study was classified as favorable, unfavorable, equivocal, or not applicable. Clinical publications were ranked using the LOE guidelines produced by the Oxford Center for Evidence-Based Medicine. Overall, 1356 papers were analyzed, out of which 864 were suitable for LOE grading. There was good interobserver reliability for assignment of LOE grade, κ=0.897 (psource of funding (psource and study outcome (p=.01). The proportion of industry-funded studies with favorable outcomes (88%) was higher than that of publicly and foundation-funded studies (73% and 74%, respectively). The associated odds ratio for reporting favorable outcomes

  7. Teammates and social influence affect weight loss outcomes in a team-based weight loss competition.

    Science.gov (United States)

    Leahey, Tricia M; Kumar, Rajiv; Weinberg, Brad M; Wing, Rena R

    2012-07-01

    Team-based internet interventions are increasing in popularity as a way of promoting weight loss in large numbers of individuals. Given that social networks influence health behavior change, this study investigated the effects of teammates and social influence on individual weight loss during a team-based weight loss competition. Shape Up Rhode Island (SURI) 2009 was a 12-week online program open to adult residents of Rhode Island. Participants joined with a team and competed with other teams on weight loss and/or physical activity. Overweight/obese (OW/OB) individuals (N = 3,330; 76% female; age = 46.1 ± 10.8; BMI = 31.2 ± 5.3 kg/m(2)), representing 987 teams, completed the weight loss program. Multilevel modeling was used to examine whether weight loss clustered among teammates and whether percentage of teammates in the weight loss division and reported teammate influence on weight loss were associated with individual weight outcomes. OW/OB completers reported losing 4.2 ± 3.4% of initial body weight. Weight loss was similar among teammates (intraclass correlation coefficient (ICC) = 0.10, P social influence for weight loss were associated with greater percent weight loss (P's ≤ 0.002). Similarly, achieving a clinically significant (5%) weight loss tended to cluster within teams (ICC = 0.09; P social influence for weight loss were associated with increased likelihood of achieving a 5% weight loss (odds ratio (OR) = 1.06; OR = 1.20, respectively). These results suggest that teammates affect weight loss outcomes during a team-based intervention. Harnessing and maximizing teammate influence for weight loss may enhance weight outcomes in large-scale team-based programs.

  8. Teachers' and Students' Work-Culture Variables Associated with Positive School Outcome.

    Science.gov (United States)

    Goldwater, Orna D.; Nutt, Roberta L.

    1999-01-01

    Investigates whether goodness of fit between teachers' and students' backgrounds is associated with subjective grading and objective achievement at school. One hundred one seventh graders and twenty of their teachers completed the Self-Report Family Inventory. Similarity between teachers' and students' work-culture variables was associated with…

  9. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality

    Directory of Open Access Journals (Sweden)

    Harris PR

    2014-08-01

    Full Text Available Patricia R E Harris,1 Phyllis K Stein,2 Gordon L Fung,3 Barbara J Drew4 1Electrocardiographic Monitoring Research Laboratory, School of Nursing, Department of Physiological Nursing, University of California, San Francisco, CA, USA; 2Heart Rate Variability Laboratory, School of Medicine, Division of Cardiology, Washington University, St Louis, MO, USA; 3Cardiology Services, Mount Zion, Department of Medicine, Division of Cardiology, University of California, San Francisco, CA, USA; 4School of Nursing, Department of Physiological Nursing, Division of Cardiology, University of California, San Francisco, CA, USA Objective: This study sought to examine the prognostic value of heart rate variability (HRV measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS. Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ≥18 hours of sinus rhythm were selected for HRV analysis (number [N] =193. Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. Results: During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms2 predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4–3.8, P=0.001. Variables significantly associated with death included natural logs of total power and ultra low frequency

  10. Impact of Burnout on Organizational Outcomes, the Influence of Legal Demands: The Case of Ecuadorian Physicians

    Directory of Open Access Journals (Sweden)

    Paola Ochoa

    2018-05-01

    Full Text Available Interest in burnout has developed extensively worldwide, but there is scarce the literature regarding the consequences that new legal demands have on burnout and on organizational outcomes in physicians. The global context of the medical profession has been characterized in the recent years by changes in the employment patterns, profound intensification of work, and increment of labor flexibility. In this context, the study aims to analyze the influence of burnout on organizational outcomes in physicians, depending on new legal demands perception in Ecuador. Regarding the method, the research was cross sectional and in the first stage, studied the psychometric characteristics, validity and reliability of the instrument to assess burnout through a series of confirmatory factor analyses (CFA. In a second part, we assessed, the robustness of the model of causal relations between the burnout dimensions and organizational outcomes. We carried out a series of path analysis, structural equation model. The study was accomplished in five hospitals and the sample was incidental, comprising 435 physicians from Ecuador. We divided the group in two subcategories, Sample A, composed by participants that considered that new Criminal Code (COIP affects them and the Sample B, the group of physicians who believed that the COIP does not affect them. Burnout was assessed with the Spanish adaptation of the Maslach Burnout Inventory (MBI, the Organizational outcomes were measured with a seven-item self-report questionnaire, and we included an item regarding to the influence of new Criminal Code. We formulated four hypotheses, that considered that physicians who believed that the COIP affect them experience a greater negative influence of burnout on organizational outcomes. The results indicated that the group of physicians who believed that the COIP affects them (Sample A experienced a greater negative influence of cynicism on productivity than Sample B. Moreover

  11. Impact of Burnout on Organizational Outcomes, the Influence of Legal Demands: The Case of Ecuadorian Physicians.

    Science.gov (United States)

    Ochoa, Paola

    2018-01-01

    Interest in burnout has developed extensively worldwide, but there is scarce the literature regarding the consequences that new legal demands have on burnout and on organizational outcomes in physicians. The global context of the medical profession has been characterized in the recent years by changes in the employment patterns, profound intensification of work, and increment of labor flexibility. In this context, the study aims to analyze the influence of burnout on organizational outcomes in physicians, depending on new legal demands perception in Ecuador. Regarding the method, the research was cross sectional and in the first stage, studied the psychometric characteristics, validity and reliability of the instrument to assess burnout through a series of confirmatory factor analyses (CFA). In a second part, we assessed, the robustness of the model of causal relations between the burnout dimensions and organizational outcomes. We carried out a series of path analysis, structural equation model. The study was accomplished in five hospitals and the sample was incidental, comprising 435 physicians from Ecuador. We divided the group in two subcategories, Sample A, composed by participants that considered that new Criminal Code (COIP) affects them and the Sample B, the group of physicians who believed that the COIP does not affect them. Burnout was assessed with the Spanish adaptation of the Maslach Burnout Inventory (MBI), the Organizational outcomes were measured with a seven-item self-report questionnaire, and we included an item regarding to the influence of new Criminal Code. We formulated four hypotheses, that considered that physicians who believed that the COIP affect them experience a greater negative influence of burnout on organizational outcomes. The results indicated that the group of physicians who believed that the COIP affects them (Sample A) experienced a greater negative influence of cynicism on productivity than Sample B. Moreover, the lack of

  12. Variables predictive of outcome in patients with acute hypercapneic respiratory failure treated with noninvasive ventilation

    International Nuclear Information System (INIS)

    Salahuddin, N.; Irfan, M.; Khan, S.; Naeem, M.; Haque, A.S.

    2010-01-01

    To assess results with NIV in acute hypercapneic respiratory failure and to identify outcome predictors. This was a retrospective observational study on consecutive patients presenting with acute type II respiratory failure and meeting criteria for NIV use over a 5 year period. Patients presenting with haemodynamic instability, inability to protect their airway, malignant arrhythmias and recent oesophageal surgery were excluded. Univariate and Multivariate regression analysis was used to determine the impact on survival. A p value of 35 Meq/L (adjusted Odds ratio 0.9; 95% CI 0.83, 0.98, p < 0.015) identified those less at risk for intubation. NIV was found to be both safe and effective in the management of acute hypercapneic respiratory failure. Sepsis and serum HCO/sub 3/ at admission identified patients having poor outcomes (JPMA 60:13; 2010). (author)

  13. The Influence of No Fault Compensation on Functional Outcomes After Lumbar Spine Fusion.

    Science.gov (United States)

    Montgomery, Alexander Sheriff; Cunningham, John Edward; Robertson, Peter Alexander

    2015-07-15

    compared with the dramatically inferior outcomes for these patients under other worker's compensation systems, suggest that the system of compensation has a major influence on patient outcomes, and that change of compensation to a universal no fault system is beneficial for patients undergoing lumbar fusion surgery. 2.

  14. Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes.

    Science.gov (United States)

    Walker, Rebekah J; Strom Williams, Joni; Egede, Leonard E

    2016-04-01

    There is strong evidence that race, ethnicity and social determinants of health significantly influence outcomes for patients with diabetes. A better understanding of the mechanisms of these relationships or associations would improve development of cost-effective, culturally tailored programs for patients with diabetes. This article reviews the current state of the literature on the influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes for diabetes, with particular emphasis on the rural South to give an overview of the state of the literature. The literature review shows that racial or ethnic differences in the clinical outcomes for diabetes, including glycemic, blood pressure (BP) and lipid control, continue to persist. In addition, the literature review shows that the role of social determinants of health on outcomes, and the possible role these determinants play in disparities have largely been ignored. Psychosocial factors, such as self-efficacy, depression, social support and perceived stress, show consistent associations with self-care, quality of life and glycemic control. Neighborhood factors, such as food insecurity, social cohesion and neighborhood esthetics have been associated with glycemic control. Perceived discrimination has also been associated with self-care and the psychological component of quality of life. Healthcare professionals need to be skilled in assessing social determinants of health and taking them into consideration in clinical care. In addition, more research is needed to identify the separate and combined influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes in diabetes, especially in the South, where the burden of disease is particularly high. Copyright © 2016 Southern Society for Clinical Investigation. All rights reserved.

  15. Modelling variable dropout in randomised controlled trials with longitudinal outcomes: application to the MAGNETIC study.

    Science.gov (United States)

    Kolamunnage-Dona, Ruwanthi; Powell, Colin; Williamson, Paula Ruth

    2016-04-28

    Clinical trials with longitudinally measured outcomes are often plagued by missing data due to patients withdrawing or dropping out from the trial before completing the measurement schedule. The reasons for dropout are sometimes clearly known and recorded during the trial, but in many instances these reasons are unknown or unclear. Often such reasons for dropout are non-ignorable. However, the standard methods for analysing longitudinal outcome data assume that missingness is non-informative and ignore the reasons for dropout, which could result in a biased comparison between the treatment groups. In this article, as a post hoc analysis, we explore the impact of informative dropout due to competing reasons on the evaluation of treatment effect in the MAGNETIC trial, the largest randomised placebo-controlled study to date comparing the addition of nebulised magnesium sulphate to standard treatment in acute severe asthma in children. We jointly model longitudinal outcome and informative dropout process to incorporate the information regarding the reasons for dropout by treatment group. The effect of nebulised magnesium sulphate compared with standard treatment is evaluated more accurately using a joint longitudinal-competing risk model by taking account of such complexities. The corresponding estimates indicate that the rate of dropout due to good prognosis is about twice as high in the magnesium group compared with standard treatment. We emphasise the importance of identifying reasons for dropout and undertaking an appropriate statistical analysis accounting for such dropout. The joint modelling approach accounting for competing reasons for dropout is proposed as a general approach for evaluating the sensitivity of conclusions to assumptions regarding missing data in clinical trials with longitudinal outcomes. EudraCT number 2007-006227-12 . Registration date 18 Mar 2008.

  16. The Human Skin Microbiome Associates with the Outcome of and Is Influenced by Bacterial Infection

    OpenAIRE

    van Rensburg, Julia J.; Lin, Huaiying; Gao, Xiang; Toh, Evelyn; Fortney, Kate R.; Ellinger, Sheila; Zwickl, Beth; Janowicz, Diane M.; Katz, Barry P.; Nelson, David E.; Dong, Qunfeng; Spinola, Stanley M.

    2015-01-01

    ABSTRACT The influence of the skin microbiota on host susceptibility to infectious agents is largely unexplored. The skin harbors diverse bacterial species that may promote or antagonize the growth of an invading pathogen. We developed a human infection model for Haemophilus ducreyi in which human volunteers are inoculated on the upper arm. After inoculation, papules form and either spontaneously resolve or progress to pustules. To examine the role of the skin microbiota in the outcome of H. ...

  17. The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda

    OpenAIRE

    Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

    2017-01-01

    Background Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored...

  18. Leader Affect and Leadership Effectiveness: How leader affective displays influence follower outcomes

    OpenAIRE

    Visser, Victoria

    2013-01-01

    textabstractThe aim of this dissertation is to uncover the relationship between leader affective displays and leadership effectiveness. Five empirical studies were conducted to test the influence of several leader affective displays on different follower outcomes that indicate leadership effectiveness. The results showed that leader happy displays enhance followers’ creative performance, whereas leader sad displays enhance followers’ analytical performance. In addition, a leader displaying ha...

  19. Autonomy, Affiliation, and Ability: Relative Salience of Factors that Influence Online Learner Motivation and Learning Outcomes

    Directory of Open Access Journals (Sweden)

    Kuan-Chung Chen

    2010-03-01

    Full Text Available Autonomy, affiliation, and ability appear as main factors that influence online learners‟ motivation and learning outcomes, however, the relative salience of these three factors remains unclear in the online learning literature. Drawing on Deci and Ryan‟s self-determination theory, this study sought to bridge this gap by investigating the relative salience of perceived autonomy, affiliation, and ability on learner motivation and learning outcomes in two special education online programs (N = 262. This study found that the most salient predictor varied from categories of motivation and learning outcomes, and the number of significant predictors increased by participants‟ level of motivation/self-determination. Results of this study provide implications for online learner support.

  20. The Influence of Posttraumatic Stress Disorder on Treatment Outcomes of Patients With Borderline Personality Disorder.

    Science.gov (United States)

    Boritz, Tali; Barnhart, Ryan; McMain, Shelley F

    2016-06-01

    The aim of this study was to determine the influence of posttraumatic stress disorder (PTSD) on treatment outcomes in patients with borderline personality disorder (BPD). Participants were 180 individuals diagnosed with BPD enrolled in a randomized controlled trial that compared the clinical and cost effectiveness of dialectical behavior therapy (DBT) and general psychiatric management (GPM). Multilevel linear models and generalized linear models were used to compare clinical outcomes of BPD patients with and without PTSD. BPD patients with comorbid PTSD reported significantly higher levels of global psychological distress at baseline and end of treatment compared to their non-PTSD counterparts. Both groups evidenced comparable rates of change on suicide attempts and non-suicidal self-injury (NSSI), global psychological distress, and BPD symptoms over the course of treatment and post-treatment follow-up. DBT and GPM were effective for BPD patients with and without PTSD across a broad range of outcomes.

  1. The influence of radiotherapy on cosmetic outcome after breast conservative surgery

    International Nuclear Information System (INIS)

    McCormick, Beryl; Sacchini, Virgilio; Luini, Alberto; Agresti, Roberto; Greco, Marco; Manzari, Antonella; Mariani, Luigi; Zucali, Roberto

    1995-01-01

    Purpose: The influence of radiotherapy in the cosmetic outcome after conservative surgery for breast cancer was evaluated using an objective method of calculating the asymmetry between the two breasts. Methods and Materials: One hundred and one patients treated with the same conservative surgery were evaluated for cosmetic outcome. Sixty-one of them received external radiotherapy (50 + 10 Gy) to the residual breast; the remaining 40 underwent surgery only. The aspect of the patients' breasts was objectively assessed for symmetry by means of a computerized technique. A subjective assessment of the cosmetic outcome was performed both by physician and patient. These objective and subjective assessments were compared in the two groups treated with or without radiotherapy. Results: The results obtained did not show significant differences in terms of cosmetic outcome in the two groups. Skin telangectasia was noted in two radiotherapy patients, while hypertrophic breast scars were only noted in six nonirradiated patients. Conclusions: We found that standard radiotherapy does not seem to influence the symmetry and the cosmetic results in breast conservative treatment when compared to a similar group of patients with the same quadrantectomy procedure and no radiotherapy

  2. Alpha male replacements in nonhuman primates: Variability in processes, outcomes, and terminology.

    Science.gov (United States)

    Teichroeb, Julie A; Jack, Katharine M

    2017-07-01

    Alpha male replacements occur in all primates displaying a dominance hierarchy but the process can be extremely variable. Here, we review the primate literature to document differences in patterns of alpha male replacements, showing that group composition and dispersal patterns account for a large proportion of this variability. We also examine the consequences of alpha male replacements in terms of sexual selection theory, infanticide, and group compositions. Though alpha male replacements are often called takeovers in the literature, this term masks much of the variation that is present in these processes. We argue for more concise terminology and provide a list of terms that we suggest more accurately define these events. Finally, we introduce the papers in this special issue on alpha male replacements in the American Journal of Primatology and discuss areas where data are still lacking. © 2017 Wiley Periodicals, Inc.

  3. Variable sleep schedules and outcomes in children with psychopathological problems: preliminary observations

    Directory of Open Access Journals (Sweden)

    Spruyt K

    2012-02-01

    Full Text Available Karen Spruyt1, Danielle L Raubuck2, Katie Grogan2, David Gozal1, Mark A Stein21Department of Pediatrics and Comer Children’s Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL; 2Institute for Juvenile Research, Hyperactivity and Learning Problems Clinic, University of Illinois at Chicago, Chicago, ILBackground: Night-to-night variability in sleep of children with attention deficit hyperactivity disorder (ADHD may be a mediator of behavioral phenotype. We examined the potential association between alertness, sleep, and eating behaviors in children with ADHD and comorbid problems.Methods: Sleep was monitored by actigraphy for 7 days. Questionnaires were used to assess sleep complaints, habits and food patterns by parental report, and sleep complaints and sleepiness by child report.Results: The group comprised 18 children, including 15 boys, aged 9.4 ± 1.7 years, 88.9% Caucasian, who took one or multiple medications. Children slept on average for 6 hours and 58 minutes with a variability of 1 hour 3 minutes relative to the mean, and their sleepiness scores were highly variable from day to day. Most children had a normal body mass index (BMI. Sleepiness and BMI were associated with sleep schedules and food patterns, such that they accounted for 76% of variance, predominantly by the association of BMI with mean wake after sleep onset and by bedtime sleepiness, with wake after sleep onset variability. Similarly, 97% of variance was shared with eating behaviors, such as desserts and snacks, and fast food meals were associated with morning sleepiness.Conclusion: Disrupted sleep and sleepiness appears to favor unhealthy food patterns and may place children with ADHD at increased risk for obesity.Keywords: sleep, child, attention deficit hyperactivity disorder, actigraphy

  4. Longitudinal assessment of maternal parenting capacity variables and child adjustment outcomes in pediatric cancer.

    Science.gov (United States)

    Fedele, David A; Mullins, Larry L; Wolfe-Christensen, Cortney; Carpentier, Melissa Y

    2011-04-01

    This preliminary investigation aimed to longitudinally examine parenting capacity variables, namely parental overprotection, perceived child vulnerability, and parenting stress and their relation to child adjustment in mothers of children on treatment for cancer. As part of a larger study, biological mothers (N=22) completed measures of parental overprotection, perceived child vulnerability, parenting stress, and child adjustment at Time 1 and a follow-up time point. Analyses were conducted to determine whether (1) levels of parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up and (2) if Time 1 parenting capacity variables were associated with child adjustment at follow-up. Results revealed that parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up, and levels of parental overprotection, perceived child vulnerability, and parenting stress at Time 1 were significantly related to child adjustment at follow-up. Collectively, the preliminary findings of this study indicate that mothers of children with cancer evidence improved parenting capacity over time. Furthermore, it seems that Time 1 parenting capacity variables are significantly related to later child adjustment.

  5. The influence of grazing on surface climatological variables of tallgrass prairie. Final Technical Report

    International Nuclear Information System (INIS)

    Seastedt, T.R.; Dyer, M.I.; Turner, C.L.

    1992-01-01

    Mass and energy exchange between most grassland canopies and the atmosphere are mediated by grazing activities. Ambient temperatures can be increased or decreased by grazers. Data have been assembled from simulated grazing experiments on Konza Prairie Research Natural Area and observations on adjacent pastures grazed by cattle show significant changes in primary production, nutrient content, and bidirectional reflectance characteristics as a function of grazing intensity. The purpose of this research was to provide algorithms that would allow incorporation of grazing effects into models of energy budgets using remote sensing procedures. The approach involved: (1) linking empirical measurements of plant biomass and grazing intensities to remotely sensed canopy reflectance, and (2) using a higher resolution, mechanistic grazing model to derive plant ecophysiological parameters that influence reflectance and other surface climatological variables

  6. Analysis of risk factors influencing the outcome of the Epley maneuver.

    Science.gov (United States)

    Domínguez-Durán, E; Domènech-Vadillo, E; Álvarez-Morujo de Sande, M G; González-Aguado, R; Guerra-Jiménez, G; Ramos-Macías, Á; Morales-Angulo, C; Martín-Mateos, A J; Figuerola-Massana, E; Galera-Ruiz, H

    2017-10-01

    Benign paroxysmal positional vertigo (BPPV) is the most frequent type of vertigo. The treatment of canalithiasis of the posterior semicircular canal consists in performing a particle-repositioning maneuver, such as the Epley maneuver (EM). However, the EM is not effective in all cases. The objective of this study is to identify risk factors, which predict the EM failure, among the clinical variables recorded in anamnesis and patient examination. This is an observational prospective multicentric study. All patients presenting with BPPV were recruited and applied the EM and appointed for a follow-up visit 7 days later. The following variables were recorded: sex, age, arterial hypertension, diabetes, hyperlipidemia, smoking habit, alcohol consumption, migraine, osteoporosis, diseases of the inner ear, previous ipsilateral BPPV, previous traumatic brain injury, previous sudden head deceleration, time of evolution, sulpiride or betahistine treatment, experienced symptoms, outcome of the Halmagyi maneuver, laterality, cephalic hyperextension of the neck, intensity of nystagmus, intensity of vertigo, duration of nystagmus, occurrence of orthotropic nystagmus, symptoms immediately after the EM, postural restrictions, and symptoms 7 days after the EM. Significant differences in the rate of loss of nystagmus were found for six variables: hyperlipidemia, previous ipsilateral BPPV, intensity of nystagmus, duration of nystagmus, post-maneuver sweating, and subjective status. The most useful significant variables in the clinical practice to predict the success of the EM are previous BPPV and intensity of nystagmus. In the other significant variables, no physiopathological hypothesis can be formulated or differences between groups are too small.

  7. Seasonal and tidal influence on the variability of nitrous oxide in the Tagus estuary, Portugal

    Directory of Open Access Journals (Sweden)

    Célia Gonçalves

    2010-11-01

    Full Text Available In order to evaluate seasonal and tidal influence on the variability of dissolved nitrous oxide (N2O in the Tagus estuary, Portugal, water sampling was carried out along the salinity gradient (May and November 2006 and during several tidal cycles (February and April 2007 at a fixed site. N2O and other relevant environmental parameters, temperature, salinity, dissolved oxygen and inorganic nitrogen forms (nitrate, nitrite and ammonium were measured. Dissolved N2O concentrations showed strong tidal and seasonal variability, with the highest values occurring in February 2007 (13.7 nM, spring tide and November 2006 (18.4 nM, upper estuary, apparently related to major Tagus river discharge. The existence of N2O sources was noticed in middle estuary. During spring tide, the input from external sources may be augmented by water column nitrification, making this process a contributor to the enhancement of N2O concentration in the estuary. Estimated N2O air-sea fluxes to the atmosphere reached a maximum value of ~10.4 μmol m-2 d-1 in February 2007 during spring tide and in May 2006 in the upper and lower (left bank estuary. Although the Tagus estuary behaves predominantly as a source of atmospheric N2O, it appears to be a weaker source than other, more eutrophic estuaries.

  8. Influences of Social and Style Variables on Adult Usage of African American English Features

    Science.gov (United States)

    Craig, Holly K.; Grogger, Jeffrey T.

    2013-01-01

    Purpose In this study, the authors examined the influences of selected social (gender, employment status, educational achievement level) and style variables (race of examiner, interview topic) on the production of African American English (AAE) by adults. Method Participants were 50 African American men and women, ages 20–30 years. The authors used Rapid and Anonymous Survey (RAS) methods to collect responses to questions on informal situational and formal message-oriented topics in a short interview with an unacquainted interlocutor. Results Results revealed strong systematic effects for academic achievement, but not gender or employment status. Most features were used less frequently by participants with higher educational levels, but sharp declines in the usage of 5 specific features distinguished the participants differing in educational achievement. Strong systematic style effects were found for the 2 types of questions, but not race of addressee. The features that were most commonly used across participants—copula absence, variable subject–verb agreement, and appositive pronouns—were also the features that showed the greatest style shifting. Conclusions The findings lay a foundation with mature speakers for rate-based and feature inventory methods recently shown to be informative for the study of child AAE and demonstrate the benefits of the RAS. PMID:22361105

  9. Influence of school-level and family-level variables on Chinese college students' aggression.

    Science.gov (United States)

    Zhou, Jiawei; Yang, Jiarun; Yu, Yunmiao; Wang, Lin; Han, Dong; Zhu, Xiongzhao; He, Jincai; Qiu, Xiaohui; Yang, Xiuxian; Qiao, Zhengxue; Sui, Hong; Yang, Yanjie

    2017-08-01

    With the frequent occurrence of campus violence, scholars have devoted increasing attention to college students' aggression. This study aims to estimate the prevalence of aggression in Chinese university students and identify factors that could influence their aggression. We can thus find methods to reduce the incidence of college students' aggression in the future. A multi-stage stratified sampling procedure was used to select university students (N = 4565) aged 16-25 years in Harbin. The Aggression Questionnaire, the Adolescent Self-Rating Life Events Checklist and the Social Support Revalued Scale were used to collect data. Females reported lower levels of aggression than males (p aggression, and the model was highly significant (R 2  = .233, Ad R 2  = .230, p aggression is affected by gender, family-level and school-level variables. Aggression scores are significantly correlated with not only family-level or school-level variables independently, but their combination as well. We find that the risk factors for aggression include a dissatisfying profession, higher levels of study pressure, poor parental relationships, poor interpersonal relationships, the presence of siblings, punishment, health maladjustment, less subjective support, and lower levels of utilization of social support.

  10. Influence of psychological variables in morbidly obese patients undergoing bariatric surgery after 24 months of evolution.

    Science.gov (United States)

    Rodríguez-Hurtado, José; Ferrer-Márquez, Manuel; Fontalba-Navas, Andrés; García-Torrecillas, Juan Manuel; Olvera-Porcel, M Carmen

    Bariatric surgery is considered a more effective means of achieving weight loss than non-surgical options in morbid obesity. Rates of failure or relapse range from 20 to 30%. The study aims to analyse the influence of psychological variables (self-esteem, social support, coping strategies and personality) in the maintenance of weight loss after bariatric surgery. A cohort study was conducted involving 64 patients undergoing bariatric surgery for 24 months. At the end of the follow-up period, patients were divided into 2sub-cohorts classified as successes or failures. Success or favorable development was considered when the value of percent excess weight loss was 50 or higher. No statistically significant differences were observed between the 2groups in any variable studied. All patients had high self-esteem (87,3 those who failed and 88,1 those who are successful) and social support (90,2 and 90,9). Patients who succeed presented higher scores for cognitive restructuring (57,1) and were more introverted (47,1), while those who failed scored more highly in desiderative thinking (65,7) and were more prone to aggression (50,7) and neuroticism (51,7). High self-esteem and social support does not guarantee successful treatment. The groups differed in how they coped with obesity but the data obtained do not justify the weight evolution. In the absence of psychopathology, personality trait variability between patients is insufficient to predict the results. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Discrete factor approximations in simultaneous equation models: estimating the impact of a dummy endogenous variable on a continuous outcome.

    Science.gov (United States)

    Mroz, T A

    1999-10-01

    This paper contains a Monte Carlo evaluation of estimators used to control for endogeneity of dummy explanatory variables in continuous outcome regression models. When the true model has bivariate normal disturbances, estimators using discrete factor approximations compare favorably to efficient estimators in terms of precision and bias; these approximation estimators dominate all the other estimators examined when the disturbances are non-normal. The experiments also indicate that one should liberally add points of support to the discrete factor distribution. The paper concludes with an application of the discrete factor approximation to the estimation of the impact of marriage on wages.

  12. Culture and ethnicity influence outcomes of the Scoliosis Research Society Instrument in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Morse, Lee Jae; Kawakami, Noriaki; Lenke, Lawrence G; Sucato, Daniel J; Sanders, James O; Diab, Mohammad

    2012-05-20

    Retrospective comparative study. To report preoperative differences in the Scoliosis Research Society Outcomes Instrument (SRS-30) between multiple US ethnicities and native Japanese and Korean children with adolescent idiopathic scoliosis (AIS). The SRS-24 was developed in a US cohort with AIS. Comparative studies using the SRS-24 between US and Japanese patients showed differences, suggesting that culture might affect functional outcome. Preoperative SRS-30 outcomes were collected from 1853 children with AIS from 6 different ethnic groups: US white (1234), black (213), Hispanic (78), and Asian (29), as well as native Japanese (192) and Koreans (107). Analysis of covariance of 4 SRS-30 domains (pain, appearance, activity, and mental) was compared between groups adjusting for differences in age, sex, major curve magnitude, and body mass index. Pairwise comparisons of the 4 SRS-30 domains were adjusted for multiple comparisons, using Bonferroni correction. A P value of less than 0.05 was considered significant. Significant differences between ethnicities were found in all domains (P Culture and ethnicity influence SRS-30 outcomes in AIS. Whites reported more pain than Japanese and Koreans. Japanese and Koreans had the lowest appearance scores. Koreans additionally were distinguished by the lowest activity, mental, and total scores. These cultural and ethnic differences must be taken into account when counseling patients with AIS and studying functional outcomes.

  13. Influence of body habitus on feasibility and outcome of laparoscopic liver resections: a prospective study.

    Science.gov (United States)

    Ratti, Francesca; D'Alessandro, Valentina; Cipriani, Federica; Giannone, Fabio; Catena, Marco; Aldrighetti, Luca

    2016-06-01

    The aim of the present study was to prospectively investigate whether the anthropometric measures of A Body Shape Index (ABSI, taking into account waist circumference adjusted for height and weight) affects feasibility and outcome of laparoscopic liver resections. One hundred patients undergoing laparoscopic liver resection were prospectively included in the study (2014-2015). Preoperative clinical parameters, including body mass index (BMI) and ABSI were evaluated for associations with intraoperative outcome and postoperative results (morbidity, mortality and functional recovery). Twenty-two and 78 patients underwent major and minor hepatectomies, respectively. Conversion rate was 9%, mean blood loss was 210 ± 115 ml. Postoperative morbidity was 15% and mortality was nil. Mean length of stay was 4 days. When considering the entire series, ABSI was not associated with intra and postoperative outcome. After stratification of patients according to difficulty score, Pearson's correlation demonstrated an association between ABSI and intraoperative blood loss (P = 0.03) and time for functional recovery (P = 0.05) in patients undergoing resections with high score of difficulty. Body habitus has an influence on outcome of laparoscopic liver resections with high degree of difficulty, while feasibility and outcome of low difficulty resections seem not to be affected by anthropometric measures. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  14. Influence diagram of physiological and environmental factors affecting heart rate variability: an extended literature overview

    Directory of Open Access Journals (Sweden)

    Julien Fatisson

    2016-09-01

    Full Text Available Heart rate variability (HRV corresponds to the adaptation of the heart to any stimulus. In fact, among the pathologies affecting HRV the most, there are the cardiovascular diseases and depressive disorders, which are associated with high medical cost in Western societies. Consequently, HRV is now widely used as an index of health.In order to better understand how this adaptation takes place, it is necessary to examine which factors directly influence HRV, whether they have a physiological or environmental origin. The primary objective of this research is therefore to conduct a literature review in order to get a comprehensive overview of the subject.The system of these factors affecting HRV can be divided into the following five categories: physiological and pathological factors, environmental factors, lifestyle factors, non-modifiable factors and effects. The direct interrelationships between these factors and HRV can be regrouped into an influence diagram. This diagram can therefore serve as a basis to improve daily clinical practice as well as help design even more precise research protocols.

  15. How Ocean Color Influences the Interplay Between Annual and Interannual Tropical Pacific Variability

    Science.gov (United States)

    Hammann, A. C.; Gnanadesikan, A.

