DIABETES OBESITY & METABOLISM, Issue 6 2007
L. Meneghini
The Predictable Results and Experience in Diabetes through Intensification and Control to Target: An International Variability Evaluation 303 (PREDICTIVEÔ 303) Study (n = 5604) evaluated the effectiveness of insulin detemir, a long-acting basal insulin analogue, using a simplified patient self-adjusted dosing algorithm (303 Algorithm group) compared with standard-of-care physician-driven adjustments (Standard-of-care group) in a predominantly primary care setting, over a period of 6 months. Insulin detemir was to be started once-daily as add-on therapy to any other glucose-lowering regimens or as a replacement of prestudy basal insulin in patients with type 2 diabetes. Investigator sites rather than individual patients were randomized to either the 303 Algorithm group or the Standard-of-care group. Patients from the 303 Algorithm group sites were instructed to adjust their insulin detemir dose every 3 days based on the mean of three ,adjusted' fasting plasma glucose (aFPG) values (capillary blood glucose calibrated to equivalent plasma glucose values) using a simple algorithm: mean aFPG < 80 mg/dl (<4.4 mmol/l), reduce dose by 3 U; aFPG between 80 and 110 mg/dl (4.4,6.1 mmol/l), no change; and aFPG > 110 mg/dl (>1.1 mmol/l), increase dose by 3 U. The insulin detemir dose for patients in the Standard-of-care group was adjusted by the investigator according to the standard of care. Mean A1C decreased from 8.5% at baseline to 7.9% at 26 weeks for the 303 Algorithm group and from 8.5 to 8.0% for the Standard-of-care group (p = 0.0106 for difference in A1C reduction between the two groups). Mean FPG values decreased from 175 mg/dl (9.7 mmol/l) at baseline to 141 mg/dl (7.8 mmol/l) for the 303 Algorithm group and decreased from 174 mg/dl (9.7 mmol/l) to 152 mg/dl (8.4 mmol/l) for the Standard-of-care group (p < 0.0001 for difference in FPG reduction between the two groups). Mean body weight remained the same at 26 weeks in both groups (change from baseline 0.1 and ,0.2 kg for the 303 Algorithm group and the Standard-of-care group respectively). At 26 weeks, 91% of the patients in the 303 Algorithm group and 85% of the patients in the Standard-of-care group remained on once-daily insulin detemir administration. The rates of overall hypoglycaemia (events/patient/year) decreased significantly from baseline in both groups [from 9.05 to 6.44 for the 303 Algorithm group (p = 0.0039) and from 9.53 to 4.95 for the Standard-of-care group (p < 0.0001)]. Major hypoglycaemic events were rare in both groups (0.26 events/patient/year for the 303 Algorithm group and 0.20 events/patient/year for the Standard-of-care group; p = 0.2395). In conclusion, patients in the 303 Algorithm group achieved comparable glycaemic control with higher rate of hypoglycaemia as compared with patients in the Standard-of-care group, possibly because of more aggressive insulin dose adjustments. The vast majority of the patients in both groups were effectively treated with once-daily insulin detemir therapy. The use of insulin detemir in this predominantly primary care setting achieved significant improvements in glycaemic control with minimal risk of hypoglycaemia and no weight gain. [source]

THE THERAPEUTIC ALLIANCE IN HOME-BASED FAMILY THERAPY: IS IT PREDICTIVE OF OUTCOME?

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2002
Lee N. Johnson
This study examined the association between the therapeutic alliance in family therapy and changes in symptom distress, interpersonal relationships, and family coping. The participants (N = 81) were members of low socioeconomic status families referred to a university clinic for in-home family therapy. Participants completed the Outcome Questionnaire, Family Crisis Oriented Personal Evaluation, and the Family Therapy Alliance questionnaires. Regression analyses revealed that the therapeutic alliance explained 19% of the variance in symptom distress changes for mother, 55% for fathers, and 39% for adolescents. The implications of these findings for practicing and researching family therapy are presented. [source]

Predictive, concurrent, prospective and retrospective validity of self-reported delinquency

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2003
Darrick Jolliffe
Background The self-report method is widely used to measure offending. Previous studies suggest that it is generally valid, but that its validity may be lower for blacks than for whites. Aim To assess the validity of self-reported offending in relation to court referrals, and to investigate how it varies with types of offences, sex and race. Method Annual court and self-report data were collected between ages 11 and 17 for eight offences in the Seattle Social Development Project, which is a prospective longitudinal survey of 808 youths. Results Self-reports predicted future court referrals. Predictive validity was highest for drug offences, for males and for whites, and lowest for females and Asians. The probability of youths with a court referral reporting offences and arrests was highest for drug offences, for males, for whites and for blacks. Retrospective ages of onset agreed best with prospective ages for drug offences, Asians and whites. More Asians than blacks or whites failed retrospectively to report offences that had been reported prospectively. Conclusions The validity of self-reports of offending was high, especially for drug offences, for males and for whites. Contrary to prior research, validity was high for black males. It was lowest for Asian females. Sex and race differences in validity held up after controlling for socioeconomic status. Differential validity probability did not reflect police bias. Copyright © 2003 Whurr Publishers Ltd. [source]

