Objective: To evaluate the risk factors for systemic inflammatory response syndrome (SIRS) after flexible ureteroscopic lithotripsy (FUL). Materials and Methods: Patients who underwent FUL between October 2012 and November 2013 were studied. Complete data was available for 260 adult patients who met this criteria. Preoperative and intraoperative risk factors that potentially contribute to SIRS were compared in patients who developed postoperative SIRS and those who did not. Furthermore, multivariable logistic regression analysis was performed and the odds ratio (OR) and 95% confidence interval (CI) were calculated to identify the independent risk factors for SIRS after FUL. Results: The incidence of SIRS after FUL was 8.1%. In the univariate test analysis, significant correlation between SIRS and four factors was noted: sex of the patient (P<0.001), stone size (P=0.001), irrigation flow rate (P<0.001), and irrigation volume (P<0.001). Multivariable logistic regression analysis identified stone size (OR=1.691; 95% CI,0.879-3.255), small-caliber ureteral access sheath (UAS) (OR=2.293; 95% CI, 0.730-7.200), irrigation flow rate (OR=1.161; 95% CI, 1.096-1.230), and struvite calculi (OR=3.331; 95% CI, 0.971-11.426) as independent risk factors for SIRS after FUL. Conclusions: We recommend that the length of lithotripsy be well controlled in patients with large stone burden and struvite calculi. Staging procedures are also required. Additionally, irrigating with a low flow rate and low pressure and using a large-caliber UAS for better drainage are required to keep a low renal pelvic pressure during FUL procedures.

Multiple correlated time-to-event endpoints often occur in clinical trials and some time-to-event endpoints are more important than others. Most weighted multiple testing adjustment methods have been proposed to control family-wise type I error rates either only consider the correlation among continuous or binary endpoints or totally disregard the correlation among the endpoints. For continuous or binary endpoints, the correlation matrix can be directly estimated from the corresponding correlated endpoints. However, it is challenging to directly estimate the correlation matrix from the multiple endpoints in survival data since censoring is involved. In this chapter, we propose a weighted multiple testing correction method for correlated time-to-event endpoints in survival data, based on the correlation matrix estimated from the WLW method proposed by Wei, Lin, and Weissfeld. Simulations are conducted to study the family-wise type I error rate of the proposed method and to compare the power performance of the proposed method to the nonparametric multiple testing methods such as the alpha-exhaustive fallback (AEF), fixed-sequence (FS), and the weighted Holm-Bonferroni method when used for the correlated time-to-event endpoints. The proposed method and others are illustrated using a real dataset from Fernald Community Cohort (formerly known as the Fernald Medical Monitoring Program).

Background and Objectives We previously reported a risk genomic region (ie, PTP4A1-PHF3-EYS) for alcohol dependence in a genome-wide association study (GWAS). We also reported a rare variant constellation across this region that was significantly associated with alcohol dependence. In the present study, we significantly increased the marker density within this region and examined the specificity of the associations of common variants for alcohol dependence. Methods One African-American discovery sample (681 cases with alcohol dependence and 508 controls), one European-American replication sample (1,409 alcohol dependent cases and 1,518 controls), and one European-Australian replication sample (a total of 6,438 family subjects with 1,645 alcohol dependent probands) underwent association analysis. A total of 38,714 subjects from 18 other cohorts with 10 different neuropsychiatric disorders served as contrast groups. Results We found 289 SNPs that were nominally associated with alcohol dependence in the discovery sample (p-<-.05). Fifty-six associations of them were significant after correction (1.9-×-10-6-≤-p-≤-1.6-×-10 -5). No markers were significantly associated with other neuropsychiatric disorders after experiment-wide correction. Conclusions and Scientific Significance We confirmed with our previous findings that PTP4A1-PHF3-EYS variants were significantly associated with alcohol dependence, which were replicable across multiple independent populations and were specific for alcohol dependence. These findings suggested that this region might harbor a causal variant(s) for alcohol dependence. (Am J Addict 2014;23:411-414)

