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Wide Variability (wide + variability)

Distribution by Scientific Domains

Medical Sciences	58%
Life Sciences	16%
Humanities and Social Sciences	6%
6 Other Domains	20%

Distribution within Medical Sciences

Consumer Health General	15%
12 Other Subdomains	70%

Selected Abstracts

Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2004
Sigrid Østensjø MSc PT
In this study we assessed the distribution of spasticity, range of motion (ROM) deficits, and selective motor control problems in children with cerebral palsy (CP), and examined how these impairments relate to each other and to gross motor function and everyday activities. Ninety-five children (55 males, 40 females; mean age 58 months, SD18 months, range 25 to 87 months) were evaluated with the modified Ashworth scale (MAS), passive ROM, the Selective Motor Control scale (SMC), the Gross Motor Function Measure (GMFM), and the Pediatric Evaluation of Disability Inventory (PEDI). Types of CP were hemiplegia (n=19), spastic diplegia (n=40), ataxic diplegia (n=4), spastic quadriplegia (n=16), dyskinetic (n=9), and mixed type (n=7). Severity spanned all five levels of the Gross Motor Function Classification System (GMFCS). The findings highlight the importance of measuring spasticity and ROM in several muscles and across joints. Wide variability of correlations of MAS, ROM, and SMC indicates a complex relationship between spasticity, ROM, and selective motor control. Loss of selective control seemed to interfere with gross motor function more than the other impairments. Further analyses showed that motor impairments were only one component among many factors that could predict gross motor function and everyday activities. Accomplishment of these activities was best predicted by the child's ability to perform gross motor tasks. [source]

Variability in the upper limit of normal for serum alanine aminotransferase levels: A statewide study,

HEPATOLOGY, Issue 6 2009
Anand Dutta
We conducted a study to characterize the variability in the upper limit of normal (ULN) for alanine aminotransferase (ALT) across different laboratories (labs) in Indiana and to understand factors leading to such variability. A survey was mailed to all eligible labs (n = 108) in Indiana, and the response rate was 62%. The survey queried for ALT ULN, the type of chemical analyzer used, five College of American Pathologists (CAP) sample results, and methods used to establish the reference interval. There was a wide variability in the ALT ULN for both men and women. Eighty-five percent of labs used chemical analyzers belonging to one of the four brands. For all five CAP samples, there was a statistically significant difference in ALT values measured by different analyzers (P < 0.0001), but these differences were not clinically significant. The majority of labs used the manufacturers' recommendations for establishing their ALT ULN rather than in-house healthy volunteer testing (only 17%). When healthy volunteers were tested, the process for testing was haphazard in terms of the number of individuals tested, frequency of testing, and criteria for choosing the reference population. After controlling for chemical analyzer type, there was no significant relationship between ALT ULN values and the method used for its establishment. Conclusion: Wide variability in ALT ULN across different labs is more likely due to variable reference intervals of different chemical analyzers. It may be possible to minimize variability in ALT ULN by (1) each lab solely following the manufacturers' recommendations and (2) manufacturers of different analyzers following consistent and rigorous methodology in establishing the reference range. Alternatively, studies should be undertaken to identify outcome-based reference intervals for ALT. (HEPATOLOGY 2009.) [source]

International prevalence of physical activity in youth and adults

OBESITY REVIEWS, Issue 6 2008
S. B. Sisson
Summary Understanding population prevalences of physical activity is important to develop benchmarks for current baseline levels to monitor future changes, and for making country/regional comparisons. The purpose was to review the global prevalence of physical activity levels among youth and adults. Standardized literature searches for articles about national prevalences of physical activity were conducted in PubMed. A total of 34 studies in adults and 28 studies in youth were deemed contemporary (1996 , present) and met the inclusion criteria for this review. Wide variability was present between countries in the prevalence of physical activity (as measured and defined by individual studies). Studies with the highest reported prevalences of physical activity were for men in Sweden (77%), women in Denmark (81%), 12- to 15-year-old boys in Australia (74%) and <12-year-old girls (75%) in China. The countries with the lowest reported prevalences of physical activity were men in Brazil (4%), women in Saudi Arabia (2%) and Thailand (2%), and 17- to 18-year-old boys (0%) and 17- to18-year-old girls (0%) in Russia. The ranges of prevalence of physical activity, mode of data collection, and determination of meeting the physical activity threshold vary greatly between countries. However, the aggregation of these data can be a useful resource to practitioners, interventionists and epidemiologists. [source]

Extreme value predictions based on nonstationary time series of wave data

ENVIRONMETRICS, Issue 1 2006
Christos N. Stefanakos
Abstract A new method for calculating return periods of various level values from nonstationary time series data is presented. The key idea of the method is a new definition of the return period, based on the MEan Number of Upcrossings of the level x* (MENU method). In the present article, the case of Gaussian periodically correlated time series is studied in detail. The whole procedure is numerically implemented and applied to synthetic wave data in order to test the stability of the method. Results obtained by using several variants of traditional methods (Gumbel's approach and the POT method) are also presented for comparison purposes. The results of the MENU method showed an extraordinary stability, in contrast to the wide variability of the traditional methods. The predictions obtained by means of the MENU method are lower than the traditional predictions. This is in accordance with the results of other methods that also take into account the dependence structure of the examined time series. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Registration of plant protection products in EPPO countries: current status and possible approaches to harmonization

