Profiles of drug users in Switzerland and effects of early-onset intensive use of alcohol, tobacco and cannabis on other illicit drug use.

QUESTIONS UNDER STUDY / PRINCIPLES: The main aim of this study was to investigate profiles of drug users, with a particular focus on illicit drugs other than cannabis, and to explore the effect of early-onset intensive use (drunkenness, daily smoking, high on cannabis) on profiles of illicit drug use. METHODS: Baseline data from a representative sample of 5,831 young Swiss men in the ongoing Cohort Study on Substance Use Risk Factors were used. Substance use (alcohol, tobacco, cannabis and 15 types of other illicit drug) and age of onset of intensive use were assessed. The Item Response Theory (IRT) and prevalence rates at different ages of onset were used to reveal different profiles of illicit drug use. RESULTS: In addition to cannabis, there were two profiles of other illicit drug use: (a) "softer" drug users (uppers, hallucinogens and inhaled drugs), among which ecstasy had the highest discriminatory potential (IRT slope = 4.68, standard error (SE) = 0.48; p <0.001); and (b) "harder" drug users (heroin, ketamine, gamma-hydroxybutyrate/gamma-hydroxylactone, research chemicals, crystal meth and spice), among which ketamine had the highest discriminatory potential (slope = 4.05; SE = 0.63; p <0.001). Onset of intensive use at the age of 12 years or younger also discriminated between these two profiles. CONCLUSION: Both the IRT model and the effect of onset of intensive use enabled two groups of illicit drugs to be identified. In particular, very early onset (at 12 years or younger) intensive use of any substance was a marker for later use of the second group of drugs.

Alcohol consumption in late adolescence and early adulthood - where is the problem?

Risky single-occasion drinking (RSOD) is more common in late adolescence and early adulthood (approximately between the ages of 16 and 30) than in any other period in life. This is also the age when young people in Switzerland and many other European countries are legally allowed to buy and drink alcohol, but they usually do not yet have adult responsibilities. This paper reviews evidence from the international literature and provides examples of studies conducted in Switzerland demonstrating that (a) RSOD is by far most prevalent on Saturday evenings followed by Friday evenings, usually because young people go out and do not have any work or study responsibilities the next day; (b) RSOD results from drinking in private before going out ("predrinking") and accelerating the pace of drinking (i.e. increasing the number of drinks consumed per hour); (c) RSOD is often not accidental but purposeful,. to seek excitement, to have fun and to feel the effects of alcohol; (d) RSOD occurs predominantly outside the home, mostly in bars, pubs, discos or at special events and festivals; (e) RSOD often results in intended and unintended injuries and other acute consequences, which are leading risk factors for mortality and morbidity in this age group. Effective prevention strategies should include attempts to reduce opportunities to engage in heavy drinking as well as strategies to reduce its harmful consequences.

Could concomitant radio-chemotherapy improve the outcomes of early-stage node negative anal canal cancer patients? A retrospective analysis of 122 patients.

One hundred twenty-two early-stage anal canal cancer patients (median age: 69 years) were treated with curative radiotherapy with (70 patients) or without (52 patients) concomitant chemotherapy. Median follow-up was 65 months (range: 4-238). At multivariate analysis, concomitant chemotherapy significantly improved local control (p = .007). Local control significantly influenced all considered endpoints, except the metastases free survival. The global rates of G3-G4 acute and late toxicity were 13.1% and 8.2%, respectively, and they were not increased by concomitant chemotherapy. Finally, concomitant chemotherapy is efficacious and safe in the treatment of T1-2N0 anal canal cancer patients and should be prospectively studied.

Early detection and intervention for infants at risk of autism spectrum disorders

