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PubMed2006

Partnership dynamics and sexual health risks among male adolescents in the Favelas of Recife, Brazil.

CONTEXT: Adolescents' past and current partnerships influence their sexual health risks. Males' responsibilities and needs in terms of sexual health have long received less attention than females'. It is important to examine male adolescent sexual and contraceptive patterns within the broader context of partnership dynamics. METHODS: In May 2000, 1,438 males aged 13-19 living in the urban shantytowns of Recife, Brazil, were surveyed. Adolescents gave detailed partnership, sexual and contraceptive history data in the form of month-by-month calendars for the prior two years. Logistic regression analyses were used to examine the associations between prior and current partnership experience and contraceptive use. RESULTS: Overall, 76% of respondents reported having had at least one partnership in the past two years; 49% of partnerships involved intercourse. On average, steady and casual partnerships lasted 4.7 months and 1.6 months, respectively. Respondents typically had spent 2.8 months of the past two years in a sexual partnership, 1.2 months of which were unprotected by contraceptive use. Of those with a recent partnership, having had a prior sexual partner was associated with elevated odds of being sexually active in the current or most recent partnership (odds ratio, 4.0). Of sexually active adolescents, having used contraceptives at first sex or in a former sexual partnership was associated with elevated odds of having used a condom in the current or most recent sexual partnership (7.9 and 6.5, respectively). CONCLUSIONS: Prevention programs need to have an accurate portrait of adolescent partnership dynamics, an adequate understanding of adolescent sexuality and a realistic estimation of actual exposure to risk, so interventions and messages can be tailored to adolescents' realities.

Adolescent↗
PubMed1992

A review of epidemiological methods applied in studies on laboratory animal allergy. With a discussion of the relation between prevalence and risk of an irreversible disease in a dynamic population of constant size.

The risk of developing an occupational allergic respiratory disease depends strongly on the duration of exposure. For estimating the instantaneous risk (hazard function) in a dynamic cohort, information is required for each cohort member on the time of exposure either until disease onset or until termination by leaving the job or the end of the study. However, most existing epidemiological studies on occupational allergies are cross-sectional, computing prevalences; no information on job-leavers and on their disease status is obtained. The functional dependency of prevalence on risk, as well as on the rate of leaving the job among the diseased and on the distribution of exposure duration, is described, with special attention to the sensitivity of the prevalence to differences of the rate of leaving the job. A literature review of 15 studies on laboratory animal allergy is given; none of the studies collected and reported all the information necessary for risk estimation.

Animals↗
PubMed2004

How predation risk affects the temporal dynamics of avian leks: greater sage grouse versus golden eagles.

Leks often attract predators as well as mates, yet most evolutionary models have assumed that sexual selection, not predation, drives lekking behavior. We explored the influence of predation on lek dynamics using a stochastic dynamic game model based on the lek-breeding greater sage grouse (Centrocercus urophasianus) and its principal avian predator, the golden eagle (Aquila chrysaetos). The model predicts time-dependent male lek attendance as a function of factors affecting both mating success (female arrival rate, male numbers, and social status) and predation risk (eagle arrival rate and group size). Dominant males are predicted to arrive sooner and leave later than subordinates, especially if mating skew is high, predation risk is low, or the relationship between lek size and female arrival rate is weak. Both high mean levels of predation risk and small lek size should reduce lek attendance, but the relative tendency of predators to attack large versus small leks has little influence on predicted lekking behavior. Field observations confirmed the predicted effects of female arrival rate, lek size, male dominance, and weather-dependent predator arrival rates on lek departure times. Predicted effects of female arrival rates and male dominance on seasonal lek attendance were also supported. Our model provides an empirically supported adaptive explanation for short-term lek dynamics. It also suggests alternative interpretations for phenomena previously invoked to support the hotshot and skew models of lek formation.

Animals↗
PubMed1983

Comparison of cardiovascular risk in maximal isometric and dynamic exercise.

With the hypothesis that isometric exercise testing offers important clinical information yet is neglected because of overemphasis on its risk, we compared it with dynamic testing for variables indicative of myocardial ischemia. In a medical office, 287 patients were each subjected once to both a one-minute maximal handgrip stress test and maximal treadmill test while monitored noninvasively for cardiovascular responses. Systolic blood pressures usually increased more with the treadmill test, diastolic more with the handgrip. The treadmill tests caused greater mean heart rate and rate-pressure products, as well as more ST segment displacements, arrhythmias, and symptoms and signs. However, there were some unpredictable individual differences in the isometric blood pressure responses. Isometric testing is easy and useful and, if properly monitored, causes less risk to the patient than dynamic testing.

