IMPORTANCE: Acute traumatic spinal cord injury results in disability and use of health care resources, yet data on contemporary national trends of traumatic spinal cord injury incidence and etiology ...are limited. OBJECTIVE: To assess trends in acute traumatic spinal cord injury incidence, etiology, mortality, and associated surgical procedures in the United States from 1993 to 2012. DESIGN, SETTING, AND PARTICIPANTS: Analysis of survey data from the US Nationwide Inpatient Sample databases for 1993-2012, including a total of 63 109 patients with acute traumatic spinal cord injury. MAIN OUTCOMES AND MEASURES: Age- and sex-stratified incidence of acute traumatic spinal cord injury; trends in etiology and in-hospital mortality of acute traumatic spinal cord injury. RESULTS: In 1993, the estimated incidence of acute spinal cord injury was 53 cases (95% CI, 52-54 cases) per 1 million persons based on 2659 actual cases. In 2012, the estimated incidence was 54 cases (95% CI, 53-55 cases) per 1 million population based on 3393 cases (average annual percentage change, 0.2%; 95% CI, −0.5% to 0.9%). Incidence rates among the younger male population declined from 1993 to 2012: for age 16 to 24 years, from 144 cases/million (2405 cases) to 87 cases/million (1770 cases) (average annual percentage change, −2.5%; 95% CI, −3.3% to −1.8%); for age 25 to 44 years, from 96 cases/million (3959 cases) to 71 cases/million persons (2930 cases), (average annual percentage change, −1.2%; 95% CI, −2.1% to −0.3%). A high rate of increase was observed in men aged 65 to 74 years (from 84 cases/million in 1993 695 cases to 131 cases/million 1465 cases; average annual percentage change, 2.7%; 95% CI, 2.0%-3.5%). The percentage of spinal cord injury associated with falls increased significantly from 28% (95% CI, 26%-30%) in 1997-2000 to 66% (95% CI, 64%-68%) in 2010-2012 in those aged 65 years or older (P < .001). Although overall in-hospital mortality increased from 6.6% (95% CI, 6.1%-7.0%) in 1993-1996 to 7.5% (95% CI, 7.0%-8.0%) in 2010-2012 (P < .001), mortality decreased significantly from 24.2% (95% CI, 19.7%-28.7%) in 1993-1996 to 20.1% (95% CI, 17.0%-23.2%) in 2010-2012 (P = .003) among persons aged 85 years or older. CONCLUSIONS AND RELEVANCE: Between 1993 and 2012, the incidence rate of acute traumatic spinal cord injury remained relatively stable but, reflecting an increasing population, the total number of cases increased. The largest increase in incidence was observed in older patients, largely associated with an increase in falls, and in-hospital mortality remained high, especially among elderly persons.
Data for US adults aged ≥20 years from National Health and Nutrition Examination Survey for the years 2003–2014 were analyzed to evaluate how adjusted (N = 8481) and unadjusted (N = 9080) levels of ...selected perfluoroalkyl acids (PFAA) vary across the different stages of glomerular function (GF) among those who did not have diabetes, anemia, or albuminuria as compared to those who had diabetes only, anemia only, and albuminuria only. PFAAs selected for analyses were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA). Irrespective of GF stage, there was no noticeable evidence to suggest that adjusted levels of PFAA for those with diabetes only are any lower than those with no diabetes, no anemia, and no albuminuria. Those who had anemia only were found to have lower adjusted levels of at least PFOA, PFOS, PFDA, and PFHxS than those who had no diabetes, no anemia, and no albuminuria. These results were seen in the presence (eGFR < 60 mL/min/1.73 m2) as well as the absence of chronic kidney disease. For GF-1 (eGFR > 90 mL/min/1.73 m2), GF-2 (60 ≤ eGFR ≤ 90 mL/min/1.73 m2), and GF-3B/4 (15 < eGFR ≤ 45 mL/min/1.73 m2), those who had albuminuria only had lower adjusted levels of PFOA, PFOS, and PFHxS than those who had no diabetes, no anemia, and no albuminuria. In general, adjusted levels of those who had albuminuria only were lower than those who had anemia only at GF-3 and more often than not at GF-1 and GF-2. Rise in adjusted levels of PFAA from GF-1 to GF-3A (45 < eGFR < 60 mL/min/1.73 m2) was faster for those with anemia only than any other comparison group for the total population and females.