Autism is a developmental disorder that is characterized by abnonnal social interactions and communications as well as repetitive and restricted activities and interests. There is evidence of a genetic component, as 5% of younger siblings are diagnosed if their older sibling has been diagnosed. Autism is generally not diagnosed until age 3 at the earliest, yet it has been shown that early intervention for children with autism can greatly increase their functioning. Because of this, it is important that symptoms of autism are identified as early as possible so that diagnosis can occur as soon as possible to allow these children the earliest intervention. This thesis was divided into two parts. The first looked at the psychometrics of two proposed measures, the Parent Observation Checklist (POC), administered monthly, and the Infant Behavior Summary Evaluation (mSE), administered bimonthly, to see if they can be used with the infant population to identify autistic symptoms in infants who are at high risk for autism or related problems because they have an older sibling with autism. Study 1 reported acceptable psychometric properties of both the POC and IBSE in terms of test-retest reliability, internal consistency, construct validity and predictive validity. These results provide preliminary evidence that parent report measures can help to detect early symptoms of ASD in infants. The POC was shown to differentiate infants who were diagnosed from a matched group that was not diagnosed by 3 years of age. The second part of this thesis involved a telephone interview of parents who reported developmental and/or behavior problems in their high-risk infants that may be early signs of Autism Spectrum Disorder (ASD). During the interview, a service questionnaire was administered to see what interventions (including strategies recommended by the researchers) their at risk infants and affected older siblings were receiving, how satisfied the parents were with them and how effective they felt the interventions were. 3 Study 2 also yielded promising results. Parents utilized a variety of services for at risk infants and children with ASD. The interventions included empirically validated early intervention (e.g., ABA) to non-empirically validated treatments (e.g., diet therapy). The large number of nonempirically validated treatments parents used was surprising, yet parents reported being involved and satisfied, and thought that the services were effective. Parents' perceptions of their stress levels went down slightly and feelings of competence rose when they accessed services for their infants. Overall, the results of this thesis provide new evidence that parent-report methods hold promise as early detection instruments for ASD in at-risk infants. More research is needed to further validate these instruments as well as to understand the variables related to the parents' choice of early intervention for their at risk and affected children.

Secretory immunity in overweight and obese versus normal-weight early-and late-pubertal females

Obesity is a condition associated with a wide variety of health problems including hypertension, dyslipidemia, diabetes mellitus, certain forms of cancer, cardiovascular disease, and gallstones (157). TTiere is growing evidence that obesity may also be related to compromised immune function due to altered metabolic, psychological, and physical attributes (93). The aim of this study was to compare: a) immunity-related variables such as frequency of upper respiratory tract infections (URTI) and salivary secretory immunoglobulin A (sIgA) levels between overweight/obese (OB) and normal weight (NW) early-pubertal and late-pubertal girls, and b) stress-related variables such as Cortisol, melatonin, the melatonin/cortisol ratio, testosterone and the testosterone/cortisol ratio. Physical activity levels, stress indicators, and fatigue were used to explain potential differences in the dependent variables. It was hypothesized that the OB females would have lower melatonin (M) and higher Cortisol (C) and testosterone (T) levels compared with NW girls, regardless of maturity status. The altered levels of melatonin, Cortisol, and testosterone, would result in decreased M/C and T/C ratios, despite the increase in testosterone in OB females. It was hypothesized that this altered hormonal status results in a compromised immunity marked by higher frequency of upper respiratory tract infections (URTI) and decreased levels of secretory immunoglobulin A (sIgA). It was also hypothesized that OB girls would participate in less hours of physical activity than their NW counterparts and that this would relate to their stress and immunity levels. Forty (16 early- and 24 late-pubertal) overweight and obese females were compared to fifty-three (27 eariy- and 26 late-pubertal) age-matched normal-weight control subjects. Participants were categorized as early-pubertal (EP) or late-pubertal (LP) using Tanner self-staging of secondary sex characteristics. Subjects were classified into the two adiposity groups according to relative body fat (%BF), where normal weight (NW) subjects had a %BF less than 25%, and overweight and obese (OB) subjects had a %BF greater than 27.5%. Participants completed a number of questionnaires and information was collected on menstrual history, smoking history, alcohol and caffeine consumption, and medical history. Following the determination of maturity status, a complete anthropometric assessment was made including height, body mass, and body composition. All questionnaires and measurements were completed during a one-hour visit between 1 500 and 1900 hours Relative body fat was assessed using bioelectrical impedance analysis. Resting saliva samples were obtained and assayed (ELISA) for testosterone, Cortisol, melatonin and secretory immunoglobulin A. Physical activity was self-reported using the Godin- Shephard Leisure time questionnaire, and quantified using Actigraph GTIM accelerometers, which participants wore for seven consecutive days from the time they woke up in the morning, until the time they went to bed. Late-pubertal girls also completed questionnaires on their perceived stress and fatigue. Finally, all participants also filled out a one-month health log to record frequency of symptoms of upper respiratory tract infections (URTI). Significant age effects were found for testosterone, Cortisol, incidence of sickness, and sIgA when controlling for physical activity, however there were no significant effects of adiposity on any of the variables. There was a trend which neared-significance for an effect of adiposity on sIgA (p=0.01). There were no significant differences between the groups on the total selfreported leisure-time physical activity in METs per week, however EP girls recorded significantly greater levels of moderate, hard, and very hard physical activity from accelerometers. Results of the perceived stress and fatigue questionnaires in late-pubertal girls demonstrated that contrary to what was hypothesized, NW girls reported more stress and more fatigue than OB girls. Results of the present study suggest that excess adiposity in early- and latepubescent girls may not have a negative impact on immunity as hypothesized.