    2010-12-01

    While the basic mechanisms responsible for ENSO have long been known, many details still evade our understanding. Since the behavior of the real climate system appears to be highly sensitive to such details, however, our ability to model, let alone predict it with any confidence has so far been rather restricted. Not only can small perturbations in many state variables lead to strongly amplified responses, but also do spatial and temporal scales of variability rarely occur in isolation from each other. Both points are born out in the study by Anderson et al. (2009), who removed surface chlorophyll in different regions of the tropical (but mostly off-equatorial) Pacific in a coupled ocean-atmosphere-land-ice model. Different removal patterns lead to large differences in the amplitudes of both ENSO and the equatorial annual cycle. Anderson et al.’s analysis focuses on ENSO and reveals that the transmission of off-equatorial perturbations to the equator happens mainly through a changed atmospheric response to SST anomalies. Here, we analyze the same data with respect to the annual cycle and how it interacts with ENSO. Guilyardi (2006) reports that observations and models alike show a zero-sum-type behavior of annual and ENSO-scale variability; increased spectral power in the annual band means decreased power in the ENSO band and vice versa. This is not the case for the different patterns of chlorophyll removal in our model, and hence it appears that this removal changes a fundamental part of its mean state. The dynamics of the annual cycle are likely influenced by oceanic meridional temperature advection, which provides another possible route for off-to-equatorial signal propagation. A common aspect of the tropical annual cycle in most coupled climate models is the presence of a double ITCZ instead of a single north-shifted one. Even though this appears to be unrelated to (albeit influenced by) the changes in ocean color, our model exhibits a much improved

  16. Influence of arterial occlusion on outcome after intravenous thrombolysis for acute ischemic stroke.

    Science.gov (United States)

    Medlin, Friedrich; Amiguet, Michael; Vanacker, Peter; Michel, Patrik

    2015-01-01

    We aimed to assess the interaction between intravenous thrombolysis (IVT) and arterial occlusion on acute cervicocerebral computed tomographic angiography on the outcome of patients with acute ischemic stroke. Patients from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) registry with onset-to-door-time ≤4 hours, acute cervicocerebral computed tomographic angiography, a premorbid modified Rankin Scale ≤2, and a National Institute of Health Stroke Scale (NIHSS) >4 were selected. Patients with significant intracranial arterial obstruction (≥50%-99%) and undergoing acute endovascular treatment were excluded. An interaction analysis of IVT and initial arterial occlusion for favorable 3 months outcome (modified Rankin Scale <3) were performed with adjustment for potential confounders. Among 654 included patients, 382 (58%) showed arterial occlusion, of whom 263 (69%) received IVT. Two hundred seventy-two showed no/minimal obstruction of whom 139 (51%) received IVT. In the adjusted interaction analysis, there was a trend in favor of the arterial occlusion group (odds ratio [OR]=3.97; 95% confidence interval [CI], 0.83-18.97; P=0.08). IVT (versus no IVT) was associated with better outcome in patients with occlusion (adjusted OR for favorable outcome, 3.01; 95% CI, 1.10-8.28) but not in patients with no/minimal obstruction (OR, 0.76; 95% CI, 0.21-2.74). Conversely, patients with occlusion had a similar rate of favorable outcome as no/minimal obstruction when thrombolysed (OR, 0.5; 95% CI, 0.17-1.47) but had a less favorable outcome without thrombolysis (OR, 0.13; 95% CI, 0.04-0.44). In this retrospective analysis of consecutive patients with acute ischemic stroke, there was a trend for more favorable outcomes with IVT in the setting of initial arterial occlusion than in the setting of no/minimal obstruction. Before confirmation in randomized controlled studies, this information should not influence thrombolysis decisions, however. © 2014 American Heart

  17. Environmental and management influences on temporal variability of near saturated soil hydraulic properties☆

    Science.gov (United States)

    Bodner, G.; Scholl, P.; Loiskandl, W.; Kaul, H.-P.

    2013-01-01

    Structural porosity is a decisive property for soil productivity and soil environmental functions. Hydraulic properties in the structural range vary over time in response to management and environmental influences. Although this is widely recognized, there are few field studies that determine dominant driving forces underlying hydraulic property dynamics. During a three year field experiment we measured temporal variability of soil hydraulic properties by tension infiltrometry. Soil properties were characterized by hydraulic conductivity, effective macroporosity and Kosugi's lognormal pore size distribution model. Management related influences comprised three soil cover treatment (mustard and rye vs. fallow) and an initial mechanical soil disturbance with a rotary harrow. Environmental driving forces were derived from meteorological and soil moisture data. Soil hydraulic parameters varied over time by around one order of magnitude. The coefficient of variation of soil hydraulic conductivity K(h) decreased from 69.5% at saturation to 42.1% in the more unsaturated range (− 10 cm pressure head). A slight increase in the Kosugi parameter showing pore heterogeneity was observed under the rye cover crop, reflecting an enhanced structural porosity. The other hydraulic parameters were not significantly influenced by the soil cover treatments. Seedbed preparation with a rotary harrow resulted in a fourfold increase in macroporosity and hydraulic conductivity next to saturation, and homogenized the pore radius distribution. Re-consolidation after mechanical loosening lasted over 18 months until the soil returned to its initial state. The post-tillage trend of soil settlement could be approximated by an exponential decay function. Among environmental factors, wetting-drying cycles were identified as dominant driving force explaining short term hydraulic property changes within the season (r2 = 0.43 to 0.59). Our results suggested that beside considering average

  18. Assistive technology outcomes in post-secondary students with disabilities: the influence of diagnosis, gender, and class-level.

    Science.gov (United States)

    Malcolm, Matt P; Roll, Marla C

    2017-11-01

    This study investigated how outcomes of assistive technology (AT) services for college students with disabilities are influenced by diagnosis, gender and class-level (e.g., Freshman). Students' pre- and post-intervention ratings of their performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure, COPM) were analyzed, as well as students' responses on a survey about AT service provision, use, and preferences. Data from 455 students revealed "learning disability" to be the most prevalent diagnosis (38%), similar numbers of females and males served, and Freshmen (23.1%) as the largest class-level seeking AT services. For COPM data, each two-way analysis of variance (ANOVA) (grouping variable = diagnosis) revealed that pre-post change scores significantly improved for the entire sample, and that students with a mood disorder experienced the greatest changes compared to other diagnoses. COPM scores significantly and similarly improved for females and males, and across class levels. AT Survey ratings about timeliness of services and independent AT use were significantly lower for students with mobility deficits/pain and neurological damage, respectively. Gender and class-level variables did not significantly impact AT Survey ratings. The study results reveal that features of a college student's diagnosis may influence AT service outcomes, and student-perceptions of AT services ability to use AT. Implications for Rehabilitation College students who are Freshman and/or who have a learning disability are the most prevalent students referred for campus-based assistive technology services. While student ratings of academic task performance significantly increase across diagnostic groupings, these improvements were greatest for those with a mood disorder compared to other diagnostic groups. Service-providers should consider that features of certain diagnoses or disabilities may influence the student?s perception of AT service

  19. Influence of personality on the outcome of treatment in depression: systematic review and meta-analysis.

    Science.gov (United States)

    Newton-Howes, Giles; Tyrer, Peter; Johnson, Tony; Mulder, Roger; Kool, Simone; Dekker, Jack; Schoevers, Robert

    2014-08-01

    There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with depressive disorders and whether this is influenced by type of treatment, a systematic electronic search of MEDLINE, CINAHL, and PsycINFO from 1966, 1982, and 1882, respectively, until February 2007 was undertaken. The keyword terms depression, mental illness, and personality disorder were used. All references were reviewed and personal correspondence was undertaken. Only English language papers were considered. Any English language paper studying a depressed adult population was considered for inclusion. Studies needed to clearly define depression and personality disorder using peer-reviewed instruments or International Classification of Disease/Diagnostic Statistical Manual criteria. Outcome assessment at greater than 3 weeks was necessary. Final inclusion papers were agreed on by consensus by at least two reviewers. All data were extracted using predetermined criteria for depression by at least two reviewers in parallel. Disagreement was settled by consensus. Complex data extraction was confirmed within the study group. Data were synthesized using log odds ratios in the Cochrane RevMan 5 program. The finding of comorbid personality disorder and depression was associated with a more than double the odds of a poor outcome for depression compared with those with no personality disorder (OR 2.16, CI 1.83-2.56). This effect was not ameliorated by the treatment modality used for the depressive disorder. This finding led to the conclusion that personality disorder has a negative impact on the outcome of depression. This finding is important in considering prognosis in depressive disorders.

  20. Comorbidity negatively influences the outcomes of diagnostic tests for musculoskeletal pain in the orofacial region.

    Science.gov (United States)

    Koutris, Michail; Visscher, Corine M; Lobbezoo, Frank; Naeije, Machiel

    2013-06-01

    The aim of this study was to investigate whether diagnostic tests for musculoskeletal pain in the orofacial region [temporomandibular disorder (TMD) pain] are influenced by the presence of comorbid conditions, and to determine whether this influence decreases when the presence of "familiar pain" is used as outcome measure. In total, 117 patients (35 men, 82 women; 75 TMD-pain patients, 42 pain-free patients; mean age ± SD = 42.94 ± 14.17 years) were examined with palpation tests and dynamic/static tests. After each test, they were asked whether any pain was provoked and whether this pain response was familiar or not. For four clinical outcome measures (pain on palpation, familiar pain on palpation, pain on dynamic/static tests, and familiar pain on dynamic/static tests), multiple logistic regression analyses were performed with the presence of TMD pain as the primary predictor and regional (neck/shoulder) pain, widespread pain, depression, and somatization as comorbid factors. Pain on palpation was not associated with the primary predictor but with regional pain [P = 0.02, odds ratio (OR) = 4.59] and somatization (P = 0.011, OR = 8.47), whereas familiar pain on palpation was associated with the primary predictor (P = 0.003, OR = 5.23), but also with widespread pain (P = 0.001, OR = 2.02). Pain on dynamic/static tests was associated with the primary predictor (P pain on dynamic/static tests was only associated with the primary predictor (P diagnostic tests are negatively influenced by the presence of comorbidity. This influence decreases when the presence of familiar pain is used as outcome measure. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  1. Hypothetical Outcome Plots Outperform Error Bars and Violin Plots for Inferences about Reliability of Variable Ordering.

    Science.gov (United States)

    Hullman, Jessica; Resnick, Paul; Adar, Eytan

    2015-01-01

    Many visual depictions of probability distributions, such as error bars, are difficult for users to accurately interpret. We present and study an alternative representation, Hypothetical Outcome Plots (HOPs), that animates a finite set of individual draws. In contrast to the statistical background required to interpret many static representations of distributions, HOPs require relatively little background knowledge to interpret. Instead, HOPs enables viewers to infer properties of the distribution using mental processes like counting and integration. We conducted an experiment comparing HOPs to error bars and violin plots. With HOPs, people made much more accurate judgments about plots of two and three quantities. Accuracy was similar with all three representations for most questions about distributions of a single quantity.

  2. Hypothetical Outcome Plots Outperform Error Bars and Violin Plots for Inferences about Reliability of Variable Ordering.

    Directory of Open Access Journals (Sweden)

    Jessica Hullman

    Full Text Available Many visual depictions of probability distributions, such as error bars, are difficult for users to accurately interpret. We present and study an alternative representation, Hypothetical Outcome Plots (HOPs, that animates a finite set of individual draws. In contrast to the statistical background required to interpret many static representations of distributions, HOPs require relatively little background knowledge to interpret. Instead, HOPs enables viewers to infer properties of the distribution using mental processes like counting and integration. We conducted an experiment comparing HOPs to error bars and violin plots. With HOPs, people made much more accurate judgments about plots of two and three quantities. Accuracy was similar with all three representations for most questions about distributions of a single quantity.

  3. Penalized regression procedures for variable selection in the potential outcomes framework.

    Science.gov (United States)

    Ghosh, Debashis; Zhu, Yeying; Coffman, Donna L

    2015-05-10

    A recent topic of much interest in causal inference is model selection. In this article, we describe a framework in which to consider penalized regression approaches to variable selection for causal effects. The framework leads to a simple 'impute, then select' class of procedures that is agnostic to the type of imputation algorithm as well as penalized regression used. It also clarifies how model selection involves a multivariate regression model for causal inference problems and that these methods can be applied for identifying subgroups in which treatment effects are homogeneous. Analogies and links with the literature on machine learning methods, missing data, and imputation are drawn. A difference least absolute shrinkage and selection operator algorithm is defined, along with its multiple imputation analogs. The procedures are illustrated using a well-known right-heart catheterization dataset. Copyright © 2015 John Wiley & Sons, Ltd.

  4. A multicenter study of outcome in systemic lupus erythematosus. I. Entry variables as predictors of prognosis.

    Science.gov (United States)

    Ginzler, E M; Diamond, H S; Weiner, M; Schlesinger, M; Fries, J F; Wasner, C; Medsger, T A; Ziegler, G; Klippel, J H; Hadler, N M; Albert, D A; Hess, E V; Spencer-Green, G; Grayzel, A; Worth, D; Hahn, B H; Barnett, E V

    1982-06-01

    A retrospective study of factors influencing survival in 1,103 patients with systemic lupus erythematosus (SLE) was carried out at 9 university centers diverse in geographic, socioeconomic, and racial characteristics. The mortality and disease characteristics of the patients at study entry varied widely among centers. The survival rates from the time patients with a diagnosis of SLE were first evaluated at the participating center was 90% at 1 year, 77% at 5 years, and 71% at 10 years. Patients with a serum creatinine greater than 3 mg/dl at study entry had the lowest survival rates: 48%, 29%, and 12% at 1, 5, and 10 years, respectively. Survival rate also correlated independently with the entry hematocrit, degree of proteinuria, number of preliminary American Rheumatism Association criteria for SLE satisfied, and source of funding of medical care. When data were corrected for socioeconomic status, race/ethnic origin did not significantly influence survival. Survival rates varied widely at different participating institutions, generally due to differences in disease severity. Place of treatment was independently associated with survival only in the second year after study entry. Disease duration before study entry did not account for the differences in disease severity.

  5. Relapse May Serve as a Mediator Variable in Longitudinal Outcomes in Multiple Sclerosis.

    Science.gov (United States)

    Stone, Lael Anne; Cutter, Gary Raymond; Fisher, Elizabeth; Richert, Nancy; McCartin, Jennifer; Ohayon, Joan; Bash, Craig; McFarland, Henry

    2016-05-01

    Contrast-enhancing lesions (CEL) on magnetic resonance imaging (MRI) are believed to represent inflammatory disease activity in multiple sclerosis (MS), but their relationship to subsequent long-term disability and progression is unclear, particularly at longer time periods such as 8-10 years. Between 1989 and 1994, 111 MS patients were seen at the National Institutes of Health for clinical evaluations and 3 monthly contrast-enhanced MRI scans. Of these, 94 patients were re-evaluated a mean of 8 years later (range 6.1-10.5 years) with a single MRI scan and clinical evaluation. CEL number and volume were determined at baseline and follow-up. The number of relapses was ascertained over the follow-up period and annualized relapse rates were calculated. Other MRI parameters, such as T2 hyperintensity volume, T1 volume, and brain parenchymal fraction, were also calculated. While there was no direct correlation between CEL number or volume at baseline and disability status at follow-up, CEL measures at baseline did correlate with number of relapses observed in the subsequent years, and the number of relapses in turn correlated with subsequent disability as well as transition to progressive MS. While number and volume of CEL at baseline do not directly correlate with disability in the longer term in MS, our data suggest that 1 route to disability involves relapses as a mediator variable in the causal sequence of MS progression from CEL to disability. Further studies using relapse as a mediator variable in a larger data set may be warranted. Copyright © 2015 by the American Society of Neuroimaging.

  6. A Two Year Longitudinal Outcome Study of Addicted Health Care Professionals: An Investigation of the Role of Personality Variables

    Directory of Open Access Journals (Sweden)

    Daniel Angres

    2013-01-01

    Full Text Available The co-morbidity of personality disorders (PDs and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.

  7. The influence of variable range of motion training on neuromuscular performance and control of external loads.

    Science.gov (United States)

    Clark, Ross A; Humphries, Brendan; Hohmann, Erik; Bryant, Adam L

    2011-03-01

    Resistance training programs that emphasize high force production in different regions of the range of motion (ROM) may provide performance benefits. This study examined whether variable ROM (VROM) training, which consists of partial ROM training with countermovements performed in a different phase of the ROM for each set, results in improved functional performance. Twenty-two athletes (age 22.7 ± 2.4 years, height 1.81 ± 0.07 m, and body mass 94.6 ± 14.5 kg) with extensive resistance training backgrounds performed either a VROM or full ROM control (CON) 5-week, concentric work-matched training program. The participants were assigned to a group based on stratified randomization incorporating their strength levels and performance gains in preceding training microcycles. Testing consisted of assessing the force-ROM relationship during isokinetic and isometric bench press and ballistic bench throws, with normalized electromyography amplitude assessed during the isometric tests. Repeated-measure analyses of variance revealed that the VROM intervention significantly (p force (+15.7%), in addition to isokinetic peak force in the terminal ROM (13.5% increase). No significant differences were observed in the CON group or between groups for any other outcome measures. Analysis of the force-ROM relationship revealed that that the VROM intervention enhanced performance at shorter muscle lengths. These findings suggest that VROM training improves terminal and midrange performance gains, resulting in the athlete possessing an improved ability to control external loading and produce dynamic force.

  8. The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.

    Science.gov (United States)

    Young, Melissa F; Nguyen, Phuong Hong; Addo, O Yaw; Hao, Wei; Nguyen, Hieu; Pham, Hoa; Martorell, Reynaldo; Ramakrishnan, Usha

    2015-11-01

    This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n=1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4kg) was associated with a 283g (95%CI: 279-286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4kg) (250g; 95% CI: 245-255). Women with a PPW pregnancy were more likely to give birth to a SGA (OR 2.9: 95%CI 1.9-4.5, OR 3.3: 95%CI 2.2-5.1) or LBW infant (OR 3.1: 95%CI 1.5-6.2, OR 3.4: 95%CI 1.6-7.2), respectively. These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW pregnancy along with routine obstetric care on gestational weight gain is critical to improve birth outcomes. NCT01665378 (https://clinicaltrials.gov/show/NCT01665378). Copyright © 2015

  9. The influence of spatial variability of lithological and morphometric characters on drainage network arrangement

    Science.gov (United States)

    Coco, Laura; Buccolini, Marcello

    2015-04-01

    calculated drainage density (D) computed by the ratio between total drainage length and basin area. We used National and Regional Geological Map as source of lithological characters. The data were analyzed via statistics in terms of average trend and fluctuations. We split the basins into two groups according to the prevalent lithology. The first group included the basins prevalently made up of clays and sandy clays, the second includes the ones mainly constituted by conglomerates on surface. A Regression Analysis revealed that the influence of MSI on D was driven by the lithology. Indeed, we individuated two logarithmic trends of the MSI-D interpolators corresponding to the lithological groups. This finding demonstrated the great influence of lithology not only on D and MSI, but especially on their relation, depending on the different lithotechnical properties of the lithologies under study. Further enhancements will focus on evaluating the influence of spatial variability of lithology and morphology on the evolution of the current drainage network. We intend to investigate the future development of the fluvial dynamic starting from the current DEM (instead of the pre-incision one) and considering other variables that are generally deemed as drivers of the fluvial dynamic (e.g. land use, land cover).

  10. Effectiveness of Splanchnic Nerve Neurolysis for Targeting Location of Cancer Pain: Using the Pain Drawing as an Outcome Variable.

    Science.gov (United States)

    Novy, Diane M; Engle, Mitchell P; Lai, Emily A; Cook, Christina; Martin, Emily C; Trahan, Lisa; Yu, Jun; Koyyalagunta, Dhanalakshmi

    2016-07-01

    The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominal pain has been investigated using numeric pain intensity rating as an outcome variable. The outcome variable in this study used the grid method for obtaining a targeted pain drawing score on 60 patients with pain from pancreatic or gastro-intestinal primary cancers or metastatic disease to the abdominal region. Results demonstrate excellent inter-rater agreement (intra-class correlation [ICC] coefficient at pre-SNN = 0.97 and ICC at within one month post-SNN = 0.98) for the grid method of scoring the pain drawing and demonstrate psychometric generalizability among patients with cancer-related pain. Using the Wilcoxon signed rank test and associated effect sizes, results show significant improvement in dispersion of pain following SNN. Effect sizes for the difference in pre-SNN to 2 post-SNN time points were higher for the pain drawing than for pain intensity rating. Specifically, the effect size difference from pre- to within one month post-SNN was r = 0.42 for pain drawing versus r = 0.23 for pain intensity rating. Based on a smaller subset of patients who were seen within 1 - 6 months following SNN, the effect size difference from pre-SNN was r = 0.46 for pain drawing versus r = 0.00 for pain intensity rating. Collectively, these data support the use of the pain drawing as a reliable outcome measure among patients with cancer pain for procedures such as SNN that target specific location and dispersion of pain.

  11. Tongue motion variability with changes of upper airway stimulation electrode configuration and effects on treatment outcomes.

    Science.gov (United States)

    Steffen, Armin; Kilic, Ayse; König, Inke R; Suurna, Maria V; Hofauer, Benedikt; Heiser, Clemens

    2017-12-27

    Upper airway stimulation (UAS) is an effective treatment for obstructive sleep apnea (OSA). Previous data have demonstrated a correlation between the phenotype of tongue motion and therapy response. Closed loop hypoglossal nerve stimulation implant offers five different electrode configuration settings which may result in different tongue motion. Two-center, prospective consecutive trial in a university hospital setting. Clinical outcomes of 35 patients were analyzed after at least 12 months of device use. Tongue motion was assessed at various electrode configuration settings. Correlation between the tongue motion and treatment response was evaluated. OSA severity was significantly reduced with the use of UAS therapy (P < .001). Changes in tongue motion patterns were frequently observed (58.8%) with different electrode configuration settings. Most of the patients alternated between right and bilateral protrusion (73.5%), which are considered to be the optimal phenotypes for selective UAS responses. Different voltage settings were required to achieve functional stimulation levels when changing between the electrode settings. UAS is highly effective for OSA treatment in selected patients with an apnea-hypopnea index between 15 and 65 events per hour and higher body mass index. Attention should be given to patients with shifting tongue movement in response to change of electrode configuration. The intraoperative cuff placement should be reassessed when tongue movement shifting is observed. 4 Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Visit-to-Visit Variability in Blood Pressure and Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Nephropathy

    DEFF Research Database (Denmark)

    McMullan, Ciaran J; Lambers Heerspink, Hiddo J; Parving, Hans-Henrik

    2014-01-01

    -to-visit variability was calculated from the SD of the systolic blood pressure from 4 visits occurring 3-12 months postrandomization. OUTCOMES: The kidney disease outcome was defined as time to confirmed doubling of serum creatinine level, end-stage renal disease, or death; the cardiovascular outcome was defined......BACKGROUND: Increased systolic blood pressure variability between outpatient visits is associated with increased incidence of cardiovascular end points. However, few studies have examined the association of visit-to-visit variability in systolic blood pressure with clinically relevant kidney...... disease outcomes. We analyzed the association of systolic blood pressure visit-to-visit variability with renal and cardiovascular morbidity and mortality among individuals with diabetes and nephropathy. STUDY DESIGN: Observational analysis of IDNT (Irbesartan Diabetic Nephropathy Trial) and the RENAAL...

  13. Adélie penguin survival: age structure, temporal variability and environmental influences.

    Science.gov (United States)

    Emmerson, Louise; Southwell, Colin

    2011-12-01

    The driving factors of survival, a key demographic process, have been particularly challenging to study, especially for winter migratory species such as the Adélie penguin (Pygoscelis adeliae). While winter environmental conditions clearly influence Antarctic seabird survival, it has been unclear to which environmental features they are most likely to respond. Here, we examine the influence of environmental fluctuations, broad climatic conditions and the success of the breeding season prior to winter on annual survival of an Adélie penguin population using mark-recapture models based on penguin tag and resight data over a 16-year period. This analysis required an extension to the basic Cormack-Jolly-Seber model by incorporating age structure in recapture and survival sub-models. By including model covariates, we show that survival of older penguins is primarily related to the amount and concentration of ice present in their winter foraging grounds. In contrast, fledgling and yearling survival depended on other factors in addition to the physical marine environment and outcomes of the previous breeding season, but we were unable to determine what these were. The relationship between sea-ice and survival differed with penguin age: extensive ice during the return journey to breeding colonies was detrimental to survival for the younger penguins, whereas either too little or too much ice (between 15 and 80% cover) in the winter foraging grounds was detrimental for adults. Our results demonstrate that predictions of Adélie penguin survival can be improved by taking into account penguin age, prior breeding conditions and environmental features.

  14. Crop-ecology and nutritional variability influence growth and secondary metabolites of Stevia rebaudiana Bertoni.

    Science.gov (United States)

    Pal, Probir Kumar; Kumar, Rajender; Guleria, Vipan; Mahajan, Mitali; Prasad, Ramdeen; Pathania, Vijaylata; Gill, Baljinder Singh; Singh, Devinder; Chand, Gopi; Singh, Bikram; Singh, Rakesh Deosharan; Ahuja, Paramvir Singh

    2015-02-27

    Plant nutrition and climatic conditions play important roles on the growth and secondary metabolites of stevia (Stevia rebaudiana Bertoni); however, the nutritional dose is strongly governed by the soil properties and climatic conditions of the growing region. In northern India, the interactive effects of crop ecology and plant nutrition on yield and secondary metabolites of stevia are not yet properly understood. Thus, a field experiment comprising three levels of nitrogen, two levels of phosphorus and three levels of potassium was conducted at three locations to ascertain whether the spatial and nutritional variability would dominate the leaf yield and secondary metabolites profile of stevia. Principal component analysis (PCA) indicates that the applications of 90 kg N, 40 kg P2O5 and 40 kg K2O ha-1 are the best nutritional conditions in terms of dry leaf yield for CSIR-IHBT (Council of Scientific and Industrial Research- Institute Himalayan Bioresource Technology) and RHRS (Regional Horticultural Research Station) conditions. The spatial variability also exerted considerable effect on the leaf yield and stevioside content in leaves. Among the three locations, CSIR-IHBT was found most suitable in case of dry leaf yield and secondary metabolites accumulation in leaves. The results suggest that dry leaf yield and accumulation of stevioside are controlled by the environmental factors and agronomic management; however, the accumulation of rebaudioside-A (Reb-A) is not much influenced by these two factors. Thus, leaf yield and secondary metabolite profiles of stevia can be improved through the selection of appropriate growing locations and proper nutrient management.

  15. On the Variability of the East Australian Current: Jet Structure, Meandering, and Influence on Shelf Circulation

    Science.gov (United States)

    Archer, Matthew R.; Roughan, Moninya; Keating, Shane R.; Schaeffer, Amandine

    2017-11-01

    Given the importance of western boundary currents over a wide range of scales in the ocean, it is crucial that we understand their dynamics to accurately predict future changes. For this, we need detailed knowledge of their structure and variability. Here we investigate the jet structure of the East Australian Current (EAC), using observations from HF radars and moorings deployed at 30°S-31°S. Meandering, core velocity, width, and eddy kinetic energy (EKE) are quantified from 4 years of hourly 1.5 km resolution surface current maps (2012-2016), to obtain the most detailed representation of the surface EAC jet to date. The EAC flows predominantly over the ˜1,500 m isobath 50 km offshore but makes large amplitude displacements eastward every 65-100 days—the time scale associated with mesoscale eddy shedding at the EAC separation. Smaller-amplitude, higher-frequency meanders occur every 20-45 days. Using a coordinate frame that follows the jet, we show core velocity and EKE exhibit seasonality in both magnitude and variance, being maximum in summer (1.55 m s-1 mean core velocity), minimum in winter (0.8 m s-1). However, it is the eddy-shedding time scale that dominates jet variability. As the EAC moves shoreward, shelf temperature and along-stream velocity vary linearly with jet movement, within ˜35 km of the core. The EAC is within this range 75% of the time, demonstrating its importance to the shelf circulation. Temperature and velocity fluctuations at the 70 m (100 m) isobath are more influenced by wind (EAC encroachment), with the strongest response occurring when wind and EAC act constructively.

  16. Lhermitte's sign: Incidence and treatment variables influencing risk after irradiation of the cervical spinal cord

    International Nuclear Information System (INIS)

    Fein, D.A.; Marcus, R.B. Jr.; Parsons, J.T.; Mendenhall, W.M.; Million, R.R.

    1993-01-01

    Lhermitte's sign is a relatively infrequent sequela of irradiation of the cervical spinal cord. In this study, the authors sought to determine whether various treatment parameters influenced the likelihood of developing Lhermitte's sign. Between October 1964 and December 1987, 2901 patients with malignancies of the upper respiratory tract were treated at the University of Florida. The dose of radiation to the cervical spinal cord was calculated for those patients who had a minimum 1-year follow-up. A total of 1112 patients who received a minimum of 3000 cGy to at least 2 cm of cervical spinal cord were included in this analysis. Forty patients (3.6%) developed Lhermitte's sign. The mean time to development of Lhermitte's sign after irradiation was 3 months, and the mean duration of symptoms was 6 months. No patient with Lhermitte's sign developed transverse myelitis. Several variables were examined in a univariate analysis, including total dose to the cervical spinal cord, length of cervical spinal cord irradiated, dose per fraction, continuous-course compared with split-course radiotherapy, and once-daily compared with twice-daily irradiation. Only two variables proved to be significant. Six (8%) of 75 patients who received > 5000 cGy to the cervical spinal cord developed Lhermitte's sign compared with 34 (3.3%) of 1037 patients who received < 5000 cGy (p = .04). For patients treated with once-daily fractionation, 28 (3.4%) of 821 patients who received < 200 cGy per fraction developed Lhermitte's sign compared with 6 (10%) of 58 patients who received ≥ 200 cGy (p = .02). An increased risk of developing Lhermitte's sign was demonstrated for patients who received either ≥ 200 cGy per fraction (one fraction per day) or ≥ 5000 cGy total dose to the cervical spinal cord. 29 refs., 1 fig., 5 tabs

  17. Hemodynamic variables predict outcome of emergency thoracotomy in the pediatric trauma population.

    Science.gov (United States)

    Wyrick, Deidre L; Dassinger, Melvin S; Bozeman, Andrew P; Porter, Austin; Maxson, R Todd

    2014-09-01

    Limited data exist regarding indications for resuscitative emergency thoracotomy (ETR) in the pediatric population. We attempt to define the presenting hemodynamic parameters that predict survival for pediatric patients undergoing ETR. We reviewed all pediatric patients (age <18years), entered into the National Trauma Data Bank from 2007 to 2010, who underwent ETR within one hour of ED arrival. Mechanism of injury and hemodynamics were analyzed using Chi squared and Wilcoxon tests. 316 children (70 blunt, 240 penetrating) underwent ETR, 31% (98/316) survived to discharge. Less than 5% of patients survived when presenting SBP was ≤50mmHg or heart rate was ≤70bpm. For blunt injuries there were no survivors with a pulse ≤80bpm or SBP ≤60mmHg. When survivors were compared to nonsurvivors, blood pressure, pulse, and injury type were statistically significant when treated as independent variables and in a logistic regression model. When ETR was performed for SBP ≤50mmHg or for heart rate ≤70bpm less than 5% of patients survived. There were no survivors of blunt trauma when SBP was ≤60mmHg or pulse was ≤80bpm. This review suggests that ETR may have limited benefit in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Influences of Training on Individual Outcomes for High School Sports Officials

    Directory of Open Access Journals (Sweden)

    Timothy D. Ryan

    2014-04-01

    Full Text Available The primary purpose of this study was to explore the influences of training on specific quality of work outcomes of job satisfaction, pay satisfaction, and intentions to leave within high school sports officials. Evidence suggests that there is a shortage of high school officials in all categories of high school sport. Via a web-based survey, we explored the effects of training on the individual outcomes under study. Results indicated that the level of training had a significant effect on job satisfaction, pay satisfaction, and turnover intentions. Analyses indicated that officials with less training had higher turnover intentions and lower job satisfaction than officials who had more training. Conversely, officials who engaged numerous training hours had lower pay satisfaction. This exploratory study supports the importance of training high school officials but, more importantly, provides an initial assessment on the reverse effects of training on pay satisfaction.

  19. The Influence Of Learning Model Guided Findings Of Student Learning Outcomes

    Directory of Open Access Journals (Sweden)

    A. SaefulBahri

    2015-03-01

    Full Text Available Abstract This study examines the influence of the learning model guided findings on student learning outcomes in subjects PAI eighth grade students of SMP Plus al Masoem. The research method used in this study is a quantitative method in the form of quasi-experiment Quasi-Experimental Design. The findings of the study are expected to demonstrate 1 the difference significant increase in learning outcomes between the experimental class using guided discovery method that uses the control class discussion of learning models 2 Constraints in the method of guided discovery activities and the limited ability of educators in the experimental class in implements the method of guided discovery and constraints faced by students while digging the information they need so we need special strategies to motivate students in the experimental class in order for them creatively find the right way to gather information that supports learning PAI.

  20. Influence of Production Variables on Eco-Friendly Briquettes from Coconut and Bambara Nut Shells

    Directory of Open Access Journals (Sweden)

    O. A. Sotannde

    2017-08-01

    Full Text Available This study investigates the influence of production variables on the properties of molasses-induced fuel briquettes from Coconut (Cocos nucifera L. and Bambara nut (Vigna subterranea L. Verdc. shells. The milled samples of both raw materials were mixed with molasses at ratios 100:20, 100:25, 100:30 and 100:35 by weight respectively, and briquetted using a Jack press at an average pressure of 1.2KN/m2. A 3x4 factorial experiment in completely randomized design was used. The briquettes produced were subjected to both physical and combustion tests. The tests revealed that majority of the variations in briquette properties were largely influenced by the type of biomass residues used while molasses’ content also contributed significant effect atp < 0.05. Coconut shell briquettes had higher compressed density though lower in relaxed form (0.80 g·cm-3vs 0.78 g·cm-3 when compared to Bambara nut shell briquettes (0.77 g.cm-3vs0.75 g.cm-3. Both physical and combustion properties were significantly improved when both bio-residue mixtures were used. Briquettes from the mixtures had the highest average fixed carbon and heating values of 85.21% and 32.80 MJ·kg-1 respectively, though it was 83.83% and 32.12 MJ·kg-1for coconut shell briquette and 82.18% and 32.03 MJ·kg-1for Bambara nut shell briquette. Therefore, based on physical and combustion characteristics, the best Bambara nut briquettes and its mixture with coconut shell were produced when molasses content was 30%. In contrast, the best coconut shell briquette was produced when molasses content was 35%. These two level are therefore recommended for production of quality briquettes from these agro-residues.

  1. Influence of weather variables and plant communities on grasshopper density in the Southern Pampas, Argentina.

    Science.gov (United States)

    de Wysiecki, María Laura; Arturi, Marcelo; Torrusio, Sandra; Cigliano, María Marta

    2011-01-01

    temperature had no significant effect on total grasshopper density, these weather variables and plant communities had differential influence on the dominant grasshopper species.