EPPO BULLETIN, Issue 2 2001
J. Rüegg
A survey concerning registration of plant protection products was carried out in 41 EPPO member countries. Twenty six countries responded and results are summarized in three groups. Various models are discussed which seek to adapt product dosage to the crowns of fruit-tree crops. The tree row volume model (TRV) is favoured by the authors since it can adequately cope with the wide variability of orchards encountered across Europe. It is suggested that experimenters who carry out registration field trials should measure the height and width of the tree crowns and the distance between the tree rows to facilitate comparison of registration trials including residue data. [source]

A clinical and genetic study of 56 Saudi Wilson disease patients: identification of Saudi-specific mutations

EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2004
M. Al Jumah
Wilson disease (WD) is a hereditary disorder, with recessive transmission and genetic heterogeneity. Several mutations of ATP7B, the gene underlying WD, were reported in many ethnic groups. In this study, mutation screening in ATP7B of 56 Saudi Arabian WD patients was undertaken. The clinical data of all patients were recorded. The entire ATP7B coding sequence, including intron,exon boundaries were screened for mutation by the polymerase chain reaction (PCR)-based mutation detection technique and DNA sequencing. Thirty-nine patients were symptomatic at presentation and 17 subjects were pre-symptomatic siblings of affected patients. Fourteen patients had neurological, 11 patients had mixed (hepatic and neurological), and 14 patients had hepatic presentations. Family history suggestive of WD was present in 72% of cases and 68% had consanguineous parents. Genetic analysis showed disease-causing mutations in three exons (exons 8, 19 and 21) of the ATP7B gene in 28 patients (50%). Mutations in exons 21 (18 cases) and 19 (one case) were unique for Saudis. This large series of Saudi patients with WD has shown wide variability in the genomic substrate of WD. There is no correlation between genotype and clinical presentation. [source]

Trading safety for food: evidence from gut contents in roach and bleak captured at different distances offshore from their daytime littoral refuge

FRESHWATER BIOLOGY, Issue 5 2006
Z. MACIEJ GLIWICZ
Summary 1. Regular diel habitat shifts in roach were detected by hydro-acoustics in five moderately eutrophic, stratifying (maximum depth 24,27 m) and approximately circular lakes (of surface area 15, 75, 125, 300 and 900 ha and diameters 250, 600, 1000, 1700 and 2600 m) in north-eastern Poland in the years 1998,2000, when the lakes were free of smelt and other typical offshore planktivores, and their offshore areas were completely free of fish during the day. 2. The diel change in roach distribution was shown to assume a similar pattern in each lake: fish migrated from a daytime littoral refuge towards the centre of the lake at dusk, and returned to the littoral refuge at dawn. After sunset, fish gradually dispersed offshore until they covered the entire lake area in each of the three smaller lakes. In each of the two larger lakes, only small numbers of fish were seen in the central area at night, implying that the centre of the lake retained high food availability throughout the summer. 3. Inshore,offshore gradients in zooplankton prey density, body size, and numbers of eggs per clutch were weak or undetectable in the two smallest lakes, but strong and persistent in the three larger lakes, with Daphnia densities 5,30 times as high and body length 1.2,1.5 times as great in the central area as inshore. 4. The likely increase in the potential predation risk with distance from the littoral daytime refuge was found to be compensated by increased food gains in those fish which moved offshore at dusk to feed within a short time window, when light intensity was lower to make the risk reduced, but still high enough to see zooplankton prey. The benefit because of increased prey acquisition was greatest in the centre of the largest lake (at 1300 m from the shore), as revealed from gut inspections of roach and bleak trawl-sampled at different distances from the edge of the reed belt, and seen as a gradual, order-of-magnitude increase in the volume of food in the foregut, The food volume against distance-from-shore regression was highly significant on each of the four sampling dates in the largest lake, in spite of the wide variability of food volume in individual fish. [source]

Variability in the upper limit of normal for serum alanine aminotransferase levels: A statewide study,

Anomalous Defects and Dynamic Failure of Armor Ceramics

INTERNATIONAL JOURNAL OF APPLIED CERAMIC TECHNOLOGY, Issue 3 2004
M.P. Bakas
The ballistic performance of state-of-the-art silicon carbide armor material can exhibit a fairly wide variability in certain test configurations, which, it is proposed, may be due to the presence of large (>0.1 mm), rare defects, termed, herein, "anomalous" defects. SiC rubble resulting from ballistic tests was examined, as were quasi-static test samples. Ballistic fragment fracture surfaces revealed large carbonaceous defects that seemed to affect fracture path and mode. Low-strength biaxial flexure samples demonstrated similar defects (>0.1 mm) as failure origins. Carbonaceous defects similar in appearance but smaller in size were also found at the fracture origins of SiC bend bars. Frequently, alumina inclusions were found within the carbonaceous discontinuities. These alumina inclusions may cause the graphitic regions to form during sintering. The random distribution of such large, rare carbonaceous discontinuities from sample-to-sample, as well as batch-to-batch variability, may explain high ballistic variability for SiC armor ceramics. [source]