Early motor repertoire is related to level of self-mobility in children with cerebral palsy at school age

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2009
JANNEKE LM BRUGGINK MD
Aim, To determine the predictive value of the early motor repertoire for the level of self-mobility in children with cerebral palsy (CP) at school age. Method, Video recordings were made at 11 to 17 weeks post-term of 37 preterm infants (20 males, 17 females) who later developed CP. The early motor repertoire was assessed by obtaining a motor optimality score. At 6 to 12 years, children were classified according to the Gross Motor Function Classification System (GMFCS). Results, Of 37 children (mean gestational age 29.1wks, SD 1.9; mean birthweight 1273g, SD 324), nine had unilateral and 28 had bilateral spastic CP. Twelve children were in GMFCS level I, three level II, 10 level III, four level IV, and eight level V. The absence of the age-adequate motor repertoire, a cramped motor repertoire, an abnormal kicking pattern, and a non-flat supine posture were associated with lower levels of self-mobility (,2 for trend test, p<0.05). Predictive for a low level of self-mobility was a cramped motor repertoire/non-flat supine posture (positive predictive values [PPV] 100%, negative predictive values [NPV] 54%). Predictive for a high level of self-mobility was a non-cramped repertoire/flat supine posture (PPV 80%, NPV 74%). Interpretation, Several aspects of the motor repertoire at 11 to 17 weeks post-term predicted the degree of functional limitations in children with CP at school age. [source]

Predictive and reactive co-ordination of grip and load forces in bimanual lifting in man

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2003
R. Martyn Bracewell
Abstract We investigated the intra- and inter-manual coordination of grip force (GF) and load force (LF) during bimanual lifting and holding of a single object. In a voluntary task involving lifting a predictable load (Experiment 1), we showed scaling of GF to LF generated by either hand, similar to effects seen in previous unimanual studies. Moreover, the GF rates generated by the two hands were correlated. In part this correlation was due to the correlation between the LF rates. However, the GF rates remained correlated when the effects of the correlation in LF rates were partialled out. This novel finding suggests an additional co-ordinative constraint at the level of specification of GFs. As a contrast to the predictable loading in the first experiment, in the second experiment loading was temporally unpredictable and elicited reactive increases in GF. In Experiment 2, the intermanual correlation of GF rates was stronger than in Experiment 1. We speculate that this result reflects greater degrees of co-ordinative constraint at lower levels in the motor control hierarchy. [source]

Evidence-based librarianship: what might we expect in the years ahead?,

HEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2002
Jonathan D. Eldredge
Objective: To predict the possible accomplishments of the Evidence-Based Librarianship (EBL) movement by the years 2005, 2010, 2015 and 2020. Methods: Predictive. The author draws upon recent events, relevant historical events and anecdotal accounts to detect evidence of predictable trends. Results: The author develops a set of probable predictions for the development of EBL. Although incomplete evidence exists, some trends still seem discernible. Conclusion: By 2020, EBL will have become indistinguishable from mainstream health sciences librarianship/informatics practices. [source]

The Prevalence, Incidence and Factors Predictive of Mental Ill-Health in Adults with Profound Intellectual Disabilities.

JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 6 2007
Prospective Study
[source]

The Prevalence, Incidence and Factors Predictive of Mental Ill-Health in Adults with Profound Intellectual Disabilities.

JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 6 2007
Prospective Study
[source]

Predictive and interpolative biplots applied to canonical variate analysis in the discrimination of vegetable oils by their fatty acid composition

JOURNAL OF CHEMOMETRICS, Issue 9 2004
M. Rui Alves
Abstract The fatty acid profiles of 120 commercial unblended peanut, corn, soybean and sunflower vegetable oils and 17 commercial brands of blended edible oils were determined by HRGC/FID/capillary column, including several cis and trans isomers of mono-, di- and tri-unsaturated fatty acids as well as fatty acids with an odd number of carbon atoms. Although many statistical techniques may show some usefulness in the description and analysis of the data obtained, predictive biplots applied to canonical variate analysis prove to be a very useful way of carrying out interpretations and an important aid in building up models, while interpolative biplots display great advantages in the utilization of models for classification purposes on a day-to-day basis. Furthermore, these biplots require only a modest understanding of statistical tools, since all judgements are made regarding original fatty acids and original measuring units. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Is Gadolinium Enhancement Predictive of the Development of Brain Atrophy in Multiple Sclerosis?