Buddhism and the earth : environmental thought in early Buddhist philosophy

Introduction Fundamental to the philosophy of Buddhism, is the insight that there is "unsatisfactohness" (dukkha) in the world and that it can be eliminated through the practice of the Noble Eight Fold Path. Buddhism also maintains that the world as we experience and entities that exist are bereft of any substantiality. Instead existence is manifest through dependent origination. All things are conditional; nothing is permanent. However, inherent in this dependent existence is the interconnectedness of all beings and their subjection to the cosmic law of karma. Part of cultivating the Eight Fold path includes a deep compassion for all other living things, 'trapped' within this cycle of dependent origination. This compassion or empathy (karuna) is crucial to the Buddhist path to enlightenment. It is this emphasis on karuna that shows itself in Mahayana Buddhism with respect to the theory of the boddhisatva (or Buddha-to-be) since the boddhisatva willingly postpones his/her own enlightenment to help others on the same path. One of the ramifications of the theory of dependent origination is that there is no anthropocentric bias placed on humans over the natural world. Paradoxically the doctrine of non-self becomes an ontology within Buddhism, culminating in the Mayahana realization that a common boundary exists between samsara and nirvana. Essential to this ontology is the life of dharma or a moral life. Ethics is not separated from ontology. As my thesis will show, this basic outlook of Buddhism has implications toward our understanding of the Buddhist world-view with respect to the current human predicament concerning the environment. While humans are the only ones who can 4 attain "Buddhahood", it is because of our ability to understand what it means to follow the Eight fold path and act accordingly. Because of the interconnectedness of all entities {dharmas), there is an ontological necessity to eliminate suffering and 'save the earth' because if we allow the earth to suffer, we ALL suffer. This can be understood as an ethical outlook which can be applied to our interaction with and treatment of the natural environment or environment in the broadest sense, not just trees plants rocks etc. It is an approach to samsara and all within it. It has been argued that there is no ontology in Buddhism due to its doctrine of "non-self". However, it is a goal of this thesis to argue that there does exist an original ontology in Buddhism; that according to it, the nature of Being is essentially neither "Being nor non-being nor not non-being" as illustrated by Nagarjuna. Within this ontology is engrained an ethic or 'right path' (samma marga) that is fundamental to our being and this includes a compassionate relationship to our environment. In this dissertation I endeavour to trace the implications that the Buddhist worldview has for the environmental issues that assail us in our age of technology. I will explore questions such as: can the Buddhist way of thinking help us comprehend and possibly resolve the environmental problems of our day and age? Are there any current environmental theories which are comparable to or share common ground with the classical Buddhist doctrines? I will elucidate some fundamental doctrines of early Buddhism from an environmental perspective as well as identify some comparable modern environmental theories such as deep ecology and general systems theory, that seem to share in the wisdom of classical Buddhism and have much to gain from a deeper appreciation of Buddhism.

Age-related changes in ERPs associated with context-based and response-based interference