•Those with anemia only had among the lowest levels of PFAAs.•Those with albuminuria only had among the lowest levels of PFAAs.•Rise in adjusted levels of PFAA from GF-1 to GF-3A was fastest for those with anemia only.
Data from National Health and Nutrition Examination Survey for 2005–2012 were used to study the trends and variability in the levels of urinary thiocyanate (u-SCN), perchlorate (u-P8), and nitrate ...(u-NO3) by gender, race/ethnicity, active smoking, and exposure to environmental tobacco smoke (ETS) at home for those aged 12–19 and ≥20years old. For those aged ≥20years, adjusted levels of u-SCN, u-P8, and u-NO3 (i) were lower for males than females (p<0.01), and (ii) were higher for non-Hispanic white (NHW) than non-Hispanic black (NHB) (p<0.01). Also, for those aged ≥20years NHB had higher adjusted levels than Mexican American (MA) for u-SCN (p<0.01) but NHB had lower adjusted levels than MA for u-P8 (p<0.01) and u-NO3 (p<0.01). For those aged 12–19years, adjusted levels of u-SCN, u-P8, and u-NO3 did not vary by gender (p>0.05), and adjusted levels of u-P8 and u-NO3 for NHB were lower than for NHW (p<0.01) as well as higher for NHB than MA for u-SCN (p<0.01) and lower for NHB than MA (p<0.01) for u-P8 and u-NO3. Among those aged ≥20years, active smoking was associated with higher adjusted levels of u-SCN (p<0.01) in a dose-response manner and active smoking was associated with lower adjusted levels of u-P8 (p<0.01) in a dose-response manner. Exposure to ETS was associated with higher adjusted levels of u-SCN (p=0.02) and lower adjusted levels of u-P8 (p<0.01) among ≥20years old. Adjusted levels of u-P8 decreased over 2005–2012 among both 12–19 (p<0.01) and ≥20years old (p=0.04). There was borderline increase in the adjusted levels of u-NO3 for those aged ≥20years (p=0.05) over 2005–2012.
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•Smokers had higher levels of u-SCN than nonsmokers among ≥20years old.•Smokers had lower levels of u-P8 than nonsmokers among ≥20years old.•Adjusted levels of u-P8 declined over 2005-2012.•Among adults, males had lower levels of u-SCN, u-P8, and u-NO3 than females.•Exposure to ETS was associated with higher levels of u-SCN.
Highlights • Variability by gender, race, smoking in selected metabolites of VOC was studied. • Smoking was associated with increased levels of the majority of VOC metabolites. • Nonsmoking females ...had lower levels of selected metabolites than male nonsmokers. • Female smokers had higher levels of selected metabolites than male smokers.
Purpose: To determine the level of awareness and knowledge about glaucoma surgery and post-surgery counseling amongst paramedical staff at a tertiary eye-care hospital. Methods: This observational ...cross-sectional study included a random sample of 94 hospital personnel: 37 general nurse midwives, 47 ophthalmic assistants, and 10 patient caretakers (PCTs). Participants were administered a questionnaire about glaucoma surgery and post-surgery counseling of patients. Results: The study included 41 (43.6%) females and 53 (56.4%) males. The mean age of the participants was 24.85 ± 4.54 years. All participants were aware of trabeculectomy surgery in glaucoma (100%). A total of 95.7% knew that surgery helps in controlling IOP, of whom 57 (60.6%) participants got information during their course of learning. Overall 53 (56.4%) believed that surgery is done when medication failure occurs, and 58 (61.7%) knew that surgery helps in preserving vision. A total of 63 (67.0%) participants knew to counsel patients to visit an ophthalmologist when called for and take the treatment as advised, whereas 74 (78.7%) correctly said to visit an ophthalmologist immediately if pain/diminution of vision/discharge occurs. Overall, PCTs were found to be having significantly better knowledge (P = 0.01) compared to others and they also reported ophthalmologists as the chief source of information. Conclusion: This study revealed that paramedical staff had an excellent awareness of trabeculectomy surgery. However, the knowledge and counseling parts of the questionnaire revealed less than satisfactory responses. So, there is a need to continuously educate paramedical staff members so that they can help in propagating information about the role of glaucoma surgery and the importance of proper follow-up.