  2. Tidal variability of nutrients in a coastal coral reef system influenced by groundwater

    Science.gov (United States)

    Wang, Guizhi; Wang, Shuling; Wang, Zhangyong; Jing, Wenping; Xu, Yi; Zhang, Zhouling; Tan, Ehui; Dai, Minhan

    2018-02-01

    To investigate variation in nitrite, nitrate, phosphate, and silicate in a spring-neap tide in a coral reef system influenced by groundwater discharge, we carried out a time-series observation of these nutrients and 228Ra, a tracer of groundwater discharge, in the Luhuitou fringing reef at Sanya Bay in the South China Sea. The maximum 228Ra, 45.3 dpm 100 L-1, appeared at low tide and the minimum, 14.0 dpm 100 L-1, appeared during a flood tide in the spring tide. The activity of 228Ra was significantly correlated with water depth and salinity in the spring-neap tide, reflecting the tidal-pumping feature of groundwater discharge. Concentrations of all nutrients exhibited strong diurnal variation, with a maximum in the amplitude of the diel change for nitrite, nitrate, phosphate, and silicate in the spring tide of 0.46, 1.54, 0.12, and 2.68 µM, respectively. Nitrate and phosphate were negatively correlated with water depth during the spring tide but showed no correlation during the neap tide. Nitrite was positively correlated with water depth in the spring and neap tide due to mixing of nitrite-depleted groundwater and nitrite-rich offshore seawater. They were also significantly correlated with salinity (R2 ≥ 0.9 and P reef system was closely related with biological processes during both tidal periods, but the biological influence appeared to be less dominant, as inferred from the less significant correlations (R2 = 0.16) during the spring tide when groundwater discharge was more prominent. Thus, the variability of nutrients in the coral reef system was regulated mainly by biological uptake and release in a spring-neap tide and impacted by mixing of tidally driven groundwater and offshore seawater during spring tide.

  3. Picophytoplankton variability: Influence of winter convective mixing and advection in the northeastern Arabian Sea

    Science.gov (United States)

    Bemal, Suchandan; Anil, Arga Chandrashekar; Shankar, D.; Remya, R.; Roy, Rajdeep

    2018-04-01

    The deepening of mixed layer and ensuing changes in optical and physicochemical properties of euphotic zone can influence phytoplankton community dynamics in the northeastern Arabian Sea during winter monsoon. The response of picophytoplankton community to such changes during winter convective mixing is not well understood. Herein, we have compared variations in the picophytoplankton community structure during early (November-December 2012), peak (end-January 2014) and late (mid-February 2015) winter monsoon from three separate cruises in the southern northeastern Arabian Sea. The higher Synechococcus abundance owing to entrainment of nutrients in mixed layer was observed during peak winter monsoon, while the concomitant changes in nitrate concentration, light and oxygen environment restricted Prochlorococcus growth resulting in lower abundance during the same period. This highlights the diverse responses of picophytoplankton groups to physicochemical changes of water column during winter convective mixing. The divinyl chlorophyll b/a ratio (marker for Prochlorococcus ecotypes) indicated prevalence of one low-light adapted ecotype (sensitive to light shock) in sub-surface water, one high-light adapted ecotype in surface water during early winter monsoon and both disappeared during intense mixing period in peak winter monsoon. Subsequently, a distinct low-light adapted ecotype, capable to tolerate light shock, was noticed during late winter monsoon and we argue that this ecotype is introduced to southern northeastern Arabian Sea through advection from north by sub-surface circulation. The total picophytoplankton biomass available to microbial loop is restored during late winter monsoon, when stratification begins, with a higher abundance of Synechococcus and the re-occurrence of Prochlorococcus population in the region. These inferences indicate that variability in picophytoplankton community structure and their contribution to the microbial loop are driven by

  4. Electromagnetic fields produced by incubators influence heart rate variability in newborns.

    Science.gov (United States)

    Bellieni, C V; Acampa, M; Maffei, M; Maffei, S; Perrone, S; Pinto, I; Stacchini, N; Buonocore, G

    2008-07-01

    Incubators are largely used to preserve preterm and sick babies from postnatal stressors, but their motors produce high electromagnetic fields (EMFs). Newborns are chronically exposed to these EMFs, but no studies about their effects on the fragile developing neonatal structure exist. To verify whether the exposure to incubator motor electric power may alter autonomous nervous system activity in newborns. Heart rate variability (HRV) of 43 newborns in incubators was studied. The study group comprised 27 newborns whose HRV was studied throughout three 5-minute periods: with incubator motor on, off, and on again, respectively. Mean HRV values obtained during each period were compared. The control group comprised 16 newborns with constantly unrecordable EMF and exposed to changes in background noise, similar to those provoked by the incubator motor. Mean (SD) total power and the high-frequency (HF) component of HRV increased significantly (from 87.1 (76.2) ms2 to 183.6 (168.5) ms2) and the mean low-frequency (LF)/HF ratio decreased significantly (from 2.0 (0.5) to 1.5 (0.6)) when the incubator motor was turned off. Basal values (HF = 107.1 (118.1) ms2 and LF/HF = 1.9 (0.6)) were restored when incubators were turned on again. The LF spectral component of HRV showed a statistically significant change only in the second phase of the experiment. Changes in background noise did not provoke any significant change in HRV. EMFs produced by incubators influence newborns' HRV, showing an influence on their autonomous nervous system. More research is needed to assess possible long-term consequences, since premature newborns may be exposed to these high EMFs for months.

  5. Expression patterns of the aquaporin gene family during renal development: influence of genetic variability.

    Science.gov (United States)

    Parreira, Kleber S; Debaix, Huguette; Cnops, Yvette; Geffers, Lars; Devuyst, Olivier

    2009-08-01

    High-throughput analyses have shown that aquaporins (AQPs) belong to a cluster of genes that are differentially expressed during kidney organogenesis. However, the spatiotemporal expression patterns of the AQP gene family during tubular maturation and the potential influence of genetic variation on these patterns and on water handling remain unknown. We investigated the expression patterns of all AQP isoforms in fetal (E13.5 to E18.5), postnatal (P1 to P28), and adult (9 weeks) kidneys of inbred (C57BL/6J) and outbred (CD-1) mice. Using quantitative polymerase chain reaction (PCR), we evidenced two mRNA patterns during tubular maturation in C57 mice. The AQPs 1-7-11 showed an early (from E14.5) and progressive increase to adult levels, similar to the mRNA pattern observed for proximal tubule markers (Megalin, NaPi-IIa, OAT1) and reflecting the continuous increase in renal cortical structures during development. By contrast, AQPs 2-3-4 showed a later (E15.5) and more abrupt increase, with transient postnatal overexpression. Most AQP genes were expressed earlier and/or stronger in maturing CD-1 kidneys. Furthermore, adult CD-1 kidneys expressed more AQP2 in the collecting ducts, which was reflected by a significant delay in excreting a water load. The expression patterns of proximal vs. distal AQPs and the earlier expression in the CD-1 strain were confirmed by immunoblotting and immunostaining. These data (1) substantiate the clustering of important genes during tubular maturation and (2) demonstrate that genetic variability influences the regulation of the AQP gene family during tubular maturation and water handling by the mature kidney.

  6. Influence of intrauterine and extrauterine growth on neurodevelopmental outcome of monozygotic twins

    Directory of Open Access Journals (Sweden)

    R.K. Reolon

    2008-08-01

    Full Text Available There have been indications that intrauterine and early extrauterine growth can influence childhood mental and motor function. The objective of the present study was to evaluate the influence of intrauterine growth restriction and early extrauterine head growth on the neurodevelopmental outcome of monozygotic twins. Thirty-six monozygous twin pairs were evaluated at the corrected age of 12 to 42 months. Intrauterine growth restriction was quantified using the fetal growth ratio. The effects of birth weight ratio, head circumference at birth and current head circumference on mental and motor outcomes were estimated using mixed-effect linear regression models. Separate estimates of the between (interpair and within (intrapair effects of each measure on development were thus obtained. Neurodevelopment was assessed with the Bayley Scales of Infant Development, 2nd edition, by a psychologist blind to the exposure. A standardized neurological examination was performed by a neuropediatrician who was unaware of the exposures under investigation. After adjustment, birth weight ratio and head circumference at birth were not associated with motor or mental outcomes. Current head circumference was associated with mental but not with motor outcomes. Only the intrapair twin effect was significant. An increase of 1 cm in current head circumference of one twin compared with the other was associated with 3.2 points higher in Mental Developmental Index (95%CI = 1.06-5.32; P < 0.03. Thus, no effect of intrauterine growth was found on cognition and only postnatal head growth was associated with cognition. This effect was not shared by the co-twin.

  7. Influence of corneal asphericity on the refractive outcome of intraocular lens implantation in cataract surgery.

    Science.gov (United States)

    Savini, Giacomo; Hoffer, Kenneth J; Barboni, Piero

    2015-04-01

    To evaluate the possible influence of anterior corneal surface asphericity on the refractive outcomes in eyes having intraocular lens (IOL) implantation after cataract surgery. Fondazione G.B. Bietti IRCCS, Rome, Italy. Retrospective comparative case series. Intraocular lens power was calculated using the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Asphericity (Q-value) was measured at 8.0 mm with a Placido-disk corneal topographer (Keratron), a rotating Scheimpflug camera (Pentacam), and a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius). The relationship between the error in refraction prediction (ie, difference between expected refraction and refraction measured 1 month after surgery) and the Q-value was assessed by linear regression. The same IOL model (Acrysof SA60AT) was implanted in 115 eyes of 115 consecutive patients. Regression analysis showed a statistically significant relationship between the error in refraction prediction and the Q-value with all formulas and all devices. In all cases, a more negative Q-value (prolate cornea) was associated with a myopic outcome, whereas a more positive Q-value (oblate cornea) was associated with a hyperopic outcome. The highest coefficient of determination was detected between the Hoffer Q formula and the Placido-disk corneal topographer (R(2) = 0.2630), for which the error in refraction prediction (y) was related to the Q-value (x) according to the formula y = -0.2641 + 1.4589 × x. Corneal asphericity influences the refractive outcomes of IOL implantation and should be taken into consideration when using third-generation IOL power formulas. Dr. Hoffer receives book royalties from Slack, Inc., Thorofare, New Jersey, and formula royalties from all manufacturers using the Hoffer Q formula. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. The Influence of Methotrexate Treatment on Male Fertility and Pregnancy Outcome After Paternal Exposure.

    Science.gov (United States)

    Grosen, Anne; Kelsen, Jens; Hvas, Christian Lodberg; Bellaguarda, Emanuelle; Hanauer, Stephen B

    2017-04-01

    Inflammatory bowel disease incidence peaks during the reproductive years. Methotrexate (MTX) is frequently used for inflammatory bowel disease, but its use during pregnancy is contraindicated in women because of teratogenic effects. The aim of this review is to investigate the influence of MTX on male fertility and pregnancy outcomes after paternal MTX exposure. A systematic literature search was performed by applying 2 focus areas, "methotrexate" and "male fertility or pregnancy outcome." Terms and keywords were used both as MeSH terms and free-text searches. Pertinent articles were searched for additional relevant references. In animal studies, MTX induces aberrations in sperm DNA that have not been identified in humans. The effects of MTX on human sperm quality have only been described in case reports. A transient adverse effect on sperm quality with low-dose MTX has been reported, but several other cases have not found harmful effects of MTX. MTX has not been measured in human sperm ejaculates; yet, the risk of a direct toxic effect on the fetus through MTX-contaminated seminal plasma seems negligible. Until now, 284 pregnancies with paternal MTX exposure have been reported. The outcomes were 248 live births and a total of 13 malformations, with no overt indication of MTX embryopathy. This review reveals the lack of studies on the safety of MTX with regard to male reproduction. It is not clear whether MTX transiently influences male fertility and sperm DNA integrity, and more studies are needed. Comparative cohort studies found no increased risk of adverse pregnancy outcomes.

  9. Variable gene dispersal conditions and spatial deforestation patterns can interact to affect tropical tree conservation outcomes.

    Directory of Open Access Journals (Sweden)

    Yamini Kashimshetty

    dispersal regimens will be a likely outcome of fragmentation. Conservation implications include possible manual interventions (manual manipulations of offspring dispersers and/or pollinators in forest fragments to increase population recovery and genetic diversity retention.

  10. Variable gene dispersal conditions and spatial deforestation patterns can interact to affect tropical tree conservation outcomes.

    Science.gov (United States)

    Kashimshetty, Yamini; Pelikan, Stephan; Rogstad, Steven H

    2015-01-01

    regimens will be a likely outcome of fragmentation. Conservation implications include possible manual interventions (manual manipulations of offspring dispersers and/or pollinators) in forest fragments to increase population recovery and genetic diversity retention.

  11. Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome

    International Nuclear Information System (INIS)

    Kajtazi, Naim I; Arulneyam, Jayanthi C; AlSenani, Fahmi M; Zimmerman, Valerie A; AlShami, Sadiq Y

    2009-01-01

    To investigate cerebral venous thrombosis (CVTR) clinical presentations, risk factors, and response to treatment in Saudi Arabia. Retrospective analysis of the King Farad Medical City, Riyadh, acute stroke database from April 2005 through February 2008 revealed 22 patients with CVTR. Hyper coagulable work-up and neuroimaging were performed. Sixteen patients were female (72.7%), and the median age was 35 years. Clinical presentations included: headache (77.3%), seizures (54.5%), focal neurological signs (54.5%), and decreased level of consciousness (50%). Over two-thirds (n=11; 69%) of female patients had a history of oral contraceptive use, which was the most common risk factor. Protein S deficiency (n=3), anti phospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n=1), rhinocerebral mucormycosis (n=1), leukemia (n=1), non-Hodgkin's lymphoma (n=1), sepsis (n=1), and unknown (n=6) were causes. Affected areas included superior sagittal (n=13), transverse (n=16), sigmoid (n=14), straight (n=6), and cavernous sinus (n=1); internal cerebral vein (n=2); vein of Galen (n=3); cortical veins (n=10); and internal jugular vein (n=12). Two patients had quadriparesis, and 2 patients died. The remainder (n=18, 81.8%) improved. Bilateral hemorrhagic presentation or venous infarction, deep venous system thrombosis, and underlying malignancy had less favorable results. Presentations in our series were similar to those in other reports, although altered consciousness and seizures were more common. Cortical vein involvement was also higher than commonly reported. Oral contraceptive use was a primary risk factor in female patients. Outcomes were favorable in 81.8% of patients. (author)

  12. Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

    Science.gov (United States)

    Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

    2011-06-01

    Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome

    DEFF Research Database (Denmark)

    Benfield, Thomas; Jensen, J S; Nordestgaard, B G

    2007-01-01

    AIMS/HYPOTHESIS: Diabetes mellitus is believed to increase susceptibility to infectious diseases. The effects of hyperglycaemia per se on infectious disease risk are unknown and the influence of diabetes on infectious disease outcome is controversial. MATERIALS AND METHODS: We studied 10......,063 individuals from the Danish general population, who were participants in The Copenhagen City Heart Study, over a follow-up period of 7 years. Risk of hospitalisation caused by any infectious disease, and subsequent risk of disease progression to death were estimated by Cox proportional hazards regression...

  14. Comorbid Diagnosis of Psychotic Disorders in Borderline Personality Disorder: Prevalence and Influence on Outcome

    Directory of Open Access Journals (Sweden)

    C. W. Slotema

    2018-03-01

    Full Text Available BackgroundA diagnosis of psychotic disorder is traditionally considered incompatible with borderline personality disorder (BPD, even though patients sometimes fulfill the diagnostic criteria for both disorders. How often this happens is barely known, as is the influence of comorbid psychotic disorders on the outcome of BPD. Since studies on isolated auditory verbal hallucinations in patients with BPD indicate that these perceptual symptoms have severe consequences and are associated with suicidal behavior and hospitalization, patients with comorbid psychotic disorders are unlikely to fare better.ObjectiveTo examine the point prevalence of psychotic disorders in patients with BPD, their association with the outcome of BPD, and their predictive value for outcome.MethodsIn a cross-sectional design, 84 female outpatients diagnosed with BPD were interviewed with the aid of the MINI-International Neuropsychiatric Interview to establish the point prevalence of comorbid psychotic and other comorbid disorders. After termination of their treatment at a specialized outpatient clinic, the type of referral was considered to be a “good” outcome when they were referred to their general practitioner or to basic psychiatric care for noncomplex patients, and a “poor” outcome when referred to a specialized psychiatric department or to a psychiatric district team for patients with severe psychiatric disorders.ResultsPsychotic disorders were present in 38% of the patients with BPD. With a prevalence of 20%, psychotic disorder not otherwise specified (NOS was the most common subtype; the least common types were schizophrenia (2%, substance-induced psychotic disorder (2%, and brief psychotic disorder (1%. Among six types of comorbid disorders, only psychotic disorders were associated with a poor outcome; they were also predictors for a poor outcome, along with comorbid mood disorders, eating disorders, and somatoform disorders, as well as the severity of BPD

  15. Spike Pattern Structure Influences Synaptic Efficacy Variability Under STDP and Synaptic Homeostasis. I: Spike Generating Models on Converging Motifs

    Directory of Open Access Journals (Sweden)

    Zedong eBi

    2016-02-01

    Full Text Available In neural systems, synaptic plasticity is usually driven by spike trains. Due to the inherent noises of neurons and synapses as well as the randomness of connection details, spike trains typically exhibit variability such as spatial randomness and temporal stochasticity, resulting in variability of synaptic changes under plasticity, which we call efficacy variability. How the variability of spike trains influences the efficacy variability of synapses remains unclear. In this paper, we try to understand this influence under pair-wise additive spike-timing dependent plasticity (STDP when the mean strength of plastic synapses into a neuron is bounded (synaptic homeostasis. Specifically, we systematically study, analytically and numerically, how four aspects of statistical features, i.e. synchronous firing, burstiness/regularity, heterogeneity of rates and heterogeneity of cross-correlations, as well as their interactions influence the efficacy variability in converging motifs (simple networks in which one neuron receives from many other neurons. Neurons (including the post-synaptic neuron in a converging motif generate spikes according to statistical models with tunable parameters. In this way, we can explicitly control the statistics of the spike patterns, and investigate their influence onto the efficacy variability, without worrying about the feedback from synaptic changes onto the dynamics of the post-synaptic neuron. We separate efficacy variability into two parts: the drift part (DriftV induced by the heterogeneity of change rates of different synapses, and the diffusion part (DiffV induced by weight diffusion caused by stochasticity of spike trains. Our main findings are: (1 synchronous firing and burstiness tend to increase DiffV, (2 heterogeneity of rates induces DriftV when potentiation and depression in STDP are not balanced, and (3 heterogeneity of cross-correlations induces DriftV together with heterogeneity of rates. We anticipate our

  16. Variability and condition of common minnow (Phoxinus phoxinus, Cyprinidae, Cypriniformes) on the Semipalatinsk range and out of its influence

    International Nuclear Information System (INIS)

    Mitrofanov, I.V.; Matmuratov, S.A.

    2003-01-01

    Populations of common minnow (Phoxinus phoxinus) from five rivers of Irtysh and Balkhash basins were investigated. Population from the Shagan river situated inside area of Semipalatinsk Range influence. This population has normal sexual structure and high growth rate. Condition factor of all fishes is high. Population from Semipalatinsk Range has increased variability of characteristics due to increasing of stochastic part of general variability. Abnormalities of external fish morphology are not observed in this area. Asymmetry of bilateral characteristics is low. (author)

  17. Participatory ergonomics simulation of hospital work systems: The influence of simulation media on simulation outcome

    DEFF Research Database (Denmark)

    Andersen, Simone Nyholm; Broberg, Ole

    2015-01-01

    of tool operation support ergonomics identification and evaluation related to the work system entities space and technologies & tools. The table-top models’ high fidelity of function relations and affordance of a helicopter view support ergonomics identification and evaluation related to the entity......Current application of work system simulation in participatory ergonomics (PE) design includes a variety of different simulation media. However, the actual influence of the media attributes on the simulation outcome has received less attention. This study investigates two simulation media: full......-scale mock-ups and table-top models. The aim is to compare, how the media attributes of fidelity and affordance influence the ergonomics identification and evaluation in PE design of hospital work systems. The results illustrate, how the full-scale mock-ups’ high fidelity of room layout and affordance...

  18. Simplex optimization of the variables influencing the determination of pefloxacin by time-resolved chemiluminescence

    Science.gov (United States)

    Murillo Pulgarín, José A.; Alañón Molina, Aurelia; Jiménez García, Elisa

    2018-03-01

    A new chemiluminescence (CL) detection system combined with flow injection analysis (FIA) for the determination of Pefloxacin is proposed. The determination is based on an energy transfer from Pefloxacin to terbium (III). The metal ion enhances the weak CL signal produced by the KMnO4/H2SO3/Pefloxacin system. A modified simplex method was used to optimize chemical and instrumental variables. The influence of the interaction of the permanganate, Tb (III), sodium sulphite and sulphuric acid concentrations, flow rate and injected sample volume was thoroughly investigated by using a modified simplex optimization procedure. The results revealed a strong direct relationship between flow rate and CL intensity throughout the studied range that was confirmed by a gamma test. The response factor for the CL emission intensity was used to assess performance in order to identify the optimum conditions for maximization of the response. Under such conditions, the CL response was proportional to the Pefloxacin concentration over a wide range. The detection limit as calculated according to Clayton's criterion 13.7 μg L- 1. The analyte was successfully determined in milk samples with an average recovery of 100.6 ± 9.8%.

  19. Biotic and abiotic variables influencing plant litter breakdown in streams: a global study

    Science.gov (United States)

    Pearson, Richard G.; Hui, Cang; Gessner, Mark O.; Pérez, Javier; Alexandrou, Markos A.; Graça, Manuel A. S.; Cardinale, Bradley J.; Albariño, Ricardo J.; Arunachalam, Muthukumarasamy; Barmuta, Leon A.; Boulton, Andrew J.; Bruder, Andreas; Callisto, Marcos; Chauvet, Eric; Death, Russell G.; Dudgeon, David; Encalada, Andrea C.; Ferreira, Verónica; Figueroa, Ricardo; Flecker, Alexander S.; Gonçalves, José F.; Helson, Julie; Iwata, Tomoya; Jinggut, Tajang; Mathooko, Jude; Mathuriau, Catherine; M'Erimba, Charles; Moretti, Marcelo S.; Pringle, Catherine M.; Ramírez, Alonso; Ratnarajah, Lavenia; Rincon, José; Yule, Catherine M.

    2016-01-01

    Plant litter breakdown is a key ecological process in terrestrial and freshwater ecosystems. Streams and rivers, in particular, contribute substantially to global carbon fluxes. However, there is little information available on the relative roles of different drivers of plant litter breakdown in fresh waters, particularly at large scales. We present a global-scale study of litter breakdown in streams to compare the roles of biotic, climatic and other environmental factors on breakdown rates. We conducted an experiment in 24 streams encompassing latitudes from 47.8° N to 42.8° S, using litter mixtures of local species differing in quality and phylogenetic diversity (PD), and alder (Alnus glutinosa) to control for variation in litter traits. Our models revealed that breakdown of alder was driven by climate, with some influence of pH, whereas variation in breakdown of litter mixtures was explained mainly by litter quality and PD. Effects of litter quality and PD and stream pH were more positive at higher temperatures, indicating that different mechanisms may operate at different latitudes. These results reflect global variability caused by multiple factors, but unexplained variance points to the need for expanded global-scale comparisons. PMID:27122551

  20. Influence of age, sexual maturation, anthropometric variables and body composition on flexibility

    Directory of Open Access Journals (Sweden)

    Keila Donassolo Santos

    2010-04-01

    Full Text Available Since flexibility is an important component of health-related physical fitness at all ages, this parameter should be evaluated in chi ldren and adolescent s because the abi l ity to acquire and maintain levels of flexibility is greater in this age group. Thus, the objective of this study was to evaluate body weight, height, BMI and flexibility according to chronological age and sexual maturat ion and to determine the influence of these var iables on flexibi l ity in student s f rom publ ic and private schools. A cross-sectional descriptive and analytical study was conducted. The sample consisted of 2604 girls aged 8 to 17 years. Body weight, height, BMI, sexual maturation, and flexibility were evaluated. The data were analyzed descriptively using the following inferential tests: two-way analysis of variance (ANOVA followed by the Tukey post-hoc test, Pearson’s and Spearman’s simple correlation coefficients, and stepwise multiple regression analysis. The SPSS® 13.0 program was used for all statistical analyses, with a level of significance of p<0.05. Significant differences with increasing age and maturation stage were observed for the variables body weight, height and BMI when compared to the subsequent year. In conclusion, body wei-ght and height increased with increasing age, especially between 8 and 13 years, and flexibility remained stable throughout childhood and adolescence.

  1. The Influence of Trainee Gaming Experience and Computer Self-Efficacy on Learner Outcomes of Videogame-Based Learning Environments

    National Research Council Canada - National Science Library

    Orvis, Karin A; Orvis, Kara L; Belanich, James; Mullin, Laura N

    2005-01-01

    .... The purpose of the current research was to investigate the influence of two trainee characteristics, prior videogame experience and computer self-efficacy, on learner outcomes of a videogame-based training environment...

  2. Influence of CHDs on psycho-social and neurodevelopmental outcomes in children with Down syndrome.

    Science.gov (United States)

    Visootsak, Jeannie; Huddleston, Lillie; Buterbaugh, Allison; Perkins, Adrienne; Sherman, Stephanie; Hunter, Jessica

    2016-02-01

    To evaluate the family psycho-social outcomes of children with Down syndrome and atrioventricular septal defect, and examine the impact of these variables on the child's neurodevelopmental outcome. This was a cross-sectional study that consisted of 57 children with Down syndrome - 20 cases and 37 controls - of ~12-14 months of age. In both groups, we assessed the development of the child, the quality of the child's home environment, and parenting stress. Compared with the Down syndrome without CHD group, the atrioventricular septal defect group revealed lower scores in all developmental domains, less optimal home environments, and higher parental stress. Significant differences in development were seen in the areas of cognition (p=0.04), expressive language (p=0.05), and gross motor (pneurodevelopmental deficits. Finding that parental stress and home environment may play a role in the neurodevelopmental outcomes may prompt new family-directed interventions and anticipatory guidance for the families of children with Down syndrome who have a CHD.

  3. Differential Influence of Distinct Components of Increased Blood Pressure on Cardiovascular OutcomesR3

    Science.gov (United States)

    Cheng, Susan; Gupta, Deepak K.; Claggett, Brian; Sharrett, A. Richey; Shah, Amil M.; Skali, Hicham; Takeuchi, Madoka; Ni, Hanyu; Solomon, Scott D.

    2013-01-01

    Elevation in blood pressure (BP) increases risk for all cardiovascular events. Nevertheless, the extent to which different indices of BP elevation may be associated to varying degrees with different cardiovascular outcomes remains unclear. We studied 13,340 participants (aged 54±6 years, 56% women, 27% black) of the Atherosclerosis Risk in Communities Study who were free of baseline cardiovascular disease. We used Cox proportional hazards models to compare the relative contributions of systolic (SBP), diastolic (DBP), pulse pressure (PP), and mean arterial pressure (MAP) to risk for coronary heart disease (CHD), heart failure (HF), stroke, and all-cause mortality. For each multivariable-adjusted model, the largest area under the receiver-operating curve (AUC) and smallest -2 log likelihood values were used to identify BP measures with the greatest contribution to risk prediction for each outcome. A total of 2095 CHD events, 1669 HF events, 771 stroke events, and 3016 deaths occurred during up to 18±5 years of follow up. In multivariable analyses adjusting for traditional cardiovascular risk factors, the BP measures with the greatest risk contributions were: SBP for CHD (AUC=0.74); PP for HF (AUC=0.79), SBP for stroke (AUC=0.74), and PP for all-cause mortality (AUC=0.74). With few exceptions, results were similar in analyses stratified by age, sex, and race. Our data indicate that distinct BP components contribute variably to risk for different cardiovascular outcomes. PMID:23876475

  4. Influence of perfusion and ventilation scans on therapeutic decision making and outcome in cases of possible embolism

    International Nuclear Information System (INIS)

    Mercandetti, A.J.; Kipper, M.S.; Moser, K.M.

    1985-01-01

    The authors examined the influence of perfusion (Q) and ventilation (V) scans on therapeutic decision making and outcome among 229 patients referred for lung scans because embolism was suggested and found that specific V/Q scan patterns strongly influenced postscan decisions regarding initiation, maintenance or cessation of heparin therapy. These therapeutic decisions bore a relationship to outcome (recurrences and death) and disclosed decision-making deficits that need remedy by future investigational and educational efforts. 25 references, 5 tables

  5. Factors that influence outcomes in cochlear implantation in adults, based on patient related characteristics - a retrospective study

    NARCIS (Netherlands)

    Kraaijenga, Véronique J C; Smit, Adriana L; Stegeman, Inge; Smilde, Jeanet J M; van Zanten, G A; Grolman, Wilko

    2016-01-01

    OBJECTIVE: Outcomes in speech perception following cochlear implantation in adults vary widely. Many studies have been carried out to identify and quantify factors that influence outcomes. This paper adds a new dimension to pre-existing literature. DESIGN: Single center retrospective cohort study.

  6. The influence of interleukin-7 receptor α-chain haplotypes on outcome after allogeneic hematopoietic cell transplantation

    DEFF Research Database (Denmark)

    Broux, B; Shamim, Z; Wang, T

    2014-01-01

    We investigated the influence of IL-7 receptor α-chain (IL-7Rα) gene haplotypes in donors on the outcome of haematopoietic cell transplantation (HCT). Unlike the association between single donor SNPs and HCT outcome found previously, only trends towards association were found here, due to 'diluti...

  7. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: There are many indications for hepatic retransplantation. AIM: To identify factors influencing retransplantation needs and outcomes. PATIENTS AND METHODS: Retransplantation records from January 1993 to March 2005 were analysed. Patient and disease characteristics and survival outcomes for retransplantation were compared between various groups. RESULTS: Totally, 286 primary and 42 hepatic retransplantations were performed. Retransplantation indications included primary sclerosing cholangitis (PSC), primary biliary cirrhosis, chronic hepatitis C (HCV), chronic active hepatitis (CAH), and alcohol-related disease. Mean follow-up post-retransplantation was 31 +\\/- 9 months. Actuarial patient survival at 3 months, 1 year, 3 years, 5 years, and at the end of study was 71.4, 69, 59.5, 54.7, and 50%, respectively. Early and late retransplantation had 1-year survival of 73 and 68.5%, respectively. Retransplantation need was significantly higher for PSC, HCV, and CAH. CONCLUSIONS: Hepatic retransplantation remains a successful salvage option for transplant complications; however, its need is significantly influenced by the primary liver disease.

  8. Results after laparoscopic partial splenectomy for children with hereditary spherocytosis: Are outcomes influenced by genetic mutation?

    Science.gov (United States)

    Pugi, Jakob; Carcao, Manuel; Drury, Luke J; Langer, Jacob C

    2018-05-01

    Laparoscopic partial splenectomy (LPS) theoretically maintains long-term splenic immune function for children with hereditary spherocytosis (HS). Our goal was to review our results after LPS and to determine if specific genetic mutations influence outcome. All children with HS undergoing LPS between 2005 and 2016 were reviewed. Thirty-one children underwent LPS (16 male) at a median age of 9 (range 2-18) years. All experienced an increase in hemoglobin and decrease in reticulocyte count early after LPS and at last follow-up. Twenty-two were sent for genetic analysis. Mutations in α-spectrin, β-spectrin, and Ankyrin were identified in 6, 5, and 11 patients, respectively. Gene mutation was not correlated with complications, perioperative transfusion, length of hospital stay, or median hemoglobin, platelet, or reticulocyte counts. Three children required completion splenectomy at 10.9, 6.9, and 3.2years post-LPS, each with a different gene mutation. LPS is effective in reversing anemia and reducing reticulocytosis. So far less than 10% have required completion splenectomy, and those children did benefit from delaying the risks of asplenia. In this preliminary analysis, genetic mutation did not influence outcome after LPS. A larger multicenter study is necessary to further investigate potential correlations with specific genetic mutations. Prognosis Study. IV. Copyright © 2018. Published by Elsevier Inc.

  9. e-Learning in Advanced Life Support-What factors influence assessment outcome?

    Science.gov (United States)

    Thorne, C J; Lockey, A S; Kimani, P K; Bullock, I; Hampshire, S; Begum-Ali, S; Perkins, G D

    2017-05-01

    To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Variability in foF2 at an equatorial station and the influence of magnetic activity

    International Nuclear Information System (INIS)

    Adeniyi, J.O.; Radicella, S.M.