Age-related differences in information processing have often been explained through deficits in older adults' ability to ignore irrelevant stimuli and suppress inappropriate responses through inhibitory control processes. Functional imaging work on young adults by Nelson and colleagues (2003) has indicated that inferior frontal and anterior cingulate cortex playa key role in resolving interference effects during a delay-to-match memory task. Specifically, inferior frontal cortex appeared to be recruited under conditions of context interference while the anterior cingulate was associated with interference resolution at the stage of response selection. Related work has shown that specific neural activities related to interference resolution are not preserved in older adults, supporting the notion of age-related declines in inhibitory control (Jonides et aI., 2000, West et aI., 2004b). In this study the time course and nature of these inhibition-related processes were investigated in young and old adults using high-density ERPs collected during a modified Sternberg task. Participants were presented with four target letters followed by a probe that either did or did not match one of the target letters held in working memory. Inhibitory processes were evoked by manipulating the nature of cognitive conflict in a particular trial. Conflict in working memory was elicited through the presentation of a probe letter in immediately previous target sets. Response-based conflict was produced by presenting a negative probe that had just been viewed as a positive probe on the previous trial. Younger adults displayed a larger orienting response (P3a and P3b) to positive probes relative to a non-target baseline. Older adults produced the orienting P3a and 3 P3b waveforms but their responses did not differentiate between target and non-target stimuli. This age-related change in response to targetness is discussed in terms of "early selection/late correction" models of cognitive ageing. Younger adults also showed a sensitivity in their N450 response to different levels of interference. Source analysis of the N450 responses to the conflict trials of younger adults indicated an initial dipole in inferior frontal cortex and a subsequent dipole in anterior cingulate cortex, suggesting that inferior prefrontal regions may recruit the anterior cingulate to exert cognitive control functions. Individual older adults did show some evidence of an N450 response to conflict; however, this response was attenuated by a co-occurring positive deflection in the N450 time window. It is suggested that this positivity may reflect a form of compensatory activity in older adults to adapt to their decline in inhibitory control.

Early childhood pedagogical practice within a cultural kaleidoscope

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 E38 K39 2006

EARLY LIFE EXPOSURE TO GENISTEIN AND DAIDZEIN DISRUPTS STRUCTURAL DEVELOPMENT OF REPRODUCTIVE ORGANS IN FEMALE MICE

In mice, exposure to isoflavones (ISO), abundant in soy infant formula, during the first 5 d of life alters structural and functional development of reproductive organs. Effects of longer exposures are unknown. The study objective was to evaluate whether exposure to a combination of daidzein and genistein in the first 10 compared to 5 d of life results in greater adverse effects on ovarian and uterine structure in adult mice. Thirteen litters of 8–12 pups were cross-fostered and randomized to corn oil or ISO (2 mg daidzein + 5 mg genistein/kg body weight/d) for the first 5 or 10 d of life. The 10-d protocol mimicked the period when infants are fed soy protein formula (SPF) but avoids the time when suckling pups can consume the mother’s diet. Body and organ weights and histology of ovaries and uteri were analyzed. There were no differences in the ovary or uterus weight, number of ovarian follicles, number of multiple oocyte follicles, or percent of ovarian cysts with 5 or 10 d of ISO intervention compared to respective controls. The 10-d ISO group had higher body weights from 6 d to 4 mo. of age and a higher percent of hyperplasia in the oviduct than the respective control. Lower numbers of ovarian corpus lutea and a higher incidence of abnormal changes were reported in the uteri of both ISO groups compared to their respective controls. Five- and 10-d exposure to ISO had similar long-lasting adverse effects on the structures of ovaries and uterus in adult mice. Only the 10-d ISO exposure resulted in greater body weight gain at adulthood.

Developmental trajectories of body mass index in early childhood : an 8-year longitudinal study