Diversity examination based on physical, technological and chemical traits in a locally grown landrace of faba bean (Vicia faba L. var. major)

INTERNATIONAL JOURNAL OF FOOD SCIENCE & TECHNOLOGY, Issue 12 2009
Giovanni Avola
Summary Fifteen accessions of a locally adapted Sicilian population (,Larga di Leonforte') of faba bean were evaluated for their physical and technological properties and chemical composition. Results showed a high seed weight (1000 seed weight around 2500 × g) along with a great seed size with wide variability among accessions. When all data were combined, the seeds initial water uptake was 0.21 g min,1. Differences between accessions were found in hydration capacity (ranging between 133% and 160%) and retainable firmness after 40 min of cooking (ranging between 18.8 and 13.6 N cm,2). In addition, the average contents of 46.0, 25.2 and 2.6 g 100 g,1 dry weight basis were ascertained for starch, protein and tannin, respectively, with considerable variation among accessions. The result's interpretation, carried out through a methodological approach based on multivariate analysis, seem to support the view that parameters such as seed dimension, starch, protein and tannin content, can be effectively adopted as elements of comparison among landraces in grain legumes. [source]

The Virtual International Stroke Trials Archive (VISTA): results and impact on future stroke trials and management of stroke patients

INTERNATIONAL JOURNAL OF STROKE, Issue 2 2010
C. Weimar
Background The Virtual International Stroke Trials Archive was established to improve stroke care and trial design through the collation, categorization and potential access to data sets from clinical trials for the treatment of stroke. Methods Virtual International Stroke Trials Archive currently provides access to a combined data set of 29 anonymised acute stroke trials and one acute stroke registry with data on >27 500 patients aged between 18 and 103 (mean 71) years. Results Virtual International Stroke Trials Archive has facilitated research across a broad canvas. The prognosis was poor in patients with very high blood pressure at the time of admission or with a wide variability of systolic blood pressure during the acute phase. The late occurrence of hyperthermia following an ischaemic stroke worsens the prognosis. Stroke lateralisation is not an important predictor of cardiac adverse events or 90-day mortality. Haemorrhagic transformation is seen frequently in patients with cardio-embolic strokes and is associated with a poor prognosis when occurring after the acute phase. Virtual International Stroke Trials Archive has allowed various prognostic models for patients with ischaemic or haemorrhagic stroke to be established and validated. More direct outcomes such as lesion volume can be useful in phase II clinical trials for determining whether a phase III trial should be undertaken. New outcome measures such as ,home time' may also strengthen future trials. On a worldwide level, the prognosis of stroke patients differs considerably between various countries. Conclusion Virtual International Stroke Trials Archive provides an excellent opportunity for analysis of natural history data and prognosis. It has the potential to influence clinical trial design and implementation through exploratory data analyses. [source]

Heterogeneity in Serum 25-Hydroxy-Vitamin D Response to Cholecalciferol in Elderly Women with Secondary Hyperparathyroidism and Vitamin D Deficiency

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2010
Andrea Giusti MD
OBJECTIVES: To compare the effects on parathyroid hormone (PTH) and 25-hydroxy-vitamin D (25(OH)D) of two dosing regimens of cholecalciferol in women with secondary hyperparathyroidism (sHPTH) and hypovitaminosis D and to investigate variables affecting 25(OH)D response to cholecalciferol. DESIGN: Randomized-controlled trial with 6-month follow-up. SETTING: Two osteoporosis centers in northern Italy. PARTICIPANTS: Sixty community-dwelling women aged 65 and older with sHPTH and hypovitaminosis D, creatinine clearance greater than 65 mL/min and without diseases or drugs known to influence bone and vitamin D metabolism. INTERVENTION: Cholecalciferol 300,000 IU every 3 months, once at baseline and once at 3 months (intermittent D3 group) or cholecalciferol 1,000 IU/day (daily D3 group). MEASUREMENTS: Serum PTH, 25(OH)D, calcium, bone-specific alkaline phosphatase, ,-C-terminal telopeptide of type I collagen, phosphate, 24-hour urinary calcium excretion. RESULTS: The two groups had similar baseline characteristics. All participants had vitamin D deficiency [25(OH)D<20 ng/mL)], and 36 subjects (60%) had severe deficiency (<10 ng/mL), with no difference between the groups (severe deficiency: intermittent D3 group, n=18; daily D3 group, n=18). After 3 and 6 months, both groups had a significant increase in 25(OH)D and a reduction in PTH. Mean absolute increase±standard deviation of 25(OH)D at 6 months was higher in the intermittent D3 group (22.7±11.8 ng/mL) than in the daily D3 group (13.7±6.7 ng/mL, P<.001), with a higher proportion of participants in the intermittent D3 group reaching desirable serum concentration of 25(OH)D , 30 ng/mL (55% in the intermittent D3 group vs 20% in the daily D3 group, P<.001). Mean percentage decrease of PTH in the two groups was comparable, and at 6 months, a similar proportion of participants reached normal PTH values. 25(OH)D response to cholecalciferol showed a wide variability. In a logistic regression analysis, body mass index and type of treatment appeared to be significantly associated with normalization of 25(OH)D values. CONCLUSION: Cholecalciferol 300,000 IU every 3 months was more effective than 1,000 IU daily in correcting vitamin D deficiency, although the two groups achieved similar effects on PTH at 6 months. Only 55% of the higher-dose intermittent group reached desirable concentrations of 25(OH)D, suggesting that yet-higher doses will be required for adequate vitamin D repletion. [source]