Future weak lensing surveys potentially hold the highest statistical power for constraining cosmological parameters compared to other cosmological probes. The statistical power of a weak lensing ...survey is determined by the sky coverage, the inverse of the noise in shear measurements and the galaxy number density. The combination of the latter two factors is often expressed in terms of n
eff - the 'effective number density of galaxies used for weak lensing measurements'. In this work, we estimate n
eff for the Large Synoptic Survey Telescope (LSST) project, the most powerful ground-based lensing survey planned for the next two decades. We investigate how the following factors affect the resulting n
eff of the survey with detailed simulations: (1) survey time, (2) shear measurement algorithm, (3) algorithm for combining multiple exposures, (4) inclusion of data from multiple filter bands, (5) redshift distribution of the galaxies and (6) masking and blending. For the first time, we quantify in a general weak lensing analysis pipeline the sensitivity of n
eff to the above factors.
We find that with current weak lensing algorithms, expected distributions of observing parameters, and all lensing data (r and i band, covering 18 000 degree2 of sky) for LSST, n
eff 37 arcmin−2 before considering blending and masking, n
eff 31 arcmin−2 when rejecting seriously blended galaxies and n
eff 26 arcmin−2 when considering an additional 15 per cent loss of galaxies due to masking. With future improvements in weak lensing algorithms, these values could be expected to increase by up to 20 per cent. Throughout the paper, we also stress the ways in which n
eff depends on our ability to understand and control systematic effects in the measurements.
We study the impact of systematic errors on planned weak-lensing surveys and compute the requirements on their contributions so that they are not a dominant source of the cosmological parameter error ...budget. The generic types of error we consider are multiplicative and additive errors in measurements of shear, as well as photometric redshift errors. In general, more powerful surveys have stronger systematic requirements. For example, for a SuperNova/Acceleration Probe (SNAP)-type survey the multiplicative error in shear needs to be smaller than 1 per cent of the mean shear in any given redshift bin, while the centroids of photometric redshift bins need to be known to be better than 0.003. With about a factor of 2 degradation in cosmological parameter errors, future surveys can enter a self-calibration regime, where the mean systematic biases are self-consistently determined from the survey and only higher order moments of the systematics contribute. Interestingly, once the power-spectrum measurements are combined with the bispectrum, the self-calibration regime in the variation of the equation of state of dark energy wa is attained with only a 20-30 per cent error degradation.
The skewness of the aperture mass statistic Jarvis, M.; Bernstein, G.; Jain, B.
Monthly notices of the Royal Astronomical Society,
July 2004, Letnik:
352, Številka:
1
Journal Article
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ABSTRACT
We present simple formulae for calculating the skewness and kurtosis of the aperture mass statistic for weak lensing surveys, which is insensitive to masking effects of survey geometry or ...variable survey depth. The calculations are the higher order analogues of the formula given by Schneider, van Waerbeke & Mellier, which has been used to compute the variance of the aperture mass from several lensing surveys. As our formula requires the three‐point shear correlation function, we also present an efficient tree‐based algorithm for measuring it. We show how our algorithm would scale in computing time and memory usage for future lensing surveys. We also apply the procedure to our Cerro Tololo Inter‐American Observatory (CTIO) survey data, originally described by Jarvis et al. We find that the skewness is positive (inconsistent with zero) at the 2σ level. However, the signal is too noisy from this data to usefully constrain cosmology.
Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty and present age- and sex-stratified national rates of shoulder ...arthroplasty. We also assessed contemporary complication rates, mortality rates, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009 through 2011 to calculate estimates of shoulder arthroplasty and assessed trends using Joinpoint (National Cancer Institute, Bethesda, MD) regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (anatomic total shoulder arthroplasty, hemiarthroplasty, and reverse shoulder arthroplasty) increased significantly from 52,397 procedures (95% confidence interval CI, 47,093-57,701) in 2009 to 67,184 cases (95% CI, 60,638-73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75- to 84-year-old female subgroup (77 per 100,000 persons; 95% CI, 67-87). Revision cases comprised 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were because of mechanical complications/loosening whereas 18% were because of dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a 3-year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded because a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial, and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed.
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