Trajectoires développementales de l’IMC durant l’enfance: Une étude longitudinale sur 8 ans. Introduction : L’obésité infantile, origine de nombreux problèmes de santé, représente un grand défi en santé publique. Récemment, l’importance d’étudier l’évolution du surpoids durant l’enfance ainsi que les facteurs de risques précoces pour l’obésité a été reconnue. Les trajectoires développementales d’indice de masse corporelle (IMC) chez les jeunes représentent une approche innovatrice qui nous permet de mieux comprendre cette problématique importante. Objectifs: 1) Identifier des trajectoires développementales distinctes de groupes d’enfants selon leur IMC durant l’enfance, et 2) Explorer les facteurs de risques précoces qui prédisent l’appartenance de l’enfant à la trajectoire d’IMC le plus élevé Hypothèses: 1) On s’attend à retrouver un groupe d’enfants qui suit une trajectoire d’IMC élevée durant l’enfance. 2) On s’attend à ce que certaines caractéristiques de la mère (ex : tabac pendant la grossesse et IMC élevé), soient associées à l’appartenance de l’enfant au groupe ayant la trajectoire «IMC élevé ». Méthodes: Estimation des trajectoires développementales d’IMC d’enfants, dans un échantillon populationnel (n=1957) au Québec (ELDEQ). Les IMC ont été calculés à partir de données fournies par les mères des enfants et recueillis chaque année sur une durée de 8 ans. Des données propres à l’enfant sa mère, ainsi que socioéconomiques, ont étés recueillies. Une régression logistique multinomiale a été utilisée pour distinguer les enfants avec un IMC élevé des autres enfants, selon les facteurs de risques précoces. Les programmes PROC TRAJ (extension de SAS), SPSS (version 16), et SAS (version 9.1.3) ont été utilisés pour ces analyses. Résultats: Trois trajectoires d’IMC ont étés identifiées : IMC « bas-stable » (54,5%), IMC « modéré » (41,0%) et IMC « élevé et en hausse » (4,5%). Le groupe « élevé et en hausse » incluait des enfants pour qui l’IMC à 8 ans dépassait la valeur limite pour l’obésité. Les analyses de régression logistique ont révélé que deux facteurs de risques maternels étaient significativement associés avec la trajectoire “en hausse” par rapport aux deux autres groupes : le tabac durant la grossesse et le surpoids maternel. Conclusions: Des risques d’obésité infantile peuvent êtres identifiés dès la grossesse. Des études d’intervention sont requises pour identifier la possibilité de réduire le risque d’obésité chez l’enfant en ciblant le tabac et le surpoids maternelle durant la grossesse. Mots clés: Indice de masse corporelle (IMC), obésité infantile, trajectoires développementales de groupe, facteurs de risque précoce, étude populationnelle, tabac pendant la grossesse, obésité maternelle.

Impact of neonatal total parenteral nutrition and early glucose-enriched diet on glucose metabolism and physical phenotypes in Guinea Pig

Les oxydants infusés avec la nutrition parentéral (NP) néonatale induisent une modification du métabolisme des lipides et du glucose, donnant lieu à l’âge adulte à un phénotype de carence énergétique (faible poids, baisse de l’activité physique). L’hypothèse qu’une diète précoce riche en glucose prévient ces symptômes plus tard dans la vie, fut évalué chez le cobaye par un ANOVA en plan factoriel complet à deux facteurs (p < 0:05) : NP du jour 3 à 7, suivit d’une nourriture régulière (chow) (NP+) vs. chow à partir du 3ième jour (NP-), combiné avec une eau de consommation enrichie en glucose (G+) ou non (G-) à partir de la 3ième semaine. Les paramètres suivant ont été mesurés à l’âge de 9 semaine: taux de croissance, activité physique, activité de phosphofructokinase-1 et glucokinase (GK), niveau hépatique de glucose-6-phosphate (G6P), glycogène, pyruvate et potentiel redox du glutathion, poids du foie, glycémie, tolérance au glucose, concentrations hépatiques et plasmatiques en triacylglycérides (TG) et cholestérol. Le groupe G+ (vs. G-) avait un taux de croissance plus bas, une activité de GK et une concentration en G6P plus élevée, et un potentiel redox plus bas (moins oxydé). Le niveau plasmatique de TG était moins élevé dans le groupe NP+ (vs. NP-). Les traitements n’eurent aucun effet sur les autres paramètres. Ces résultats suggèrent qu’indépendamment de la NP, une alimentation riche en glucose stimule la glycolyse et déplace l’état redox vers un statut plus réduit, mais ne surmonte pas les effets de la NP sur le phénotype physique de carence énergétique.

The impact of early life adversity on cortical structure in adolescent twins followed since birth