    2003-01-01

    Variability in foF2 is investigated for an equatorial station in the African region. Variability during the day time at high solar activity varies between 10 and 30 percent. It varies between 10 and 20 percent at high solar activity. Magnetic storms increase the variability at both solar activity periods. (author)

  11. The influence of tracheostomy timing on outcomes in trauma patients: A meta-analysis.

    Science.gov (United States)

    Cai, Shi-Qi; Hu, Jun-Wu; Liu, Dong; Bai, Xiang-Jun; Xie, Jie; Chen, Jia-Jun; Yang, Fan; Liu, Tao

    2017-04-01

    This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia. A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI). 20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group. Pooled data revealed that mortality was not lower in trauma patients with ET compared to those with LT/IP. However, ET was found to be associated with a significantly reduced length of ICU and hospital stay, shorter MV duration and lower risk of pneumonia. Evidence of this meta-analysis supports the dimorphism in some clinical outcomes of trauma patients with different tracheostomy timing. Additional well-designed randomized controlled trials (RCTs) are needed to confirm it in future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Nutrition and Helicobacter pylori: Host Diet and Nutritional Immunity Influence Bacterial Virulence and Disease Outcome

    Directory of Open Access Journals (Sweden)

    Kathryn P. Haley

    2016-01-01

    Full Text Available Helicobacter pylori colonizes the stomachs of greater than 50% of the world’s human population making it arguably one of the most successful bacterial pathogens. Chronic H. pylori colonization results in gastritis in nearly all patients; however in a subset of people, persistent infection with H. pylori is associated with an increased risk for more severe disease outcomes including B-cell lymphoma of mucosal-associated lymphoid tissue (MALT lymphoma and invasive adenocarcinoma. Research aimed at elucidating determinants that mediate disease progression has revealed genetic differences in both humans and H. pylori which increase the risk for developing gastric cancer. Furthermore, host diet and nutrition status have been shown to influence H. pylori-associated disease outcomes. In this review we will discuss how H. pylori is able to create a replicative niche within the hostile host environment by subverting and modifying the host-generated immune response as well as successfully competing for limited nutrients such as transition metals by deploying an arsenal of metal acquisition proteins and virulence factors. Lastly, we will discuss how micronutrient availability or alterations in the gastric microbiome may exacerbate negative disease outcomes associated with H. pylori colonization.

  13. Influence of Lumbar Lordosis on the Outcome of Decompression Surgery for Lumbar Canal Stenosis.

    Science.gov (United States)

    Chang, Han Soo

    2018-01-01

    Although sagittal spinal balance plays an important role in spinal deformity surgery, its role in decompression surgery for lumbar canal stenosis is not well understood. To investigate the hypothesis that sagittal spinal balance also plays a role in decompression surgery for lumbar canal stenosis, a prospective cohort study analyzing the correlation between preoperative lumbar lordosis and outcome was performed. A cohort of 85 consecutive patients who underwent decompression for lumbar canal stenosis during the period 2007-2011 was analyzed. Standing lumbar x-rays and 36-item short form health survey questionnaires were obtained before and up to 2 years after surgery. Correlations between lumbar lordosis and 2 parameters of the 36-item short form health survey (average physical score and bodily pain score) were statistically analyzed using linear mixed effects models. There was a significant correlation between preoperative lumbar lordosis and the 2 outcome parameters at postoperative, 6-month, 1-year, and 2-year time points. A 10° increase of lumbar lordosis was associated with a 5-point improvement in average physical scores. This correlation was not present in preoperative scores. This study showed that preoperative lumbar lordosis significantly influences the outcome of decompression surgery on lumbar canal stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The Influence of Hearing Aid Use on Outcomes of Children With Mild Hearing Loss.

    Science.gov (United States)

    Walker, Elizabeth A; Holte, Lenore; McCreery, Ryan W; Spratford, Meredith; Page, Thomas; Moeller, Mary Pat

    2015-10-01

    This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Five- or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a speech perception in noise task. Regression models were used to investigate the influence of cumulative auditory experience (audibility, early intervention, HA use) on outcomes. Full-time HA users demonstrated significantly higher scores on vocabulary and grammar measures compared with nonusers. There were no significant differences between the 3 groups on articulation or speech perception measures. After controlling for the variance in age at confirmation of HL, level of audibility, and enrollment in early intervention, only amount of daily HA use was a significant predictor of grammar and vocabulary. The current results provide evidence that children's language development benefits from consistent HA use. Nonusers are at risk in areas such as vocabulary and grammar compared with other children with mild HL who wear HAs regularly. Service providers should work collaboratively to encourage consistent HA use.

  15. The Influence of Cardiac Risk Factor Burden on Cardiac Stress Test Outcomes.

    Science.gov (United States)

    Schrock, Jon W; Li, Morgan; Orazulike, Chidubem; Emerman, Charles L

    2011-06-01

    Chest pain is the most common admission diagnosis for observation unit patients. These patients often undergo cardiac stress testing to further risk stratify for coronary artery disease (CAD). The decision of whom to stress is currently based on clinical judgment. We sought to determine the influence of cardiac risk factor burden on cardiac stress test outcome for patients tested from an observation unit, inpatient or outpatient setting. We performed a retrospective observational cohort study for all patients undergoing stress testing in our institution from June 2006 through July 2007. Cardiac risk factors were collected at the time of stress testing. Risk factors were evaluated in a summative fashion using multivariate regression adjusting for age and known coronary artery disease. The model was tested for goodness of fit and collinearity and the c statistic was calculated using the receiver operating curve. A total of 4026 subjects were included for analysis of which 22% had known CAD. The rates of positive outcome were 89 (12.0%), 95 (12.6%), and 343 (16.9%) for the OU, outpatients, and hospitalized patients respectively. While the odds of a positive test outcome increased for additional cardiac risk factors, ROC curve analysis indicates that simply adding the number of risk factors does not add significant diagnostic value. Hospitalized patients were more likely to have a positive stress test, OR 1.41 (1.10 - 1.81). Our study does not support basing the decision to perform a stress test on the number of cardiac risk factors.

  16. [The influence of variable and constant magnetic fields on biota and biological activity of ordinary chernozem soils].

    Science.gov (United States)

    Denisova, T V; Kazeev, K Sh

    2007-01-01

    In model experiments on influence variable magnetic fields of industrial frequency (50 Hz) an induction of 1500 and of 6000 mkTl and the constant magnetic field an induction of 6000 mkTl and of 15000 mkTl during 5 days of exposure on biological properties of chernozem ordinary is shown, that the soil microflora is more sensitive to magnetic fields, than enzymes activity. Bacteria are more sensitive, than microscopic mushrooms. Dehydrogenase it is steady against influence of all variants. Constant magnetic field by the induction of 15000 mkTl rendered practically identical authentic overwhelming influence on catalase and saccharase activity - on 51 and 47% accordingly.

  17. Malnutrition is prevalent in patients with cardiorenal syndrome and negatively influences clinical outcome.

    Science.gov (United States)

    Gigante, A; Rosato, E; Barbano, B; Di Mario, F; Di Lazzaro-Giraldi, G; Gasperini, M L; Pofi, R; Laviano, A

    2018-01-01

    Cardiorenal syndrome (CRS) describes the concurrent failure of cardiac and renal function, each influencing the other. Malnutrition and cachexia frequently develop in patients with heart failure or kidney failure. However, no information is currently available on the prevalence of malnutrition in CRS patients. We studied CRS patients admitted to an internal medicine ward during a 5-month period and evaluated their clinical characteristics and nutritional status. Malnutrition risk was assessed by using the validated screening tool NRS-2002 whilst body composition was assessed by bioimpedance analysis and muscle function was measured by handgrip (HG) strength. Cardiac mass was also recorded. Length of stay, hospital readmission and 6-month mortality were registered. During the study period, 22 CRS patients were studied. Twenty patients were diagnosed with either CRS type 1 or CRS type 5. In CRS patients, fat-free mass showed a trend toward representing a protective factor for 6-month mortality (OR=0.904; p=0.06). Also, fat-free mass correlated with HG strength and cardiac ejection fraction. Malnutrition risk was diagnosed in 45% of the patients, whereas 8 patients met the definition of cachexia. Even without statistical significance, CRS patients with malnutrition had lower BMI (Body Mass Index) (p=0.038) and fat-free mass (p= n.s.). However, CRS malnutrition was associated to higher 6-month mortality (p= 0.05), and appears to negatively influence the outcome in CRS (OR= 9; p= 0.06). Our results show that malnutrition is prevalent in CRS patients and influences the clinical outcome. The assessment of nutritional status, and particularly body composition, should be implemented in daily practice of patients with CRS.

  18. Influence of political opposition and compromise on conservation outcomes in the Tongass National Forest, Alaska.

    Science.gov (United States)

    Beier, Colin M

    2008-12-01

    To understand how a highly contentious policy process influenced a major conservation effort, I examined the origins, compromises, and outcomes of the Alaska National Interest Lands Conservation Act of 1980 (ANILCA) for the Tongass National Forest. Tongass wilderness designation was among the most controversial issues in the ANILCA debate, and it faced strong opposition from influential lawmakers, land managers, and Alaska residents. To investigate the influence of this opposition on Tongass conservation outcomes, I conducted a gap analysis of Tongass reserves and a policy analysis of the ANILCA debate and traced the influence of specific interests through the amendments, negotiations, and resulting compromises needed to enact ANILCA. Overall, I found that Tongass reserves comprise a broadly representative cross-section of ecosystems and species habitats in southeastern Alaska. Redrawn reserve boundaries, industry subsidies, and special access regulations reflected compromises to minimize the impact of wilderness conservation on mining, timber, and local stakeholder interests, respectively. Fragmentation of the Admiralty Island National Monument-the most ecologically valuable and politically controversial reserve-resulted from compromises with Alaskan Native (indigenous peoples of Alaska) corporations and timber interests. Despite language to accommodate "reasonable access" to wilderness reserves, ongoing access limitations highlight the concerns of Alaska residents that opposed ANILCA several decades ago. More broadly, the Tongass case suggests that early and ambitious conservation action may offset strong political opposition; compromises needed to establish key reserves often exacerbate development impacts in unprotected areas; and efforts to minimize social conflicts are needed to safeguard the long-term viability of conservation measures.

  19. Measuring the Impact of Gastrointestinal Variables on the Systemic Outcome of Two Suspensions of Posaconazole by a PBPK Model.

    Science.gov (United States)

    Hens, Bart; Talattof, Arjang; Paixão, Paulo; Bermejo, Marival; Tsume, Yasuhiro; Löbenberg, Raimar; Amidon, Gordon L

    2018-03-29

    For the last two decades, the application of physiologically based pharmacokinetic (PBPK) models has grown exponentially in the field of oral absorption and in a regulatory context. Although these models are widely used, their predictive power should be validated and optimized in order to rely on these models and to know exactly what is going on "under the hood". In this study, an automated sensitivity analysis (ASA) was performed for 11 gastrointestinal (GI) variables that are integrated into the PBPK software program Simcyp®. The model of interest was a previously validated workspace that was able to predict the intraluminal and systemic behavior of two different suspensions of posaconazole in the Simcyp® Simulator. The sensitivity of the following GI parameters was evaluated in this model: gastric and duodenal pH, gastric and duodenal bicarbonate concentrations (reflecting buffer capacity), duodenal bile salts concentration, gastric emptying, the interdigestive migrating motor complex (IMMC), small intestinal transit time (SITT), gastric and jejunal volumes, and permeability. The most sensitive parameters were gastric/duodenal pH and gastric emptying, for both suspensions. The outcome of the sensitivity analyses highlights the important GI variables that must be integrated into an in vivo predictive dissolution test to help and create a rational and scientific framework/design for product development of novel and generic drug products.

  20. The influence of climatic variability on local population dynamics of Cercidium microphyllum (foothill paloverde)

    Science.gov (United States)

    Bowers, Janice E.; Turner, R.M.

    2002-01-01

    This study investigated correlations among climatic variability, population age structure, and seedling survival of a dominant Sonoran Desert tree, Cercidium microphyllum (foothill paloverde), at Tucson, Arizona, USA. A major goal was to determine whether wet years promote seedling establishment and thereby determine population structure. Plant age was estimated from basal circumference for a sample of 980 living and dead trees in twelve 0.5-ha plots. Ages ranged from 1 to 181 years. Age frequency distribution showed that the population is in decline. Most (51.2%) of the 814 living trees were 40-80 years old; only 6.5% were younger than 20 years. The average age of the 166 dead trees was 78 years. Fifty-nine percent of dead trees were aged 60-100 years. Survival of newly emerged seedlings was monitored for 7 years in a 557-m2 permanent plot. Mean survival in the 1st year of life was 1.7%. Only 2 of 1,008 seedlings lived longer than 1 year. Length of survival was not correlated with rainfall. Residual regeneration, an index of the difference between predicted and observed cohort size, showed that regeneration was high during the first half of the twentieth century and poor after the mid-1950s. Trends in regeneration did not reflect interannual variation in seasonal temperature or rain before 1950, that is, in the years before urban warming. Taken together, the seedling study and the regeneration analysis suggest that local population dynamics reflect biotic factors to such an extent that population age structure might not always be a reliable clue to past climatic influences.

  1. Influence of processing variables on the mechanical behavior of HDPE/clay nanocomposites

    Directory of Open Access Journals (Sweden)

    Renata Barbosa

    2012-06-01

    Full Text Available Nanocomposites were processed using the technique of melt intercalation, starting from a concentrated polar compatibilizer/organoclay (PE-g-MA/organoclay prepared in an internal mixer. The concentrate was incorporated into the matrix of HDPE by two methods: I counter-rotating twin-screw extruder and II co-rotating twin-screw extruder, using two screw profiles (ROS and 2KB90. After extrusion, the specimens of the extruded composites were injection molded. The X-ray diffraction (XRD technique was used to analyze the degree of expansion of the prepared clays. To analyze the degree of exfoliation of obtained nanocomposites, XRD and TEM (transmission electron microscopy were used. The influence of processing variables on mechanical properties was studied through the behavior of the modulus and tensile strength of nanocomposite systems. By XRD and TEM, it was seen that the clay was well dispersed in the matrix and the presence of intercalated and partially exfoliated hybrid structure for nanocomposites was observed when the systems were prepared in counter-rotating twin-screw extruder. A similar behavior was observed in the use of screws (2KB90 or ROS of the nanocomposites, with a reduction in modulus and tensile strength. Although the mixing process by extruding be the most common industrial practice, and also it is the preferred strategy for the preparation of polymer nanocomposites, much of the literature was directed to the study of chemical modification of clay, type and level of compatibilizer, in order to maximize the compatibility between clay and the polymeric matrix. On the other hand, studies about the role of the processing and configurations of screws are relatively scarce. The main motivation of this work was to expand and to contribute to spread a better understanding of the effects of processing to obtain polymer nanocomposites.

  2. On the functional form of particle number size distributions: influence of particle source and meteorological variables

    Science.gov (United States)

    Cugerone, Katia; De Michele, Carlo; Ghezzi, Antonio; Gianelle, Vorne; Gilardoni, Stefania

    2018-04-01

    Particle number size distributions (PNSDs) have been collected periodically in the urban area of Milan, Italy, during 2011 and 2012 in winter and summer months. Moreover, comparable PNSD measurements were carried out in the rural mountain site of Oga-San Colombano (2250 m a.s.l.), Italy, during February 2005 and August 2011. The aerosol data have been measured through the use of optical particle counters in the size range 0.3-25 µm, with a time resolution of 1 min. The comparison of the PNSDs collected in the two sites has been done in terms of total number concentration, showing higher numbers in Milan (often exceeding 103 cm-3 in winter season) compared to Oga-San Colombano (not greater than 2×102 cm-3), as expected. The skewness-kurtosis plane has been used in order to provide a synoptic view, and select the best distribution family describing the empirical PNSD pattern. The four-parameter Johnson system-bounded distribution (called Johnson SB or JSB) has been tested for this aim, due to its great flexibility and ability to assume different shapes. The PNSD pattern has been found to be generally invariant under site and season changes. Nevertheless, several PNSDs belonging to the Milan winter season (generally more than 30 %) clearly deviate from the standard empirical pattern. The seasonal increase in the concentration of primary aerosols due to combustion processes in winter and the influence of weather variables throughout the year, such as precipitation and wind speed, could be considered plausible explanations of PNSD dynamics.

  3. ENSO influence on the interannual variability of the Red Sea convergence zone and associated rainfall

    KAUST Repository

    Dasari, Hari Prasad

    2017-07-18

    The Red Sea convergence zone (RSCZ) is formed by opposite surface winds blowing from northwest to southeast directions at around 18°-19°N between October and January. A reverse-oriented, low-level monsoon trough at 850hPa, known as the Red Sea trough (RST), transfers moisture from the southern Red Sea to RSCZ. The positions of the RSCZ and RST and the intensity of the RST have been identified as important factors in modulating weather and climatic conditions across the Middle East. Here, we investigate the influence of the El Niño southern oscillation (ENSO) on the interannual variability of RSCZ, RST, and regional rainfall during winter months. Our results indicate that El Niño (warm ENSO phase) favours a shift of the RSCZ to the north and a strengthening of the RST in the same direction. Conversely, during November and December of La Niña periods (cold ENSO phase), the RSCZ shift to the south and the RST strengthens in the same direction. During El Niño periods, southeasterly wind speeds increase (20-30%) over the southern Red Sea and northwesterly wind speeds decrease (10-15%) over the northern Red Sea. Noticeable increases in the number of rainy days and the intensity of rain events are observed during El Niño phases. These increases are associated with colder than normal air intrusion at lower levels from the north combined with warm air intrusion from the south over the RSCZ. Our analysis suggests that during El Niño winters, warmer sea surface temperatures and higher convective instability over the Red Sea favour local storms conditions and increase rainfall over the Red Sea and adjoining regions.

  4. Does Set for Variability Mediate the Influence of Vocabulary Knowledge on the Development of Word Recognition Skills?

    Science.gov (United States)

    Tunmer, William E.; Chapman, James W.

    2012-01-01

    This study investigated the hypothesis that vocabulary influences word recognition skills indirectly through "set for variability", the ability to determine the correct pronunciation of approximations to spoken English words. One hundred forty children participating in a 3-year longitudinal study were administered reading and…

  5. Regional and hemispheric influences on temporal variability in baseline carbon monoxide and ozone over the Northeast US

    Science.gov (United States)

    Interannual variability in baseline carbon monoxide (CO) and ozone (O3), defined as mixing ratios under minimal influence of recent and local emissions, was studied for seven rural sites in the Northeast US over 2001–2010. Annual baseline CO exhibited statistically signific...

  6. Influence from genetic variability on opioid use for cancer pain: a European genetic association study of 2294 cancer pain patients

    DEFF Research Database (Denmark)

    Klepstad, P; Fladvad, T; Skorpen, F

    2011-01-01

    variability with opioid doses in a large population using a confirmatory validation population was warranted. We recruited 2294 adult European patients using a World Health Organization (WHO) step III opioid and analyzed single nucleotide polymorphisms (SNPs) in genes with a putative influence on opioid...

  7. Influence of variable heat transfer coefficient of fireworks and crackers on thermal explosion critical ambient temperature and time to ignition

    Directory of Open Access Journals (Sweden)

    Guo Zerong

    2016-01-01

    Full Text Available To study the effect of variable heat transfer coefficient of fireworks and crackers on thermal explosion critical ambient temperature and time to ignition, considering the heat transfer coefficient as the power function of temperature, mathematical thermal explosion steady state and unsteady-state model of finite cylindrical fireworks and crackers with complex shell structures are established based on two-dimensional steady state thermal explosion theory. The influence of variable heat transfer coefficient on thermal explosion critical ambient temperature and time to ignition are analyzed. When heat transfer coefficient is changing with temperature and in the condition of natural convection heat transfer, critical ambient temperature lessen, thermal explosion time to ignition shorten. If ambient temperature is close to critical ambient temperature, the influence of variable heat transfer coefficient on time to ignition become large. For firework with inner barrel in example analysis, the critical ambient temperature of propellant is 463.88 K and the time to ignition is 4054.9s at 466 K, 0.26 K and 450.8s less than without considering the change of heat transfer coefficient respectively. The calculation results show that the influence of variable heat transfer coefficient on thermal explosion time to ignition is greater in this example. Therefore, the effect of variable heat transfer coefficient should be considered into thermal safety evaluation of fireworks to reduce potential safety hazard.

  8. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease.

    Science.gov (United States)

    van Hagen, Iris M; Baart, Sara; Fong Soe Khioe, Rebekah; Sliwa-Hahnle, Karen; Taha, Nasser; Lelonek, Malgorzata; Tavazzi, Luigi; Maggioni, Aldo Pietro; Johnson, Mark R; Maniadakis, Nikolaos; Fordham, Richard; Hall, Roger; Roos-Hesselink, Jolien W

    2018-05-01

    Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease. The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country). A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate. While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  9. Social Support Influences on Substance Abuse Outcomes among Sober Living House Residents with Low and Moderate Psychiatric Severity

    Science.gov (United States)

    Polcin, Douglas L.; Korcha, Rachael

    2017-01-01

    Social support and psychiatric severity are known to influence substance abuse. However, little is known about how their influences vary under different conditions. We aimed to study how different types of social support were associated with substance abuse outcomes among persons with low and moderate psychiatric severity who entered Sober Living…

  10. Differential Responding by Rhesus Monkeys (Macaca mulatta and Humans (Homo sapiens to Variable Outcomes in the Assurance Game

    Directory of Open Access Journals (Sweden)

    Audrey E. Parrish

    2014-08-01

    Full Text Available Behavioral flexibility in how one responds to variable partner play can be examined using economic coordination games in which subjects play against a variety of partners and therefore may need to alter their behavior to produce the highest payoff. But how do we study this behavioral flexibility once players have settled on a response? Here, we investigated how responding by rhesus monkeys (Macaca mulatta and humans (Homo sapiens playing a computerized single-player version of a coordination game, the Assurance game, changed as a function of the variable responses (Stag/Hare generated by multiple simulations (SIMs. We were interested in whether individuals could track and differentially respond to changing frequencies of Stag and Hare play by the SIMs, especially with regard to the payoff dominant (Stag-Stag outcome, something that could not be done with real partners as they quickly settled on the Stag response. For both monkeys and humans, there was a linear relationship between proportion of Stag play by the subject and the likelihood of the Stag choice by the SIM such that both species increased their use of Stag as the SIM increased its use of the Stag response. However, humans more closely matched their proportion of Stag responses to that of the SIM, whereas monkeys adopted a different, but equally effective, strategy of exploiting the higher-paying Stag alternative. These results suggest that monkeys and humans demonstrate sensitivity to a dynamic game environment in which they encounter variable contingencies for the same response options, although they may employ different strategies to maximize reward.

  11. What Variables Are Associated With the Outcome of Arthroscopic Lysis and Lavage Surgery for Internal Derangement of the Temporomandibular Joint?

    Science.gov (United States)

    Haeffs, Tyler H; D'Amato, Lindsay N; Khawaja, Shehryar N; Keith, David A; Scrivani, Steven J

    2018-04-26

    Arthroscopic lysis and lavage surgery (AS) is an effective modality that can decrease pain and increase maximum interincisal opening (MIO) in patients with internal derangement (ID) of the temporomandibular joint (TMJ). However, some patients remain in pain or have limited mandibular range of motion despite AS. The purpose of this study was to determine the effectiveness, prevalence of adverse effects, and predictors of response to TMJ AS in patients with TMJ arthralgia and ID. A retrospective cohort study was conducted using data of patients who had undergone AS by a single surgeon (D.A.K.) from September 2010 to April 2015 in the Department of Oral and Maxillofacial Surgery at Massachusetts General Hospital (Boston, MA). Variables, including demographic data, medical history, and clinical presentation, were extracted and analyzed. Criteria for surgical success were defined as a postoperative MIO of at least 35 mm and a postoperative pain level no higher than 3 on an 11-point Likert-type numeric verbal pain rating scale. Appropriate descriptive and analytic statistics were computed and significance was set at a P value less than .05. Of the 247 participants, 226 (91.5%) were women. The mean age of the sample was 38 ± 15.4 years. Successful surgical outcome was achieved in 62.3% of patients. Based on logistic regression analysis, higher initial mean pain score and concurrent use of benzodiazepines were the only variables that predicted an unsuccessful surgical outcome (P < .001; P = .005). Adverse effects were reported by 13.4% of patients, the most common being postoperative increase in pain (13.4%), temporary malocclusion (1.2%), and temporary paresthesia in the preauricular region (0.4%). The results from this study indicate that in patients with ID of the TMJ unresponsive to noninvasive treatments, high initial pain scores and concurrent use of benzodiazepines are correlated with an unsuccessful outcome after AS. Copyright © 2018. Published by

  12. The concept of attributes and preventions of the variables that influence the pipeline risk in the Muhlbauer Method

    Energy Technology Data Exchange (ETDEWEB)

    Schafer, Alexandro G. [Universidade Federal do Pampa (UNIPAMPA), Bage, RS (Brazil)

    2009-07-01

    There are several methods for the risk assessment and risk management applied to pipelines, among them the Muhlbauer's Method. Muhlbauer is an internationally recognized authority on pipeline risk management. The purpose of this model is to evaluate the public exposure to the risk and identify ways for management that risk in fact. The assessment is made by the attribution of quantitative values to the several items that influences in the pipeline risk. Because the ultimate goal of the risk assessment is to provide a means of risk management, it is sometimes useful to make a distinction between two types of risk variables. The risk evaluator can categorize each index risk variable as either an attribute or a prevention. This paper approaches the subject of the definition of attributes and preventions in the Muhlbauer basic model of risk assessment and also presents a classification of the variables that influence the risk in agreement with those two categories. (author)

  13. Quality of life outcomes in women with endometriosis are highly influenced by recruitment strategies.

    Science.gov (United States)

    De Graaff, A A; Dirksen, C D; Simoens, S; De Bie, B; Hummelshoj, L; D'Hooghe, T M; Dunselman, G A J

    2015-06-01

    To what extent are outcome measures in endometriosis-related quality of life studies influenced by the setting in which patient recruitment is performed? Quality of life outcomes in women with endometriosis are highly influenced by recruitment strategies. Most studies on quality of life in women with endometriosis are conducted in tertiary care centres or patient associations. It is conceivable that the setting in which patient recruitment is performed influences the quality of life results. This has not been investigated before. Retrospective questionnaire based cohort study (part of the World Endometriosis Research Foundation (WERF) EndoCost study). The investigated women were recruited in three settings: a tertiary care centre for endometriosis (n = 135); five secondary care centres (n = 63); an endometriosis patient association (n = 291). The secondary and tertiary care population included women with a laparoscopic and/or histological diagnosis of endometriosis. The patient association population consisted of women with a self-reported diagnosis of surgically confirmed endometriosis. The populations did not differ in terms of age, co-morbidities and education level. Delay of diagnosis was the longest in the patient association (median 7 years) (tertiary care 2 years; secondary care 1.5 years) (P values were analysed as if the symptom was not present. Missing values never exceeded 10%, except for one value. Therefore, it can be expected that the effect of missing data on the outcome is negligible. Twenty-five patients belonged to more than one category. A sensitivity analysis showed that the influence of assigning patients to another category was limited. Outcomes regarding quality of life are highly influenced by recruitment strategy. None of the groups appeared to be a representative selection of the total population of women with endometriosis. An alternative strategy for creating a representative population for cost and quality of life studies is probably to

  14. Does increased salinity influence the competitive outcome of two producer species?

    Science.gov (United States)

    Venâncio, C; Anselmo, E; Soares, A; Lopes, I

    2017-02-01

    Within the context of global climate changes, it is expected that low-lying coastal freshwater ecosystems will face seawater intrusion with concomitant increase in salinity levels. Increased salinity may provoke disruption of competitive relationships among freshwater species. However, species may be capable of acclimating to salinity, which, in turn, may influence the resilience of ecosystems. Accordingly, this work aimed at assessing the effects of multigenerational exposure to low levels of salinity in the competitive outcome of two species of green microalgae: Raphidocelis subcapitata and Chlorella vulgaris. To attain this, three specific objectives were delineated: (1) compare the toxicity of natural seawater (SW) and NaCl (as a surrogate of SW) to the two microalgae, (2) determine the capacity of the two microalgae species to acclimate to low salinity levels, and (3) assess the influence of exposure to low salinity levels in the competitive outcome of the two microalgae. Results revealed SW to be slightly less toxic than NaCl for the two microalgae. The EC 25,72 h for growth rate was 4.63 and 10.3 mS cm -1 for R. subcapitata and 6.94 and 15.4 mS cm -1 for C. vulgaris, respectively for NaCl and SW. Both algae were capable of acclimating to low levels of salinity, but C. vulgaris seemed to acclimate faster than R. subcapitata. When exposed in competition, under control conditions, the growth rates of C. vulgaris were lower than those of R. subcapitata. However, C. vulgaris was capable of acquiring competitive advantage equaling or surpassing the growth rate of R. subcapitata with the addition of NaCl or SW, respectively. The multigenerational exposure to low levels of salinity influenced the competitive outcome of the two algae both under control and salinity exposure. These results suggest that long-term exposure to low salinity stress can cause shifts in structure of algae communities and, therefore, should not be neglected since algae are at the basis

  15. Can a soda-lime glass be used to demonstrate how patterns of strength dependence are influenced by pre-cementation and resin-cementation variables?

    LENUS (Irish Health Repository)

    Hooi, Paul

    2013-01-01

    To determine how the variability in biaxial flexure strength of a soda-lime glass analogue for a PLV and DBC material was influenced by precementation operative variables and following resin-cement coating.

  16. Cognitive functioning in elderly people and the influence of the socio-educative variables - Results from the ELES Study

    Directory of Open Access Journals (Sweden)

    Mª Feli González

    2013-12-01

    Full Text Available Cognitive functioning changes in elderly people. The degree of decline varies across different cognitive abilities and other variables, such as educational level and life-time professional activity, can slow down this process. This study investigates the pattern of cognitive performance in people over 50 years old, taking into account the influence of educational level and profession. Research data were collected during the pilot study of the Longitudinal Aging Study in Spain (ELES in which a representative sample of non-institutionalized Spanish older people was assessed. The following cognitive variables were evaluated: general cognitive functioning, verbal memory, working memory span, visuomotor speed, and language. Differences were found in all cognitive variables in the different age groups, and according to educational level and profession. These differences remained after controlling for the age variable. Population studies provide a global perspective of cognitive performance in older people and help to identify the role of the different associated factors.

  17. Influence of the processing variables on the performance of MAGCLA(TM): friction coefficient and radius of the particles

    International Nuclear Information System (INIS)

    Augusto, Paulo A; Castelo-Grande, Teresa; Barbosa, Domingos; Estevez, A M

    2007-01-01

    This work presents simulation results for the behaviour of different particles in a new magnetic-classifier (MAGCLA(TM)), which is capable of separating and classifying particles according to their magnetic susceptibilities. In a previous article the results for a blank simulation were reported. In this paper the blank simulation is compared with the results obtained for the variation of two of the main processing variables: friction coefficient, μ, and the radius of the particles, r part , in the outcome results

  18. The influence of older age on breast cancer treatment decisions and outcome

    International Nuclear Information System (INIS)

    Merchant, Thomas E.; McCormick, Beryl; Yahalom, Joachim; Borgen, Patrick

    1996-01-01

    Purpose: Information concerning the differences between older and younger women with breast cancer, treated with standard therapy, is lacking from many prospective series. The purpose of this study is to identify factors that influence treatment decisions and determine if women age 65 and older are treated differently than younger women. The outcomes of older women would then be compared to younger women to determine if treatment differences influence outcome. Methods and Materials: The records of 558 women with early invasive breast cancer who were treated with breast conserving surgery and radiation therapy were retrospectively reviewed. Four hundred thirty-two women under the age of 65 (range: 24-64) and 126 women age 65 and older (range: 65-85) were assessed for treatment differences including breast reexcision, extent of axillary dissection, extent of breast and nodal irradiation, and the use of chemotherapy or hormonal therapy. Differences in the treatment of the two groups were determined and the end points of local control, disease-free survival, and overall survival were compared. Median follow-up was 5.5 years. Results: The two treatment groups had identical pathologic TNM staging with the exception that 21% of the older age group and 5% of the younger age group did not undergo axillary dissection. Women age 65 and older were less likely to have a reexcision, extensive axillary dissection, chemotherapy, or nodal irradiation. They were more likely to receive hormonal therapy. Reexcision in older women was positively influenced by a family history of breast cancer and negatively influenced by a history of previous malignancy. None of the patients who were treated without an axillary dissection suffered a regional recurrence. Although local control was better in older patients, there were no differences in disease-free or overall survival for the two groups. Discussion: The findings of this study reveal that older patients have significant treatment

  19. Influence of social cognitive and ethnic variables on academic goals of underrepresented students in science and engineering: a multiple-groups analysis.

    Science.gov (United States)

    Byars-Winston, Angela; Estrada, Yannine; Howard, Christina; Davis, Dalelia; Zalapa, Juan

    2010-04-01

    This study investigated the academic interests and goals of 223 African American, Latino/a, Southeast Asian, and Native American undergraduate students in two groups: biological science and engineering (S/E) majors. Using social cognitive career theory (Lent, Brown, & Hackett, 1994), we examined the relationships of social cognitive variables (math/science academic self-efficacy, math/science outcome expectations), along with the influence of ethnic variables (ethnic identity, other-group orientation) and perceptions of campus climate to their math/science interests and goal commitment to earn an S/E degree. Path analysis revealed that the hypothesized model provided good overall fit to the data, revealing significant relationships from outcome expectations to interests and to goals. Paths from academic self-efficacy to S/E goals and from interests to S/E goals varied for students in engineering and biological science. For both groups, other-group orientation was positively related to self-efficacy and support was found for an efficacy-mediated relationship between perceived campus climate and goals. Theoretical and practical implications of the study's findings are considered as well as future research directions.

  20. The Influence of Learning Management Technology to Student’s Learning Outcome

    Directory of Open Access Journals (Sweden)

    Taufiq Lilo Adi Sucipto

    2017-02-01

    Full Text Available The study examines the influence of learning management systems to the implementation of flipped classroom model in a vocational school in Indonesia. The flipped classroom is a relatively new educational model that inverts students’ time to study on lectures and time spent on homework. Despite studies have been conducted on the model, few addressed the impact of the use of a learning management system to the performance of students involved in such learning model particularly within Indonesian educational systems context. A quasi-experiment approach was applied to an experiment class and another control class. Upon the analysis, the results emphasized previously held research outcomes. The use of Edmodo learning management systems enhances students’ performance in the experiment class, relative to those of the control class.     Except where otherwise noted, content on this site is licensed under a Creative Commons Attribution 4.0 International License.