Modelling ecological half-lives for radiocaesium in Norwegian brown trout populations

JOURNAL OF APPLIED ECOLOGY, Issue 1 2000
Dag O. Hessen
Summary 1.,Models of ecological half-life may be valuable and cost-effective predictive tools for authorities setting restrictions on human consumption of freshwater fish after environmental releases of radioactivity. This work aimed to validate such a model for radioactive caesium (134Cs and 137Cs) in brown trout Salmo trutta populations. Data were drawn from lakes with a wide variability in abiotic and biotic factors and initial caesium load. 2.,In Norway, the highest fallout (more than 150 kBq m,2 of 137Cs) from the Chernobyl accident occurred in Oppland county, in south central Norway. Radioactivity was measured in more than 1800 samples of brown trout in nearly 100 localities in this region during 1986,95. 3.,The back-calculated maximum initial radioactivity on 1 January 1987 showed a strong regional variability (range 443,13 370; average 3855 Bq kg,1). Large variation in initial radioactivity was also recorded on a local scale (within 50 km). 4.,The ecological half-life model for caesium in brown trout populations for 1987,94/95 gave a close fit to real data from all localities with sufficient time series. Predicted half-lives ranged from 1·2 to 4·2 years (average 2·5) but 95% confidence limits were narrow (2·7 and 2·3 years). 5.,The overall variability in radioactivity levels over time was almost entirely related to the initial load and, with few exceptions, 88% of the changes in radioactivity was explained by the simple regression model. Modest variability in ecological half-life was not correlated with initial activity, and no clear effects of water quality or season could be detected. For most lakes, levels of radioactivity in brown trout appeared to be predictable, with high accuracy after a fallout event, without extensive information on population ecology and water quality. However, more detailed work may be required to assess patterns within individual lakes. [source]

Current practice compared with the international guidelines: endoscopic surveillance of Barrett's esophagus

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2007
Nassira Amamra MPH
Abstract Rationale, aims and objectives, To describe the current practice for the surveillance of patients with Barrett's esophagus, to compare this practice with the national guidelines published by the French Society of Digestive Endoscopy in 1998 and to identify the factors associated with the compliance to guidelines. Method, To determine the attitudes of French hepatogastroenterologists to screening for Barrett's oesophagus, a postal anonymous questionnaire survey was undertaken. It was sent to 246 hepatogastroenterologists in the Rhone-Alpes area. We defined eight criteria allowed to assess the conformity of practices with the guidelines. We created three topics composed of several criterion. The topics analysed were ,Biopsies', ,Surveillance' and the diagnosis of high grade dysplasia. We studied the factors which could be associated with the compliance with the guidelines. Results, The response rate was 81.3%. For 58.0% of the gastroenterologists, endoscopic biopsy sampling were made according to French guidelines (four-quadrant biopsies at 2 cm intervals). Agreement was 78.0% regarding the interval of surveillance for no dysplasia (every 2 or 3 years) and 78.5% regarding the low-grade dysplasia (every 6 or 12 months). For the management of high-grade dysplasia, 28.6% actually confirm the diagnosis by a second anatomopathologist and 42.0% treated by proton pump inhibitor during 2 months. Concerning the biopsies, the young gastroenterologists and gastroenterologists practising in university hospitals had a better adherence to the guidelines (Relative Risk: 2.22, 95% CI 1.25,3.95 and 3.74, 95% CI 1.04,13.47, respectively). The other factors of risk were not statistically significant. Conclusions, The endoscopic follow-up is mostly realized in accordance with the national guidelines. However, there is a wide variability in individual current practice. [source]

Timing and nature of late Quaternary mountain glaciation,

JOURNAL OF QUATERNARY SCIENCE, Issue 6-7 2008
Glenn D. Thackray
Abstract Compilations of regional- to subcontinental-scale mountain glacier chronologies from five continents, plus Hawaii, examine the temporal and spatial patterns of mountain glaciation. The compilations yield key insights into the nature of past fluctuations in temperature and precipitation in mountains and adjacent regions, and provide baseline data for examining the dynamics of glacier responses to climate change. Key insights from these compilations include the wide variability of glacier responses to fluctuations in insolation, temperature and precipitation and the regionally specific variations in climatic variables through late Quaternary time. The compilations highlight the need to improve the density and quality of geochronological data and to enhance the understanding of the links between climate and glaciation. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Strategy hubs: Domain portals to help find comprehensive information

JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 1 2006
Suresh K. Bhavnani
Recent studies suggest that the wide variability in type, detail, and reliability of online information motivate expert searchers to develop procedural search knowledge. In contrast to prior research that has focused on finding relevant sources, procedural search knowledge focuses on how to order multiple relevant sources with the goal of retrieving comprehensive information. Because such procedural search knowledge is neither spontaneously inferred from the results of search engines, nor from the categories provided by domain-specific portals, the lack of such knowledge leads most novice searchers to retrieve incomplete information. In domains like healthcare, such incomplete information can lead to dangerous consequences. To address the above problem, a new kind of domain portal called a Strategy Hub was developed and tested. Strategy Hubs provide critical search procedures and associated high-quality links to enable users to find comprehensive and accurate information. We begin by describing how we collaborated with physicians to systematically identify generalizable search procedures to find comprehensive information about a disease, and how these search procedures were made available through the Strategy Hub. A controlled experiment suggests that this approach can improve the ability of novice searchers in finding comprehensive and accurate information, when compared to general-purpose search engines and domain-specific portals. We conclude with insights on how to refine and automate the Strategy Hub design, with the ultimate goal of helping users find more comprehensive information when searching in unfamiliar domains. [source]

Water Use by Thermoelectric Power Plants in the United States,

JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 1 2007
Xiaoying Yang
Abstract:, Thermoelectric power generation is responsible for the largest annual volume of water withdrawals in the United States although it is only a distant third after irrigation and industrial sectors in consumptive use. The substantial water withdrawals by thermoelectric power plants can have significant impacts on local surface and ground water sources, especially in arid regions. However, there are few studies of the determinants of water use in thermoelectric generation. Analysis of thermoelectric water use data in existing steam thermoelectric power plants shows that there is wide variability in unitary thermoelectric water use (in cubic decimeters per 1 kWh) within and among different types of cooling systems. Multiple-regression models of unit thermoelectric water use were developed to identify significant determinants of unit thermoelectric water use. The high variability of unit usage rates indicates that there is a significant potential for water conservation in existing thermoelectric power plants. [source]

Identifying occupational therapists' referral priorities in community health

OCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2003
MSc Occupational Therapy Course Leader, Priscilla Harries Dip.COT
Abstract Occupational therapists in British community mental health teams have been debating how the most effective services can be targeted at the most needy clients. This paper presents the results of a quantitative study that examined 40 British occupational therapists' referral prioritization policies. Results showed half of the participants felt their generic responsibilities, which involved having care coordination responsibilities, were too large. Only 25% of participants co-ordinated care for clients whose needs were related to occupational dysfunction. Judgement analysis, that involved regressing the 40 individuals' prioritization decisions onto the 90 respective referral scenarios, was used to statistically model how referral information had been weighted. Group agreement of prioritization was moderate with the reason for referral, history of violence and diagnosis being given the most weighting. Consistency in policy application, as measured by examining prioritization decisions on identical referrals, showed wide variability. Further research is required to identify the optimal and most stable policies within this group. Copyright © 2003 Whurr Publishers Ltd. [source]

Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitions

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2009
Riccardo Davanzo
Summary Human milk has several advantages in the nutrition of very-low-birthweight (VLBW) infants. However, there are limited data on breast feeding (BF) in neonatal intensive care units (NICU). The aim of this study was to identify a practical definition of BF rate in VLBW infants and to test its applicability and reproducibility in Italian NICUs. The study population included all VLBW infants discharged from 12 level 3 NICUs, over a 12-month period. Type of feeding was recorded according to the World Health Organisation (WHO) definition, with a 72-h recall period. We enrolled 594 VLBW infants. Mean birthweight was 1105 g (SD: 267), mean gestational age was 29.2 weeks (SD: 2.7) and mean length of stay in NICUs was 62.5 days (SD: 56.5). At discharge, 30.5% of VLBW infants were exclusively breast fed, 0.2% were predominantly breast fed, 23.8% were on complementary feeding and 45.5% were exclusively formula fed. A wide variability in BF rates was seen between centres. Among exclusively breast-fed VLBW infants, only 10% sucked directly and exclusively at the breast. WHO definitions can be used to assess type of feeding at discharge from NICUs. We speculate that common feeding definitions may allow both comparisons among different NICUs and ratings of quality improvement programmes. [source]

Interactions between fetal HLA-DQ alleles and maternal smoking influence birthweight

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2006
G. Malcolm Taylor
Summary Maternal smoking during pregnancy inhibits fetal growth, and is a major cause of childhood and adult morbidity, including increased risks of cardiovascular disease and diabetes. However, the use of birthweight as a proxy for future smoking-related morbidity is hindered by its wide variability, suggesting a role for other birthweight-modifying factors. We report here, for the first time, that interactions between specific fetal HLA-DQA1 and DQB1 alleles and maternal smoking can influence birthweight. We compared mean birthweights of a series of term, HLA-DQ typed white UK newborns (n = 552) whose mothers had either smoked (n = 211) or not smoked (n = 341) during pregnancy. Maternal smoking during pregnancy resulted in an average birthweight reduction of 244 g, but the combined effects of maternal smoking and fetal DQA1*0101 or DQB1*0501 alleles resulted in a 230 and 240 g further reduction in mean birthweight, respectively, resulting from interactions between smoking and these DQ types. Other fetal DQ allele-specific interactions with maternal smoking are suggested by a ,protective' effect on smoking-associated birthweight reduction in newborns typing for DQA1*0201 and DQB1*0201. Our results suggest biological interactions between maternal cigarette smoking during pregnancy and specific fetal DQ alleles that affect fetal growth. The precise nature of these interactions merits further investigation, as knowledge of fetal HLA-DQ type may be useful in refining risk estimates of severe fetal growth restriction because of maternal smoking during pregnancy. [source]