Des études animales ont montré que l’exposition du foetus à l’adversité affecte le développement cérébral et la régulation d’émotions plus tard. Cette régulation serait reliée aux changements structurels cérébraux, particulièrement au circuit fronto-limbique. Cependant, ces résultats n’ont pas été entièrement répliqués chez l’humain. Le but de cette étude était de tester si l'adversité précoce conduit à des altérations structurelles des régions (orbitofrontal, préfrontal, cingulaire) fronto-limbiques, identifiées comme régions-clés dans la (de)régulation d’émotions. Les mesures principales de l’adversité étaient un poids léger à la naissance et l’hostilité maternelle puisqu’ils étaient parmi les plus prédictifs des résultats développementaux et comportementaux chez l’humain. Les mesures secondaires, incluant le tempérament difficile d’enfant et l’impulsivité en adolescence, étaient utilisées du à leur lien avec le développement cérébral et émotionnel. Les participants étaient des jumeaux identiques, membres de l’Étude des Jumeaux Nouveau-nés du Québec (ÉJNQ, N = 650 paires) suivis depuis 5 mois à 15 ans, leur âge actuel. Ceci a permis de mieux contrôler le facteur génétique et ainsi mieux isoler les effets d’environnement. Trente-sept paires ont été recrutées. La structure cérébrale de chacun, obtenue avec l’imagerie par résonance magnétique, a été analysée avec la régression linéaire. Le poids à la naissance n’a eu aucun effet. L’hostilité maternelle a prédit une réduction de l’aire du gyrus cingulaire postérieur. Tempérament difficile a prédit une réduction de l’aire du cortex orbitofrontal. L’impulsivité était associée avec l’aire et volume du cortex préfrontal réduits. Ces résultats soulignent l’importance des interventions précoces afin d’empêcher des altérations menant à la psychopathologie.

Statistical Machine Learning Techniques for the Prediction of Learning Disabilities in School-Age Children

Learning Disability (LD) is a general term that describes specific kinds of learning problems. It is a neurological condition that affects a child's brain and impairs his ability to carry out one or many specific tasks. The learning disabled children are neither slow nor mentally retarded. This disorder can make it problematic for a child to learn as quickly or in the same way as some child who isn't affected by a learning disability. An affected child can have normal or above average intelligence. They may have difficulty paying attention, with reading or letter recognition, or with mathematics. It does not mean that children who have learning disabilities are less intelligent. In fact, many children who have learning disabilities are more intelligent than an average child. Learning disabilities vary from child to child. One child with LD may not have the same kind of learning problems as another child with LD. There is no cure for learning disabilities and they are life-long. However, children with LD can be high achievers and can be taught ways to get around the learning disability. In this research work, data mining using machine learning techniques are used to analyze the symptoms of LD, establish interrelationships between them and evaluate the relative importance of these symptoms. To increase the diagnostic accuracy of learning disability prediction, a knowledge based tool based on statistical machine learning or data mining techniques, with high accuracy,according to the knowledge obtained from the clinical information, is proposed. The basic idea of the developed knowledge based tool is to increase the accuracy of the learning disability assessment and reduce the time used for the same. Different statistical machine learning techniques in data mining are used in the study. Identifying the important parameters of LD prediction using the data mining techniques, identifying the hidden relationship between the symptoms of LD and estimating the relative significance of each symptoms of LD are also the parts of the objectives of this research work. The developed tool has many advantages compared to the traditional methods of using check lists in determination of learning disabilities. For improving the performance of various classifiers, we developed some preprocessing methods for the LD prediction system. A new system based on fuzzy and rough set models are also developed for LD prediction. Here also the importance of pre-processing is studied. A Graphical User Interface (GUI) is designed for developing an integrated knowledge based tool for prediction of LD as well as its degree. The designed tool stores the details of the children in the student database and retrieves their LD report as and when required. The present study undoubtedly proves the effectiveness of the tool developed based on various machine learning techniques. It also identifies the important parameters of LD and accurately predicts the learning disability in school age children. This thesis makes several major contributions in technical, general and social areas. The results are found very beneficial to the parents, teachers and the institutions. They are able to diagnose the child’s problem at an early stage and can go for the proper treatments/counseling at the correct time so as to avoid the academic and social losses.