  1. A systematic review of the influence of the retail food environment around schools on obesity-related outcomes.

    Science.gov (United States)

    Williams, J; Scarborough, P; Matthews, A; Cowburn, G; Foster, C; Roberts, N; Rayner, M

    2014-05-01

    The high prevalence of childhood obesity has led to questions about the influence of 'obesogenic' environments on children's health. Public health interventions targeting the retail food environment around schools have been proposed, but it is unclear if they are evidence based. This systematic review investigates associations between food outlets near schools and children's food purchases, consumption and body weight. We conducted a keyword search in 10 databases. Inclusion criteria required papers to be peer reviewed, to measure retailing around schools and to measure obesity-related outcomes among schoolchildren. Thirty papers were included. This review found very little evidence for an effect of the retail food environment surrounding schools on food purchases and consumption, but some evidence of an effect on body weight. Given the general lack of evidence for association with the mediating variables of food purchases and consumption, and the observational nature of the included studies, it is possible that the effect on body weight is a result of residual confounding. Most of the included studies did not consider individual children's journeys through the food environment, suggesting that predominant exposure measures may not account for what individual children actually experience. These findings suggest that future interventions targeting the food environment around schools need careful evaluation. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

  2. Influence of bladder and rectal volume on spatial variability of a bladder tumor during radical radiotherapy

    International Nuclear Information System (INIS)

    Pos, Floris J.; Koedooder, Kees; Hulshof, Maarten C.C.M.; Tienhoven, Geertjan van; Gonzalez Gonzalez, Dionisio

    2003-01-01

    Purpose: To assess the spatial variability of a bladder tumor relative to the planning target volume boundaries during radical radiotherapy, and furthermore to develop strategies to reduce spatial variability. Methods and Materials: Seventeen patients with solitary T2-T4N0M0 bladder cancer were treated with a technique delivering 40 Gy/2 Gy in 20 fractions to the whole bladder with a concomitant boost to the bladder tumor of 20 Gy in 1 Gy fractions in an overall time of 4 weeks. CT scans were made weekly, immediately after treatment, and matched with the planning CT scan. Spatial variability of the tumor, as well as bladder volume and rectal diameter, were scored for each patient each week. Results: In 65% of patients, a part of the tumor appeared outside the planning target volume boundaries at least one time during the course of radiotherapy. No consistent relation of this variability with time was found. Bladder volumes and rectal diameters showed marked variability during the course of treatment. A large initial bladder volume and rectal diameter predicted a large volume variation and a large tumor spatial variability. Conclusion: In this study, a margin of 1.5 to 2 cm seemed to be inadequate in 65% of the patients with respect to spatial variability. Bladder volume and rectal diameter were found to be predictive for spatial variability of a bladder tumor during concomitant boost radiotherapy

  3. Influence of bladder and rectal volume on spatial variability of a bladder tumor during radical radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Pos, Floris J; Koedooder, Kees; Hulshof, Maarten C.C.M.; Tienhoven, Geertjan van; Gonzalez Gonzalez, Dionisio

    2003-03-01

    Purpose: To assess the spatial variability of a bladder tumor relative to the planning target volume boundaries during radical radiotherapy, and furthermore to develop strategies to reduce spatial variability. Methods and Materials: Seventeen patients with solitary T2-T4N0M0 bladder cancer were treated with a technique delivering 40 Gy/2 Gy in 20 fractions to the whole bladder with a concomitant boost to the bladder tumor of 20 Gy in 1 Gy fractions in an overall time of 4 weeks. CT scans were made weekly, immediately after treatment, and matched with the planning CT scan. Spatial variability of the tumor, as well as bladder volume and rectal diameter, were scored for each patient each week. Results: In 65% of patients, a part of the tumor appeared outside the planning target volume boundaries at least one time during the course of radiotherapy. No consistent relation of this variability with time was found. Bladder volumes and rectal diameters showed marked variability during the course of treatment. A large initial bladder volume and rectal diameter predicted a large volume variation and a large tumor spatial variability. Conclusion: In this study, a margin of 1.5 to 2 cm seemed to be inadequate in 65% of the patients with respect to spatial variability. Bladder volume and rectal diameter were found to be predictive for spatial variability of a bladder tumor during concomitant boost radiotherapy.

  4. THE INFLUENCE OF EUROPEAN CLIMATE VARIABILITY MECHANISM ON AIR TEMPERATURE IN ROMANIA

    Directory of Open Access Journals (Sweden)

    M. MATEI

    2013-03-01

    Full Text Available The main objective of the present paper is to analyze the temporal and spatial variability of air-temperature in Romania, by using mean air-temperature values provided by the ECA&D project (http://eca.knmi.nl/. These data sets will be filtered by means of the EOF (Empirical Orthogonal Function analysis, which describes various modes of space variability and time coefficient series (PC series. The EOF analysis will also be used to identify the main way of action of the European climate variability mechanism, by using multiple variables in grid points, provided by the National Centre of Atmospheric Research (NCAR, USA. The variables considered here are: sea level pressure (SLP, geopotential height at 500 mb (H500 and air temperature at 850 mb (T850, for the summer and winter seasons. The linear trends and shift points of considered variables are then assessed by means of the Mann-Kendall and Pettitt non-parametric tests. By interpreting the results, we can infer that there is causal relationship between the large-scale analyzed parameters and temperature variability in Romania. These results are consistent with those presented by Busuioc et al., 2010, where the main variation trends of the principal European variables are shown.

  5. Influence of climate variability on anchovy reproductive timing off northern Chile

    Science.gov (United States)

    Contreras-Reyes, Javier E.; Canales, T. Mariella; Rojas, Pablo M.

    2016-12-01

    We investigated the relationship between environmental variables and the Gonadosomatic Monthly Mean (GMM) index of anchovy (Engraulis ringens) to understand how the environment affects the dynamics of anchovy reproductive timing. The data examined corresponds to biological information collected from samples of the landings off northern Chile (18°21‧S, 24°00‧S) during the period 1990-2010. We used the Humboldt Current Index (HCI) and the Multivariate ENSO Index (MEI), which combine several physical-oceanographic factors in the Tropical and South Pacific regions. Using the GMM index, we studied the dynamics of anchovy reproductive timing at different intervals of length, specifically females with a length between 11.5 and 14 cm (medium class) and longer than 14 cm (large class). Seasonal Autoregressive Integrated Mobile Average (SARIMA) was used to predict missing observations. The trends of the environment and reproductive indexes were explored via the Breaks For Additive Season and Trend (BFAST) statistical technique and the relationship between these indexes via cross-correlation functions (CCF) analysis. Our results showed that the habitat of anchovy switched from cool to warm condition, which also influenced gonad development. This was revealed by two and three significant changes (breaks) in the trend of the HCI and MEI indexes, and two significant breaks in the GMM of each time series of anchovy females (medium and large). Negative cross-correlation between the MEI index and GMM of medium and large class females was found, indicating that as the environment gets warmer (positive value of MEI) a decrease in the reproductive activity of anchovy can be expected. Correlation between the MEI index and larger females was stronger than with medium females. Additionally, our results indicate that the GMM index of anchovy for both length classes reaches two maximums per year; the first from August to September and the second from December to January. The

  6. Influence of acute normobaric hypoxia on physiological variables and lactate turn point determination in trained men.

    Science.gov (United States)

    Ofner, Michael; Wonisch, Manfred; Frei, Mario; Tschakert, Gerhard; Domej, Wolfgang; Kröpfl, Julia M; Hofmann, Peter

    2014-12-01

    The goal of this study is to evaluate the response of physiological variables to acute normobaric hypoxia compared to normoxia and its influence on the lactate turn point determination according to the three-phase model of energy supply (Phase I: metabolically balanced at muscular level; Phase II: metabolically balanced at systemic level; Phase III: not metabolically balanced) during maximal incremental exercise. Ten physically active (VO2max 3.9 [0.49] l·min(-1)), healthy men (mean age [SD]: 25.3 [4.6] yrs.), participated in the study. All participants performed two maximal cycle ergometric exercise tests under normoxic as well as hypoxic conditions (FiO2 = 14%). Blood lactate concentration, heart rate, gas exchange data, and power output at maximum and the first and the second lactate turn point (LTP1, LTP2), the heart rate turn point (HRTP) and the first and the second ventilatory turn point (VETP1, VETP2) were determined. Since in normobaric hypoxia absolute power output (P) was reduced at all reference points (max: 314 / 274 W; LTP2: 218 / 184 W; LTP1: 110 / 96 W), as well as VO2max (max: 3.90 / 3.23 l·min(-1); LTP2: 2.90 / 2.43 l·min(-1); LTP1: 1.66 / 1.52 l·min(-1)), percentages of Pmax at LTP1, LTP2, HRTP and VETP1, VETP2 were almost identical for hypoxic as well as normoxic conditions. Heart rate was significantly reduced at Pmax in hypoxia (max: 190 / 185 bpm), but no significant differences were found at submaximal control points. Blood lactate concentration was not different at maximum, and all reference points in both conditions. Respiratory exchange ratio (RER) (max: 1.28 / 1.08; LTP2: 1.13 / 0.98) and ventilatory equivalents for O2 (max: 43.4 / 34.0; LTP2: 32.1 / 25.4) and CO2 (max: 34.1 / 31.6; LTP2: 29.1 / 26.1) were significantly higher at some reference points in hypoxia. Significant correlations were found between LTP1 and VETP1 (r = 0.778; p better the performance of the athletes the higher is the effect of hypoxiaThe HRTP and LTP2 are

  7. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes

    Directory of Open Access Journals (Sweden)

    Aryal S

    2014-10-01

    Full Text Available Shambhu Aryal,1 Enrique Diaz-Guzman,2 David M Mannino3 1Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, 2Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, 3Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, USA Abstract: Chronic obstructive pulmonary disease (COPD, one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research. Keywords: chronic obstructive lung disease, sex, smoking, comorbidity, sex bias

  8. Mucosal Perforation During Laparoscopic Heller Myotomy Has No Influence on Final Treatment Outcome.

    Science.gov (United States)

    Salvador, Renato; Spadotto, Lorenzo; Capovilla, Giovanni; Voltarel, Guerrino; Pesenti, Elisa; Longo, Cristina; Cavallin, Francesco; Nicoletti, Loredana; Ruol, Alberto; Valmasoni, Michele; Merigliano, Stefano; Costantini, Mario

    2016-12-01

    The aims of the study were (a) to examine the final outcome in patients experiencing accidental mucosal perforation during laparoscopic Heller myotomy with Dor fundoplication (LHD) and (b) to evaluate whether perforation episodes might influence the way in which surgeons subsequently approached the LHD procedure. We studied all consecutive patients that underwent LHD between 1992 and 2015. Patients were divided into two main groups: those who experienced an intraoperative mucosal perforation (group P) and those whose LHD was uneventful (group NP). Two additional groups were compared: group A, which consisted of patients operated by a given surgeon immediately before a perforation episode occurred, and group B, which included those operated immediately afterwards. Eight hundred seventy-five patients underwent LHD; a mucosal perforation was detected in 25 patients (2.9 %), which was found unrelated to patients' symptom's score and age, radiological stage, manometric pattern, or the surgeon's experience. The median postoperative symptom score was similar for the two groups as the failure rate: 92 failures in group NP (10.8 %) and 4 in group P (16 %) (p = 0.34); moreover, symptoms recurred in 2 patients of group A (10 %) and 3 patients of group B (15 %) (p = 0.9). Accidental perforation during LHD is infrequent and impossible to predict on the grounds of preoperative therapy or the surgeon's personal experience. Despite a longer surgical procedure and hospital stay, the outcome of LHD is much the same as for patients undergoing uneventful myotomy. A recent mucosal perforation does not influence the surgeon's subsequent performance.

  9. The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda.

    Science.gov (United States)

    Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

    2017-12-19

    Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored the relationship between caregiver depression and adolescent mental health in two refugee settlements, Kiryandongo and Adjumani, in Uganda. Adolescents between 13 and 17 and their caregivers participated in a household survey, which included measures of adolescent anxiety and depression, and caregiver depression. Analysis was conducted using multiple logistic regression models, and results were reported for the full sample and for each site separately. In Kiryandongo, a one-unit increase in a caregiver's depression score tripled the odds that the adolescent would have high levels of anxiety symptoms (AOR: 3.0, 95% CI: 1.4, 6.1), while in Adjumani, caregiver depression did not remain significant in the final model. Caregiver depression, gender and exposure to violence were all associated with higher symptoms of adolescent depression in both sites and the full sample, for example, a one unit increase in caregiver depression more than tripled the odds of higher levels of symptoms of adolescent depression (AOR: 3.6, 95% CI: 2.0, 6.2). Caregiver depression is a consistently significantly associated with adverse mental health outcomes for adolescents in this study. Adolescent well-being is significantly affected by caregiver mental health in this refugee context. Child protection interventions in humanitarian contexts do not adequately address the influence of caregivers' mental health, and there are opportunities to integrate child protection programming with prevention and treatment of

  10. Quality-of-Life Outcomes of Patients following Patellofemoral Stabilization Surgery: The Influence of Trochlear Dysplasia.

    Science.gov (United States)

    Hiemstra, Laurie Anne; Kerslake, Sarah; Lafave, Mark R

    2017-11-01

    Trochlear dysplasia is a well-described risk factor for recurrent patellofemoral instability. Despite its clear association with the incidence of patellofemoral instability, it is unclear whether the presence of high-grade trochlear dysplasia influences clinical outcome after patellofemoral stabilization. The purpose of this study was to assess whether trochlear dysplasia influenced patient-reported, disease-specific outcomes in surgically treated patellar instability patients, when risk factors were addressed in accordance with the à la carte surgical approach to the treatment of patellofemoral instability. The study design is of a case series. A total of 318 patellar stabilization procedures were performed during the study period. Of these procedures, 260 had adequate lateral radiographs and complete Banff Patellar Instability Instrument (BPII) scores available for assessment. A Pearson r correlation was calculated between four characteristics of trochlear dysplasia, the BPII total and the BPII symptoms, and physical complaints scores, a mean of 24 months following patellofemoral stabilization. Independent t -tests were performed between stratified trochlear dysplasia groups (no/low grade and high grade) and all BPII measures. There was a statistically significant correlation between measures of trochlear dysplasia and quality-of-life physical symptoms scores, an average of 2 years following patellofemoral stabilization surgery. The BPII symptoms and physical complaints domain score, as well as the individual weakness and stiffness questions, correlated with the classification of trochlear dysplasia as well as the presence of a trochlear bump ( p  patellofemoral stabilization surgery. There was a significant correlation between patient-reported physical symptoms after surgery and high-grade trochlear dysplasia. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Tidal variability of nutrients in a coastal coral reef system influenced by groundwater

    Directory of Open Access Journals (Sweden)

    G. Wang

    2018-02-01

    nutrients in the water column, 5.43 (R2  =  0.27 and 14.2 (R2  =  0.76, respectively. This similarity indicates that the composition of nutrients in the water column of the reef system was closely related with biological processes during both tidal periods, but the biological influence appeared to be less dominant, as inferred from the less significant correlations (R2  =  0.16 during the spring tide when groundwater discharge was more prominent. Thus, the variability of nutrients in the coral reef system was regulated mainly by biological uptake and release in a spring–neap tide and impacted by mixing of tidally driven groundwater and offshore seawater during spring tide.

  12. The Influence of Violence Victimization on Sexual Health Behaviors and Outcomes.

    Science.gov (United States)

    Latimer, Jennifer; Fleckman, Julia; Wallace, Maeve; Rountree, Michele; Theall, Katherine

    2017-05-01

    This study examines the implications of a history of personal violence on health and health behaviors. A secondary analysis of cross-sectional data involving adults (n = 214) from a semirural area in southern Louisiana between October 2008 and December 2010 was conducted to ascertain the association between a personal history of violence victimization and indicators of sexual health behaviors and outcomes: communication with sexual partners about HIV status, consistent condom use, and sexually transmitted infection (STI). While violence victimization is widely accepted as a risk factor for high-risk sex behavior, the mechanisms underlying violence victimization's influence on sexual health outcomes remain unclear. Bivariate analyses demonstrated a significant positive association between experience of physical abuse and lifetime history of STI. Surprisingly, respondents reporting lifetime physical violence were more than two times more likely to ask sexual partners about HIV status [odds ratio (OR) for physical attack = 2.23, 95% confidence intervals (CI) = 1.00-4.97; OR for physical injury = 4.60, 95% CI = 1.79-11.85]. Consistent condom use was not significantly associated with violence exposure in adjusted models. There was no evidence that communication with sexual partners mediated the relationship between experiences of violence and condom use. The link between personal history of violence and condom use may be mediated through alternative pathways beyond communication.

  13. The influence of smoking and other risk factors on the outcome after radiochemotherapy for anal cancer

    International Nuclear Information System (INIS)

    Mai, Sabine Kathrin; Welzel, Grit; Haegele, Verena; Wenz, Frederik

    2007-01-01

    Smoking is an important risk factor for the development of cancer. Smoking during radiochemotherapy therapy may have a negative influence on prognosis. We evaluated the effect of smoking during radiochemotherapy on the outcome for patients with anal cancer. Sixty-eight patients (34 smokers, 34 non-smokers) treated by radiochemotherapy for anal cancer were analysed. The effect of smoking during radiochemotherapy and other risk factors (gender, T- and N category, tumor site, dose, therapy protocol) on disease-specific survival (DSS), local control (LC) and colostomy free survival (CFS) was evaluated. There was a significant difference in age and male:female ratio between the two groups. With a median follow up of 22 months (max. 119) DSS, LC, and CFS were 88%, 84% and 84%. A significant difference in local control between smokers (S) and non-smokers (NS) was found (S 74% vs. NS 94%, p = .03). For DSS and CFS a difference in terms of outcome between smokers and non-smokers was seen (DSS: S 82% vs. NS 96%, p = .19, CFS: S 75% vs. 91%, p = .15), which did not reach statistical significance. In multivariate analyses only gender had a significant association with LC and T category with CFS. The other risk factors did not reach statistical significance. Even though our evaluation reached statistical significance only in univariate analysis, we suggest, that the role of smoking during radiochemotherapy for anal cancer should not be ignored. The potential negative effect on prognosis should be explained to patients before therapy

  14. Inherited Variants in Wnt Pathway Genes Influence Outcomes of Prostate Cancer Patients Receiving Androgen Deprivation Therapy

    Directory of Open Access Journals (Sweden)

    Jiun-Hung Geng

    2016-11-01

    Full Text Available Aberrant Wnt signaling has been associated with many types of cancer. However, the association of inherited Wnt pathway variants with clinical outcomes in prostate cancer patients receiving androgen deprivation therapy (ADT has not been determined. Here, we comprehensively studied the contribution of common single nucleotide polymorphisms (SNPs in Wnt pathway genes to the clinical outcomes of 465 advanced prostate cancer patients treated with ADT. Two SNPs, adenomatous polyposis coli (APC rs2707765 and rs497844, were significantly (p ≤ 0.009 and q ≤ 0.043 associated with both prostate cancer progression and all-cause mortality, even after multivariate analyses and multiple testing correction. Patients with a greater number of favorable alleles had a longer time to disease progression and better overall survival during ADT (p for trend ≤ 0.003. Additional, cDNA array and in silico analyses of prostate cancer tissue suggested that rs2707765 affects APC expression, which in turn is correlated with tumor aggressiveness and patient prognosis. This study identifies the influence of inherited variants in the Wnt pathway on the efficacy of ADT and highlights a preclinical rationale for using APC as a prognostic marker in advanced prostate cancer.

  15. The interrupted learner: How distractions during live and video lectures influence learning outcomes.

    Science.gov (United States)

    Zureick, Andrew H; Burk-Rafel, Jesse; Purkiss, Joel A; Hortsch, Michael

    2017-11-27

    New instructional technologies have been increasingly incorporated into the medical school learning environment, including lecture video recordings as a substitute for live lecture attendance. The literature presents varying conclusions regarding how this alternative experience impacts students' academic success. Previously, a multi-year study of the first-year medical histology component at the University of Michigan found that live lecture attendance was positively correlated with learning success, while lecture video use was negatively correlated. Here, three cohorts of first-year medical students (N = 439 respondents, 86.6% response rate) were surveyed in greater detail regarding lecture attendance and video usage, focusing on study behaviors that may influence histology learning outcomes. Students who reported always attending lectures or viewing lecture videos had higher average histology scores than students who employed an inconsistent strategy (i.e., mixing live attendance and video lectures). Several behaviors were negatively associated with histology performance. Students who engaged in "non-lecture activities" (e.g., social media use), students who reported being interrupted while watching the lecture video, or feeling sleepy/losing focus had lower scores than their counterparts not engaging in these behaviors. This study suggests that interruptions and distractions during medical learning activities-whether live or recorded-can have an important impact on learning outcomes. Anat Sci Educ 00: 000-000. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  16. INFLUENCE OF THE SAGITTAL BALANCE ON THE CLINICAL OUTCOME IN SPINAL FUSION

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    Marcela Almeida Campos Coutinho

    2016-03-01

    Full Text Available ABSTRACT Objective: Evaluates which radiographic parameters of the sagittal and spinopelvic balance influence the clinical and functional outcomes of a sample of patients undergoing spinal fusion. Methods: We studied 32 patients who underwent spinal fusion. Radiographs of the total spine were obtained from all patients. The clinical and functional parameters studied were analysis of pain by visual analogic scale (VAS and Oswestry and SRS-30 questionnaires. We analyzed the correlation between the clinical and functional parameters and radiographic parameters of the sagittal and spinopelvic balance. Results: There was no significant correlation between parameters pelvic incidence (PI, pelvic tilt (PT, lumbar lordosis (LL and difference between PI and LL (PI-LL and clinical parameters (p > 0.05 and r <0.2. Significant correlation were identified only between Sagittal Vertical Axis (SVA and Satisfaction with Treatment domain of SRS-30 (r = 0.402 e p = 0.023 and between thoracic kyphosis (TK and the total SRS-30 (r = 0.419 and p = 0.017. Conclusions: According to the study results, it was not possible to precisely characterize the role of the parameters of the sagittal and spinopelvic balance in the post-operative analysis of the clinical outcome of spinal fusion. There was a significant correlation only between SVA and the Satisfaction with Treatment domain of SRS-30 and between TK and total SRS-30.

  17. GOAL PROFILES, MENTAL TOUGHNESS AND ITS INFLUENCE ON PERFORMANCE OUTCOMES AMONG WUSHU ATHLETES

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    Garry Kuan

    2007-10-01

    Full Text Available This study examined the association between goal orientations and mental toughness and its influence on performance outcomes in competition. Wushu athletes (n = 40 competing in Intervarsity championships in Malaysia completed Task and Ego Orientations in Sport Questionnaire (TEOSQ and Psychological Performance Inventory (PPI. Using cluster analysis techniques including hierarchical methods and the non-hierarchical method (k-means cluster to examine goal profiles, a three cluster solution emerged viz. cluster 1 - high task and moderate ego (HT/ME, cluster 2 - moderate task and low ego (MT/LE and, cluster 3 - moderate task and moderate ego (MT/ME. Analysis of the fundamental areas of mental toughness based on goal profiles revealed that athletes in cluster 1 scored significantly higher on negative energy control than athletes in cluster 2. Further, athletes in cluster 1 also scored significantly higher on positive energy control than athletes in cluster 3. Chi-square (χ2 test revealed no significant differences among athletes with different goal profiles on performance outcomes in the competition. However, significant differences were observed between athletes (medallist and non medallist in self- confidence (p = 0.001 and negative energy control (p = 0.042. Medallist's scored significantly higher on self-confidence (mean = 21.82 ± 2.72 and negative energy control (mean = 19.59 ± 2.32 than the non-medallists (self confidence-mean = 18.76 ± 2.49; negative energy control mean = 18.14 ± 1.91.

  18. Tibial Sesamoid Position Influence on Functional Outcome and Satisfaction After Hallux Valgus Surgery.

    Science.gov (United States)

    Chen, Jerry Yongqiang; Rikhraj, Kiran; Gatot, Cheryl; Lee, Justine Yun Yu; Singh Rikhraj, Inderjeet

    2016-11-01

    During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery. Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII). The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001). We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery. Level III, retrospective comparative series. © The Author(s) 2016.

  19. [The influence of patient-controlled epidural analgesia on labor progress and neonatal outcome].

    Science.gov (United States)

    Rzepka, Rafał; Zukowski, Maciej; Michalczyk, Michał; Nikodemski, Tomasz; Torbé, Andrzej; Kwiatkowski, Sebastian; Mikołajek-Bedner, Wioletta; Czajka, Ryszard

    2012-02-01

    The aim of the study was to check the influence of patient control epidural analgesia on labor progress and neonatal outcome. 144 parturients were included into the clinical trial. In 73 cases patient control epidural analgesia was used and in 71 cases pethidine (meperidine) solution was given intravenously. Apgar score, umbilical artery pH, pain intensity the time of the first, second and third stage of labor the rate of episiotomy and uterine postpartum abrasions and the rate of caesarean sections and vaginal operative delivery were compared. The time of the second stage of labor was significantly longer in the study group (40.99 vs 26.49 min, p- neonatal outcome was comparable in both groups. There were no differences in the time of the first and the second stage of labor in primiparas and multiparas analyzed separately. Visual Analogue Score was lower in the study group (Ch(2)-12,48, p-0.25), especially in the subgroups of primiparas and multiparas. Patient control epidural analgesia does not affect the time of the first and second stage of labor, oxytocin augmentation of labor may be the reason of that. This method is a more effective way of relieving labor pain. An increase of operative delivery is not observed after patient control epidural analgesia on condition that low doses and concentrations of analgesic drugs are used.

  20. The Influence of AHI1 Variants on the Diagnosis and Treatment Outcome in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Stefano Porcelli

    2015-01-01

    Full Text Available The present study aimed to explore whether four single nucleotide polymorphisms (SNPs within the AHI1 gene could be associated with schizophrenia (SCZ and whether they could predict the clinical outcomes in SCZ patients treated with antipsychotics. Four hundred twenty-six (426 in-patients with SCZ and 345 controls were genotyped for four AHI1 SNPs (rs11154801, rs7750586, rs9647635 and rs9321501. Baseline and clinical measures for SCZ patients were assessed through the Positive and Negative Syndrome Scale (PANSS. Allelic and genotypic frequencies in SCZ subjects were compared with those of controls using the χ2 statistics. The repeated-measure ANOVA was used for the assessment of treatment outcomes measured by PANSS changes. The case-control analysis did not show any difference in the genotypic distribution of the SNPs, while in the allelic analysis, a weak association was found between the rs9647635 A allele and SCZ. Furthermore, in the haplotype analysis, three haplotypes resulted in being associated with SCZ. On the other hand, two SNPs (rs7750586 and rs9647635 were associated with clinical improvement of negative symptoms in the allelic analysis, although in the genotypic analysis, only trends of association were found for the same SNPs. Our findings suggest a possible influence of AHI1 variants on SCZ susceptibility and antipsychotic response, particularly concerning negative symptomatology. Subsequent well-designed studies would be mandatory to confirm our results due to the methodological shortcomings of the present study.

  1. The Influence of AHI1 Variants on the Diagnosis and Treatment Outcome in Schizophrenia

    Science.gov (United States)

    Porcelli, Stefano; Pae, Chi-Un; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A.; Masand, Prakash S.; Balzarro, Beatrice; Alberti, Siegfried; De Ronchi, Diana; Serretti, Alessandro

    2015-01-01

    The present study aimed to explore whether four single nucleotide polymorphisms (SNPs) within the AHI1 gene could be associated with schizophrenia (SCZ) and whether they could predict the clinical outcomes in SCZ patients treated with antipsychotics. Four hundred twenty-six (426) in-patients with SCZ and 345 controls were genotyped for four AHI1 SNPs (rs11154801, rs7750586, rs9647635 and rs9321501). Baseline and clinical measures for SCZ patients were assessed through the Positive and Negative Syndrome Scale (PANSS). Allelic and genotypic frequencies in SCZ subjects were compared with those of controls using the χ2 statistics. The repeated-measure ANOVA was used for the assessment of treatment outcomes measured by PANSS changes. The case-control analysis did not show any difference in the genotypic distribution of the SNPs, while in the allelic analysis, a weak association was found between the rs9647635 A allele and SCZ. Furthermore, in the haplotype analysis, three haplotypes resulted in being associated with SCZ. On the other hand, two SNPs (rs7750586 and rs9647635) were associated with clinical improvement of negative symptoms in the allelic analysis, although in the genotypic analysis, only trends of association were found for the same SNPs. Our findings suggest a possible influence of AHI1 variants on SCZ susceptibility and antipsychotic response, particularly concerning negative symptomatology. Subsequent well-designed studies would be mandatory to confirm our results due to the methodological shortcomings of the present study. PMID:25622261

  2. Thematic analysis of US stakeholder views on the influence of labour nurses' care on birth outcomes.

    Science.gov (United States)

    Lyndon, Audrey; Simpson, Kathleen Rice; Spetz, Joanne

    2017-10-01

    Childbirth is a leading reason for hospital admission in the USA, and most labour care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated nurse-sensitive quality measures for maternity care. We aimed to engage primary stakeholders of maternity care in identifying the aspects of nursing care during labour and birth they believe influence birth outcomes, and how these aspects of care might be measured. This qualitative study used 15 focus groups to explore perceptions of 73 nurses, 23 new mothers and 9 physicians regarding important aspects of care. Transcripts were analysed thematically. Participants in the final six focus groups were also asked whether or not they thought each of five existing perinatal quality measures were nurse-sensitive. Nurses, new mothers and physicians identified nurses' support of and advocacy for women as important to birth outcomes. Support and advocacy actions included keeping women and their family members informed, being present with women, setting the emotional tone, knowing and advocating for women's wishes and avoiding caesarean birth. Mothers and nurses took technical aspects of care for granted, whereas physicians discussed this more explicitly, noting that nurses were their 'eyes and ears' during labour. Participants endorsed caesarean rates and breastfeeding rates as likely to be nurse-sensitive. Stakeholder values support inclusion of maternity nursing care quality measures related to emotional support and providing information in addition to physical support and clinical aspects of care. Care models that ensure labour nurses have sufficient time and resources to engage in the supportive relationships that women value might contribute to better health outcomes and improved patient experience. 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/.

  3. Culture media influenced laboratory outcomes but not neonatal birth weight in assisted reproductive technology.

    Science.gov (United States)

    Yin, Tai-lang; Zhang, Yi; Li, Sai-jiao; Zhao, Meng; Ding, Jin-li; Xu, Wang-ming; Yang, Jing

    2015-12-01

    Whether the type of culture media utilized in assisted reproductive technology has impacts on laboratory outcomes and birth weight of newborns in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was investigated. A total of 673 patients undergoing IVF/ICSI and giving birth to live singletons after fresh embryo transfer on day 3 from Jan. 1, 2010 to Dec. 31, 2012 were included. Three types of culture media were used during this period: Quinn's Advantage (QA), Single Step Medium (SSM), and Continuous Single Culture medium (CSC). Fertilization rate (FR), normal fertilization rate (NFR), cleavage rate (CR), normal cleavage rate (NCR), good-quality embryo rate (GQER) and neonatal birth weight were compared using one-way ANOVA and χ (2) tests. Multiple linear regression analysis was performed to determine the impact of culture media on laboratory outcomes and birth weight. In IVF cycles, GQER was significantly decreased in SSM medium group as compared with QA or CSC media groups (63.6% vs. 69.0% in QA; vs. 71.3% in CSC, P=0.011). In ICSI cycles, FR, NFR and CR were significantly lower in CSC medium group than in other two media groups. No significant difference was observed in neonatal birthweight among the three groups (P=0.759). Multiple linear regression analyses confirmed that the type of culture medium was correlated with FR, NFR, CR and GQER, but not with neonatal birth weight. The type of culture media had potential influences on laboratory outcomes but did not exhibit an impact on the birth weight of singletons in ART.

  4. Environmental variable influence in the process of suppliers choice: a study in agribusiness in the microregion of Assis-SP

    Directory of Open Access Journals (Sweden)

    Edenis Cesar Oliveira

    2016-08-01

    Full Text Available The global market characterized by competition, has demanded of new placements organizations, particularly as to how implement and develop relations with its trading partners. The Supply Chain Management emerges as a tool that provides organizations with the most effective management of the consequences of these relations. The incorporation of environmental issues in the organizational context reflected directly across chain. Organizations began to consider sustainability as a major factor in relations with its stakeholders, justifying the emergence of Sustainable Management of Supply Chain. The study aims to analyze the influence of environmental variable introduced in decisions and selection of suppliers of sugarcane agro-industries located in the micro-region of Assis-SP. Was held from Multiple Case Study in six agribusinesses, collecting data through semi-structured interviews, applied to sixteen actors directly involved with the subject matter, in addition to document analysis to support the interviews. For data analysis, applied to content analysis with the help of ATLAS.ti software. The results showed that, of the six surveyed companies, in agribusiness AGR2, FOR1 and for2 the environmental variable has a weak influence in the selection of its suppliers; in AGR1 the influence is average and only in AGR3 and AGR4 agribusinesses environmental variable has a strong influence.

  5. Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study

    Directory of Open Access Journals (Sweden)

    Röder Christoph

    2010-09-01

    Full Text Available Abstract Background In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. Methods Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. Results Overall, 16,634 (70% out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. Conclusions The Sleep Standard Evaluation Questionnaire (SEQ-Sleep is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.

  6. The potential influence of short-term environmental variability on the composition of testate amoeba communities in Sphagnum peatlands.

    Science.gov (United States)

    Sullivan, Maura E; Booth, Robert K

    2011-07-01

    Testate amoebae are a group of moisture-sensitive, shell-producing protozoa that have been widely used as indicators of changes in mean water-table depth within oligotrophic peatlands. However, short-term environmental variability (i.e., sub-annual) also probably influences community composition. The objective of this study was to assess the potential influence of short-term environmental variability on the composition of testate amoeba communities in Sphagnum-dominated peatlands. Testate amoebae and environmental conditions, including hourly measurements of relative humidity within the upper centimeter of the peatland surface, were examined throughout the 2008 growing season at 72 microsites within 11 peatlands of Pennsylvania and Wisconsin, USA. Relationships among testate amoeba communities, vegetation, depth to water table, pH, and an index of short-term environmental variability (EVI), were examined using nonmetric multidimensional scaling and correlation analysis. Results suggest that EVI influences testate amoeba communities, with some taxa more abundant under highly variable conditions (e.g., Arcella discoides, Difflugia pulex, and Hyalosphenia subflava) and others more abundant when environmental conditions at the peatland surface were relatively stable (e.g., Archerella flavum and Bullinularia indica). The magnitude of environmental variability experienced at the peatland surface appears to be primarily controlled by vegetation composition and density. In particular, sites with dense Sphagnum cover had lower EVI values than sites with loose-growing Sphagnum or vegetation dominated by vascular plants and/or non-Sphagnum bryophytes. Our results suggest that more environmental information may be inferred from testate amoebae than previously recognized. Knowledge of relationships between testate amoebae and short-term environmental variability should lead to more detailed and refined environmental inferences.

  7. Factors influencing psychological, social and health outcomes after major burn injuries in adults: cohort study protocol.

    Science.gov (United States)

    Druery, Martha; Newcombe, Peter A; Cameron, Cate M; Lipman, Jeffrey

    2017-06-17

    The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. Australia New

  8. Relative influence of age, resting heart rate and sedentary life style in short-term analysis of heart rate variability

    OpenAIRE

    E.R. Migliaro; P. Contreras; S. Bech; A. Etxagibel; M. Castro; R. Ricca; K. Vicente

    2001-01-01

    In order to assess the relative influence of age, resting heart rate (HR) and sedentary life style, heart rate variability (HRV) was studied in two different groups. The young group (YG) consisted of 9 sedentary subjects aged 15 to 20 years (YG-S) and of 9 nonsedentary volunteers (YG-NS) also aged 15 to 20. The elderly sedentary group (ESG) consisted of 16 sedentary subjects aged 39 to 82 years. HRV was assessed using a short-term procedure (5 min). R-R variability was calculated in the time-...

  9. Genetic Influence on Slope Variability in a Childhood Reflexive Attention Task.

    Directory of Open Access Journals (Sweden)

    Rebecca A Lundwall

    Full Text Available Individuals are not perfectly consistent, and interindividual variability is a common feature in all varieties of human behavior. Some individuals respond more variably than others, however, and this difference may be important to understanding how the brain works. In this paper, we explore genetic contributions to response time (RT slope variability on a reflexive attention task. We are interested in such variability because we believe it is an important part of the overall picture of attention that, if understood, has the potential to improve intervention for those with attentional deficits. Genetic association studies are valuable in discovering biological pathways of variability and several studies have found such associations with a sustained attention task. Here, we expand our knowledge to include a reflexive attention task. We ask whether specific candidate genes are associated with interindividual variability on a childhood reflexive attention task in 9-16 year olds. The genetic makers considered are on 11 genes: APOE, BDNF, CHRNA4, COMT, DRD4, HTR4, IGF2, MAOA, SLC5A7, SLC6A3, and SNAP25. We find significant associations with variability with markers on nine and we discuss the results in terms of neurotransmitters associated with each gene and the characteristics of the associated measures from the reflexive attention task.

  10. Influence of intravertebral cleft on percutaneous vertebroplasty outcome of osteoporotic vertebral compression fractures

    International Nuclear Information System (INIS)

    Zhu Xuee; Wu Chungen; Zhang Ji; Cheng Yongde; Gu Yifeng; Li Minghua; Hu Xiaohui

    2008-01-01

    Objective: To evaluate the influence of intravertebral cleft on percutaneous vertebroplasty (PVP)outcome and the efficacy in the treatment of osteoporotic compression fracture and compare to those without intravertebral cleft. Methods: A retrospective study was conducted to review 95 consecutive PVP procedures for 176 compression fractures. Patients were excluded with more than a single vertebral body involvement neoplasm history, lack of complete imaging materials and follow-up of incoordinated patients. Group A consisted of 18 patients with intravertebral cleft, while group B comprised 25 patients without intravertebral cleft. PMMA leakages were classified as intradiscal, perivertebral soft tissue, perivertebral venous and epidural types. The frequencies of leakage were compared between two groups using χ 2 and Fisher exact tests. Visual analogue scale (VAS)and Owestry disability index (ODI)scores were recorded before hand. Results: After PVP, all patients showed significant pain relief and improvement of daily activity function(P 0.05)between the two groups. PMMA leakage occurred in 11 (61.1%)of 18 fractures with intravertebral clefts and 15 (60%)of 25 fractures without intravertebral clefts, revealing no significant difference, but existing between the most frequent seen types in both groups (P < 0.05). Conclusions: PVP is an effective treatment for osteoporotic compression fractures with and without intravertebral cleft. There was no influence of intravertebral clefts on pain relief, improvement of daily activity function and incidence of PMMA leakage besides the PMMA leakage types. (authors)

  11. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers.

    LENUS (Irish Health Repository)

    McGowan, Ciara A

    2010-07-01

    Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

  12. Participatory ergonomics simulation of hospital work systems: The influence of simulation media on simulation outcome.

    Science.gov (United States)

    Andersen, Simone Nyholm; Broberg, Ole

    2015-11-01

    Current application of work system simulation in participatory ergonomics (PE) design includes a variety of different simulation media. However, the actual influence of the media attributes on the simulation outcome has received less attention. This study investigates two simulation media: full-scale mock-ups and table-top models. The aim is to compare, how the media attributes of fidelity and affordance influence the ergonomics identification and evaluation in PE design of hospital work systems. The results illustrate, how the full-scale mock-ups' high fidelity of room layout and affordance of tool operation support ergonomics identification and evaluation related to the work system entities space and technologies & tools. The table-top models' high fidelity of function relations and affordance of a helicopter view support ergonomics identification and evaluation related to the entity organization. Furthermore, the study addresses the form of the identified and evaluated conditions, being either identified challenges or tangible design criteria. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  13. The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy.

    Science.gov (United States)

    Fonseca, Adriana Barbosa de Lima; Simon, Marise do Vale; Cazzaniga, Rodrigo Anselmo; de Moura, Tatiana Rodrigues; de Almeida, Roque Pacheco; Duthie, Malcolm S; Reed, Steven G; de Jesus, Amelia Ribeiro

    2017-02-06

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae. According to official reports from 121 countries across five WHO regions, there were 213 899 newly diagnosed cases in 2014. Although leprosy affects the skin and peripheral nerves, it can present across a spectrum of clinical and histopathological forms that are strongly influenced by the immune response of the infected individuals. These forms comprise the extremes of tuberculoid leprosy (TT), with a M. leprae-specific Th1, but also a Th17, response that limits M. leprae multiplication, through to lepromatous leprosy (LL), with M. leprae-specific Th2 and T regulatory responses that do not control M. leprae replication but rather allow bacterial dissemination. The interpolar borderline clinical forms present with similar, but less extreme, immune biases. Acute inflammatory episodes, known as leprosy reactions, are complications that may occur before, during or after treatment, and cause further neurological damages that can cause irreversible chronic disabilities. This review discusses the innate and adaptive immune responses, and their interactions, that are known to affect pathogenesis and influence the clinical outcome of leprosy.

  14. Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

    International Nuclear Information System (INIS)

    Horwitz, Eric; Ziaja, Ellen; Vicini, Frank; Dmuchowski, Carl; Gonzalez, Jose; Stromberg, Jannifer; Brabbins, Donald; Hollander, Jay; Chen, Peter; Martinez, Alvaro

    1995-01-01

    Purpose: Biochemical control is rapidly becoming the standard to assess treatment outcome of clinically localized prostate cancer. However, no standardized definition of biochemical control has been established. We reviewed our experience treating patients with localized prostate cancer and applied 3 different commonly used definitions to estimate the variability in rates of biochemical control. Materials and Methods: Between (1(87)) and (12(91)), 480 patients with clinically localized prostate cancer received uniform treatment with external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. The median dose to the prostate was 66.6 Gy (range 58 to 70.4 Gy) through a 4 field technique. A total of 14 patients received pelvic nodal RT (median dose 45 Gy). Four hundred seventy patients had post-treatment (posttx) PSA values and 414 patients had pre-treatment (pretx) PSA values. Three different definitions of biochemical control were used: 1) Biochemical control was defined as posttx PSA nadir < 1 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 2) Biochemical control was defined as posttx PSA nadir < 1.5 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 3) Posttx PSA nadir < 4 ng/ml without a time limit. Once the nadir was achieved, and it did not rise above normal, the patient was considered controlled. Clinical local control was defined as no palpable prostate nodularity beyond 18 months, no new prostate nodularity, or a negative biopsy. If hormonal therapy was started, the patient was censored for biochemical failure at that time. Results: Median follow-up is 48 months (range 3 to 112 months). Pre-treatment PSA values were correlated with biochemical response using the 3 definitions of biochemical control as well as clinical local

  15. Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Chronic work-related stress is an independent risk factor for cardiometabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. The purpose of this study was to determine if an office worksite-based hatha yoga program could improve physiological stress, evaluated via heart rate variability (HRV), and associated health-related outcomes in a cohort of office workers. Methods Thirty-seven adults employed in university-based office positions were randomized upon the completion of baseline testing to an experimental or control group. The experimental group completed a 10-week yoga program prescribed three sessions per week during lunch hour (50 min per session). An experienced instructor led the sessions, which emphasized asanas (postures) and vinyasa (exercises). The primary outcome was the high frequency (HF) power component of HRV. Secondary outcomes included additional HRV parameters, musculoskeletal fitness (i.e. push-up, side-bridge, and sit & reach tests) and psychological indices (i.e. state and trait anxiety, quality of life and job satisfaction). Results All measures of HRV failed to change in the experimental group versus the control group, except that the experimental group significantly increased LF:HF (p = 0.04) and reduced pNN50 (p = 0.04) versus control, contrary to our hypotheses. Flexibility, evaluated via sit & reach test increased in the experimental group versus the control group (p yoga sessions (n = 11) to control (n = 19) yielded the same findings, except that the high adherers also reduced state anxiety (p = 0.02) and RMSSD (p = 0.05), and tended to improve the push-up test (p = 0.07) versus control. Conclusions A 10-week hatha yoga intervention delivered at the office worksite during lunch hour did not improve HF power or other HRV parameters. However, improvements in flexibility, state anxiety and musculoskeletal fitness were noted with high adherence

  16. Hypocretin measurement: shelf age of radioimmunoassay kit, but not freezer time, influences assay variability.

    Science.gov (United States)

    Keating, Glenda; Bliwise, Donald L; Saini, Prabhjyot; Rye, David B; Trotti, Lynn Marie

    2017-09-01

    The hypothalamic peptide hypocretin 1 (orexin A) may be assayed in cerebrospinal fluid to diagnose narcolepsy type 1. This testing is not commercially available, and factors contributing to assay variability have not previously been comprehensively explored. In the present study, cerebrospinal fluid hypocretin concentrations were determined in duplicate in 155 patient samples, across a range of sleep disorders. Intra-assay variability of these measures was analyzed. Inter-assay correlation between samples tested at Emory and at Stanford was high (r = 0.79, p hypocretin values, such that kits closer to expiration exhibit significantly more variability.

  17. Exploring the role of social capital influence variables on travel behaviour

    DEFF Research Database (Denmark)

    Di Ciommo, Floridea; Comendador, Julio; Eugenia Lopez-Lambas, Maria

    2014-01-01

    This paper explores the potential role of individual trip characteristics and social capital network variables in the choice of transport mode. A sample of around 100 individuals living or working in one suburb of Madrid (i.e. Las Rosas district of Madrid) participated in a smartphone short panel......, the model incorporated two "social capital network" variables: participation in voluntary activities and receiving help for various tasks (i.e. child care, housekeeping, etc.). Both variables improved the capacity of the model to explain transport mode shifts. Further, our results confirm that the shift...

  18. The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach.

    Science.gov (United States)

    McKay, Virginia R; Hoffer, Lee D; Combs, Todd B; Margaret Dolcini, M

    2018-06-05

    Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are sustained. Although human resource capacity and population outcomes are theoretically related, examining them over time within real-world experiments is difficult. Simulation approaches, especially agent-based models, offer advantages that complement existing methods. We used an agent-based model to examine the relationships among human resources, EBI delivery, and population outcomes by simulating provision of an EBI through a hypothetical agency and its staff. We used data from existing studies examining a widely implemented HIV prevention intervention to inform simulation design, calibration, and validity. Once we developed a baseline model, we used the model as a simulated laboratory by systematically varying three human resource variables: the number of staff positions, the staff turnover rate, and timing in training. We tracked the subsequent influence on EBI delivery and the level of population risk over time to describe the overall and dynamic relationships among these variables. Higher overall levels of human resource capacity at an agency (more positions) led to more extensive EBI delivery over time and lowered population risk earlier in time. In simulations representing the typical human resource investments, substantial influences on population risk were visible after approximately 2 years and peaked around 4 years. Human resources, especially staff positions, have an important impact on EBI sustainability and ultimately population health. A minimum level of human resources based on the context (e.g., size of the initial population and characteristics of the EBI) is likely needed for an EBI to have a meaningful impact on

  19. [Cardiac myxoma -- the influence of preoperative clinical presentation and surgical technique on late outcome].

    Science.gov (United States)

    Mikić, Aleksandar; Obrenović-Krcanski, Bilijana; Kocica, Mladen; Vranes, Mile; Lacković, Vesna; Velinović, Milos; Miarković, Miroslav; Kovacević, Natasa; Djukić, Petar

    2007-01-01

    Cardiac myxomas are the most frequent primary tumours of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavourable localization, myxomas are considered "functionally malignant" tumours. Diagnosis of cardiac myxoma necessitates surgical treatment. To analyse: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumour basis solving) on early, and late outcomes. From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Centre of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1 +/- 16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8 x 3.8 cm (range: 1 x l cm to 9 x 8 cm) and 6 x 4 cm (range: 3 x 2 cm to 9 x 5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late

  20. Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C

    DEFF Research Database (Denmark)

    Borgquist, Ola; Wise, Matt P; Nielsen, Niklas

    2017-01-01

    OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes...... of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." SETTING: Thirty-six sites in Europe...... and Australia. PATIENTS: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. INTERVENTIONS: Targeted temperature management at 33°C or 36°C. MEASUREMENTS AND MAIN RESULTS: Nonparametric tests as well as multiple logistic regression and mixed...

  1. Spike Pattern Structure Influences Synaptic Efficacy Variability Under STDP and Synaptic Homeostasis. II: Spike Shuffling Methods on LIF Networks

    Directory of Open Access Journals (Sweden)

    Zedong Bi

    2016-08-01

    Full Text Available Synapses may undergo variable changes during plasticity because of the variability of spike patterns such as temporal stochasticity and spatial randomness. Here, we call the variability of synaptic weight changes during plasticity to be efficacy variability. In this paper, we investigate how four aspects of spike pattern statistics (i.e., synchronous firing, burstiness/regularity, heterogeneity of rates and heterogeneity of cross-correlations influence the efficacy variability under pair-wise additive spike-timing dependent plasticity (STDP and synaptic homeostasis (the mean strength of plastic synapses into a neuron is bounded, by implementing spike shuffling methods onto spike patterns self-organized by a network of excitatory and inhibitory leaky integrate-and-fire (LIF neurons. With the increase of the decay time scale of the inhibitory synaptic currents, the LIF network undergoes a transition from asynchronous state to weak synchronous state and then to synchronous bursting state. We first shuffle these spike patterns using a variety of methods, each designed to evidently change a specific pattern statistics; and then investigate the change of efficacy variability of the synapses under STDP and synaptic homeostasis, when the neurons in the network fire according to the spike patterns before and after being treated by a shuffling method. In this way, we can understand how the change of pattern statistics may cause the change of efficacy variability. Our results are consistent with those of our previous study which implements spike-generating models on converging motifs. We also find that burstiness/regularity is important to determine the efficacy variability under asynchronous states, while heterogeneity of cross-correlations is the main factor to cause efficacy variability when the network moves into synchronous bursting states (the states observed in epilepsy.

  2. Influence of race on outcome in patients treated with breast conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T; Heimann, R; Powers, C; Vijayakumar, S; Ewing, C; Halpern, H; Michel, A; Rubin, S; Weichselbaum, R

    1995-07-01

    PURPOSE: Race is reported to correlate with outcome in breast cancer with African Americans (AA) having worse outcome compared to whites. However, little data is available from large standardized series of patients with early stage breast cancer. We report here the influence of race on local control (LC), disease free survival (DFS), cause specific survival (CSS) and overall survival (OS) for patients treated at our center with breast conserving therapy (BCT). MATERIALS AND METHODS: From a database of 925 patients treated between 1977 and 1993 with BCT for early stage invasive breast cancer, a total of 892 patients were available for study after excluding non-AA/non-white patients. Median age of patients was 56 years. Median follow-up was 35 months (range, 2 to 166). All patients underwent lumpectomy and radiation therapy(RT). Seven hundred eighty-six (88%) patients had axillary dissection. Median RT dose was 6000cGy with 90% of patients receiving 6000cGy or more. Two hundred fifty (28%) had chemotherapy, 327(37%) had tamoxifen and 64(7%) had both. T stage distribution was as follows: 632 T1 (71%), 244 T2 (27%), 12 T3 (1%) and 4 unknown (<1%). One hundred eighty six (21%) patients were pathologically node positive. There were 354 AA (40%) and 538 white (60%) patients. The chi-square test was used to compare distribution of prognostic factors between races. Outcome was evaluated by Kaplan-Meier actuarial method and logrank test. Sub-groups analyzed for outcome differences by race included T stage, tumor size, nodal status, grade, receptor status, age, menopausal status and family history. Multivariate analysis was performed by Cox proportional hazard model. RESULTS: No significant differences between AA and whites were seen in age, menopausal status, family history, T stage, N stage, number of nodes involved, histologic grade, total RT dose or chemotherapy. However, a larger percentage of whites received tamoxifen (43 vs 27%)(p<0.001), had low nuclear grade (19 vs 9

  3. A first look into the influence of triathlon wetsuit on resting blood pressure and heart rate variability

    Directory of Open Access Journals (Sweden)

    A Prado

    2016-12-01

    Full Text Available The purpose of this study was to investigate the effects of wearing a wetsuit on resting cardiovascular measures (blood pressure (BP, heart rate variability (HRV. The influence of position (upright, prone and wetsuit size were also explored. Participants (n=12 males, 33.3±12.1 years had BP and HRV measured during six resting conditions: standing or prone while not wearing a wetsuit (NWS, wearing the smallest (SWS, or largest (LWS wetsuit (based upon manufacturer guidelines. Heart rate was recorded continuously over 5-mins; BP was measured three times per condition. HRV was represented by the ratio of low (LF and high (HF frequency (LF/HF ratio; mean arterial pressure (MAP was calculated. Each dependent variable was analyzed using a 2 (position x 3 (wetsuit repeated measures ANOVA (α=0.05. Neither HRV parameter was influenced by position x wetsuit condition interaction (p>0.05 and MAP was not influenced by position (p=0.717. MAP and LF/HF ratio were both influenced by wetsuit condition (p<0.05 with higher during SWS than NWS (p=0.026 while LF/HF ratio was lower during SWS compared to NWS (p=0.032. LF/HF ratio was influenced by position being greater during standing vs. prone (p=0.001. It was concluded that during resting while on land (i.e., not submerged in water, wearing a small, tight-fitting wetsuit subtlety altered cardiovascular parameters for healthy, normotensive subjects.

  4. Changes of extreme precipitation and nonlinear influence of climate variables over monsoon region in China

    KAUST Repository

    Gao, Tao; Wang, Huixia Judy; Zhou, Tianjun

    2017-01-01

    of precipitation extremes over monsoon regions in China (MRC). However, research on monsoon extremes in China and their associations with climate variables is limited. In this study, we examine the space-time variations of extreme precipitation across the MRC

  5. Severe linear growth retardation in rural Zambian children: the influence of biological variables.

    NARCIS (Netherlands)

    Hautvast, J.L.A.; Tolboom, J.J.M.; Kaftwembe, E.M.; Musonda, R.M.; Mwanakasale, V.; Staveren, W.A. van; Hof, M.A. van 't; Sauerwein, R.W.; Willems, J.L.; Monnens, L.A.H.

    2000-01-01

    BACKGROUND: The prevalence of stunting in preschool children in Zambia is high; stunting has detrimental effects on concurrent psychomotor development and later working capacity. OBJECTIVE: Our objective was to investigate biological variables that may contribute to linear growth retardation in

  6. Influence of Indian summer monsoon variability on the surface waves in the coastal regions of eastern Arabian Sea

    Digital Repository Service at National Institute of Oceanography (India)

    SanilKumar, V.; Jesbin, G.

    –885, 2016 www.ann-geophys.net/34/871/2016/ doi:10.5194/angeo-34-871-2016 © Author(s) 2016. CC Attribution 3.0 License. Influence of Indian summer monsoon variability on the surface waves in the coastal regions of eastern Arabian Sea V. Sanil Kumar and Jesbin... of the period. The annual average value is ∼ 1.5 m (Anoop et al., 2015). During the non-monsoon period, the land and sea breeze has a signif- icant influence on the wave climate of eastern AS (Glejin Ann. Geophys., 34, 871–885, 2016 www.ann-geophys.net/34...

  7. High Intrapatient Variability of Tacrolimus Exposure in the Early Period After Liver Transplantation Is Associated With Poorer Outcomes.

    Science.gov (United States)

    Rayar, Michel; Tron, Camille; Jézéquel, Caroline; Beaurepaire, Jean Marie; Petitcollin, Antoine; Houssel-Debry, Pauline; Camus, Christophe; Verdier, Marie Clémence; Dehlawi, Ammar; Lakéhal, Mohamed; Desfourneaux, Véronique; Meunier, Bernard; Sulpice, Laurent; Bellissant, Eric; Boudjema, Karim; Lemaitre, Florian

    2018-03-01

    Tacrolimus (TAC) is the cornerstone of immunosuppressive regimen in liver transplantation (LT). Its pharmacokinetics is characterized by a high interpatient and intrapatient variability (IPV) leading to an unpredictable dose-response relationship. The aim of our study was to evaluate the impact of TAC IPV (IPV) on graft and patient outcomes after LT. We retrospectively analyzed 812 LT recipients treated with TAC. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of whole blood trough concentrations. Patients were categorized in 2 groups: low IPV (CV < 40%) and high IPV (CV ≥ 40%). There were significantly more neurologic complications (31.2% vs 16.6%, P < 0.001), cardiovascular complications (19.7% vs 9.7%, P < 0.001), and acute renal failure requiring dialysis (8.5% vs 2.2%, P < 0.001) in the high CV group than in the low CV group. Moreover, graft survival was significantly poorer in the high CV group (hazard ratio, 1.42; 95% confidence interval, 1.04-1.95; P = 0.03). A pretransplantation elevated Model for End-Stage Liver Disease score (P < 0.001) and Child-Pugh grade (P < 0.001) were identified as risk factors for presenting a high CV. A high CV of TAC concentrations was found to be predictive of TAC-related toxicity and poorer survival.

  8. Characteristics of patients in routine psycho-oncological care, and changes in outcome variables during and after their treatment.

    Science.gov (United States)

    Garssen, Bert; Van der Lee, Marije; Van der Poll, Amber; Ranchor, Adelita V; Sanderman, Robbert; Schroevers, Maya J

    2016-10-01

    The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions. During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later. Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.

  9. Predicting Inpatient Detoxification Outcome of Alcohol and Drug Dependent Patients: The Influence of Sociodemographic Environment, Motivation, Impulsivity, and Medical Comorbidities

    Directory of Open Access Journals (Sweden)

    Yvonne Sofin

    2017-01-01

    Full Text Available Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients. Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined. Results. 525 (63.1% of the patients completed detoxification treatment whereas 307 (36.9% dropped out prematurely. Being female, living in a partnership, having children, being employed, and having good education were predictive for a positive outcome. Family, health, the fear of losing the job, prosecution, and emergency admission were significant motivational predictors for treatment outcome. Being younger, history of imprisonment, and the number of previous drop-outs were predictive for a negative outcome. Conclusions. Variables concerning social environment and the number of previous drop-outs have been identified as best predictors for treatment outcome. Socially stable patients benefit from the current treatment setting and treatment shall be adapted for patients with negative predictors. Treatment may consequently be tailored with respect to intervention type, duration, and intensity to improve the outcome for those patients that fulfil criteria with negative impact on treatment retention.

  10. Unintended outcomes of farmers' adaptation to climate variability: deforestation and conservation in Calakmul and Maya biosphere reserves

    Directory of Open Access Journals (Sweden)

    Claudia Rodriguez-Solorzano

    2014-06-01

    Full Text Available Minimizing the impact of climate change on farmer livelihoods is crucial, but adaptation efforts may have unintended consequences for ecosystems, with potential impacts on farmers' welfare. Unintended outcomes of climate adaptation strategies have been widely discussed, however, empirical exploration has been neglected. Grounded in scholarship on climate adaptation, environmental governance, social-ecological systems, and land-use change, this paper studies whether farmers' climate adaptation contributes to deforestation or forest conservation. The paper draws on interviews with 353 farmers from 46 communities in Calakmul Biosphere Reserve in Mexico and Maya Biosphere Reserve in Guatemala. Farmers in the area of study have implemented adaptation strategies that people around the world have used for centuries, including migration, diversification, savings, and pooling. The findings show that climate adaptation can increase deforestation or support forest conservation depending on the type of adaptation strategy farmers implement. Saving, based on cattle ranching, is a deforestation-driving strategy. The choice of this strategy is influenced by distance to the commercial and administrative center and cash benefits from the forest. Deforestation can have a negative impact on farmers' welfare, as well as harm biodiversity and contribute to increased climate change. Thus, deforestation-driving adaptation strategies may be ineffective. However, diversification, based on off-farm jobs and operating provision shops, is a conservation-driving strategy influenced by distance as well as by family size. Farmers who choose diversification to adapt may contribute to a virtuous circle in which livelihood improvement in the short term leads to enhanced social-ecological resilience in the longer term. The need for farmers to implement adaptation strategies thus represents great risk but also opportunities.

  11. Genetic influence on methadone treatment outcomes in patients undergoing methadone maintenance treatment for opioid addiction: a pilot study

    Directory of Open Access Journals (Sweden)

    Samaan Z

    2014-08-01

    Full Text Available Zainab Samaan,1–4 Monica Bawor,3,4 Brittany B Dennis,2,3 Carolyn Plater,5 Michael Varenbut,5 Jeffrey Daiter,5 Andrew Worster,5,6 David C Marsh,5,7 Charlie Tan,8 Dipika Desai,3 Lehana Thabane,2,9,10 Guillaume Pare11 1Department of Psychiatry and Behavioural Neurosciences, 2Department of Clinical Epidemiology and Biostatistics, 3Population Genomics Program, Chanchlani Research Centre, 4MiNDS Neuroscience Program, McMaster University, Hamilton, Ontario, Canada; 5Ontario Addiction Treatment Centres, Richmond Hill, Ontario, Canada; 6Department of Medicine, McMaster University, Hamilton, Ontario, Canada; 7Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada; 8Michael G. DeGroote School of Medicine, McMaster University, 9Biostatistics Unit, Centre for Evaluation of Medicine, 10System Linked Research Unit, 11Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada Introduction: Treatment of opioid addiction with methadone is effective; however, it is known to produce interindividual variability. This may be influenced in part by genetic variants, which can increase the initial risk of developing opioid addiction as well as explain differences in response to treatment. This pilot study aimed to assess the feasibility of conducting a full-scale genetic analysis to identify genes that predict methadone treatment outcomes in this population. Methods: This was a cross-sectional observational study of patients admitted to a methadone maintenance treatment program for opioid addiction. We obtained demographic and clinical characteristics in addition to blood and urine samples, for the assessment of treatment outcomes. Results: The recruitment process yielded 252 patients, representing a 20% recruitment rate. We conducted genetic testing based on a 99.6% rate of provision of DNA samples. The average retention in treatment was 3.4 years, and >50% of the participants reported psychiatric and

  12. The influences of adrenaline dosing frequency and dosage on outcomes of adult in-hospital cardiac arrest: A retrospective cohort study.

    Science.gov (United States)

    Wang, Chih-Hung; Huang, Chien-Hua; Chang, Wei-Tien; Tsai, Min-Shan; Yu, Ping-Hsun; Wu, Yen-Wen; Hung, Kuan-Yu; Chen, Wen-Jone

    2016-06-01

    To investigate the influence of dosing frequency and dosage of adrenaline on outcomes of cardiopulmonary resuscitation (CPR). We conducted a retrospective observational study in a single medical centre and included adult patients who had suffered an in-hospital cardiac arrest between 2006 and 2012. We used multivariable logistic regression analysis to evaluate the associations between independent variables and outcomes. Adrenaline average dosing frequency was calculated as the total dosage of adrenaline administered during CPR divided by the duration of CPR. Body weight (BW) was analysed as an interaction term to investigate the effect of adrenaline dosage on outcomes. Favourable neurological outcome was defined as a score of 1 or 2 on the Cerebral Performance Category scale at hospital discharge. We included 896 patients in the analysis. After adjusting for multiple confounding factors, including CPR duration, the results indicated that higher adrenaline dosing frequency was associated with lower rates of survival (odds ratio (OR): 0.05, 95% confidence interval (CI): 0.01-0.23) and favourable neurological outcome at hospital discharge (OR: 0.02, 95% CI: 0.002-0.16). A significant interaction was noted between total adrenaline dosage and BW, which indicated that, with the same adrenaline dosage, the outcomes for patients with BW≥82.5kg would be worse than those for patients with lower BW. Higher adrenaline average dosing frequency may be associated with worse outcomes after CPR. Besides, according to current recommendations, patients with BW above 82.5kg may not receive adequate dose of adrenaline. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Influence of diuretic therapy on the features of heart rhythm variability changes in chronic heart failure patients

    Directory of Open Access Journals (Sweden)

    K R Alyeva

    2018-02-01

    Full Text Available Aim. To study comparative influence of furosemide and torasemide on heart rhythm variability in patients with chronic heart failure of ischemic origin. Methods. The study included 48 patients (29 males and 19 females with ischemic heart disease complicated by chronic heart failure, NYHA functional classes II-IV. All patients were randomized into two groups: group 1 (25 patients received furosemide as diuretic therapy, and group 2 (23 patients received torasemide. All patient underwent clinical examination including assessment of complaints and physical examination, laboratory and instrumental tests (electrocardiography, echocardiography, 6-minute walk test, 24 Hour Holter ECG monitoring before and 30 days after starting diuretic therapy. Results. Against the background of one-month diuretic therapy, positive dynamics of clinical parameters was registered in both main groups of patients receiving both furosemide and torasemide. In furosemide group deterioration of heart rhythm variability was observed. Torasemide treatment resulted in considerable improvement of vegetative regulation of heart activity. Conclusion. Diuretic therapy with furosemide is characterized by changes of time and spectral parameters of vegetative regulation of heart rhythm towards strengthening of sympathetic and attenuation of parasympathetic influence; diuretic therapy with torasemide resulted in considerable improvement of heart rhythm variability parameters, attenuation of sympathetic and strengthening of parasympathetic influence on heart rhythm that provides additional cardioprotection in the treatment of patients with chronic heart failure of ischemic origin.

  14. Influence of Tönnis Grade on Outcomes of Arthroscopic Management of Symptomatic Femoroacetabular Impingement.

    Science.gov (United States)

    Byrd, J W Thomas; Bardowski, Elizabeth A; Jones, Kay S

    2018-05-19

    To define the outcomes of arthroscopic correction of femoroacetabular impingement (FAI) based on Tönnis findings within a previously reported patient population, including a comparative analysis of Tönnis grade 0 and 1 versus grade 2 changes. Outcomes (modified Harris Hip Score [mHHS]) of a previously published study of arthroscopic correction of FAI were correlated with Tönnis grade. The inclusion criteria were the first 100 consecutive patients undergoing arthroscopic FAI correction with minimum 2-year follow-up. These procedures were performed between December 2003 and May 2006. Grades were determined independently by 2 experienced clinicians. Tönnis grades 0 and 1 were compared with Tönnis grade 2. Independent variables of sex and age were also evaluated. The average age of the entire group was 34.7 years (range, 13-76 years), with 66 male and 34 female patients. Of the patients, 17 had Tönnis grade 0, 49 had Tönnis grade 1, 29 had Tönnis grade 2, and 4 had Tönnis grade 3 (1 unknown). The average mHHS improvement for Tönnis grade 0 was 20.6 points; Tönnis grade 1, 22.2 points; Tönnis grade 2, 14.9 points; and Tönnis grade 3, 18.8 points. The improvement was statistically (P 8 points) significant across all Tönnis grades. There was no difference (P = .077) between Tönnis grades 0 and 1 (21.8 points) versus grade 2 (14.9 points). There was no difference based on sex or age. These data support that statistically and clinically meaningful successful patient-reported outcomes (mHHS) at 2 years can be encountered even in the presence of Tönnis grade 2 radiographic features. Neither age nor sex was an indicator of poorer results within similar Tönnis grades. Level III, case-control study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Influence of Surface Roughness Spatial Variability and Temporal Dynamics on the Retrieval of Soil Moisture from SAR Observations

    Directory of Open Access Journals (Sweden)

    Jesús Álvarez-Mozos

    2009-01-01

    Full Text Available Radar-based surface soil moisture retrieval has been subject of intense research during the last decades. However, several difficulties hamper the operational estimation of soil moisture based on currently available spaceborne sensors. The main difficulty experienced so far results from the strong influence of other surface characteristics, mainly roughness, on the backscattering coefficient, which hinders the soil moisture inversion. This is especially true for single configuration observations where the solution to the surface backscattering problem is ill-posed. Over agricultural areas cultivated with winter cereal crops, roughness can be assumed to remain constant along the growing cycle allowing the use of simplified approaches that facilitate the estimation of the moisture content of soils. However, the field scale spatial variability and temporal variations of roughness can introduce errors in the estimation of soil moisture that are difficult to evaluate. The objective of this study is to assess the impact of roughness spatial variability and roughness temporal variations on the retrieval of soil moisture from radar observations. A series of laser profilometer measurements were performed over several fields in an experimental watershed from September 2004 to March 2005. The influence of the observed roughness variability and its temporal variations on the retrieval of soil moisture is studied using simulations performed with the Integral Equation Model, considering different sensor configurations. Results show that both field scale roughness spatial variability and its temporal variations are aspects that need to be taken into account, since they can introduce large errors on the retrieved soil moisture values.

  16. Influence of the anodizing process variables on the acidic properties of anodic alumina films

    Directory of Open Access Journals (Sweden)

    D.E. Boldrini

    Full Text Available Abstract In the present work, the effect of the different variables involved in the process of aluminum anodizing on the total surface acidity of the samples obtained was studied. Aluminum foils were treated by the electro-chemical process of anodic anodizing within the following variable ranges: concentration = 1.5-2.5 M; temperature = 303-323 K; voltage = 10-20 V; time = 30-90 min. The total acidity of the samples was characterized by two different methods: acid-base titration using Hammett indicators and potentiometric titration. The results showed that anodizing time, temperature and concentration were the main variables that determined the surface acid properties of the samples, and to a lesser extent voltage. Acidity increased with increasing concentration of the electrolytic bath, whereas the rest of the variables had the opposite effect. The results obtained provide a novel tool for variable selection in order to use synthetized materials as catalytic supports, adding to previous research based on the morphology of alumina layers.

  17. The influence of roller compaction processing variables on the rheological properties of granules

    Directory of Open Access Journals (Sweden)

    Tim Freeman

    2016-08-01

    The results demonstrate several rheological properties of the granulate, which have been shown to be closely correlated with variance in die filling and tablet strength, and are predictably influenced by the processing parameters.

  18. The influence of smoking and other risk factors on the outcome after radiochemotherapy for anal cancer

    Directory of Open Access Journals (Sweden)

    Haegele Verena

    2007-08-01

    Full Text Available Abstract Background Smoking is an important risk factor for the development of cancer. Smoking during radiochemotherapy therapy may have a negative influence on prognosis. We evaluated the effect of smoking during radiochemotherapy on the outcome for patients with anal cancer. Methods Sixty-eight patients (34 smokers, 34 non-smokers treated by radiochemotherapy for anal cancer were analysed. The effect of smoking during radiochemotherapy and other risk factors (gender, T- and N category, tumor site, dose, therapy protocol on disease-specific survival (DSS, local control (LC and colostomy free survival (CFS was evaluated. Results There was a significant difference in age and male:female ratio between the two groups. With a median follow up of 22 months (max. 119 DSS, LC, and CFS were 88%, 84% and 84%. A significant difference in local control between smokers (S and non-smokers (NS was found (S 74% vs. NS 94%, p = .03. For DSS and CFS a difference in terms of outcome between smokers and non-smokers was seen (DSS: S 82% vs. NS 96%, p = .19, CFS: S 75% vs. 91%, p = .15, which did not reach statistical significance. In multivariate analyses only gender had a significant association with LC and T category with CFS. The other risk factors did not reach statistical significance. Conclusion Even though our evaluation reached statistical significance only in univariate analysis, we suggest, that the role of smoking during radiochemotherapy for anal cancer should not be ignored. The potential negative effect on prognosis should be explained to patients before therapy.

  19. The influence of Marfans and bicuspid valves on outcomes following aortic valve reimplantation.

    Science.gov (United States)

    Martín, Carlos E; García Montero, Carlos; Serrano, Santiago-Fiz; González, Ana; Mingo, Susana; Moñivas, Vanessa; Centeno, Jorge; Forteza, Alberto

    2017-10-01

    We analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. Between March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 50 ± 3 mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome. Overall 30-day mortality was 0.37% (1/267). Mean follow-up was 59.7 ± 38.7 months. Overall survival at 1, 3, and 5 years was 98 ± 8%, 98 ± 1%, and 94 ± 2%, respectively. Freedom from reoperation and aortic regurgitation >II was 99 ± 5%, 98 ± 8%, 96.7 ± 8%, and 99 ± 6%, 98 ± 1%, 98 ± 1%, respectively at 1, 3, and 5 years follow-up, with no differences between Marfan and bicuspid aortic valve groups. (p = 0.94 and p = 0.96, respectively). No endocarditis or thromboembolic complications were documented, and 93.6% of the patients did not receive any anticoagulation therapy. The reimplantation technique for aortic root aneurysms is associated with excellent clinical and functional outcomes at short and mid-term follow-up. © 2017 Wiley Periodicals, Inc.

  20. Sphenopalatine Artery Ligation for Epistaxis: Factors Influencing Outcome and Impact of Timing of Surgery.

    Science.gov (United States)

    McDermott, Ailbhe M; O'Cathain, Eadaoin; Carey, Brian William; O'Sullivan, Peter; Sheahan, Patrick

    2016-03-01

    Sphenopalatine artery ligation is a commonly employed surgical intervention for control of posterior epistaxis unresponsive to nasal packing. The objective of the present study was to evaluate the outcome of sphenopalatine artery ligation for control of epistaxis at our institution and the impact of timing and other factors on outcome. Case series with chart review. Academic tertiary referral center. Case notes were reviewed for 45 consecutive patients undergoing sphenopalatine artery ligation for control of epistaxis between October 2008 and October 2014. Forty-one patients had nasal packing prior to sphenopalatine artery ligation, with 33 undergoing ≥2 packings. Postoperatively, 6 patients had rebleeding, which was treated with repacking (n = 4) and return to the operating room (n = 2). The overall success rate of sphenopalatine artery ligation was 87% (39 of 45). Rebleeding rate was not affected by concomitant septoplasty, anterior ethmoidal artery ligation, or postoperative nasal packing. Patients undergoing SPA ligation within the first 24 hours of admission had a significantly shorter hospital length of stay (3 vs 6 days, P = .02) and treatment cost (€5905 vs €10,001, P = .03). Length of stay was not influenced by sphenopalatine artery ligation after ≤1 nasal pack versus ≥2 packs. Timing of sphenopalatine artery ligation did not affect blood transfusion requirement (P = .84). Sphenopalatine artery ligation is an effective management strategy for surgical control of refractory epistaxis. Early timing of sphenopalatine artery ligation may lead to reductions in length of stay. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  1. Contribution of geodiversity, climate and spatial variables for biodiversity across a gradient of human influence

    Science.gov (United States)

    Tukiainen, Helena; Alahuhta, Janne; Ala-Hulkko, Terhi; Field, Richard; Lampinen, Raino; Hjort, Jan

    2016-04-01

    Implementation of geodiversity may provide new perspectives for nature conservation. The relation between geodiversity and biodiversity has been established in recent studies but remains underexplored in environments with high human pressure. In this study, we explored the effect of geodiversity (i.e. geological, hydrological and geomorphological diversity), climate and spatial variables on biodiversity (vascular plant species richness) in environments with different human impact. The study area ranged trough the boreal vegetation zone in Finland and included altogether 1401 1-km2 grid cells from urban, rural and natural environments. The contribution of environmental variable groups for species diversity in different environments was statistically analyzed with variation partitioning method. According to the results, the contribution of geodiversity decreased and the contribution of climate and spatial variables increased as the land use became more human-induced. Hence, the connection between geodiversity and species richness was most pronounced in natural state environments.

  2. Influence of climate on emergency department visits for syncope: role of air temperature variability.

    Directory of Open Access Journals (Sweden)

    Andrea Galli

    Full Text Available BACKGROUND: Syncope is a clinical event characterized by a transient loss of consciousness, estimated to affect 6.2/1000 person-years, resulting in remarkable health care and social costs. Human pathophysiology suggests that heat may promote syncope during standing. We tested the hypothesis that the increase of air temperatures from January to July would be accompanied by an increased rate of syncope resulting in a higher frequency of Emergency Department (ED visits. We also evaluated the role of maximal temperature variability in affecting ED visits for syncope. METHODOLOGY/PRINCIPAL FINDINGS: We included 770 of 2775 consecutive subjects who were seen for syncope at four EDs between January and July 2004. This period was subdivided into three epochs of similar length: 23 January-31 March, 1 April-31 May and 1 June-31 July. Spectral techniques were used to analyze oscillatory components of day by day maximal temperature and syncope variability and assess their linear relationship. There was no correlation between daily maximum temperatures and number of syncope. ED visits for syncope were lower in June and July when maximal temperature variability declined although the maximal temperatures themselves were higher. Frequency analysis of day by day maximal temperature variability showed a major non-random fluctuation characterized by a ∼23-day period and two minor oscillations with ∼3- and ∼7-day periods. This latter oscillation was correlated with a similar ∼7-day fluctuation in ED visits for syncope. CONCLUSIONS/SIGNIFICANCE: We conclude that ED visits for syncope were not predicted by daily maximal temperature but were associated with increased temperature variability. A ∼7-day rhythm characterized both maximal temperatures and ED visits for syncope variability suggesting that climate changes may have a significant effect on the mode of syncope occurrence.

  3. The Human Skin Microbiome Associates with the Outcome of and Is Influenced by Bacterial Infection.

    Science.gov (United States)

    van Rensburg, Julia J; Lin, Huaiying; Gao, Xiang; Toh, Evelyn; Fortney, Kate R; Ellinger, Sheila; Zwickl, Beth; Janowicz, Diane M; Katz, Barry P; Nelson, David E; Dong, Qunfeng; Spinola, Stanley M

    2015-09-15

    The influence of the skin microbiota on host susceptibility to infectious agents is largely unexplored. The skin harbors diverse bacterial species that may promote or antagonize the growth of an invading pathogen. We developed a human infection model for Haemophilus ducreyi in which human volunteers are inoculated on the upper arm. After inoculation, papules form and either spontaneously resolve or progress to pustules. To examine the role of the skin microbiota in the outcome of H. ducreyi infection, we analyzed the microbiomes of four dose-matched pairs of "resolvers" and "pustule formers" whose inoculation sites were swabbed at multiple time points. Bacteria present on the skin were identified by amplification and pyrosequencing of 16S rRNA genes. Nonmetric multidimensional scaling (NMDS) using Bray-Curtis dissimilarity between the preinfection microbiomes of infected sites showed that sites from the same volunteer clustered together and that pustule formers segregated from resolvers (P = 0.001, permutational multivariate analysis of variance [PERMANOVA]), suggesting that the preinfection microbiomes were associated with outcome. NMDS using Bray-Curtis dissimilarity of the endpoint samples showed that the pustule sites clustered together and were significantly different than the resolved sites (P = 0.001, PERMANOVA), suggesting that the microbiomes at the endpoint differed between the two groups. In addition to H. ducreyi, pustule-forming sites had a greater abundance of Proteobacteria, Bacteroidetes, Micrococcus, Corynebacterium, Paracoccus, and Staphylococcus species, whereas resolved sites had higher levels of Actinobacteria and Propionibacterium species. These results suggest that at baseline, resolvers and pustule formers have distinct skin bacterial communities which change in response to infection and the resultant immune response. Human skin is home to a diverse community of microorganisms, collectively known as the skin microbiome. Some resident

  4. Influence of Immobilization Time on Functional Outcome in Radial Neck Fractures in Children.

    Science.gov (United States)

    Badoi, Adina; Frech-Dörfler, Martina; Häcker, Frank-Martin; Mayr, Johannes

    2016-12-01

    Background  Radial neck fractures represent 20 to 30% of elbow fractures in children. Incorrect treatment can lead to significant permanent functional impairment. Posttraumatic avascular necrosis may cause a deformity of the radial head and neck. Deformation of the radial head and neck can be more severe after open rather than closed reduction or orthopedic treatment without reduction. The aim of our study was to analyze the influence of immobilization time on functional outcome. Patients and Methods  Retrospective, descriptive study of all children who had been treated for a radial neck fracture between 1999 and 2013 at the University Children's Hospital Basel. Patients were allocated to two groups (group 1: patients treated between 1999 and 2008, group 2: patients treated between 2009 and 2013). The fractures were classified according to the classification of Metaizeau. The primary endpoint was the percentage of patients who reached the full range of elbow motion at the end of the treatment period or the last follow-up. Secondary endpoints were immobilization time and number of patients with persistent physical restrictions of the elbow range of motion as well as the type of restrictions and subjective complaints. Results  A total of 67 patients treated for radial neck fracture were included in the first group (1999-2008). A total of 47 patients were allocated to the second group (2009-2013). Overall, 59 patients in group 1 and 39 patients in group 2 were treated nonoperatively. Average immobilization time was 22.7 days (range, 6-60 days) in group 1 and 13.2 days (range, 0-27 days) in group 2. Full range of motion was observed in 50 to 72.7% of patients in group 1 and in 71.4 to 92% of patients in group 2, depending on the grade of fracture displacement. Overall, 21 patients (31%) of group 1 showed a persistent functional restriction. In group 2, only six patients (12%) suffered from a persistent functional restriction of the elbow range of motion

  5. The influence of anthropometric, kinematic and energetic variables and gender on swimming performance in youth athletes

    OpenAIRE

    Morais, J.E.; Garrido, N.; Marques, M.C.; Silva, A.J.; Marinho, D.A.; Barbosa, Tiago M.

    2013-01-01

    The aim of this study was to assess the: (i) gender; (ii) performance and; (iii) gender versus performance interactions in young swimmers’ anthropometric, kinematic and energetic variables. One hundred and thirty six young swimmers (62 boys: 12.76 ± 0.72 years old at Tanner stages 1–2 by self-evaluation; and 64 girls: 11.89 ± 0.93 years old at Tanner stages 1–2 by self-evaluation) were evaluated. Performance, anthropometrics, kinematics and energetic variables were selected. There was a non-s...

  6. How Teachers' Beliefs About Climate Change Influence Their Instruction and Resulting Student Outcomes

    Science.gov (United States)

    Nation, M.; Feldman, A.; Smith, G.

    2017-12-01

    The purpose of the study was to understand the relationship between teachers' beliefs and understandings of climate change and their instructional practices to determine if and how they impact student outcomes. Limited research has been done in the area of teacher beliefs on climate change, their instruction, and resulting student outcomes. This study contributes to the greater understanding of teachers' beliefs and impact on climate change curriculum implementation. The study utilized a mixed methods approach to data collection and analysis. Data were collected in the form of classroom observations, surveys, and interviews from teachers and students participating in the study over a four-month period. Qualitative and quantitative findings were analyzed through thematic coding and descriptive analysis and compared in an effort to triangulate findings. The results of the study suggest teachers and students believe climate change is occurring and humans are largely to blame. Personal beliefs are important when teaching controversial topics, such as climate change, but participants maintained neutrality within their instruction of the topic, as not to appear biased or influence students' decisions about climate change, and avoid political controversy in the classroom. Overall, the study found teachers' level of understandings and beliefs about climate change had little impact on their instruction and resulting student outcomes. Based on the findings, simply adding climate change to the existing science curriculum is not sufficient for teachers or students. Teachers need to be better prepared about effective pedagogical practices of the content in order to effectively teach a climate-centered curriculum. The barriers that exist for the inclusion of teachers' personal beliefs need to be removed in order for teachers to assert their own personal beliefs about climate change within their classroom instruction. Administrators and stakeholders need to support science

  7. Clinical study on influences of enteric coated aspirin on blood pressure and blood pressure variability.

    Science.gov (United States)

    Ji, A-L; Chen, W-W; Huang, W-J

    2016-12-01

    We investigated the effects of oral administration of enteric coated aspirin (ASA) on blood pressure and blood pressure variability of hypertension patients before sleep. We observed 150 hypertension cases, classified as Grade 1-2, from September 2006 to March 2008. They are divided into a control group with 30 cases, ASA I group with 60 cases and ASA II group with 60 cases randomly. Subjects in the control group had proper diets, were losing weight, exercising and maintaining a healthy mentality and were taking 30 mg Adalat orally once a day. Based on the treatment of control group, patients in ASA I group were administered 0.1 g Bayaspirin (produced by Bayer Company) at drought in the morning. Also, based on the treatment of control group, patients in ASA II group were administered 0.1 g Bayaspirin at draught before sleep. The course of treatment is 3 months and then after the treatment, decreasing blood pressure and blood pressure variability conditions in three groups will be compared. Through the comparison of ASA II group with the control group, they have differences in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), decreasing range of blood pressure and blood pressure variability (p sleep has synergistic effects on decreasing blood pressure of hypertension patients and improving blood pressure variability.

  8. The influence of anthropometric, kinematic and energetic variables and gender on swimming performance in youth athletes.

    Science.gov (United States)

    Morais, Jorge E; Garrido, Nuno D; Marques, Mário C; Silva, António J; Marinho, Daniel A; Barbosa, Tiago M

    2013-12-18

    (i) gender; (ii) performance and; (iii) gender versus performance interactions in young swimmers' anthropometric, kinematic and energetic variables. One hundred and thirty six young swimmers (62 boys: 12.76 ± 0.72 years old at Tanner stages 1-2 by self-evaluation; and 64 girls: 11.89 ± 0.93 years old at Tanner stages 1-2 by self-evaluation) were evaluated. Performance, anthropometrics, kinematics and energetic variables were selected. There was a non-significant gender effect on performance, body mass, height, arm span, trunk transverse surface area, stroke length, speed fluctuation, swimming velocity, propulsive efficiency, stroke index and critical velocity. A significant gender effect was found for foot surface area, hand surface area and stroke frequency. A significant sports level effect was verified for all variables, except for stroke frequency, speed fluctuation and propulsive efficiency. Overall, swimmers in quartile 1 (the ones with highest sports level) had higher anthropometric dimensions, better stroke mechanics and energetics. These traits decrease consistently throughout following quartiles up to the fourth one (i.e. swimmers with the lowest sports level). There was a non-significant interaction between gender and sports level for all variables. Our main conclusions were as follows: (i) there are non-significant differences in performance, anthropometrics, kinematics and energetics between boys and girls; (ii) swimmers with best performance are taller, have higher surface areas and better stroke mechanics; (iii) there are non-significant interactions between sports level and gender for anthropometrics, kinematics and energetics.

  9. Influence of short-term blood pressure variability on blood pressure determinations

    NARCIS (Netherlands)

    Bos, W. J.; van Goudoever, J.; van Montfrans, G. A.; Wesseling, K. H.

    1992-01-01

    To evaluate the effect of blood pressure variability on Riva Rocci Korotkoff blood pressure determinations, we studied the intra-arterial pressure during Riva Rocci Korotkoff determinations in 25 patients. In 50 measurements with a cuff deflation rate of 2.5 mm Hg/sec, the systolic intra-arterial

  10. Pre-analytical and analytical factors influencing Alzheimer's disease cerebrospinal fluid biomarker variability.

    Science.gov (United States)

    Fourier, Anthony; Portelius, Erik; Zetterberg, Henrik; Blennow, Kaj; Quadrio, Isabelle; Perret-Liaudet, Armand

    2015-09-20

    A panel of cerebrospinal fluid (CSF) biomarkers including total Tau (t-Tau), phosphorylated Tau protein at residue 181 (p-Tau) and β-amyloid peptides (Aβ42 and Aβ40), is frequently used as an aid in Alzheimer's disease (AD) diagnosis for young patients with cognitive impairment, for predicting prodromal AD in mild cognitive impairment (MCI) subjects, for AD discrimination in atypical clinical phenotypes and for inclusion/exclusion and stratification of patients in clinical trials. Due to variability in absolute levels between laboratories, there is no consensus on medical cut-off value for the CSF AD signature. Thus, for full implementation of this core AD biomarker panel in clinical routine, this issue has to be solved. Variability can be explained both by pre-analytical and analytical factors. For example, the plastic tubes used for CSF collection and storage, the lack of reference material and the variability of the analytical protocols were identified as important sources of variability. The aim of this review is to highlight these pre-analytical and analytical factors and describe efforts done to counteract them in order to establish cut-off values for core CSF AD biomarkers. This review will give the current state of recommendations. Copyright © 2015. Published by Elsevier B.V.

  11. The Influence of Peer and Educational Variables on Arrest Status among At-Risk Males.

    Science.gov (United States)

    Bullis, Michael; Walker, Hill M.; Stieber, Steve

    1998-01-01

    A study examined the predictive power of selected social and academic variables regarding the arrest frequency for 11th-grade boys who seven years earlier had been judged to be at risk of developing antisocial behavior patterns. Antisocial measures on which participants scored higher were associated with more frequent arrests. (Author/CR)

  12. Intake plenum volume and its influence on the engine performance, cyclic variability and emissions

    International Nuclear Information System (INIS)

    Ceviz, M.A.

    2007-01-01

    Intake manifold connects the intake system to the intake valve of the engine and through which air or air-fuel mixture is drawn into the cylinder. Details of the flow in intake manifolds are extremely complex. Recently, most of engine companies are focused on variable intake manifold technology due to their improvement on engine performance. This paper investigates the effects of intake plenum volume variation on engine performance and emissions to constitute a base study for variable intake plenum. Brake and indicated engine performance characteristics, coefficient of variation in indicated mean effective pressure (COV imep ) as an indicator for cyclic variability, pulsating flow pressure in the intake manifold runner, and CO, CO 2 and HC emissions were taken into consideration to evaluate the effects of different plenum volumes. The results of this study showed that the variation in the plenum volume causes an improvement on the engine performance and the pollutant emissions. The brake torque and related performance characteristics improved pronouncedly about between 1700 and 2600 rpm by increasing plenum volume. Additionally, although the increase in the plenum volume caused the mixture leaner due to the increase in the intake runner pressure and lean mixtures inclined to increase the cyclic variability, a decrease was interestingly observed in the COV imep

  13. Influence of weather and climate variables on the basal area growth of individual shortleaf pine trees

    Science.gov (United States)

    Pradip Saud; Thomas B. Lynch; Duncan S. Wilson; John Stewart; James M. Guldin; Bob Heinemann; Randy Holeman; Dennis Wilson; Keith Anderson

    2015-01-01

    An individual-tree basal area growth model previously developed for even-aged naturally occurring shortleaf pine trees (Pinus echinata Mill.) in western Arkansas and southeastern Oklahoma did not include weather variables. Individual-tree growth and yield modeling of shortleaf pine has been carried out using the remeasurements of over 200 plots...

  14. The cross wavelet analysis of dengue fever variability influenced by meteorological conditions

    Science.gov (United States)

    Lin, Yuan-Chien; Yu, Hwa-Lung; Lee, Chieh-Han

    2015-04-01

    The multiyear variation of meteorological conditions induced by climate change causes the changing diffusion pattern of infectious disease and serious epidemic situation. Among them, dengue fever is one of the most serious vector-borne diseases distributed in tropical and sub-tropical regions. Dengue virus is transmitted by several species of mosquito and causing lots amount of human deaths every year around the world. The objective of this study is to investigate the impact of meteorological variables to the temporal variation of dengue fever epidemic in southern Taiwan. Several extreme and average indices of meteorological variables, i.e. temperature and humidity, were used for this analysis, including averaged, maximum and minimum temperature, and average rainfall, maximum 1-hr rainfall, and maximum 24-hr rainfall. This study plans to identify and quantify the nonlinear relationship of meteorological variables and dengue fever epidemic, finding the non-stationary time-frequency relationship and phase lag effects of those time series from 1998-2011 by using cross wavelet method. Results show that meteorological variables all have a significant time-frequency correlation region to dengue fever epidemic in frequency about one year (52 weeks). The associated phases can range from 0 to 90 degrees (0-13 weeks lag from meteorological factors to dengue incidences). Keywords: dengue fever, cross wavelet analysis, meteorological factor

  15. Executive Summary of the NHLBI Workshop Report: Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes.

    Science.gov (United States)

    Maier, Lisa A; Crouser, Elliott D; Martin, William J; Eu, Jerry

    2017-12-01

    Sarcoidosis is a systemic granulomatous disease that primarily affects the lung; it is associated with significant disparities, more commonly impacting those in the prime of their lives (age 20-50 yr, with a second peak after age 60 yr), black individuals, and women. However, the burden of disease, the ability to diagnose and prognose organ involvement and course, as well as specific treatment options, management options, and disease pathogenesis remain poorly understood. As a result, the National Heart, Lung, and Blood Institute undertook a sarcoidosis workshop, "Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes," to help address these issues by defining the scientific and clinical priorities to improve sarcoidosis care. The overarching recommendations from this workshop are outlined in the following summary and detailed in the accompanying articles. The recommendations included establishing collaborations and networks to conduct research based on consensus definitions of disease phenotypes and standards of care, and to provide clinical outreach to areas with a burden of disease to improve care. These collaborative networks would also serve as the hub to conduct clinical trials of devastating phenotypes (e.g., cardiac, neurologic, and fibrotic disease) not only for treatment but to enhance our understanding of the burden of disease. In addition, the networks would be used to leverage state-of-the-art "omics" and systems biology research, as well as other studies to advance understanding of disease pathogenesis, and development of biomarkers and therapeutic targets, with a goal to translate this information to improve care of individuals with sarcoidosis.

  16. Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population.

    Science.gov (United States)

    Sumithran, P; Purcell, K; Kuyruk, S; Proietto, J; Prendergast, L A

    2018-02-01

    Consistent, strong predictors of obesity treatment outcomes have not been identified. It has been suggested that broadening the range of predictor variables examined may be valuable. We explored methods to predict outcomes of a very-low-energy diet (VLED)-based programme in a clinically comparable setting, using a wide array of pre-intervention biological and psychosocial participant data. A total of 61 women and 39 men (mean ± standard deviation [SD] body mass index: 39.8 ± 7.3 kg/m 2 ) underwent an 8-week VLED and 12-month follow-up. At baseline, participants underwent a blood test and assessment of psychological, social and behavioural factors previously associated with treatment outcomes. Logistic regression, linear discriminant analysis, decision trees and random forests were used to model outcomes from baseline variables. Of the 100 participants, 88 completed the VLED and 42 attended the Week 60 visit. Overall prediction rates for weight loss of ≥10% at weeks 8 and 60, and attrition at Week 60, using combined data were between 77.8 and 87.6% for logistic regression, and lower for other methods. When logistic regression analyses included only baseline demographic and anthropometric variables, prediction rates were 76.2-86.1%. In this population, considering a wide range of biological and psychosocial data did not improve outcome prediction compared to simply-obtained baseline characteristics. © 2017 World Obesity Federation.

  17. The influence of global warming on natural disasters and their public health outcomes.

    Science.gov (United States)

    Diaz, James H

    2007-01-01

    With a documented increase in average global surface temperatures of 0.6 degrees C since 1975, Earth now appears to be warming due to a variety of climatic effects, most notably the cascading effects of greenhouse gas emissions resulting from human activities. There remains, however, no universal agreement on how rapidly, regionally, or asymmetrically the planet will warm or on the true impact of global warming on natural disasters and public health outcomes. Most reports to date of the public health impact of global warming have been anecdotal and retrospective in design and have focused on the increase in heat-stroke deaths following heat waves and on outbreaks of airborne and arthropod-borne diseases following tropical rains and flooding that resulted from fluctuations in ocean temperatures. The effects of global warming on rainfall and drought, tropical cyclone and tsunami activity, and tectonic and volcanic activity will have far-reaching public health effects not only on environmentally associated disease outbreaks but also on global food supplies and population movements. As a result of these and other recognized associations between climate change and public health consequences, many of which have been confounded by deficiencies in public health infrastructure and scientific debates over whether climate changes are spawned by atmospheric cycles or anthropogenic influences, the active responses to progressive climate change must include combinations of economic, environmental, legal, regulatory, and, most importantly, public health measures.

  18. Influence of implant properties and local delivery systems on the outcome in operative fracture care.

    Science.gov (United States)

    Metsemakers, W-J; Moriarty, T F; Nijs, S; Pape, H C; Richards, R G

    2016-03-01

    Fracture fixation devices are implanted into a growing number of patients each year. This may be attributed to an increase in the popularity of operative fracture care and the development of ever more sophisticated implants, which may be used in even the most difficult clinical cases. Furthermore, as the general population ages, fragility fractures become more frequent. With the increase in number of surgical interventions, the absolute number of complications of these surgical treatments will inevitably rise. Implant-related infection and compromised fracture healing remain the most challenging and prevalent complications in operative fracture care. Any strategy that can help to reduce these complications will not only lead to a faster and more complete resumption of activities, but will also help to reduce the socio-economic impact. In this review we describe the influence of implant design and material choice on complication rates in trauma patients. Furthermore, we discuss the importance of local delivery systems, such as implant coatings and bone cement, and how these systems may have an impact on the prevalence, prevention and treatment outcome of these complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Physicians working under the influence of alcohol: An analysis of past disciplinary proceedings and their outcomes.

    Science.gov (United States)

    Sendler, Damian Jacob

    2018-04-01

    The intoxicated person may cause harm to others, often requiring expert evaluation for the determination of guilt. The primary aim of this study was to determine the mechanisms of mistakes that led 17 doctors accused of working under the influence of alcohol to face malpractice. We also wanted to clarify what were the legal, professional, and financial consequences - depending on specific patient outcomes. We based analysis on the review and meta-analysis of the past forensic evaluation reports of institution-run forensics programs. Furthermore, we apply thematic analysis using combination of grounded theory and Pierre Bourdieu's theoretical framework. During the 2010-2016 timeframe, the regional forensic service opinionated on 17 physicians (3F, 14M) subjected to disciplinary action due to providing treatment under the influence of alcohol. In total, there were 157 patients potentially affected by malpractice - out of those, four were harmed; only one qualified for compensation. In the remaining 153 patients - only 11 persons reported having had awareness about the doctors' intoxication and apparent inability to perform the job, yet they agreed to receive care. Overall, in over 90% of patients, the physician did not harm anyone to a degree threatening patient's life. The supporting staff did not report experiencing distress either. The results of a blood test for the presence of alcohol were available for only four cases. Therefore, it was impossible to analyze the correlation between intoxication level and performance in providing care. All in all, in our analysis - less than 10% of 157 patients' care were compromised by provider's intoxication, either due to a mistake in diagnosis, medical procedure, or lacking communication skills. For physicians, working under the influence of alcohol is an uncommon phenomenon, but when it occurs - patients are at risk for receiving poor treatment. Presented analysis indicates that patients - just as much as supporting staff

  20. Influence of plant productivity over variability of soil respiration: a multi-scale approach

    Science.gov (United States)

    Curiel Yuste, J.

    2009-04-01

    general controlled by the seasonality of substrate supply by plants (via photosynthates translocation and/or litter) to soil. Although soil temperature and soil moisture exert a strong influence over the variation in SR, our results indicates that substrate supply by plant activity could exert a more important than previously expected role in the variability of soil respiration. 1. CREAF (Centre de Recerca Ecológica i Aplicacions Forestals), Unitat d'Ecofisiologia i Canvi Global CREAF-CEAB-CSIC, BELLATERRA (Barcelona), Spain (j.curiel@creaf.uab.es) 2. University of Antwerp (UA), Antwerp, Belgium (ivan.janssens@ua.ac.be) 3. Institute of Ecology, University of Innsbruck, Innsbruck, Austria (michael.bahn@uibk.ac.at) 4. UMR Ecologie et Ecophysiologie Forestières, Centre INRA de Nancy, France (longdoz@nancy.inra.fr) 5. ESPM, University of Calicornia at Berkeley, Berkeley, CA, US (baldocchi@nature.berkeley.edu) 6. The Woods Hole Research Center, Falmouth, USA (edavidson@whrc.org) 7. Max-Planck-Institute for Biogeochemistry, Jena, Germany (markus.reichstein@bgc-jena.mpg.de) 8. Institute of Systems Biology and Ecology, Academy of Sciences of the Czech Republic, Czech Republic (manuel@brno.cas.cz) 9. Università degli studi della Tuscia, Viterbo, Italy (arriga@unitus.it) 10. Laurence Berkeley lab, Berkeley, CA, USA (mstorn@lbl.gov) 11. Gembloux Agricultural University, Gembloux, Belgium (aubinet.m@fsagx.ac.be) 12. Fundacion CEAM(Centro de Estudios Ambientales del Mediterráneo), Valencia, Spain (arnaud@ceam.es) 13. Institute of Hydrology and Meteorology, Technische Universität Dresden, Pienner, Germany (gruenwald@forst.tu-dresden.de) 14. Department of Environmental Sciences, Second University of Naples, Caserta, Italy (ilaria.inglima@unina2.it) 15. CNRS-CEFE Montpellier, France (Laurent.MISSON@cefe.cnrs.fr) 16. Agenzia Provinciale per l'Ambiente, Bolzano, Italy (leonar@inwind.it) 17. University of Helsinki Department of Forest Ecology, Helsinki, Finland (jukka

  1. The influence of physical activity during pregnancy on maternal, fetal or infant heart rate variability: a systematic review.

    Science.gov (United States)

    Dietz, Pavel; Watson, Estelle D; Sattler, Matteo C; Ruf, Wolfgang; Titze, Sylvia; van Poppel, Mireille

    2016-10-26

    Physical activity (PA) during pregnancy has been shown to be associated with several positive effects for mother, fetus, and offspring. Heart rate variability (HRV) is a noninvasive and surrogate marker to determine fetal overall health and the development of fetal autonomic nervous system. In addition, it has been shown to be significantly influenced by maternal behavior. However, the influence of maternal PA on HRV has not yet been systematically reviewed. Therefore, the aim of this systematic review was to assess the influence of regular maternal PA on maternal, fetal or infant HRV. A systematic literature search following a priori formulated criteria of studies that examined the influence of regular maternal PA (assessed for a minimum period of 6 weeks) on maternal, fetal or infant HRV was performed in the databases Pubmed and SPORTDiscus. Quality of each study was assessed using the standardized Quality Assessment Tool for Quantitative Studies (QATQS). Nine articles were included into the present systematic review: two intervention studies, one prospective longitudinal study, and six post-hoc analysis of subsets of the longitudinal study. Of these articles four referred to maternal HRV, five to fetal HRV, and one to infant HRV. The overall global rating for the standardized quality assessment of the articles was moderate to weak. The articles regarding the influence of maternal PA on maternal HRV indicated contrary results. Five of five articles regarding the influence of maternal PA on fetal HRV showed increases of fetal HRV on most parameters depending on maternal PA. The article referring to infant HRV (measured one month postnatal) showed an increased HRV. Based on the current evidence available, our overall conclusion is that the hypothesis that maternal PA influences maternal HRV cannot be supported, but there is a trend that maternal PA might increase fetal and infant HRV (clinical conclusion). Therefore, we recommend that further, high quality studies

  2. Influence of race on outcome in patients treated with breast conserving therapy

    International Nuclear Information System (INIS)

    Campbell, T.; Heimann, R.; Powers, C.; Vijayakumar, S.; Ewing, C.; Halpern, H.; Michel, A.; Rubin, S.; Weichselbaum, R.

    1995-01-01

    PURPOSE: Race is reported to correlate with outcome in breast cancer with African Americans (AA) having worse outcome compared to whites. However, little data is available from large standardized series of patients with early stage breast cancer. We report here the influence of race on local control (LC), disease free survival (DFS), cause specific survival (CSS) and overall survival (OS) for patients treated at our center with breast conserving therapy (BCT). MATERIALS AND METHODS: From a database of 925 patients treated between 1977 and 1993 with BCT for early stage invasive breast cancer, a total of 892 patients were available for study after excluding non-AA/non-white patients. Median age of patients was 56 years. Median follow-up was 35 months (range, 2 to 166). All patients underwent lumpectomy and radiation therapy(RT). Seven hundred eighty-six (88%) patients had axillary dissection. Median RT dose was 6000cGy with 90% of patients receiving 6000cGy or more. Two hundred fifty (28%) had chemotherapy, 327(37%) had tamoxifen and 64(7%) had both. T stage distribution was as follows: 632 T1 (71%), 244 T2 (27%), 12 T3 (1%) and 4 unknown ( 4cm (5 vs 1%)(p=0.001) or were unknown size (10 vs 6%)(p=.001). Comparing AA and whites yielded 5 yr actuarial LC (94 vs 94%)(p=0.380), DFS (83 vs 85%)(p=0.120), CSS (84 vs 85%)(p=0.201) and OS (77 vs 80%)(p=0.112). Multivariate analysis demonstrated that the number of positive nodes was the strongest predictor of OS (p<.001) and although race did not reach statistical significance as an independent prognostic factor, a trend was demonstrated (p=.106). Sub-group analysis of 186 patients with ER/PR negative tumors showed significantly worse DFS (75 vs 93%)(p=0.005), CSS (79 vs 91%)(p=0.021) and OS (76 vs 89%)(p=0.011) for AA patients. Race was demonstrated to be an independent prognostic factor by multivariate analysis in this sub-group (p=.024). No significant differences by race were apparent in patients grouped by tumor size

  3. Strong influence of variable treatment on the performance of numerically defined ecological regions.

    Science.gov (United States)

    Snelder, Ton; Lehmann, Anthony; Lamouroux, Nicolas; Leathwick, John; Allenbach, Karin

    2009-10-01

    Numerical clustering has frequently been used to define hierarchically organized ecological regionalizations, but there has been little robust evaluation of their performance (i.e., the degree to which regions discriminate areas with similar ecological character). In this study we investigated the effect of the weighting and treatment of input variables on the performance of regionalizations defined by agglomerative clustering across a range of hierarchical levels. For this purpose, we developed three ecological regionalizations of Switzerland of increasing complexity using agglomerative clustering. Environmental data for our analysis were drawn from a 400 m grid and consisted of estimates of 11 environmental variables for each grid cell describing climate, topography and lithology. Regionalization 1 was defined from the environmental variables which were given equal weights. We used the same variables in Regionalization 2 but weighted and transformed them on the basis of a dissimilarity model that was fitted to land cover composition data derived for a random sample of cells from interpretation of aerial photographs. Regionalization 3 was a further two-stage development of Regionalization 2 where specific classifications, also weighted and transformed using dissimilarity models, were applied to 25 small scale "sub-domains" defined by Regionalization 2. Performance was assessed in terms of the discrimination of land cover composition for an independent set of sites using classification strength (CS), which measured the similarity of land cover composition within classes and the dissimilarity between classes. Regionalization 2 performed significantly better than Regionalization 1, but the largest gains in performance, compared to Regionalization 1, occurred at coarse hierarchical levels (i.e., CS did not increase significantly beyond the 25-region level). Regionalization 3 performed better than Regionalization 2 beyond the 25-region level and CS values continued to

  4. Influence of Disease and Patient Characteristics on Daratumumab Exposure and Clinical Outcomes in Relapsed or Refractory Multiple Myeloma

    DEFF Research Database (Denmark)

    Yan, Xiaoyu; Clemens, Pamela L; Puchalski, Thomas

    2018-01-01

    OBJECTIVE: The aim of this study was to understand the influence of disease and patient characteristics on exposure to daratumumab, an immunoglobulin Gκ (IgGκ) monoclonal antibody, and clinical outcomes in relapsed or refractory multiple myeloma (MM). PATIENTS AND METHODS: Baseline myeloma type, ...

  5. Influence of embryo culture medium (G5 and HTF) on pregnancy and perinatal outcome after IVF: a multicenter RCT

    NARCIS (Netherlands)

    Kleijkers, S.H.; Mantikou, E.; Slappendel, E.; Consten, D.; Echten-Arends, J. van; Wetzels, A.M.M.; Wely, M. van; Smits, L.J.; Montfoort, A.P. van; Repping, S.; Dumoulin, J.C.; Mastenbroek, S.

    2016-01-01

    STUDY QUESTION: Does embryo culture medium influence pregnancy and perinatal outcome in IVF? SUMMARY ANSWER: Embryo culture media used in IVF affect treatment efficacy and the birthweight of newborns. WHAT IS KNOWN ALREADY: A wide variety of culture media for human preimplantation embryos in

  6. Influence of embryo culture medium (G5 and HTF) on pregnancy and perinatal outcome after IVF: a multicenter RCT

    NARCIS (Netherlands)

    Kleijkers, Sander H. M.; Mantikou, Eleni; Slappendel, Els; Consten, Dimitri; van Echten-Arends, Jannie; Wetzels, Alex M.; van Wely, Madelon; Smits, Luc J. M.; van Montfoort, Aafke P. A.; Repping, Sjoerd; Dumoulin, John C. M.; Mastenbroek, Sebastiaan

    2016-01-01

    Does embryo culture medium influence pregnancy and perinatal outcome in IVF? Embryo culture media used in IVF affect treatment efficacy and the birthweight of newborns. A wide variety of culture media for human preimplantation embryos in IVF/ICSI treatments currently exists. It is unknown which

  7. Influence of embryo culture medium (G5 and HTF) on pregnancy and perinatal outcome after IVF : a multicenter RCT

    NARCIS (Netherlands)

    Kleijkers, Sander H. M.; Mantikou, Eleni; Slappendel, Els; Consten, Dimitri; van Echten - Arends, Jannie; Wetzels, Alex M.; van Wely, Madelon; Smits, Luc J. M.; van Montfoort, Aafke P. A.; Repping, Sjoerd; Dumoulin, John C. M.; Mastenbroek, Sebastiaan

    2016-01-01

    Does embryo culture medium influence pregnancy and perinatal outcome in IVF? Embryo culture media used in IVF affect treatment efficacy and the birthweight of newborns. A wide variety of culture media for human preimplantation embryos in IVF/ICSI treatments currently exists. It is unknown which

  8. [Influence of patellofemoral joint degeneration on outcome of medial unicompartmental knee arthroplasty].

    Science.gov (United States)

    Xu, B Y; Ji, B C; Guo, W T; Mu, W B; Cao, L

    2017-06-01

    Objective: To evaluate the influence of patellofemoral joint degeneration and pre-operative pain location on the outcome of medial Oxford unicompartmental knee arthroplasty (UKA). Methods: A total of 58 patients (58 knees) with medial Oxford UKA had been performed for medial osteoarthritis from March 2013 to July 2014 in Department of Orthopaedic Surgery at First Teaching Hospital of Xinjiang Medical University were retrospective reviewed. There were 24 males and 34 females, the age from 43 to 87 years with the mean age was 68.5 years. The mean body mass index was 25.2 kg/m(2) ranging from 19.7 to 31.5 kg/m(2). Patients were divided into anterior-medial pain group (35 knees), anterior knee pain group (17 knees) and general knee pain group (6 knees) according to pre-operative pain location. Pre-operative radiological statuses of the patellefemoral joint were defined by Ahlback system and divided into patellofemoral joint degeneration group (16 knees) and normal group (42 knees). Patients were also divided into medial patellofemoral degeneration group (20 knees), lateral patellofemoral degeneration group (12 knees) and normal group (26 knees) according to Altman scoring system. Outerbridge system was used intraoperatively and the patients were divided into patellofemoral joint degeneration group (21 knees) and normal group (37 knees). Pre- and post-operative outcomes were evaluated with Oxford Knee Score (OKS), Western Ontario and MacMaster (WOMAC) and patellofemoral score system of Lonner. T test and ANOVA were used to analyze the data. Results: The average duration of follow-up was 33 months (from 26 to 42 months). There were no patients had complications of infection, deep vein thrombosis, dislocation or loosing at the last follow-up. Compared to pre-operation, OKS (18.9±3.5 vs . 38.9±4.7, 19.3±4.2 vs . 39.6±4.6, 18.1±3.2 vs . 38.1±3.7)( t =5.64 to 7.08, all P patellofemoral joint degeneration group and normal group, the outcomes were the same according to

  9. Influence of Salmonella status on the long-term outcome of horses after colic surgery.

    Science.gov (United States)

    Southwood, Louise L; Lindborg, Susan; Myers, Marc; Aceto, Helen W

    2017-08-01

    To compare long-term outcome of Salmonella-positive versus Salmonella-negative horses discharged from hospital after colic surgery. Retrospective case-control. Horses discharged from the hospital after colic surgery. For each horse with positive culture for Salmonella enterica (SAL-POS, n = 59), at least 2 horses testing negative for S. enterica (SAL-NEG, n = 119) were enrolled. Owners were interviewed via phone at least 12 months after surgery regarding: (1) complications after discharge from the hospital; (2) duration of survival; and (3) return to prior or intended use. Association between immediate postoperative clinical variables such as Salmonella status and long-term measures of outcome was tested via ratios (odds ratio [OR]) and 95% confidence intervals. Data were analyzed for survival using a Cox proportional hazards model and for return to use using multivariable logistic regression. SAL-POS horses had a higher OR of surgical site infection (2.7 [1.1-6.9] P = .027) and weight loss (6.8 [1.8-26.1] P = .002). At the time of follow-up, there were 53/56 (95%) SAL-POS and 99/118 (84%) SAL-NEG horses alive. The final multivariable model for nonsurvival included postoperative colic (hazard ratio 7.6 [2.8-19.2] P = .002) and the interaction between Salmonella status and duration of rectal temperature > 103°F postoperatively (SAL-POS 1.04 [1.01-1.07] and SAL-NEG 1.16 [1.06-1.25], P = .005). The majority of horses returned to their intended use regardless of their SAL-POS (38/50, 76%) or SAL-NEG (77/96, 80%, P = .498) status. Salmonella-positive horses that survive to discharge from the hospital after colic surgery have similar risks of long-term complications (colic/diarrhea), survival, and return to function than Salmonella-negative horses. © 2017 The American College of Veterinary Surgeons.

  10. Influences of the Control on the Nonlinear Vibrations of a Variable Compression Ratio Mechanism

    Directory of Open Access Journals (Sweden)

    Mănescu Bogdan

    2018-01-01

    Full Text Available For the mechanism described in references the study of the nonlinear vibrations is performed considering a multibody approach for the elements of the mechanism and different laws of motion for the control element. A great attention is paid to the equilibrium of the motion. The influence of different parameters of control is highlighted in the paper. The results are numerically validated.

  11. Influence of the factor V Leiden mutation on infectious disease susceptibility and outcome

    DEFF Research Database (Denmark)

    Benfield, Thomas L; Dahl, Mortens; Nordestgaard, Borge G

    2005-01-01

    The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial.......The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial....

  12. Environmental variables influencing the expression of morphological characteristics in clones of the forage cactus

    Directory of Open Access Journals (Sweden)

    Marcela Lúcia Barbosa

    Full Text Available ABSTRACT The environmental factors that affect the morphological characteristics of different genera of cacti are little known. The aim of this study therefore was to analyse the contribution of environmental variables to growth in cladodes and plant of forage cactus clones of the genera Nopalea and Opuntia. The data used in this study were obtained from an experiment conducted in Serra Talhada, Pernambuco, Brazil, between 2012 and 2013, where the clones 'IPA Sertânia' (Nopalea, 'Miúda' (Nopalea and 'Orelha de Elefante Mexicana' (Opuntia were submitted to different irrigation depths (2.5, 5.0 and 7.5 mm and fixed irrigation intervals (7, 14 and 28 days. Morphological characteristics of the cladodes and plants and weather variables were obtained over time. Pearson's correlation, followed by multicollinearity, canonical and path analysis were applied. The minimum temperature, maximum and minimum relative humidity, wind speed and solar radiation were the variables that most affected growth in the cactus. The genus Opuntia showed less sensitivity to variations in air temperature compared to the genus Nopalea. The higher intensities of global solar radiation affected clones of the genus Nopalea more than the genus Opuntia. It can be concluded that there are different environmental requirements between forage cacti of the genera Nopalea and Opuntia.

  13. Episiotomy and its relationship to various clinical variables that influence its performance

    Science.gov (United States)

    Ballesteros-Meseguer, Carmen; Carrillo-García, César; Meseguer-de-Pedro, Mariano; Canteras-Jordana, Manuel; Martínez-Roche, Mª Emilia

    2016-01-01

    Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure. PMID:27224064

  14. The Influence of Tidal Activities on Hydrologic Variables of Paka River, Terengganu, Malaysia

    International Nuclear Information System (INIS)

    Mohd EkhwanToriman; Mohd Ekhwan Toriman; Muhammad Barzani Gasim; Haniff Muhamad

    2015-01-01

    A hydrological study was conducted to determine their characteristics at Paka River, Terengganu. Seven sampling stations were identified in this study. Sampling was started from the estuary of Paka River, and ended about 14 km away from the estuary as each station was 2 km apart from each other. Sampling was carried out at two different water tides (low and high water tides) and two durational variations which represented by the wet and dry periods. Hydrological variables such as river velocity, river width and river depth were measured by using specific equipment. River width was measured by using a range finder (model Bushnell 20-0001), river depth was measured by using a depth meter (model Speedtech SM-5) and river velocity was measured by using a flow meter/current flow meter (model FP101). Station 1 that located at the downstream identified by highest readings for hydrological variables both water tides during the first and second samplings compared to stations 7 which located at the upstream. Higher readings of hydrological variables were also shown during dry season since low freshwater flow due to less rainfall intensity in the upstream area. (author)

  15. The Influence of Tidal Activities on Hydrologic Variables of Marang River, Terengganu, Malaysia

    International Nuclear Information System (INIS)

    Mohd Ekhwan Toriman; Mohd Ekhwan Toriman; Muhammad Barzani Gasim; Nur Hidayah Ariffin; Haniff Muhamad; Norsyuhada Hairoma

    2015-01-01

    A study was conducted at Marang River, Terengganu on determination of hydrological variation of Marang River at seven sampling stations. Sampling stations were selected along Marang River started from downstream to upstream. Each station was located 2 km apart from each other. Sampling was done twice; the first sampling was in 13 November 2012 (rainy season) and was repeated for second sampling on 24 February 2013 (dry season). Hydrological measurements of river such as velocity, river width and river depth were measured by using specific equipment. River velocity was measured by using flow meter (model FP101), river width was measured by using a range finder (model Bushnell 20-0001) and river depth was measured by using depth meter. Primary data of hydrological measurements of Marang River were measured and analyzed for each sampling station. Overall, station 1 shows the highest readings for most hydrological variables at both water tides during the first and second samplings. Station 1 that was located at the Marang River estuary identified by higher hydrological variables due to seawater movement during high tide as compared to stations 7 which located at the upstream. During dry season hydrological variables were slightly decrease since low freshwater flow from the upstream due to less rainfall intensity. (author)

  16. Gain-loss-frame in outcome-interdependence : Does it influence equality or equity considerations?

    NARCIS (Netherlands)

    deDreu, CKW

    1996-01-01

    Research suggests that framing outcomes as gains produces stronger concern for distributive justice than framing outcomes as losses. Unfortunately, however, this prior research manipulated own and other's outcomes only (and not own and other's input). Hence, it remained unclear whether framing

  17. Modeling the influence of atmospheric leading modes on the variability of the Arctic freshwater cycle

    Science.gov (United States)

    Niederdrenk, L.; Sein, D.; Mikolajewicz, U.

    2013-12-01

    Global general circulation models show remarkable differences in modeling the Arctic freshwater cycle. While they agree on the general sinks and sources of the freshwater budget, they differ largely in the magnitude of the mean values as well as in the variability of the freshwater terms. Regional models can better resolve the complex topography and small scale processes, but they are often uncoupled, thus missing the air-sea interaction. Additionally, regional models mostly use some kind of salinity restoring or flux correction, thus disturbing the freshwater budget. Our approach to investigate the Arctic hydrologic cycle and its variability is a regional atmosphere-ocean model setup, consisting of the global ocean model MPIOM with high resolution in the Arctic coupled to the regional atmosphere model REMO. The domain of the atmosphere model covers all catchment areas of the rivers draining into the Arctic. To account for all sinks and sources of freshwater in the Arctic, we include a discharge model providing terrestrial lateral waterflows. We run the model without salinity restoring but with freshwater correction, which is set to zero in the Arctic. This allows for the analysis of a closed freshwater budget in the Artic region. We perform experiments for the second half of the 20th century and use data from the global model MPIOM/ECHAM5 performed with historical conditions, that was used within the 4th Assessment Report of the IPCC, as forcing for our regional model. With this setup, we investigate how the dominant modes of large-scale atmospheric variability impact the variability in the freshwater components. We focus on the two leading empirical orthogonal functions of winter mean sea level pressure, as well as on the North Atlantic Oscillation and the Siberian High. These modes have a large impact on the Arctic Ocean circulation as well as on the solid and liquid export through Fram Strait and through the Canadian archipelago. However, they cannot explain

  18. Climatic variability of river outflow in the Pantanal region and the influence of sea surface temperature

    Science.gov (United States)

    Silva, Carlos Batista; Silva, Maria Elisa Siqueira; Ambrizzi, Tércio

    2017-07-01

    This paper investigates possible linear relationships between climate, hydrology, and oceanic surface variability in the Pantanal region (in South America's central area), over interannual and interdecadal time ranges. In order to verify the mentioned relations, lagged correlation analysis and linear adjustment between river discharge at the Pantanal region and sea surface temperature were used. Composite analysis for atmospheric fields, air humidity flux divergence, and atmospheric circulation at low and high levels, for the period between 1970 and 2003, was analyzed. Results suggest that the river discharge in the Pantanal region is linearly associated with interdecadal and interannual oscillations in the Pacific and Atlantic oceans, making them good predictors to continental hydrological variables. Considering oceanic areas, 51 % of the annual discharge in the Pantanal region can be linearly explained by mean sea surface temperature (SST) in the Subtropical North Pacific, Tropical North Pacific, Extratropical South Pacific, and Extratropical North Atlantic over the period. Considering a forecast approach in seasonal scale, 66 % of the monthly discharge variance in Pantanal, 3 months ahead of SST, is explained by the oceanic variables, providing accuracy around 65 %. Annual discharge values in the Pantanal region are strongly related to the Pacific Decadal Oscillation (PDO) variability (with 52 % of linear correlation), making it possible to consider an interdecadal variability and a consequent subdivision of the whole period in three parts: 1st (1970-1977), 2nd (1978-1996), and 3rd (1997-2003) subperiods. The three subperiods coincide with distinct PDO phases: negative, positive, and negative, respectively. Convergence of humidity flux at low levels and the circulation pattern at high levels help to explain the drier and wetter subperiods. During the wetter 2nd subperiod, the air humidity convergence at low levels is much more evident than during the other two

  19. Does Traumatic Donor Cause of Death Influence Outcome after Lung Transplantation? A Single-Centre Analysis.

    Science.gov (United States)

    Pilarczyk, Kevin; Heckmann, Jens; Carstens, Henning; Lubarski, Jura; Jakob, Heinz; Pizanis, Nikolaus; Kamler, Markus

    2017-08-01

    Background  Owing to the shortage of donor organs in lung transplantation (LuTX), liberalization of donor selection criteria has been proposed. However, some studies suggested that donor traumatic brain damage might influence posttransplantation allograft function. This article aimed to investigate the association of donor cause of death (DCD) and outcome after LuTX. Methods  A retrospective analysis of 186 consecutive double LuTXs at our institution from January 2000 to December 2008 was performed. DCD was categorized into traumatic brain injury (TBI) and nontraumatic brain injury (NTBI). In addition, NTBI was sub classified as spontaneous intracerebral bleeding (B), hypoxic brain damage (H), and intracerebral neoplasia (N). Results  DCD was classified as TBI in 50 patients (26.9%) and NTBI in 136 patients (73.1%): B in 112 patients (60.2%), H in 21 patients (11.3%), and N in 3 patients (1.6%). Young male donors predominated in group TBI (mean age 36.0 ± 14.5 vs. 42.8 ± 10.7, p  donor ventilation time, or paO 2 /FiO 2 before harvesting. TBI donors received significantly more blood (3.4 ± 3.8 vs. 1.8 ± 1.9, p  = 0.03). A chest trauma was evident only in group T ( n  = 7 [3.7%] vs. 0 [0%], p  donor death did not affect the following indices of graft function: length of postoperative ventilation, paO 2 /FiO 2 ratio up to 48 hours, and lung function up to 36 months. One- and three-year survival was comparable with 84.4 and 70.4% for TBI donors versus 89.4% and 69.2% for NTBI donors. Five-year survival tended to be lower in the TBI group but did not reach statistical significance (43.4 vs. 53.9%). Conclusion  This study indicates that traumatic DCD does not affect outcome after LuTX. These results can be achieved with an ideal donor management combined with an individual case-to-case evaluation by an experienced LuTX surgeon. Georg Thieme Verlag KG Stuttgart · New York.

  20. Influence of variable oxygen concentration on the response of cells to heat or x irradiation

    International Nuclear Information System (INIS)

    Gerweck, L.E.; Richards, B.; Jennings, M.

    1981-01-01

    The influence of oxygen concentration on the lethal response of cells exposed to 43 0 C hyperthermia was determined and compared to the response of cells exposed to radiation under equivalent culturing and environmental conditions. Chinese hamster ovary (CHO) cells were heated or irradiated 0.5 h after induction of hypoxia and then reoxygenated following treatment. The oxygen enhancement ratio (OER) for heat or radiation was determined at the 1% survival level from least-squares fit of survival curves. A maximum OER of 3.1 +- 0.2 was observed in the 20 to 95% oxygen concentration range. The OER for heat, however, was 1.0 +- 0.1 irrespective of the gas-phase oxygen concentration. These results show that the lethal effects of heat are not influenced by the oxygen concentration at the time of treatment in CHO cells exposed to 43 0 C hyperthermia

  1. Travelling green : Variables influencing students’ intention to select a green hotel

    OpenAIRE

    Lindqvist, Julia; Andersson, Mikaela

    2015-01-01

    Problematization: Tourism has a major impact on the environment. However, there is a conflict of interest making it difficult for the hotel business to decrease this impact. On the one hand, there is a pressure for environmentally friendly behaviour from society. On the other hand, the customers want to be pampered during their hotel stay. This makes it necessary to further investigate what influences customers’ intention to select a green hotel. Therefore this thesis examines students’ inten...

  2. Trace element partitioning in fluvial tufa reveals variable portions of biologically influenced calcite precipitation

    Science.gov (United States)

    Ritter, Simon M.; Isenbeck-Schröter, Margot; Schröder-Ritzrau, Andrea; Scholz, Christian; Rheinberger, Stefan; Höfle, Bernhard; Frank, Norbert

    2018-03-01

    The formation of tufa is essentially influenced by biological processes and, in order to infer environmental information from tufa deposits, it has to be determined how the geochemistry of biologically influenced tufa deviates from equilibrium conditions between water and calcite precipitate. We investigated the evolution of the water and tufa geochemistry of consecutive tufa barrages in a small tufa-depositing creek in Southern Germany. High incorporation of divalent cations into tufa is ubiquitous, which is probably promoted by an influence of biofilms in the tufa element partitioning. The distribution coefficients for the incorporation of Mg, Sr and Ba into tufa at the Kaisinger creek D(Mg), D(Sr) and D(Ba) are 0.020-0.031, 0.13-0.18 and 0.26-0.43, respectively. This agrees with previous research suggesting that biofilm influenced tufa will be enriched in divalent cations over equilibrium values in the order of Mg formation with likely higher distribution coefficients and inorganically-driven tufa formation with likely lower distribution coefficients. Additionally, the distribution coefficients of metals in tufa of the Kaisinger creek D(Cd), D(Zn), D(Co) and D(Mn) show values of 11-22, 2.2-12, 0.7-4.9 and 30-57, respectively. These metals are highly enriched in upstream tufa deposits and their contents in tufa strongly decrease downstream. Such highly compatible elements could therefore be used to distinguish easily between different lateral sections in fluvial barrage-dam tufa depositional systems and could serve as a useful geochemical tool in studying ancient barrage-dam tufa depositional systems.

  3. Moderation of effects of AAC based on setting and types of aided AAC on outcome variables: an aggregate study of single-case research with individuals with ASD.

    Science.gov (United States)

    Ganz, Jennifer B; Rispoli, Mandy J; Mason, Rose Ann; Hong, Ee Rea

    2014-06-01

    The purpose of this meta-analysis was to evaluate the potential moderating effects of intervention setting and type of aided augmentative and alternative communication (AAC) on outcome variables for students with autism spectrum disorders. Improvement rate difference, an effect size measure, was used to calculate aggregate effects across 35 single-case research studies. Results indicated that the largest effects for aided AAC were observed in general education settings. With respect to communication outcomes, both speech generating devices (SGDs) and the Picture Exchange Communication System (PECS) were associated with larger effects than other picture-based systems. With respect to challenging behaviour outcomes, SGDs produced larger effects than PECS. This aggregate study highlights the importance of considering intervention setting, choice of AAC system and target outcomes when designing and planning an aided AAC intervention.

  4. Influences of Appalachian orography on heavy rainfall and rainfall variability associated with the passage of hurricane Isabel by ensemble simulations

    Science.gov (United States)

    Oldaker, Guy; Liu, Liping; Lin, Yuh-Lang

    2017-12-01

    This study focuses on the heavy rainfall event associated with hurricane Isabel's (2003) passage over the Appalachian mountains of the eastern United States. Specifically, an ensemble consisting of two groups of simulations using the Weather Research and Forecasting model (WRF), with and without topography, is performed to investigate the orographic influences on heavy rainfall and rainfall variability. In general, the simulated ensemble mean with full terrain is able to reproduce the key observed 24-h rainfall amount and distribution, while the flat-terrain mean lacks in this respect. In fact, 30-h rainfall amounts are reduced by 75% with the removal of topography. Rainfall variability is also significantly increased with the presence of orography. Further analysis shows that the complex interaction between the hurricane and terrain along with contributions from varied microphysics, cumulus parametrization, and planetary boundary layer schemes have a pronounced effect on rainfall and rainfall variability. This study follows closely with a previous study, but for a different TC case of Isabel (2003). It is an important sensitivity test for a different TC in a very different environment. This study reveals that the rainfall variability behaves similarly, even with different settings of the environment.

  5. The influence of variability on the optimal shape of an airway tree branching asymmetrically

    International Nuclear Information System (INIS)

    Mauroy, Benjamin; Bokov, Plamen

    2010-01-01

    The asymmetry of the bronchial tree has been reported on numerous occasions, and bronchi in the lung bifurcate most of the time into a major and a minor daughter. Asymmetry is most probably bound to play a role on the hydrodynamic resistance and volume occupation of the bronchial tree. Thus, in this work, we search for an optimal asymmetric airway tree crossed by Poiseuille flow that would be a good candidate to model the distal conductive part of the lung. The geometry is controlled by major and minor diameter reduction factors that depend on the generation. We show that the optimal asymmetric tree has diameter reduction factors that are adimensional from the second level of bifurcation and that they are highly dependent on the asymmetric ratio that defines the relative sizes of the major and minor branches in a bifurcation. This optimization also gives access to a cost function whose particularity is to be asymmetric around its minimum. Thus, the cliff-edge hypothesis predicts that if the system suffers variability, then the best tree is shifted from the optimal. We apply a recent theoretical model of cliff-edge in order to measure the role of variability on the determination of the best asymmetric tree. Then, we compare our results with lung data of the literature. In particular, we are able to quantify the variability needed to fit the data and to give hypothesis that could explain, at least partially, the shift found between the optimal tree and the measures in the case of asymmetric bronchial trees. Finally, our model predicts that, even if the population is adapted at best, there always exist individuals whose bronchial trees are associated with larger costs comparatively to the average and who ought to be more sensitive to geometrical remodeling

  6. Mesoscale spatiotemporal variability in a complex host-parasite system influenced by intermediate host body size

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    Sara M. Rodríguez

    2017-08-01

    Full Text Available Background Parasites are essential components of natural communities, but the factors that generate skewed distributions of parasite occurrences and abundances across host populations are not well understood. Methods Here, we analyse at a seascape scale the spatiotemporal relationships of parasite exposure and host body-size with the proportion of infected hosts (i.e., prevalence and aggregation of parasite burden across ca. 150 km of the coast and over 22 months. We predicted that the effects of parasite exposure on prevalence and aggregation are dependent on host body-sizes. We used an indirect host-parasite interaction in which migratory seagulls, sandy-shore molecrabs, and an acanthocephalan worm constitute the definitive hosts, intermediate hosts, and endoparasite, respectively. In such complex systems, increments in the abundance of definitive hosts imply increments in intermediate hosts’ exposure to the parasite’s dispersive stages. Results Linear mixed-effects models showed a significant, albeit highly variable, positive relationship between seagull density and prevalence. This relationship was stronger for small (cephalothorax length >15 mm than large molecrabs (<15 mm. Independently of seagull density, large molecrabs carried significantly more parasites than small molecrabs. The analysis of the variance-to-mean ratio of per capita parasite burden showed no relationship between seagull density and mean parasite aggregation across host populations. However, the amount of unexplained variability in aggregation was strikingly higher in larger than smaller intermediate hosts. This unexplained variability was driven by a decrease in the mean-variance scaling in heavily infected large molecrabs. Conclusions These results show complex interdependencies between extrinsic and intrinsic population attributes on the structure of host-parasite interactions. We suggest that parasite accumulation—a characteristic of indirect host

  7. Weather variability influences color and phenolic content of pigmented baby leaf lettuces throughout the season.

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    Marin, Alicia; Ferreres, Federico; Barberá, Gonzalo G; Gil, María I

    2015-02-18

    The lack of consistency in homogeneous color throughout the season of pigmented baby leaf lettuce is a problem for growers because of the rejection of the product and consequently the economic loss. Changes in color as well as individual and total phenolic composition and content as a response to the climatic variables were studied following the analysis of three pigmented baby leaf lettuces over 16 consecutive weeks from February to May, which corresponded to the most important production season in winter in Europe. Color and phenolic content were significantly (P ≤ 0.001) affected by cultivar, harvest week, and climatic variables that occurred in the last week before harvest. Radiation and temperature showed positive correlations with the content of phenolic acids and flavonoids that increased in all three cultivars as the season progressed. Cyanidin-3-O-(6''-O-malonyl)-glucoside content showed positive correlations with temperature and radiation but only in Batavia cultivars whereas in red oak leaf the correlation was with cold temperatures. Regarding hue angle, a positive correlation was shown with the number of hours at temperatures lower than 7 °C. A relationship between hue angle and the content of anthocyanins was not possible to establish. These results suggest that the colorimetric measurement of color cannot be used as a good indicator of anthocyanin accumulation because other pigments such as chlorophylls and carotenoids may contribute as well to the leaf color of pigmented lettuce. This study provides information about the impact of genotype and environment interactions on the biosynthesis of phenolic compounds to explain the variability in the leaf color and product appearance.

  8. Influence of environmental variables on diffusive greenhouse gas fluxes at hydroelectric reservoirs in Brazil.

    Science.gov (United States)

    Rogério, J P; Santos, M A; Santos, E O

    2013-11-01

    For almost two decades, studies have been under way in Brazil, showing how hydroelectric reservoirs produce biogenic gases, mainly methane (CH4) and carbon dioxide (CO2), through the organic decomposition of flooded biomass. This somewhat complex phenomenon is due to a set of variables with differing levels of interdependence that directly or indirectly affect greenhouse gas (GHG) emissions. The purpose of this paper is to determine, through a statistical data analysis, the relation between CO2, CH4 diffusive fluxes and environmental variables at the Furnas, Itumbiara and Serra da Mesa hydroelectric reservoirs, located in the Cerrado biome on Brazil's high central plateau. The choice of this region was prompted by its importance in the national context, covering an area of some two million squ