Variation in the response of melon genotypes to Fusarium oxysporum f.sp. melonis race 1 determined by inoculation tests and molecular markers

PLANT PATHOLOGY, Issue 2 2003
Y. Burger
Screening of genotypes of melon (Cucumis melo) for resistance to wilt caused by Fusarium oxysporum f.sp. melonis is often characterized by wide variability in their responses to inoculation, even under carefully controlled conditions. The variability at the seedling stage of 17 genotypes susceptible to race 1 was examined in growth-chamber experiments. Disease incidence varied from 0 to 100% in a genotype-dependent manner. Using four combinations of light (60 and 90 µE m,2 s,1) and temperatures of (27 and 31°C), only light intensity showed a statistically significant effect. Marker-assisted selection for fusarium resistance breeding using cleaved amplified polymorphic sequence (CAPS) and sequence-characterized amplified region (SCAR) markers were compared using a single set of genotypes that included 24 melon accessions and breeding lines whose genotype regarding the Fom-2 gene was well characterized. The practical value of the markers for discriminating a range of genotypes and clarifying the scoring of phenotypes was also tested using a segregating breeding population which showed codominant SCAR markers to be useful in marker-assisted selection. [source]

Relationship Among Follicular Growth, Oestrus, Time of Ovulation, Endogenous Estradiol 17, and Luteinizing Hormone in Bos Indicus Cows After a Synchronization Program

REPRODUCTION IN DOMESTIC ANIMALS, Issue 6 2007
M Maquivar
Contents To determine the pattern of follicular growth during oestrus and the relationship with estradiol and luteinizing hormone in ovulating and non-ovulating cows, three groups of (n = 10), thirty cyclic, Bos indicus cows were synchronized with CIDR, consecutively at 9-day intervals. Twenty-four hours after implant withdrawal, all cows synchronized in the same group with other cows displaying estrous behaviour after implant withdrawal were subjected to an intensive period of ultrasonographic observations (every 6 h for 120 h). Blood samples were taken to evaluate LH surge and 17- , estradiol. No differences were observed in follicular growth, ovulatory diameter and growth average in the three groups of synchronized cows. Cows ovulating (CO) had a better growth average in comparison with the group of cows not ovulating (CNO) (1.4 ± 0.7 mm vs 0.7 ± 0.5 mm, p < 0.06). The average time from estradiol release to LH surge was 39.3 ± 24.6 h. Differences were also observed between CO and CNO with respect to both the first concentration (27.7 ± 5.2 vs 58.6 ± 31.9, p < 0.004) and last concentration (79.3 ± 23.3 vs 99.2 ± 27.3, p < 0.05) of estradiol above 5 pg/ml. The average time from overt signs of oestrus to LH release was 8.4 ± 7.7 h. In the CNO, the increase in LH concentration was never above two SD from the basal average. In conclusion, there is a wide variability in follicular growth and ovulatory diameter between CO and CNO, which can affect the intervals of LH release, estradiol peak and ovulation. Yet, LH surge might be a good marker for timing ovulation in Zebu cows. [source]

Use of Cardioprotective Medications in Kidney Transplant Recipients

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2009
R. S. Gaston
Death with function causes half of late kidney transplant failures, and cardiovascular disease (CVD) is the most common cause of death in these patients. We examined the use of potentially cardioprotective medications in a prospective observational study at seven transplant centers in the United States and Canada. Among 935 patients, 87% received antihypertensive medications at both 1 and 6 months after transplantation. Similar antihypertensive regimens were used for patients with and without diabetes and CVD, but with wide variability among centers. In contrast, while 44% of patients were on angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) at the time of transplantation, the proportion taking these agents dropped to 12% at month 1, then increased to 24% at 6 months. Fewer than 30% with CVD or diabetes received ACEI/ARB therapy 6 months posttransplant. Aspirin use was uncommon (<40% of patients). Even among those with diabetes and/or CVD, fewer than 60% received aspirin and only half received a statin at 1 and 6 months. This study demonstrates marked variability in the use of cardioprotective medications in kidney transplant recipients, a finding that may reflect, among several possible explanations, clinical uncertainty due the lack of randomized trials for these medications in this population. [source]

Spatial Analysis and Surname Analysis: Complementary Tools for Shedding Light on Human Longevity Patterns