JOURNAL OF NEUROIMAGING, Issue 4 2002
A Review of the Literature
ABSTRACT Background and Purpose. Several studies have demonstrated that brain atrophy can be detected over relatively short intervals from the earliest stages of multiple sclerosis (MS). Reviewing the published data, the authors highlight some hypothetical pathological mechanisms proposed as determinants of brain atrophy. Methods. Using the terms multiple sclerosis, MRI (magnetic resonance imaging), and brain atrophy, 181 citations were identified. The authors considered only studies with prospective designs with natural-course MS patients and/or placebo-treated patients of therapeutic trials, in which patients under-went baseline and follow-up scans with a T1-weighted gadolinium diethylenetriamine penta-acetic acid sequence (0.1 mmol/kg body weight), and correlation analyses between Gd enhancement activity and brain atrophy progression. Results. Five hundred thirty-two patients of 5 natural history studies and 5 therapeutic trial studies participated in the review process. The main observation was that in patients with a relapsing-remitting (RR) disease course, there was a correlation between Gd enhancement activity and brain atrophy progression. This correlation was not influenced by any other demographic and clinical additional data considered in the review process. Conclusions. Examination of the pathological mechanisms pro-posed in the reviewed studies led the authors to believe that inflammation is only in part responsible for the development of brain atrophy. This conclusion may have an implication for the strategies of tissue protection advocated in the early stages of the RR course and strengthen recent evidence indicating that anti-inflammatory immunomodulatory agents and immunosuppressive treatments, which predominantly act against the inflammatory component of disease activity, may not have similar effects on progressive tissue loss, either in RR or progressive MS. [source]

Predictive and correlative techniques for the design, optimisation and manufacture of solid dosage forms

JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2003
Ian J. Hardy
ABSTRACT There is much interest in predicting the properties of pharmaceutical dosage forms from the properties of the raw materials they contain. Achieving this with reasonable accuracy would aid the faster development and manufacture of dosage forms. A variety of approaches to prediction or correlation of properties are reviewed. These approaches have variable accuracy, with no single technique yet able to provide an accurate prediction of the overall properties of the dosage form. However, there have been some successes in predicting trends within a formulation series based on the physicochemical and mechanical properties of raw materials, predicting process scale-up through mechanical characterisation of materials and predicting product characteristics by process monitoring. Advances in information technology have increased predictive capability and accuracy by facilitating the analysis of complex multivariate data, mapping formulation characteristics and capturing past knowledge and experience. [source]

Patterns Of Quantitative Sensation Testing Of Hypoesthesia And Hyperalgesia Are Predictive Of Diabetic Polyneuropathy,a Study Of Three Cohorts

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2000
P.J. Dyck
OBJECTIVE,To test quantitative sensation testing (QST) patterns of hypoesthesia and hyperalgesia as indicators of diabetic polyneuropathy (DPN) and its severity. RESEARCH DESIGN AND METHODS,We used Computer-Assisted Sensory Examination IV characterized the QST results of the foot of each patient in three diabetic cohorts (similar to 1,500 patients) as hyperesthetic (less than or equal to 2.5th percentile), low-normal (2.5th,50th percentiles), high-normal (50th,97.5th percentiles), or hypoesthetic (greater than or equal to 97.5th percentile), and tested associations with symptoms, impairments, and test abnormalities. RESULTS,Overall neuropathic impairment was most severe in the pancreas-renal transplant and nerve growth factor cohorts, but it was much less severe in the population-based Rochester Diabetic Neuropathy Study (RDNS) cohort. The frequency distribution of sensory abnormalities mirrored this difference. When the QST spectra of diabetic cohorts were compared with those of the control subject cohort for vibration and cooling sensations, the only abnormality observed was hypoesthesia, which was expressed as an increased number of subjects with values at or above the 97.5th percentile or by an increased percentage of cases with high-normal values. Symptoms and impairments of DPN were significantly more frequent in the subjects with Values at or above the 97.5th percentile than in the subjects whose values were between the 50th and 97.5th percentiles. For heat pain (HP) sensation thresholds (intermediate pain severity [HP:5], pain threshold [HP:0.5], and pain-stimulus response slope [HP:5-0.5]), an increased frequency of both hypoalgesia and hyperalgesia was observed (especially in the RDNS cohort). Steeper pain-stimulus response slopes were significantly associated with sensory symptoms, including severity of pain. CONCLUSIONS,1) Decreased vibratory sensation (hypoesthesia) appears to be characteristic of mild DPN, whereas pan-modality hypoesthesia is characteristic of severe DPN. 2) A shift of vibratory and cold detection thresholds and also of attributes of nerve conduction and a measure of autonomic dysfunction from low-normal (2.5th,50th percentiles) to high-normal (50th,37.5th percentiles) appears to precede overt expression of DPN and to thereby provide evidence of subclinical abnormality. 3) Heat stimulus-induced hyperesthesia (low thresholds) occurs especially in mild DPN, and, because it correlates with DPN symptoms and impairments, it must be attributed to hyperalgesia rather than to supersensitivity. Therefore, hypoalgesia or hyperalgesia may be an indicator of early DPN. [source]