Behavior of geopolymer concrete exposed to elevated temperatures

The research in the area of geopolymer is gaining momentum during the past 20 years. Studies confirm that geopolymer concrete has good compressive strength, tensile strength, flexural strength, modulus of elasticity and durability. These properties are comparable with OPC concrete.There are many occasions where concrete is exposed to elevated temperatures like fire exposure from thermal processor, exposure from furnaces, nuclear exposure, etc.. In such cases, understanding of the behaviour of concrete and structural members exposed to elevated temperatures is vital. Even though many research reports are available about the behaviour of OPC concrete at elevated temperatures, there is limited information available about the behaviour of geopolymer concrete after exposure to elevated temperatures. A preliminary study was carried out for the selection of a mix proportion. The important variable considered in the present study include alkali/fly ash ratio, percentage of total aggregate content, fine aggregate to total aggregate ratio, molarity of sodium hydroxide, sodium silicate to sodium hydroxide ratio, curing temperature and curing period. Influence of different variables on engineering properties of geopolymer concrete was investigated. The study on interface shear strength of reinforced and unreinforced geopolymer concrete as well as OPC concrete was also carried out. Engineering properties of fly ash based geopolymer concrete after exposure to elevated temperatures (ambient to 800 °C) were studied and the corresponding results were compared with those of conventional concrete. Scanning Electron Microscope analysis, Fourier Transform Infrared analysis, X-ray powder Diffractometer analysis and Thermogravimetric analysis of geopolymer mortar or paste at ambient temperature and after exposure to elevated temperature were also carried out in the present research work. Experimental study was conducted on geopolymer concrete beams after exposure to elevated temperatures (ambient to 800 °C). Load deflection characteristics, ductility and moment-curvature behaviour of the geopolymer concrete beams after exposure to elevated temperatures were investigated. Based on the present study, major conclusions derived could be summarized as follows. There is a definite proportion for various ingredients to achieve maximum strength properties. Geopolymer concrete with total aggregate content of 70% by volume, ratio of fine aggregate to total aggregate of 0.35, NaOH molarity 10, Na2SiO3/NaOH ratio of 2.5 and alkali to fly ash ratio of 0.55 gave maximum compressive strength in the present study. An early strength development in geopolymer concrete could be achieved by the proper selection of curing temperature and the period of curing. With 24 hours of curing at 100 °C, 96.4% of the 28th day cube compressive strength could be achieved in 7 days in the present study. The interface shear strength of geopolymer concrete is lower to that of OPC concrete. Compared to OPC concrete, a reduction in the interface shear strength by 33% and 29% was observed for unreinforced and reinforced geopolymer specimens respectively. The interface shear strength of geopolymer concrete is lower than ordinary Portland cement concrete. The interface shear strength of geopolymer concrete can be approximately estimated as 50% of the value obtained based on the available equations for the calculation of interface shear strength of ordinary portland cement concrete (method used in Mattock and ACI). Fly ash based geopolymer concrete undergoes a high rate of strength loss (compressive strength, tensile strength and modulus of elasticity) during its early heating period (up to 200 °C) compared to OPC concrete. At a temperature exposure beyond 600 °C, the unreacted crystalline materials in geopolymer concrete get transformed into amorphous state and undergo polymerization. As a result, there is no further strength loss (compressive strength, tensile strength and modulus of elasticity) in geopolymer concrete, whereas, OPC concrete continues to lose its strength properties at a faster rate beyond a temperature exposure of 600 °C. At present no equation is available to predict the strength properties of geopolymer concrete after exposure to elevated temperatures. Based on the study carried out, new equations have been proposed to predict the residual strengths (cube compressive strength, split tensile strength and modulus of elasticity) of geopolymer concrete after exposure to elevated temperatures (upto 800 °C). These equations could be used for material modelling until better refined equations are available. Compared to OPC concrete, geopolymer concrete shows better resistance against surface cracking when exposed to elevated temperatures. In the present study, while OPC concrete started developing cracks at 400 °C, geopolymer concrete did not show any visible cracks up to 600 °C and developed only minor cracks at an exposure temperatureof 800 °C. Geopolymer concrete beams develop crack at an early load stages if they are exposed to elevated temperatures. Even though the material strength of the geopolymer concrete does not decrease beyond 600 °C, the flexural strength of corresponding beam reduces rapidly after 600 °C temperature exposure, primarily due to the rapid loss of the strength of steel. With increase in temperature, the curvature at yield point of geopolymer concrete beam increases and thereby the ductility reduces. In the present study, compared to the ductility at ambient temperature, the ductility of geopolymer concrete beams reduces by 63.8% at 800 °C temperature exposure. Appropriate equations have been proposed to predict the service load crack width of geopolymer concrete beam exposed to elevated temperatures. These equations could be used to limit the service load on geopolymer concrete beams exposed to elevated temperatures (up to 800 °C) for a predefined crack width (between 0.1mm and 0.3 mm) or vice versa. The moment-curvature relationship of geopolymer concrete beams at ambient temperature is similar to that of RCC beams and this could be predicted using strain compatibility approach Once exposed to an elevated temperature, the strain compatibility approach underestimates the curvature of geopolymer concrete beams between the first cracking and yielding point.

Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia