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The 'small spleen' in malaria.

A cardinal feature of malaria, splenomegaly, is usually absent in adult patients who have already suffered from falciparum malaria or who are natives of an endemic falciparum zone. This is an attribute of the past episode of clinical or sub-clinical malaria which usually results in regression of the splenic size to below-normal. An ultrasonographic evaluation of spleens was done in 90 healthy adult males, who had suffered from vivax (n = 28) or falciparum (n = 25) malaria in the past, except the controls (n = 22) and natives from an endemic falciparum area (n = 15) who never suffered from malaria. Their ultrasonographic details of spleens, including the size, were compared. Besides other conspicuous differences in the ultrasonographic picture, spleen size was found significantly decreased (p < 0.01) in the group who had been affected by P. falciparum malaria; the smallest measured 7.8 cms. In P. vivax group the decrease was not significant (p < 0.1), but was highly significant in inhabitants of endemic falciparum region (p < 0.001). The present study establishes the 'Small Spleen' and looks at echotexture pattern variations thereof for the first time.

Adult↗

Adulthood age differences in causal attributions for cognitive, physical, and social performance.

Past research has revealed an unflattering pattern of attributions for the performance of the elderly. More specifically, poor performance by the elderly is attributed to internal and stable factors such as inability, whereas poor performance by the young is attributed to external and unstable factors such as bad luck. In the present study, 42 young (M age = 19.18 years) and 39 elderly (M age = 74.90 years) men and women made causal attributions for their own or for another person's hypothetical performance in the cognitive, physical, and social domains. When attributions for the same performance by young and elderly adults were compared, the results presented an unflattering view of the elderly, similar to the pattern in previous research. In contrast, when attributions for good versus poor performance by the elderly were compared, a more favorable picture emerged: The elderly were more likely to be given credit for their good performance than to be blamed for their poor performance. These findings give reason to question the pervasiveness of the negative view of the elderly that has been presented in previous studies.

Adolescent↗

Sport performance attributions: a special case of self-serving bias?

In laboratory studies, it has been found that people tend to take credit for success and to blame external factors for failure. In sport studies, this self-serving bias has not been consistently demonstrated. Two studies explored factors hypothesized to account for differences between attributions made in laboratory and field settings. Study 1 was a laboratory experiment in which subjects performed a stair climbing task. It was hypothesized that these subjects would not make self-serving attributions because the laboratory setting had been designed to include features of athletic settings. Counter to the hypothesis, results indicated self-serving bias effects. Study 2 was a field study in which elite tennis players made attributions for their match performances. As in past sport research, self-serving attributions were not found. These results support contentions that sport settings differ from laboratory settings and that further theorizing is needed to explain self-serving bias processes in sport.

Adult↗

Regional, disease specific patterns of smoking-attributable mortality in 2000.

BACKGROUND: Smoking has been causally associated with increased mortality from several diseases, and has increased considerably in many developing countries in the past few decades. Mortality attributable to smoking in the year 2000 was estimated for adult males and females, including estimates by age and for specific diseases in 14 epidemiological subregions of the world. METHODS: Lung cancer mortality was used as an indirect marker of the accumulated hazard of smoking. Never-smoker lung cancer mortality was estimated based on the household use of coal with poor ventilation. Estimates of mortality caused by smoking were made for lung cancer, upper aerodigestive cancer, all other cancers, chronic obstructive pulmonary disease (COPD), other respiratory diseases, cardiovascular diseases, and selected other medical causes. Estimates were limited to ages 30 years and above. RESULTS: In 2000, an estimated 4.83 million premature deaths in the world were attributable to smoking, 2.41 million in developing countries and 2.43 million in industrialised countries. There were 3.84 million male deaths and 1.00 million female deaths attributable to smoking. 2.69 million smoking attributable deaths were between the ages of 30-69 years, and 2.14 million were 70 years of age and above. The leading causes of death from smoking in industrialised regions were cardiovascular diseases (1.02 million deaths), lung cancer (0.52 million deaths), and COPD (0.31 million deaths), and in the developing world cardiovascular diseases (0.67 million deaths), COPD (0.65 million deaths), and lung cancer (0.33 million deaths). The share of male and female deaths and younger and older adult deaths, and of various diseases in total smoking attributable deaths exhibited large inter-regional heterogeneity, especially in the developing world. CONCLUSIONS: Smoking was an important cause of global mortality in 2000, affecting a large number of diseases. Age, sex, and disease patterns of smoking-caused mortality varied greatly across regions, due to both historical and current smoking patterns, and the presence of other risk factors that affect background mortality from specific diseases.

Adult↗

Sensory attribute variation in low-temperature-stored roasted peanut paste.

Length of sample storage can become significant in sensory studies due to panel fatigue limitations and samples needed for a reasonable expectation of finding significant differences. In roasted peanut sensory studies samples are stored between -10 and -23 degrees C to prevent or retard changes. Studies of up to 13 months' duration have examined stability and slow-rate sensory changes. Sweet taste was relatively stable, whereas bitter and tongue burn attributes increased slightly. Stale taste increased, suggesting lipid oxidation was taking place even at -23 degrees C. Painty attribute did not increase until stale was >3. An increase in fruity attribute was unexpected. With increases in fruity and stale attributes a decrease in roasted peanut was expected. However, storage at -23 degrees C seems to stabilize the roasted peanut lability when compared to storage at -10 degrees C. Fruity and stale interactions with roasted peanut and lability of roasted peanut were shown to be three separate and identifiable effects on roasted peanut.

Arachis↗

Role loss and emotional adjustment in chronic pain.

Chronic pain interrupts behaviour, interferes with functioning, and may affect a person's identity: their sense of self. We tested whether loss of role and personal attributes and current and past self-concept differentiation, predicted adjustment as indexed by measures of depression. Chronic pain patients (n=80) completed measures of pain (MPQ), disability (PDI), depression and anxiety (BDI, HADS). Measures of role and attribute loss and self-concept differentiation were derived from a Role-Attribute Test in which participants identified four social roles in four domains (friendship, occupation, leisure, family) and nominated two personal attributes in each role prior to pain onset and current. Participants reported mean losses of 3.38 roles, and 6.97 attributes. Greater losses were observed in friendship, occupation and leisure domains compared with the family domain. Multiple regression analyses revealed that after controlling for demographic and clinical differences, role and attribute loss predicted depression scores. There was no evidence that depression was associated with past self-concept differentiation. The results are discussed with reference to the methodology used and the relevance of self-identity to understand adjustment to chronic pain.

Adaptation, Psychological↗

Cross-sectional investigation of task demands and musculoskeletal discomfort among restaurant wait staff.

A cross-sectional study of task demands and musculoskeletal discomfort among a sample of 100 wait staff in ten casual dining restaurants was conducted. In addition to answering a questionnaire about musculoskeletal discomfort and symptoms experienced in the past 12 months and attributed to work, subjects were asked about various aspects of their jobs, such as shift length, number of shifts per week and safety training. The managers of the restaurants were also interviewed to gather basic information on factors such as work hours, alternative duty availability and safety practices. When asked to rank the three most important causes of injuries, the responses of both managers and wait staff were congruent with Bureau of Labor Statistics (USA) data for 1999 on the nature of injuries and attributed exposures, with slips and falls, musculoskeletal disorders and acute injuries (e.g. burns, cuts) highlighted. Of the 100 subjects, 42% reported experiencing musculoskeletal symptoms in the past year, with the lower back area (18%) and shoulder (11%) with the most frequent symptoms reported in the responses. Although many of the materials handling tasks were not excessive, the heavier tray lifts and carries are a cause for concern. There are also slip and fall issues that influence the risks of these tasks. Future research needs, including addressing the mismatch between more common materials handling assessment tools and the nature of food serving tasks, are discussed.