Interferon-, plus ribavirin for 12 months increases the sustained response rates in chronic hepatitis C relapsers

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2002
J. A. Moreno-Monteagudo
Background: The effectiveness and tolerability of combination therapy for 12 months have not been evaluated sufficiently in chronic hepatitis C relapsers to interferon. Aims: To evaluate the sustained response to interferon plus ribavirin for 12 months in chronic hepatitis C relapsers. Methods: We included 55 chronic hepatitis C relapsers in a 12-month treatment protocol with interferon (3 MU thrice weekly) plus ribavirin (1,1.2 g/day). The effectiveness was evaluated using serum aminotransferase and hepatitis C virus RNA levels, alanine aminotransferase normalization and viraemia clearance after 12 months, defining the end-of-treatment response, and 6 months after completion of therapy, defining the sustained response. Adverse effects were recorded. Results: End-of-treatment response and sustained response were achieved in 47 (85%) and 37 (67%) patients, respectively; there were 10 (21%) relapsers after combination therapy. Predictive factors of sustained response included the genotype (non-1 95% vs. 1 48%; P < 0.001), lower viraemia (503 917 ± 553 230 vs. 901 393 ± 548 267 copies/mL; P < 0.005), higher alanine aminotransferase levels (137 ± 75 vs. 103 ± 41 IU/L; P < 0.05) and a lower ,-glutamyl transpeptidase/alanine aminotransferase ratio (0.30 ± 0.23 vs. 0.49 ± 0.39; P < 0.05). Tolerance to therapy was good, with no withdrawals. Conclusions: Interferon plus ribavirin treatment for 12 months in chronic hepatitis C relapsers yields high sustained response rates and is well tolerated. The sustained response is related to a non-1 genotype, lower baseline viraemia, higher alanine aminotransferase level and a lower ,-glutamyl transpeptidase/alanine aminotransferase ratio. [source]

Global Model for Optimizing Crossflow Microfiltration and Ultrafiltration Processes: A New Predictive and Design Tool

BIOTECHNOLOGY PROGRESS, Issue 4 2005
Gautam Lal Baruah
A global model and algorithm that predicts the performance of crossflow MF and UF process individually or in combination in the laminar flow regime is presented and successfully tested. The model accounts for solute polydispersity, ionic environment, electrostatics, membrane properties and operating conditions. Computer programs were written in Fortran 77 for different versions of the model algorithm that can optimize MF/UF processes rapidly in terms of yield, purity, selectivity, or processing time. The model is validated successfully with three test cases: separation of bovine serum albumin (BSA) from hemoglobin (Hb), capture of immunoglobulin (IgG) from transgenic goat milk by MF, and separation of BSA from IgG by UF. These comparisons demonstrate the capability of the global model to conduct realistic in silico simulations of MF and UF processes. This model and algorithm should prove to be an invaluable technique to rapidly design new or optimize existing MF and UF processes separately or in combination in both pressure-dependent and pressure-independent regimes. [source]

Predictive and discriminating three-risk-group prognostic scoring system for staging Hodgkin lymphomas

CANCER, Issue 2 2007
Delphine Maucort-Boulch MD
Abstract BACKGROUND. Several 3-stage Ann Arbor classification-derived prognostic systems were constructed since 1980 to identify the prognosis of Hodgkin lymphoma (HL). Modern statistical tools were applied to 955 patients treated between 1981 and 1996 to build a 3-stage prognostic scoring system (PSS). METHODS. Each variable associated with 10-year overall survival (10-year OS) was assigned to 2 (0 or 1) or 3 (0, 1 or 3) values. By summing the values attributed to each variable, 3 stages were defined. 10-year OS, 5-year event-free survival (5-year EFS), and freedom from progression (5-year FFP) rates of the PSS and of other existing systems were then compared. RESULTS. Four variables were associated with 10-year OS: age (<40 = 0, ,40 = 1), number of involved lymphoid areas (1,2 = 0, 3,4 = 1, ,5 = 2), visceral disease (no = 0, yes = 1), and systemic symptoms (no = 0, yes = 1). Scores 0 and 1, 2 and 3, and ,4 were attributed to 59.7%, 30.9%, and 9.4% of the patients who had 10-year OS rates of 93.5, 75.7, and 53.4% and 5-year EFS / 5-year FFP rates of 91.2%/90.3%, 78.1%/76.3%, and 54.1%/52.6%, respectively. The discrimination and prediction abilities of the PSS were better than those of the other systems tested; moreover, the PSS adequately identified the few patients with a worse prognosis without resorting to the International Prognostic Score for advanced stages. The PSS was also highly predictive for 489 patients treated between 1997 and 2002. CONCLUSION. PSS is a useful alternative to the existing prognostic systems for evaluating HL patients. Cancer 2007. © 2006 American Cancer Society. [source]

Inflammatory Biomarkers are not Predictive of Intermediate-term Risk of Ventricular Tachyarrhythmias in Stable CHF Patients

CLINICAL CARDIOLOGY, Issue 8 2007
Yuval Konstantino M.D.
Abstract Background: Elevated levels of inflammatory biomarkers and brain natriuretic peptide (BNP) are associated with increased mortality in patients with heart failure (HF). Hypothesis: The aim of the current study was to assess the correlation between circulating biomarkers and ventricular tachyarrhythmias among patients with HF. Methods: Blood samples from 50 stable ambulatory HF patients with moderate to severe systolic left ventricular (LV) dysfunction and an implantable cardioverter defibrillator (ICD) were analyzed for interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-,), high-sensitivity C-reactive protein (hsCRP) and BNP. Thereafter, the patients were followed for a mean period of 152 ± 44 days, during which ventricular tachyarrhythmias were recorded by the ICDs. Results: Follow-up data were obtained from 47 patients. Of them, 45 (96%) had ischemic cardiomyopathy, 38 (81%) had New York Heart Association class I,II, 43 (91%) were males, and the mean age was 68.6 ± 11.1 years. During follow-up, 5 patients (11%) had nonsustained ventricular tachycardia (NSVT), 6 patients (13%) had sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and 36 patients (76%) had no events. The circulating biomarkers' levels upon enrollment were not significantly different between patients who subsequently had NSVT or VT/VF and patients who were free of events. Conclusions: No correlation was found between plasma levels of IL-6, TNF-,, hsCRP and BNP and ventricular arrhythmic events among stable HF patients during an intermediate term follow-up of 5.1 months. Further studies are still required to assess the association between these biomarkers and long-term risk of ventricular tachyarrhythmia. Copyright © 2007 Wiley Periodicals, Inc. [source]

Early motor development of premature infants with birthweight less than 2000 grams

ACTA PAEDIATRICA, Issue 12 2000
SJ Pedersen
The aim was to assess motor function during infancy in order to predict later function, mainly cerebral palsy. The neuromotor development of a population-based cohort of 209 of 236 (89%) survivors with a birthweight less than 2000 g was assessed using the Infant Neurological International Battery (INFANIB) and detailed neurological assessment. The infants were classified as being normal, dystonic, hypotonic or having suspected cerebral palsy (CP) at 4, 7, 13 and 18 mo corrected age if birthweight was less than 1500 g (n= 119) and at 7 and 13 mo if birthweight was 1500,1999 g (n= 90). Those with dystonia or suspected CP were followed until diagnosed as normal or as having CP after at least 36 mo of age. Fourteen (7%) finally developed CP. Motor function at 4 mo was inaccurate in predicting function at 7 mo and later. All who were normal at 7 mo remained normal in the follow-up period. Eight of 65 who were dystonic at 7 mo developed suspected CP, and three judged as suspected CP were eventually normal. The 14 who developed CP were judged as suspected CP (n= 5) or dystonic (n= 8) and one as hypotonic at 7 mo of age. Conclusions: The specificity of motor evaluation at 7 mo corrected age regarding CP is unsatisfactory, since dystonia at this age is most often transient. A normal neuromotor assessment at 7 mo is highly predictive of subsequent normal motor function. [source]

Abnormal fetal aortic velocity waveform and postnatal growth

ACTA PAEDIATRICA, Issue 11 2000
D Ley
Postnatal growth from birth up to 7 y of age was evaluated in 151 children with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. The children with abnormal fetal aortic blood flow class (BFC), of which 39/46 (85%) had a birthweight 2 SD below the mean of the population, were lean at birth and had a high rate of catch-up growth in weight and length during the first 3 and 6 mo, respectively. After the initial phases of rapid catch-up in weight and length, mean values of SD scores for weight and height remained relatively unchanged up until 2 y of age, thereafter increasing gradually up to 7 y of age, leaving 4/46 (8%) and 4/46 (8%) below ,2 SD for weight and height, respectively. The pattern of changes in length/height and weight over time did not differ between those infants with abnormal BFC and those with normal BFC. The abnormal fetal aortic waveform was not related to rate of early catch-up growth or to height or weight at 7 y of age after adjustment for deviation in growth at birth. The magnitude of deficit in weight and length at birth was more predictive of subsequent growth. [source]

Pedestrian Reactive Navigation for Crowd Simulation: a Predictive Approach

COMPUTER GRAPHICS FORUM, Issue 3 2007
Sébastien Paris
This paper addresses the problem of virtual pedestrian autonomous navigation for crowd simulation. It describes a method for solving interactions between pedestrians and avoiding inter-collisions. Our approach is agent-based and predictive: each agent perceives surrounding agents and extrapolates their trajectory in order to react to potential collisions. We aim at obtaining realistic results, thus the proposed model is calibrated from experimental motion capture data. Our method is shown to be valid and solves major drawbacks compared to previous approaches such as oscillations due to a lack of anticipation. We first describe the mathematical representation used in our model, we then detail its implementation, and finally, its calibration and validation from real data. [source]

Gait disturbance interpreted as cerebellar ataxia after MMR vaccination at 15 months of age: a follow-up study

ACTA PAEDIATRICA, Issue 1 2000
A-M Plesner
Measles, mumps and rubella (MMR) vaccination was included in the Danish childhood vaccination programme in 1987. During the following 10-y period, 550 notification records of adverse events after MMR vaccination at 15 mo of age have been registered, and a total of 41 notifications have included "gait disturbance". This corresponds to a frequency of 8 per 100 000 doses of MMR vaccine used for 15-mo-old children. The symptoms and signs are characteristic of cerebellar ataxia. In 28 notifications, the descriptions by the doctors included only "gait disturbance", while in 13 an additional interpretation was included. Thirty-two parents (78%) filled in a questionnaire and 26 (63%) agreed to participate in a clinical follow-up study. The gait disturbance symptoms mainly occurred 7,14 d after the vaccination, and the duration was median 1,2 wk (range 1 d to more than 4 mo). One-third of the children had symptoms lasting more than 2 wk. Significantly more children with long duration of symptoms had some kind of complaint or clinical signs at the follow-up in 1997. Gait disturbance registered after MMR vaccination seems to be more frequent than hitherto reported. Most cases are mild and short-lasting and a longer duration of symptoms seems to be predictive of late sequelae. A clinical diagnosis of cerebellar ataxia after MMR and the exact frequency of this adverse event remains to be tested in prospective studies. [source]

Predictive Value of Admission Electrocardiography in Patients With Heart Failure

CONGESTIVE HEART FAILURE, Issue 4 2008
Karolina M. Zareba MD
Admission electrocardiography (ECG) in heart failure (HF) patients provides important diagnostic information; however, there are limited data regarding the prognostic significance of ECG parameters for predicting cardiac events (CEs). The ECGs of 246 patients admitted with acute HF were evaluated for heart rate, rhythm, QRS and ST-T wave abnormalities, QTc duration, QT peak corrected (QTpc), T amplitude, and axis. The end points included rehospitalization for a CE or death during 30-day follow-up. There were 71 (29%) patients with CEs. In patients with CEs, atrial fibrillation (AF) was observed more frequently (27% vs 13%, respectively; P=.009) and QTpc was shorter (370±43 vs 386±44 ms, respectively; P=.020). Multivariate logistic regression analysis revealed that QTpc ,360 ms and AF were predictive of CE after adjustment for clinical covariates. In conclusion, apart from AF, the presence of short QTpc ,360 ms is independently associated with increased risk of rehospitalization or death in HF patients. [source]

Usefulness of B-Type Natriuretic Peptide as a Predictor of Treatment Outcome in Pulmonary Arterial Hypertension

CONGESTIVE HEART FAILURE, Issue 5 2004
Myung H. Park MD
We examined the utility of early modulation B-type natriuretic peptide (BNP) levels in 20 pulmonary arterial hypertension patients as a marker of response to epoprostenol therapy. The baseline BNP level was 828±217 pg/mL. A total of 19 hospitalizations and one death occurred in nine patients during 11.0±1.8 months. At baseline, a trend toward higher BNP level was observed among the event-free (Group A) as compared with clinical event patients (Group B) (1090±372 vs. 510±235 pg/mL, respectively; p=0.08). After 3 months on epoprostenol, a significant reduction among Group A occurred while Group B demonstrated an increase (288±92 vs. 610±121 pg/mL, p=0.04). A comparison of percent reduction in BNP level demonstrated a ,70±7% change among Group A and an 11±19% increase in Group B (p=0.005). A decrease in BNP level of ,50% during the first 3 months on epoprostenol was strongly predictive of event-free survival (p=0.003). This investigation establishes the utility of BNP for predicting response to epoprostenol therapy in pulmonary arterial hypertension. [source]