ANNALS OF HUMAN GENETICS, Issue 2 2008
A. Montesanto
Summary Starting from the observation that human longevity patterns show regional variations, we applied Spatial Analysis (using the Geographic Information System) and Surname Analysis to highlight the effect of the population genetic structure on such patterns. The study was carried out in Calabria, a southern Italian region which is characterized by a wide variability of geographic features (high mountains and deep valleys which created geographic isolates in the past). We identified three zones of high longevity: a male and a female longevity zone were located near the town of Cosenza (northern Calabria), while a male longevity zone was located in a mountainous and quite isolated part of the province of Reggio Calabria (southern Calabria). The latter zone was characterized by the lowest Female/Male ratio in nonagenarians observed to date. By applying surname analysis (Fisher's alpha) we found a significant negative correlation between surname abundance and index of longevity, showing that this isolated zone of male longevity presents a high level of inbreeding. On the whole, the results showed the effectiveness of spatial analysis in revealing geographical longevity patterns, and highlighted the importance of the population genetic structure in shaping such patterns. [source]

Inconsistent Evidence: Analysis of Six National Guidelines for Vaginal Birth After Cesarean Section

BIRTH, Issue 1 2010
GradDipClinEpi, Maralyn Foureur BA
Abstract:, Background:, Guidelines are increasingly used to direct clinical practice, with the expectation that they improve clinical outcomes and minimize health care expenditure. Several national guidelines for vaginal birth after cesarean section (VBAC) have been released or updated recently, and their range has created dilemmas for clinicians and women. The purpose of this study was to summarize the recommendations of existing guidelines and assess their quality using a standardized and validated instrument to determine which guidelines, if any, are best able to guide clinical practice. Methods:, English language guidelines on VBAC were purposively selected from national and professional organizations in the United Kingdom, United States, Canada, New Zealand, and Australia. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was applied to each guideline, and each was analyzed to determine the range and level of evidence on which it was based and the recommendations made. Results:, Six guidelines published or updated between 2004 and 2007 were examined. Only two of the six guidelines scored well overall using the AGREE instrument, and the evidence used demonstrated great variety. Most guidelines cited expert opinion and consensus as evidence for some recommendations. Reported success rates for VBAC ranged from 30 to 85 percent, and reported rates of uterine rupture ranged from 0 to 2.8 percent. Conclusions:, VBAC guidelines are characterized by quasi-experimental evidence and consensus-based recommendations, which lead to wide variability in recommendations and undermine their usefulness in clinical practice. (BIRTH 37:1 March 2010) [source]

Evaluation of a severity score to predict the prognosis of Fournier's gangrene

BJU INTERNATIONAL, Issue 3 2010
Saturnino Luján Marco
Study Type , Prognosis (case series) Level of Evidence 4 OBJECTIVE To determine the validity of a Fournier's gangrene severity index (FGSI), developed to assign a numerical score describing the severity of FG, and evaluate factors in the survival of patients with FG. PATIENTS AND METHODS We retrospectively reviewed 51 patients diagnosed with FG between 1994 and 2006. Data were collected on their medical history, which included vital signs (temperature, heart and respiratory rates) and metabolic variables (sodium, potassium, creatinine, bicarbonate levels, haematocrit, and white blood cell count). We computed a score relating to the severity of the disease at the time, and compared it to other features according to whether the patient survived or died. The different prognostic factors were assessed by univariate analysis with the Mann,Whitney U and Kendall A-B tests. RESULTS Of the evaluated 51 inpatients, eight died (16%) and 43 survived (84%). The median (range) age was 63 (17,85) years and the median time from the onset of the symptoms until the admission to the emergency room was 7.8 (1,60) days. The mean hospital stay was 33 (2,90) days and 17 patients were admitted to the intensive-care unit for a mean of 4.5 days. There was no statistically significant difference between the groups. Body surfaces involved were the scrotum in five patients (10%), the penis and scrotum in 11 (22%), the scrotum and perineum in 30 (59%) and the abdominal wall in five (10%). There was no statistically significant difference in the distribution in those who survived or died (P = 0.131). The median age of 60 (17,81) years in the survivors was significantly lower than that of 73.5 (50,85) years in those who died (P = 0.02). There was no significant difference (P = 0.06) between the number of repeated debridements in the survivors (3.23) and those who died (5.25). The mean (range) FGSI score for survivors was 6.7 (0,14), vs 8.7 (6,13) for those who died (P = 0.12). The only laboratory variables associated with death were serum bicarbonate (P = 0.04) and serum sodium (P = 0.02) levels. CONCLUSIONS FG is an unpredictable disease process with wide variability in its presentation. In our experience, the FGSI gives no indication of the likelihood of survival, but the risk factors for predicting the severity of FG seem to be greater in older patients and those with high sodium and low bicarbonate levels. [source]

Pathways to industrial environmental improvement in the East Asian newly industrializing economies