Adult↗
PubMed2006

Development and consideration of global policies for managing the future risks of poliovirus outbreaks: insights and lessons learned through modeling.

The success of the Global Polio Eradication Initiative promises to bring large benefits, including sustained improvements in quality of life (i.e., cases of paralytic disease and deaths avoided) and costs saved from cessation of vaccination. Obtaining and maintaining these benefits requires that policymakers manage the transition from the current massive use of oral poliovirus vaccine (OPV) to a world without OPV and free of the risks of potential future reintroductions of live polioviruses. This article describes the analytical journey that began in 2001 with a retrospective case study on polio risk management and led to development of dynamic integrated risk, economic, and decision analysis tools to inform global policies for managing the risks of polio. This analytical journey has provided several key insights and lessons learned that will be useful to future analysts involved in similar complex decision-making processes.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

Ostrinia nubilalis parasitism and the field abundance of non-target insects in transgenic Bacillus thuringiensis corn (Zea mays).

In this study, we evaluated in field trials the effects on non-target species, of transgenic corn producing the Cry1Ab toxin of Bacillus thuringiensis (Bt). In 1998, we collected Ostrinia nubilalis (Hübner) larvae from transgenic Bt corn (Novartis Hybrid 176) and non-Bt corn at four geographical sites. We found a significant variation in parasitism by the tachinids Lydella thompsoni (Herting) and Pseudoperichaeta nigrolineata (Walker) among sites, and more parasitism in non-Bt than in Bt fields. The Bt effect did not vary significantly among fields. In 1999, we performed a field experiment at two sites, comparing the temporal abundance of non-target arthropods in Bt corn (Monsanto Hybrid MON810) and non-Bt corn. The non-target insects studied included the aphids Metopolophium dirhodum (Walker), Rhopalosiphum padi (L.) and Sitobion avenae (F.), the bug Orius insidiosus (Say), the syrphid Syrphus corollae (Meigen), the ladybird Coccinella septempunctata (L.), the lacewing Chrysoperla carnea (Stephens), thrips and hymenopteran parasitoids. For all species but one, the number of individuals varied greatly over the season but did not differ between the types of corn. The only exception was thrips which, at one site, was significantly more abundant in Bt corn than in non-Bt corn. However this difference did not remain significant when we took the multiple tests into account. Implications for pest resistance management, population dynamics and risk assessment are discussed.

Animals↗
PubMedDate not supplied

[Dynamic echocardiography in coronary risk stratification].

The prognostic value of some coronary risk factors related to Stress/Echocardiography was analyzed. The most important prognostic factors during an abnormal study are: presence and time of beginning, severity and extension of the myocardial ischemic changes.

Coronary Disease↗
PubMed1987

[Dynamics of the leading risk factors of ischemic heart disease in a male population over 40-years-old according to the results of a prospective epidemiologic study].

The purpose of the survey was to study the time course of the leading CHD risk factors in an open population of men born in 1916-1935 during a prolonged prospective study and to specify CHD interrelationship with new cases of disease and a course of nonfatal CHD. A population of 5000 males from one of the Leningrad districts was examined with an interval of 7.6 yrs. The first screening included 3907 persons, the repeated screening 2096. In the period of observation the number of persons with the absence of leading risk factors decreased (from 11.5 to 9.6%), the frequency of arterial hypertension (AH) increased (from 32.9 to 42.3%), the proportion of examinees with atherogenic dyslipoproteinemia (DLP) remained the same. By the results of the first screening in 50% of the persons with atherogenic DLP the blood lipid composition in 7.6 yrs returned to normal; AH persisted in 80% of the examinees. The presence of the 3 leading risk factors during the first and second screenings was accompanied by the highest frequency of stable CHD and the highest index of new cases of disease.

Adult↗
PubMed1983

Dynamic membrane studies in individuals at risk for Huntington's disease.

Lymphocyte plasma membrane dynamics were studied by energy-transfer polarization in twenty-three neurologically normal individuals at-risk for Huntington's disease (HD). The results were compared to 10 normal controls and 10 known HD patients. The normal and HD subjects segregated into two distinct groups. The at-risk group had findings distributed along a continuum with values similar to known HD patients or to normal controls. These findings suggest that further studies of membrane dynamics will contribute to understanding the molecular defect in HD and to the development of a potential molecular marker.

Adult↗
PubMed2004

Lateral and posterior dynamic bending of the mid-shaft femur: fracture risk curves for the adult population.

The purpose of this study was to develop injury risk functions for dynamic bending of the human femur in the lateral-to-medial and posterior-to-anterior loading directions. A total of 45 experiments were performed on human cadaver femurs using a dynamic three-point drop test setup. An impactor of 9.8 kg was dropped from 2.2 m for an impact velocity of 5 m/s. Five-axis load cells measured the impactor and support loads, while an in situ strain gage measured the failure strain and subsequent strain rate. All 45 tests resulted in mid-shaft femur fractures with comminuted wedge and oblique fractures as the most common fracture patterns. In the lateral-to-medial bending tests the reaction loads were 4180 +/- 764 N, and the impactor loads were 4780 +/- 792 N. In the posterior-to-anterior bending tests the reaction loads were 3780 +/- 930 N, and the impactor loads were 4310 +/- 1040 N. The difference between the sum of the reaction forces and the applied load is due to inertial effects. The reaction loads were used to estimate the mid-shaft bending moments at failure since there was insufficient data to include the inertial effects in the calculations. The resulting moments are conservative estimates (lower bounds) of the mid-shaft bending moments at failure and are appropriate for use in the assessment of knee restraints and pedestrian impacts with ATD measurements. Regression analysis was used to identify significant parameters, and parametric survival analysis was used to estimate risk functions. Femur cross-sectional area, area moment of inertia (I), maximum distance to the neutral axis (c), I/c, occupant gender, and occupant mass are shown to be significant predictors of fracture tolerance, while no significant difference is shown for loading direction, bone mineral density, leg aspect and age. Risk functions are presented for femur cross-sectional area and I/c as they offer the highest correlation to peak bending moment. The risk function that utilizes the most highly correlated (R2 = 0.82) and significant (p = 0.0001) variable, cross-sectional area, predicts a 50 percent risk of femur fracture of 240 Nm, 395 Nm, and 562 Nm for equivalent cross-sectional area of the 5(th) percentile female, 50(th) percentile male, and 95(th) percentile male respectively.

Journal Article↗
PubMed2004

Tick ecology: processes and patterns behind the epidemiological risk posed by ixodid ticks as vectors.

The population ecology of ticks is fundamental to the spatial and temporal variation in the risk of infection by tick-borne pathogens. Tick population dynamics can only be fully understood by quantifying the rates of the demographic processes, which are influenced by both abiotic (climatic) factors acting on the free-living tick stages and biotic (host) responses to the tick as a parasite. Within the framework of a population model, I review methods and results of attempts to quantify (1) rates of tick development and the probability of diapause, (2) the probability of questing for hosts by unfed ticks, (3) the probability of ticks attaching to a host, and (4) tick mortality rates. Biologically, these processes involve the physiological and behavioural response of ticks to temperature, moisture stress and day length that result in specific patterns of seasonal population dynamics and host relationships. Temperate and tropical patterns will be illustrated with reference mostly to Ixodes ricinus and Rhipicephalus appendiculatus, respectively.

Adaptation, Physiological↗
PubMed1994

Optimization of simulation models with GADELO: a multi-population genetic algorithm.

In this paper, a new Genetic Algorithm based on the Dynamic Exploration of Local Optima (GADELO) was used to estimate the parameters of the MRD (Micro-population model of Risk-group Dynamics) micro-population model for smoking cessation by minimizing a deviation function between the model's predictions and the smoking cessation data of the Multiple Risk Factor Intervention Trial (MRFIT). The efficiency and accuracy of the GADELO estimations were consistently superior to those obtained using the standard genetic algorithm or the simplex algorithm of Nelder-Mead.

Algorithms↗
PubMed1997

[Epidemiologic risk of infectious disease transmission in regions of the Ivory Coast].