Predictive identification of human skin sensitization thresholds

CONTACT DERMATITIS, Issue 5 2005
David A. Basketter
For years, methods have been available for the predictive identification of chemicals that possess the intrinsic potential to cause skin sensitization. However, many have proven less suitable for the determination of relative sensitizing potency. In this respect, the local lymph node assay (LLNA) has been shown to have a number of important advantages. Through interpolation of LLNA dose,response data, the concentration of a chemical required to produce a threshold positive response (a 3-fold increase in activity compared with concurrent vehicle controls, the EC3 value) can be measured. The robustness of this parameter has been demonstrated rigorously in terms of inter- and intralaboratory reproducibility. Additionally, the relationship between potency estimates from the LLNA and an appreciation of human potency based on clinical experience has been reported previously. In the present investigations, we have sought to consolidate further our understanding of the association between EC3 values and human skin-sensitization potency by undertaking a thorough and extensive analysis of existing human predictive assays, particularly where dose,response information is available, from historical human repeated insult patch tests (HRIPTs). From these human data, information on the approximate threshold for the induction of skin sensitization in the HRIPT was determined for 26 skin-sensitizing chemicals. These data were then compared with LLNA-derived EC3 values. The results from each assay, expressed as dose per unit area (,g/cm2), revealed a clear linear relationship between the 2 values, thereby substantiating further the utility of LLNA EC3 values for prediction of the relative human sensitizing potency of newly identified skin sensitizers. [source]

Validity and ethics of the human 4-h patch test as an alternative method to assess acute skin irritation potential

CONTACT DERMATITIS, Issue 1 2001
Michael K. Robinson
For more than 50 years, the Draize rabbit skin irritation test has reigned supreme as the regulatory method of choice for the identification of skin irritant chemicals. To date no in vitro alternative test has been validated as an adequate replacement. However, one potential option, to test the endpoint of concern (skin irritation) in the species of concern (man) has been overlooked. The advent of predictive in vitro tools for the identification of substances corrosive to the skin has opened up the practical possibility of carrying out safe and ethical studies on small panels of humans. The human 4-h patch test has been developed to meet the needs of identifying chemical skin irritation potential, providing data which is inherently superior to that given by a surrogate model, such as the rabbit. This paper reviews in detail the present state of the human 4-h patch test, highlighting its advantages and noting its utility as the ,gold standard' on which to build future in vitro models. [source]

National Adoption of International Accounting Standards: An Institutional Perspective

CORPORATE GOVERNANCE, Issue 3 2010
William Judge
ABSTRACT Manuscript Type: Empirical Research Question/Issue: Effective corporate governance requires accurate and reliable financial information. Historically, each nation has developed and pursued its own financial standards; however, as financial markets consolidate into a global market, there is a need for a common set of financial standards. As a result, there is a movement towards harmonization of international financial reporting standards (IFRS) throughout the global economy. While there has been considerable research on the effects of IFRS adoption, there has been relatively little systematic study as to the antecedents of IFRS adoption. Consequently, this study seeks to understand why some economies have quickly embraced IFRS standards while others partially adopt IFRS and still others continue to resist. Research Findings/Results: After controlling for market capitalization and GDP growth, we find that foreign aid, import penetration, and level of education achieved within a national economy are all predictive of the degree to which IFRS standards are adopted across 132 developing, transitional and developed economies. Theoretical/Academic Implications: We found that all three forms of isomorphic pressures (i.e., coercive, mimetic, and normative) are predictive of IFRS adoption. Consequently, institutional theory with its emphasis on legitimacy-seeking by social actors was relatively well supported by our data. This suggests that the IFRS adoption process is driven more by social legitimization pressures, than it is by economic logic. Practitioner/Policy Implications: For policy makers, our findings suggest that the institutional pressures within an economy are the key drivers of IFRS adoption. Consequently, policy makers should seek to influence institutional pressures that thwart and/or enhance adoption of IFRS. For executives of multinational firms, our findings provide insights that can help to explain and predict future IFRS adoption within economies where their foreign subsidiaries operate. This ability could be useful for creating competitive advantages for foreign subsidiaries where IFRS adoption was resisted, or avoiding competitive disadvantages for foreign subsidiaries unfamiliar with IFRS standards. [source]

Predicting juvenile delinquency: The nexus of childhood maltreatment, depression and bipolar disorder

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2009
Christopher A. Mallett
Background,It is important to identify and provide preventative interventions for youth who are most at risk for offending behaviour, but the connection between early childhood or adolescent experiences and later delinquency adjudication is complicated. Aim,To test for associations between specified mental disorders or maltreatment and later delinquency adjudication. Method,Participants were a random sample of youth before the juvenile courts in two Northeast Ohio counties in the USA (n = 555) over a 4-year time frame (2003 to 2006). Results,Logistic regression analysis identified a lifetime diagnosis of depression and/or bipolar disorder to be predictive of later youth delinquency adjudication, but found that childhood maltreatment (or involvement with the child welfare system) made delinquency outcomes less likely. Implications,Study implications are discussed as they relate to professionals working in the fields of child welfare, social work, mental health and juvenile justice. Awareness of risks associated with maltreatment may have led to effective interventions, while there may be less awareness of risks from depression in young people; however, studies tend not to take account of intervention variables. Copyright © 2009 John Wiley & Sons, Ltd. [source]