Background: This longitudinal study examined maternal depression status from birth of a child to 36 months of age using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Methods: Maternal depression was assessed using the Center of Epidemiological Studies Depression Scale (CES-D) and defined as a score of ≥16. For this study, early onset depression was defined as depression within the 6 months after birth, and late onset depression was depression onset when the child was ≥24 months old. Chronic depression was defined as depression that started within 6 months after birth and lasted until 24 months of age or longer. Results: The prevalence of maternal depression was 32.2% for early onset, 7.4% for late onset, and 13.4% for chronic depression. The prevalence of maternal depression was highest at 1 month, decreased at 6 months, and then remained fairly stable until 36 months. Mothers 18-24 years of age, of black race, unemployed, with lower social support, single, or with poor general health had a higher prevalence of both early and chronic depression compared to other groups. Conclusions: Younger maternal age, poverty, lower education, and lack of social support were all significantly associated with increased maternal depression in multivariate regression models. Younger age, black race, unemployment, single status, lack of social support, and poor general health were all risk factors for increased prevalence of maternal depression.

No description available.

To examine pancreatic volume (PV) changes among patients with different duration of type 2 diabetes and whether pancreatic atrophy was associated with loss of insulin secretory capacity. Methods. This cross-sectional study (203 patients with type 2 diabetes, 93 controls without diabetes) was conducted from January 2016 to December 2017. Patients with type 2 diabetes were divided into 3 groups: recently diagnosed (duration≤2 years), midterm (duration 3-9 years), and long term (duration≥10 years). All the patients were scanned with upper abdominal computerized tomography; PV was then calculated by an experienced technician. Absolute insulin deficiency was defined as fasting C-peptide<0.9 ng/mL. Results. Compared with PV (cm3) in the controls, the mean PV was similar in patients with recently diagnosed type 2 diabetes (68.8 versus 71.0, P=0.56) but significantly reduced in patients with midterm (68.8 versus 60.8, P<0.05) and long-term (68.8 versus 53.1, P<0.001) type 2 diabetes. A similar trend was observed for the PV index (PV adjusted for body surface area and body mass index). Furthermore, rates of pancreatic atrophy and absolute insulin deficiency increased with duration of diabetes. Multiple logistic regression analysis indicated that pancreatic atrophy was associated with higher likelihood of absolute insulin deficiency (odds ratio=4.47, 95%confidence interval=1.45-13.8). Conclusions. PV was reduced in those with midterm and long-term type 2 diabetes compared to individuals without type 2 diabetes. Overall, pancreatic atrophy was associated with the loss of insulin secretory capacity in patients with type 2 diabetes.

No description available.

No description available.

<p>Angiostrongylus cantonensis is a parasitic nematode endemic to tropical and subtropical regions and is the leading cause of human eosinophilic meningitis. The parasite is commonly known as rat lungworm because the primary host in its lifecycle is the rat. A clinical overview of rat lungworm infection is presented, followed by a literature review of rat lungworm epidemiology, risk factors, and surveillance projects. Data collected from previous snail surveys in Florida was considered alongside elevation, population per square kilometer, median household income by zip code territory, and normalized difference vegetation index specific to the geographic coordinates from which the snail samples were retrieved. The parameters of interest were incorporated as possible predictor variables in a Poisson probability regression model and a negative binomial regression model. NDVI and population density were determined to be positively associated with number of snail samples positive for A. cantonensis in a given Miami-based location. A surveillance project was conducted in Hillsborough County, Florida, U.S.A.. Snail samples were collected and tested for A. cantonensis DNA via polymerase chain reaction (PCR) and gel electrophoresis. None of the samples tested positive for A. cantonensis.

American Samoa is still recovering from the debilitating consequences of the September 29, 2009 tsunami. Little is known about current household preparedness in American Samoa for future earthquakes and tsunamis. Thus, this study sought to enumerate the number of households with an earthquake and tsunami evacuation plan and to identify predictors of having a household evacuation plan through a post-tsunami survey conducted in July 2011. Members of 300 households were interviewed in twelve villages spread across regions of the principle island of Tutuila. Multiple logistic regression showed that being male, having lived in one's home for < 30 years, and having a friend who suffered damage to his or her home during the 2009 tsunami event increased the likelihood of having a household evacuation plan. The prevalence of tsunami evacuation planning was 35% indicating that survivors might feel that preparation is not necessary given effective adaptive responses during the 2009 event. Results suggest that emergency planners and public health officials should continue with educational outreach to families to spread awareness around the importance of developing plans for future earthquakes and tsunamis to help mitigate human and structural loss from such natural disasters. Additional research is needed to better understand the linkages between pre-event planning and effective evacuation responses as were observed in the 2009 events.