Accidental Falls↗

Accurate predictive modeling of response variables under dynamic condition without the use of past response data

One promising attribute of the dynamic predictive modeling method introduced by Rollins et al. [D.K. Rollins, J. Liang, P. Smith, Accurate simplistic predictive modeling of nonlinear dynamic processes, ISA Transactions 37(4) (1998) 193-203] is its ability to accurately predict output response without the use of online output data. The proposed method only needs online input data to accurately predict output behavior once the semi-empirical model has been identified using offline data. This ability is critical to chemical processes because many output variables (such as chemical composition) are often measured infrequently, inaccurately, or not at all. In addition, in the presence of extremely high measurement noise of the output variable, this work will demonstrate very accurate predictive performance. Finally, this article will show that the method of Rollins et al. can predict better without the use of output data than with the use of output data in the case of large measurement variance. Thus, the proposed method is being recommended for its accuracy, especially in situations where online output response data is limited or inaccurate.

Journal Article↗

Cigarette smoking and mortality in Japan: the Miyagi Cohort Study.

BACKGROUND: We examined the association between smoking and all-cause mortality among Japanese men and women. METHODS: In 1990, 18,945 men and 17,107 women in Miyagi Prefecture in rural northern Japan (40-64 year of age) completed a self-administered questionnaire including items on smoking. Cox regression was used to estimate relative risk (RR) of mortality according to smoking categories, with adjustment for age, education, marital status, past history of diseases, drinking, body mass index, walking, and dietary variables. During 11 years of follow-up, 1,209 men and 499 women had died. RESULTS: Multivariate RRs of all-cause mortality for current smokers as compared with never smokers were 1.71 (95% confidence interval, 1.44-2.03) for men and 1.44 (95% confidence interval, 1.06-1.94) for women. Among men, risk in past smokers who had quit smoking for 15 years or longer was not different from the risk in never smokers (RR, 0.97; 95% confidence interval, 0.68-1.39). Of all deaths, 34% in men and 4% in women were attributable to current or past smoking. CONCLUSIONS: This study indicates that smoking increases the risk of premature death among middle-aged Japanese men and women and that substantial proportion of death, especially for men, is attributable to smoking.

Adult↗

The effect of vortex formation on left ventricular filling and mitral valve efficiency.

A new mechanism for quantifying the filling energetics in the left ventricle (LV) and past mechanical heart valves (MHV) is identified and presented. This mechanism is attributed to vortex formation dynamics past MHV leaflets. Recent studies support the conjecture that the natural healthy left ventricle (LV) performs in an optimum, energy-preserving manner by redirecting the flow with high efficiency. Yet to date, no quantitative proof has been presented. The present work provides quantitative results and validation of a theory based on the dynamics of vortex ring formation, which is governed by a critical formation number (FN) that corresponds to the dimensionless time at which the vortex ring has reached its maximum circulation content, in support of this hypothesis. Herein, several parameters (vortex ring circulation, vortex ring energy, critical FN, hydrodynamic efficiencies, vortex ring propagation speed) have been quantified and presented as a means of bridging the physics of vortex formation in the LV. In fact, the diastolic hydrodynamic efficiencies were found to be 60, 41, and 29%, respectively, for the porcine, anti-anatomical, and anatomical valve configurations. This assessment provides quantitative proof of vortex formation, which is dependent of valve design and orientation, being an important flow characteristic and associated to LV energetics. Time resolved digital particle image velocimetry with kilohertz sampling rate was used to study the ejection of fluid into the LV and resolve the spatiotemporal evolution of the flow. The clinical significance of this study is quantifying vortex formation and the critical FN that can potentially serve as a parameter to quantify the LV filling process and the performance of heart valves.

Blood Flow Velocity↗

Attributional style in aggressive adolescent boys.