The development of a specialist hostel for the community management of personality disordered offenders

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2009
Stephen Blumenthal
Background,Since the late 1990s, in England and in Wales, there has been increasing interest in the particular challenges of managing offenders with personality disorder (PD). In 1999, a specialist hostel, managed by the probation service but with a high level of forensic mental health service input, was opened to high-risk PD offenders. Aims,To describe the first 93 high-risk residents with PD who were completing sentences under life licence, parole or probation, and their outcome. Methods,We investigated the nature of the offences residents had previously committed, their psychological profile in terms of personality patterns on the Millon Clinical Multiaxial Inventory (MCMI-III) and the Psychopathy Checklist-Revised (PCL-R), as well as staff commentary on their progress, to establish whether these factors related to outcome in terms of completion of stay in the hostel or premature discharge. Curfew failures and rearrest rates were also measured. Results,Of the 80 men who completed their residency within the two years of the study, the majority (50) left the hostel for positive reasons under mutual agreement. One-fifth were rearrested while resident, which is a lower rate than would be expected for such a group of offenders. PCL-R scores were predictive of outcome, but so was previous offending history. Self-defeating traits on the MCMI-III and negative comments written by hostel staff were also associated with failure. Conclusions,The hostel development demonstrated that probation and health services can work together to manage violent offenders with high levels of psychological dysfunction, and the evaluation provided some indications of how such arrangements might be enhanced. Copyright © 2009 John Wiley & Sons, Ltd. [source]

What are adolescent antecedents to antisocial personality disorder?

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2002
Rolf Loeber PhD
Background This paper fills a gap because there are very few studies that prospectively predict antisocial personality disorder (APD) from psychopathology earlier in life in clinic-referred samples of young males. Method The paper addresses the continuity between conduct disorder (CD) and other forms of psychopathology during ages 13,17 and modified APD at ages 18 and 19 (modified to remove the DSM-IV requirement of pre-existing CD by age 15) in the Developmental Trends Study. Results The results show that 82,90% of APD cases met criteria for CD at least once during ages 13,17, and very few youths who met criteria for ODD during this period progressed to APD without intermediate CD. While CD is a strong predictor of modified APD, when other factors were accounted for in regression analyses, the best predictors were callous/unemotional behaviour, depression and marijuana use. ADHD during ages 13,17 was not significant in the final model. Males with CD during adolescence who progressed to APD tended to commit more violence, as evident from their court records. Conclusions Implications are discussed for the conceptualization of developmental models leading to APD, the strengthening of relevant symptoms of CD predictive of APD, and preventive and remedial interventions. Copyright © 2002 Whurr Publishers Ltd. [source]

ROMANTIC PARTNERS' INFLUENCE ON MEN'S LIKELIHOOD OF ARREST IN EARLY ADULTHOOD,

CRIMINOLOGY, Issue 2 2008
DEBORAH M. CAPALDI
Female romantic partners' influence on official crime occurrence for men across a 12-year period in early adulthood was examined within a comprehensive dynamic prediction model, including both social learning and social control predictors. We hypothesized that relationship stability, rather than attachment to partner, would be associated with reduced likelihood of crime, whereas women's antisocial behavior would be a risk factor, along with deviant peer association. Models were tested on a sample of at-risk men [the Oregon Youth Study (OYS)] using zero-inflated Poisson (ZIP) modeling predicting 1) arrest persistence (class and count) and 2) arrest onset class. The findings indicated that women's antisocial behavior was predictive of both onset and persistence of arrests for men and that deviant peer association was predictive of persistence. Relationship stability was protective against persistence. [source]

MODELING MEDIATION IN THE ETIOLOGY OF VIOLENT BEHAVIOR IN ADOLESCENCE: A TEST OF THE SOCIAL DEVELOPMENT MODEL,

CRIMINOLOGY, Issue 1 2001
BU HUANG
The social development model seeks to explain human behavior through specification of predictive and mediating developmental relationships. It incorporates the effects of empirical predictors ("risk factors" and "protective factors") for antisocial behavior and seeks to synthesize the most strongly supported propositions of control theory, social learning theory, and differential association theory. This article examines the fit of the social development model using constructs measured at ages 10, 13, 14, and 16 to predict violent behavior at age 18. The sample of 808 is from the longitudinal panel of the Seattle Social Development Project, which in 1985 surveyed fifth-grade students from schools serving high crime neighborhoods in Seattle, Washington. Structural equation modeling techniques were used to examine the fit of the model to the data. The model fit the data (CFI ,.90, RMSEA ,.05). We conclude that the social development model adequately predicts violence at age 18 and mediates much of the effect of prior violence. Implications for theory and for prevention are discussed. [source]