BUSINESS STRATEGY AND THE ENVIRONMENT, Issue 2 2002
Michael T. Rock
After the adoption of ,grow first clean up later' environmental strategies, governments in the East Asian newly industrializing economies (NIEs) turned to environmental ,clean-up' by enacting landmark environmental legislation, creating command and control environmental agencies and promulgating tough air and water emissions standards. Available evidence suggests there is wide variability in the performance of these new environmental regulatory agencies. Most attribute this variability to differences in ,political will'. However, why have some governments among the East Asian NIEs been able to muster the ,political will' to impose duties on industrial polluters while others have not? This paper answers this question by summarizing a larger study (Rock, 2002) which examines the ,politics of industrial pollution' control in six East Asian NIEs. Each case study is based on extensive interviews, the collection of data on the effectiveness of pollution management policies, and the integration of both with the political economy literature on each economy. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment [source]

The Need for Emergency Medicine Resident Training in Informed Consent for Procedures

ACADEMIC EMERGENCY MEDICINE, Issue 9 2007
Theodore Gaeta DO
Objectives: To determine emergency medicine (EM) residents' perceptions and reported practices of obtaining informed consent for emergency department procedures. Methods: The authors performed a cross-sectional observational study of EM residents. A brief, short-answer survey was distributed that covered the following topics related to informed consent: training, confidence and comfort levels, and current practices. Data were analyzed using basic frequency displays, and descriptive statistics are reported. Results: Of the 20 programs contacted, 16 responded and agreed to distribute the invitation to their residents. A total of 402 of 490 eligible residents (82%) in the participating programs responded. The majority of EM residents (56%) had never received formal training on obtaining informed consent, and those who had reported that their primary exposure to formal training occurred during their medical school years (79%). More than half of the residents (56%) have felt uncomfortable obtaining consent for a procedure. Few residents (32%) felt very confident that they provide comprehensive information to patients, while 9% were not very confident that they disclose all pertinent risks, benefits, and alternatives to their patients. Sixty-three percent of all EM residents believed formal training is necessary, and half (52%) reported interest in receiving training (i.e., listings of risks, benefits, and alternatives as well as standards for determining which procedures need consent). The residents' current perceptions of consent requirements for commonly performed emergency department procedures (emergent and nonemergent) are also reported. Conclusions: Few residents have had formal training in informed consent, and there is wide variability in the perception of which procedures require informed consent. Residents are not confident in their knowledge of all risks and benefits of common procedures, and comfort levels in obtaining informed consent are low. Residents can benefit from additional resources that provide standardized information and formal training on the issue. [source]

Measurement Properties of the MacArthur Communicative Development Inventories at Ages One and Two Years

CHILD DEVELOPMENT, Issue 2 2000
Heidi M. Feldman
In a prospective study of child development in relation to early-life otitis media, we administered the MacArthur Communicative Development Inventories (CDI) to a large (N = 2,156), sociodemographically diverse sample of 1- and 2-year-old children. As a prerequisite for interpreting the CDI scores, we studied selected measurement properties of the inventories. Scores on the CDI/Words and Gestures (CDI-WG), designed for children 8 to 16 months old, and on the CDI/Words and Sentences (CDI-WS), designed for children 16 to 30 months old, increased significantly with months of age. On several scales of both CDI-WG and CDI-WS, standard deviations approximated or exceeded mean values, reflecting wide variability in results. Statistically significant differences in mean scores were found according to race, maternal education, and health insurance status as an indirect measure of income, but the directionality of differences was not consistent across inventories or across scales of the CDI-WS. Correlations between CDI-WG and CDI-WS ranged from .18 to .39. Our findings suggest that the CDI reflects the progress of language development within the age range 10 to 27 months. However, researchers and clinicians should exercise caution in using results of the CDI to identify individual children at risk for language deficits, to compare groups of children with different sociodemographic profiles, or to evaluate the effects of interventions. [source]

Serum levels of interferon-,, tumour necrosis factor-,, soluble interleukin-6R and soluble cell activation markers for monitoring response to treatment of leprosy reactions

CLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 2 2007
A. Iyer
Summary Identifying pathogen and host-related laboratory parameters are essential for the early diagnosis of leprosy reactions. The present study aimed to clarify the validity of measuring the profiles of serum cytokines [interleukin (IL)-4, IL-6, IL-10, interferon (IFN)-, and tumour necrosis factor (TNF)-,], the soluble IL-6 receptor (sIL-6R), soluble T cell (sCD27) and macrophage (neopterin) activation markers and Mycobacterium leprae -specific anti-PGL-I IgM antibodies in relation to the leprosy spectrum and reactions. Serum samples from 131 Indonesian leprosy patients (82 non-reactional leprosy patients and 49 reactional) and 112 healthy controls (HC) from the same endemic region were investigated. Forty-four (89·8%) of the reactional patients had erythema nodosum leprosum (ENL) while only five (10·2%) had reversal reaction (RR). Follow-up serum samples after corticosteroid treatment were also obtained from 17 of the patients with ENL and one with RR. A wide variability in cytokine levels was observed in the patient groups. However, IFN-, and sIL-6R were elevated significantly in ENL compared to non-ENL patients. Levels of IFN-,, TNF-, and sIL-6R declined significantly upon corticosteroid treatment of ENL. Thus, although the present study suggests limited applicability of serial measurement of IFN-,, TNF-, and sIL-6R in monitoring treatment efficacy of ENL, reactions it recommends a search for a wider panel of more disease-specific markers in future studies. [source]