Past research suggests that aggressive children misattribute hostile intentions to peers during ambiguous provocative interactions. This study sought to extend the analysis of attributional differences between aggressive and nonaggressive boys to a sample of court-involved adolescents and their perceptions of interactions involving both peers and adults. Three groups of youngsters (nonoffenders, nonaggressive offenders, and aggressive offenders) participated in a structured interview and provided causal attributions for interpersonal problems commonly faced by teenagers. Results indicated that offenders were more likely than nonoffenders to attribute blame to others in ambiguous problem situations. Among offenders, external, person-centered blame attributions were significantly related to aggressiveness. This relationship was found only in ambiguous situations, and the correlation between such person-centered attributions and aggressiveness was higher in adult-oriented interactions than in peer-oriented ones. Overall, the results suggest that aggressiveness among offenders is associated with an attributional style that is characterized by the tendency to attribute blame for problems in ambiguous interactions to global, dispositional characteristics of others.

Adolescent↗

Surface magnetic relaxation in cement pastes.

Surface magnetic relaxation in porous media is usually attributed to hindered rotation or to paramagnetic impurities on the surface. In cement pastes, however, it seems reasonable to attribute surface relaxation to dipole interactions in water adsorbed as water of hydration on grain surfaces. The rate limiting factor would then be the exchange rate between mobile water in the pores and adsorbed water. The hydrate relaxation time is 17 microseconds while the measured surface relaxation time is 30-40 microseconds. This difference is explained if the exchange time between mobile and adsorbed water is about the same as the relaxation time of the water of hydration. The exchange model also suggests that the surface relaxation time should decrease with temperature. Measurements testing this theory are now being prepared.

Construction Materials↗

U.S. naval aviation mishaps, 1977-92: differences between single- and dual-piloted aircraft.

The present study examined U.S. Naval aircraft mishap trends between January 1977 and December 1992 using all Class A, B, and C mishaps. Results of this investigation revealed that mishaps attributable to both human error and mechanical/environmental factors have declined steadily over the past 16 years, although mishaps attributed to human error have declined at a much slower rate. For those mishaps attributed to human error, differences were observed between single- and dual-piloted aircraft when phase-of-flight (takeoff, in-flight, landing) and time-of-day were evaluated. For single-piloted aircraft, in-flight mishaps constituted the highest proportion of mishaps during the day ( > 55%), while landing mishaps constituted the highest proportion of mishaps during the evening and night (43-65%). For dual-piloted aircraft, no consistent variation was evident for phase-of-flight and time-of-day. In-flight (approx. 55%) mishaps constituted the highest proportion of mishaps across all times of day, followed by landing (approx. 35%), and takeoff (approx. 10%) mishaps. These data support focused rather than global investigations of aviation mishaps.

Accidents, Aviation↗

Smoke gets in your eyes: smoking and visual impairment in New Zealand.

AIM: To estimate the burden of visual impairment attributable to smoking in New Zealand. METHODS: Review of Medline-indexed literature on the relationship between smoking and eye disease and use of relevant New Zealand morbidity and smoking prevalence data. RESULTS: The international literature indicates there is strong evidence that smoking is a major cause of eye disease and blindness--particularly for cataracts and age-related macular degeneration (AMD). Using the most relevant international risk estimates, we estimated that 1335 people who are registered blind in New Zealand have AMD attributable to current and past smoking (26.8% of all AMD cases in the 55 years plus age-group). It was also estimated that 31 of the registered cases of visual impairment due to cataract and 396 hospitalisations for cataract surgery per year, are attributable to smoking. While subject to various methodological limitations, these estimates are probably under-estimates of the true burden of eye disease attributable to smoking. CONCLUSIONS: Smoking is a major cause of untreatable visual impairment and also a significant reason for cataract surgery in New Zealand. There is a need for more intensive tobacco control activities in New Zealand.

Cataract↗

Expressed emotion in family members of depressed older adults.

This study examined similarities between the Expressed Emotion (EE) construct developed in the psychiatric literature and interpersonally relevant constructs derived from gerontology caregiver research. Expressed emotion and other indices derived from the Camberwell Family Interview (CFI) were assessed in 46 adult children and spouses providing care to an older adult hospitalized for major depressive disorder. The relationship of CFI indices with the family member's past and current relationship with the depressed relative, illness attributions, and emotional functioning was examined. Of the family members, 60.9% were classified as high EE. Measures of past and current relationship and illness attributions were significantly associated with most of the CFI indices. In multivariate analyses, past relationship and illness attributions predicted high EE status. Only past relationship predicted the CFI index of warmth. There is conceptual and empirical overlap between the EE construct and interpersonally relevant gerontology variables. Expressed emotion holds promise for a more complex understanding of caregiving and better caregiver interventions.