An epidemiological risk indicator based on purely entomological factors can be used to identify regions which are at higher risk of transmission within the endemic forest zones of Ivory Coast, and can serve to point out biotopes to be treated to make antivector campaigns more effective. In the forests of Ivory Coast, so-called socially open environments which are populated by a great number of ethnic groups who are highly mobile and whose amps are spread over a large area, are particularly vulnerable to epidemics of the disease. Transmission always occurs near water: at rivers, water holes, plantations. By contrast, socially closed societies consisting of a single ethnic group settled in a village are at much lower risk. It seems that human behaviour plays as much a role in transmission dynamics as environmental changes which may be more or less favourable to the vector.

Animals↗
PubMed2005

Endothelial progenitor cell therapy for atherosclerosis: the philosopher's stone for an aging population?

Much of the increased risk for atherosclerosis progression with age may be a result of age-related declines in the capacity of precursor cells to repair damage in the arterial endothelium. To estimate the impact of progenitor cell therapy for atherosclerosis on cardiovascular disease (CVD) mortality, life expectancy, and survival, as compared with the lifetime control of conventional risk factors, we modeled the health effects of bone marrow-derived endothelial progenitor cell therapy using data from the 1950 to 1996 follow-up of the Framingham Heart Study. To model cardiovascular disease mortality, we assumed that progenitor cell therapy was applied at age 30, with the effect assumed to be a 10-year delay in atherosclerosis progression. Age projections were constructed analytically using the stochastic process model for risk factor dynamics and mortality and microsimulation techniques. We considered three types of interventions: (i) keeping risk factors within selected limits to model current clinical recommendations; (ii) an age shift of 10 years to model the effects of progenitor cell therapy; and (iii) elimination of a competing risk (such as cancer). Our study suggests that progenitor cell therapy might increase life expectancy in the population as much as the complete elimination of cancer (in females, an additional 3.67 versus 3.37 years; in males, an additional 5.94 versus 2.86 years, respectively).

Adult↗
PubMed2006

A risk assessment of two interorganizational clinical information systems.

A risk analysis framework was used to examine the implementation barriers that may hamper the successful implementation of interorganizational clinical information systems (ICIS). In terms of study design, an extensive literature review was first performed in order to elaborate a comprehensive model of project risk factors. To test the applicability of the model, we next conducted a longitudinal multiple-case study of two large-scale ICIS demonstration projects carried out in Quebec, Canada. Variations in the levels of several risk dimensions measured throughout the duration of the projects were analyzed to determine their impact on successful implementation. The analysis shows that the proposed framework, composed of five risk dimensions, was very robust, and suitable for conducting a thorough risk analysis. The results also show that there are links between the quality of the risk management and the level of project outcomes. To be successful, it is important that the implementation efforts be distributed proportionally according to the importance of each of the risk factors. Furthermore, because the risks evolve dynamically, there is a need for high responsiveness to emerging implementation problems. Thus, implementation success lies in the ability of the project management team to be aware of and to manage several risk threats simultaneously and coherently since they evolve dynamically through time and interact with one another.

Canada↗
PubMed1989

Risk evaluation for bovine embryo transfer services using computer simulation and economic decision theory.

A mathematical model was used to evaluate the dynamics and risks in bovine embryo transfer. Variables included embryo collection, fertilization, and transfer rates, plus overall pregnancy rates. Decision analysis was applied to three sets of 500 simulated flushes to test three strategies: 1) nonsuperovulation, 2) superovulation using follicle stimulating hormone (FSH) and 3) superovulation using pregnant mare serum gonadotropin (PMSG). Model validation involved comparing model performance against standards derived from 39 published studies. The model's repeatability was +/- 0.10 against standards in 93% of cases, and never exceeded +/- 0.13 in all 1500 simulations. Model outcomes were accurate to +/- 3% using average results. No pregnancies occurred in 22% of nonsuperovulated donors, 8% of FSH superovulated donors, and 6% of PMSG superovulated donors. PMSG treatment averaged more pregnancies per flush than FSH treatment (4.4 vs 3.9) but showed greater variation in response (64 vs 51%). Decision analysis suggests that a PMSG-induced flush would net $105 more than an FSH-induced flush, and that either superovulation strategy would yield approximately 10 times the net income of a nonsuperovulated flush. Pricing by response (PMSG) or by transfer (FSH) is optimal for the provider of embryo transfer services.

Journal Article↗