Affect↗

Helpless attributions and depression in adolescents: the roles of anxiety, event valence, and demographics.

The relationship between helpless attributions and depression is well established. This study evaluated whether anxiety, event valence (positive or negative) and demographic variables (gender, age, socioeconomic status or race) influence this relationship. Results showed: (1) adolescents with anxiety and depression who were from lower socioeconomic backgrounds made less helpless attributions for negative events than did adolescents from higher socioeconomic backgrounds, (2) male adolescents with anxiety-only had helpless attribution styles that were similar to male adolescents with depression, but the same was not true for female adolescents, and (3) African-American adolescents showed less helpless attributions for negative events than did Caucasian adolescents. Results replicate past research showing that a helpless attribution style is associated with depression in adolescence, but suggest that this pattern may be influenced by demographic factors. Results also suggest that helpless attributions may be related to both anxiety and depression in males.

Adolescent↗

Update on clinical role of tamoxifen.

PURPOSE OF REVIEW: Breast cancer is the most common malignancy amongst women in the United States and decreased mortality over the past decade has been attributed to a combination of screening and adjuvant therapies. There has been a resurgence of interest in hormonal therapies and this article discusses the clinical status of tamoxifen in the context of emerging alternative agents for treatment and prevention of breast cancer. RECENT FINDINGS: Tamoxifen has served as a prototype for the development of selective estrogen receptor modulators at the laboratory-clinical interface. Molecular technologies have permitted elucidation of mechanisms for tissue specific action and led to newer selective estrogen receptor modulators with potentially greater antitumour efficacy and attenuated uterotrophic profile. Publications over the past 12 months have emphasized the risks of thromboembolism and endometrial carcinoma associated with tamoxifen use which has accelerated application of other hormonal agents for treatment of advanced disease and as neoadjuvant therapy. This article reviews the current role of tamoxifen in the treatment of early and advanced breast cancer together with its potential for chemoprevention. Models for quantitative risk assessment are being developed to identify women for whom chemoprotection is justified. SUMMARY: Recent data showing a survival advantage for the aromatase inhibitor letrozole compared with tamoxifen in the advanced setting and improvement in disease-free survival for the aromatase inhibitor anastrozole versus tamoxifen as adjuvant treatment may herald a major shift in standard first-line endocrine therapies for both advanced and early disease and ultimately chemoprevention of breast cancer. Other agents including newer SERMs and pure antiestrogens are undergoing phase III clinical trials and future endocrine and biological therapies are likely to include more selective and targeted therapies, which may be efficacious in both hormone-sensitive and receptor-negative disease.

Adult↗

Interpreting the decline in tuberculosis: the role of secular trends in effective contact.

BACKGROUND: The dramatic decline in tuberculosis (TB) in developed countries during the past century has been attributed to many factors, including improvements in living and social conditions and, more recently, effective treatment. Each of these changes should have reduced the average number of individuals 'effectively contacted' (i.e. sufficiently to transmit infection) by each infectious TB case. METHOD: Estimates of the average number of individuals effectively contacted by each infectious TB case, for each year since 1900 in England and Wales, are derived as the ratio between published estimates of the annual risk of infection and estimates of the prevalence of infectious cases, as derived using a published model of the epidemiology of TB. RESULTS: The results suggest that each infectious case contacted, on average, about 22 individuals in 1900 sufficiently to transmit Mycobacterium tuberculosis infection, and that this number declined to about 10 by 1950 and to approximately one by 1990. CONCLUSIONS: Although several factors contributed to the decline in TB in developed countries during this century, a major contributor has been the decline in the number of effective contacts by each case over time. Similar declines have doubtless occurred over the past century for many infections in developed countries.

Adolescent↗